Putting Trendy Restaurants on Notice (20 Month Update)

March 11, 2012 by  
Filed under Our Recovery Journal

Each of life’s decisions is a consequence of one of the following considerations:

  • What do I want to do?
  • What do I have to do?
  • What am I able to do?

The first of these three considerations is an active choice.  You actively choose to go for a run, call a friend, or watch the game on TV.  Each individual choice might be either a good or bad choice, and most people have the freedom to decide among thousands of such choices every day.

The second consideration can be thought of as a forced choice.  You decide not to watch TV because you have to clean the house.  You cannot meet a friend for lunch because you have work to do.  You end a phone call earlier than you’d like because you have to deal with a disagreement between the kids.

The third and final consideration limits your choices.  You may not be able to work because of the flu.  You avoid karaoke night because you’re just not able to sing well.  You choose not to exercise with certain people because you are not able to keep up.


Decision-Making In the Wake of a Traumatic Brain Injury

Twenty months ago, every single decision in Jessica’s life was one of ability.  Every action limited by what she was able to do.  The stroke and TBI created such severe problems that her body could not even maintain consciousness.  Her active mind wasn’t available to make decisions, so her life at that time existed strictly in the subconscious.  Once she woke from the coma, the first actions she was able to perform were simple and straightforward.  They included making eye contact, attempting to listen, and smiling.  These actions were not automatic:  controlling them required focused attention.  With some practice, her control over these actions improved as she moved from part-time to full-time consciousness.

Fast forward to today and Jess is able to do much more of what she wants to do.  She has worked so hard to regain function in her arm, hand, leg, and mind.  Despite stiffness in the hand and a lack of muscle control below one knee, Jess has increased her functional ability to impressive levels.  She can do a lot more of what she wants to do.  She can now make phone calls, walk around the house, and play with baby on the floor.


Increases from Hard Work & Surgery

Each new day brings the possibility of new functional gains.  Jessica works hard in therapy and is still in the process of trading her time and effort for the possibility of increased function.  Every gain transfers daily activity from the unable to do it category into the want to do it category.  As confidence grows, activities may even change to expectations.  They can then move to the have to do it category.  Months and months of individual gains bring us closer to living the kind of life we desire.

Jess wants to walk further and faster.  Recently she has been limited by a stiff foot and painful callous.  In her case, the next step was orthopedic surgery:  lengthening & transferring ankle tendons in order to reset the foot into its natural position.  The surgery was successful and the surgeon felt that everything had gone according to plan.

While Jess was casted and able to walk immediately, the foot was pretty tender.  After a week of rest, it was time for her to begin walking.  During the second week of recovery, she walked her first lap at the indoor track.  By the third week, she was able to do three laps.  More importantly, the foot is now striking the ground correctly.  Despite the weight and awkwardness of a huge cast, Jess now lands on her heel and rolls forward to the toe.


The Freedom of a Night Out

Living with limited function means a lot of meals at home.  Jess is often able to help in preparing and cooking the evening meal.  When the occasion arises to consider restaurant food, the event is now much different than it was before the trauma.  My family is simply not suited to handle the potential frustrations of a restaurant trip.  Loading up the car, worrying about crowds and weather conditions, and dealing with three impatient children are just some of the hassles that come with eating out.  The uncertainty of a potential restaurant experience presents a risk that is rarely worth the reward.  Take-out is a much more sensible choice.

Pittsburgh is a city that is not exactly known for being hip, cool, or modern.  Even if our city was known for bistros and open-air shopping, we would not have taken much advantage of these amenities.  As most parents know, “before children” is a completely different era than “after children.”

A big night out is something that is not part of our normal routine.  However, last weekend we had the opportunity to go out without the kids.  The allure of a fabulous dessert was enough to warrant an outdoor walk through the riverside shopping district.  The restaurant of choice was the Cheesecake Factory.  We had been there once before and found that it is not exactly kid friendly.  An hour long wait and the lack of a children’s menu resulted in a long night (but a great learning opportunity) for two young parents with two little ones.

Our limitations are much different today, and a night out would be a great test.  Walking from parking garage to restaurant, waiting an hour or more to be seated, and maneuvering through crowds of people were some of the apprehensions of the evening.  I wondered if Jess would be in pain, tire out, or be fearful of falling.  The reward was worth the risk, though.  We were totally committed to seeing it through.

The weather was calm and the outside temp surprisingly warm.  The most intimidating obstacle was the crosswalk that spanned the street in front of the restaurant.  At a pace of 1 mile/hr, the crosswalk resembled a huge footbridge across the asphalt.  Cars waited patiently for us to make our way, and Jess internalized the stares of the people behind the windshields.  Intuition told her that the slow trek across the street was an embarrassing form of public exposure for a young and capable mother.

When using the cane to walk, Jess focused all her scanning on the ground below to ensure solid footing.  On longer walks, she prefers to lose the cane and hold my hand.  She feels secure and speedy this way.  Freedom from planting the cane allows her the freedom to look around.  It’s not hard to see that we are a slow moving target that attracts people’s attention.  Strangers may smile or wave people like us on, but on the inside they can’t help but wonder about the source of our handicap.

The best thing about eating out infrequently is being able to treat the experience like money doesn’t matter.  The primary investment has already been made in childcare for the kids and courage for the journey.  The cost of an additional appetizer or desert added little to the night’s bill.  It felt good to splurge without regret.


Front Row Seats to Jess’ Psyche

Sometimes a small comment can carry a big meaning.  The content of the comment itself contains much of the meaning.  The way the comment is delivered provides insight into the speaker’s psyche.  Interrogators are trained to use questioning techniques that elicit useful information from victims, witnesses, and suspects.  Some comments are so revealing that even the rest of us can read between the lines.

Day after day of a similar routine can be a huge drag on a patient as well as those around them.  Jessica has to work so much harder than everyone else in order to gain a tiny bit of additional function in her life.  She wants to do so much more than she does now, but she simply is not able to complete many of the tasks she wants to do.  Conquering an obstacle first requires believing it is possible.  For many tasks, it may take hundreds or even thousands of attempts to feel like the goal is getting nearer.  The frustration of continued failed attempts plays with the mind and tricks it into believing no progress is being made.

Complacency is a great fear for our continued recovery.  Why do something that is hard for you when there is always someone else around who can complete the task with little effort?  It is a natural consequence of stroke recovery to reach for the low hanging fruit and let someone else get the rest.  In fact, most people go through life plucking the fruit that is easy to reach.

Jessica made the most amazing comment the other day.  We were driving in the car and she noticed a group of runners headed toward the jogging trail.  Jess commented “I can’t wait until I can run again.”  It was a shocking comment from someone who hasn’t run a single step in over two years.  Even more impressive than her comment was the way she delivered it.  It rolled off her tongue matter-of-factly and with a hint of impatience.  There was no sadness or longing in the delivery.  She stated it as a fact… as someone who knows it is just a matter of time.


Cohesion with the Family

Success breeds confidence.  That saying describes Jess well as she begins her new life of pain-free walking.  She was so used to focusing on physical pain that her mind dreaded each new step.  Now that the pain has been neutralized, Jess’ mind is getting used to taking pain free steps.  Her mind is wrapping itself around new possibilities that exist with her surgically repaired leg.

Instead of letting those around her know her next move, Jess is now apt to push her chair out from the table and walk into the other room.  I am left wondering what she intends to do in there.   She is happy to keep her intentions to herself and allow me to wonder.  Of all the great places and amazing people in the world, there is nothing as satisfying as deciding to do something for yourself and then doing it.  Nothing is as liberating as the feeling of personal freedom.

The kids intuitively understand subtle changes in their mother.  She has earned enough respect to insert herself into the management of our family.  I get a kick out of sending the kids to her with their disagreements.  Increasing interaction with the baby has elevated her self-esteem.  Charlotte now grabs a book and mom becomes the storyteller. One minute later the book is on the ground as Jess playfully adjusts to the role of a toddler’s punching bag.  One of her “mom” duties is to change one diaper each day.  The very first time was tough:  the baby kicked, squirmed, and fought.  The persistence of repeating this task every day has made it easier for both mom and baby to complete.  Diaper changing is now something the two of them can almost do independently.


Breaking from the Checklist Mentality

Contentment is a double-edged sword.  It is wonderful to be happy with what we have, but also dangerous to lose the will to continue growing.  The more comfortable we feel with our current life, the easier it is to stay put.  Habits that have formed are tough to break.  The comfort level of our daily routine stifles our desire to try something different.  The things we want to do are replaced by things we feel we have to do.  Life turns into a checklist of the things that must be done to get ourselves through each day, week, and month.

The checklist mentality is powerfully seductive.  No matter how varied our experiences and personal history, it is easy to trivialize the value of life by turning it into a giant “to do” list.  The danger is in allowing items on our daily checklist to become the cornerstones of our life.  These items are far too trivial to be used to define our life.

Our focus is on putting these checklist tasks on autopilot whenever possible to free up time for real living.  Moments worth focusing on are those that provide a greater sense of accomplishment and worth.  A great evening out, a trusting gaze from your child, and genuine conversation with a good friend… these are the moments we try to keep in focus.  Photographs of our family’s life now play a big role in Jess’ happiness.  As Jess continues to develop new skills, we will strive to minimize the stress related to our checklist items.  Instead, we will do the best we can with what we have… and then we’ll save the memory with a picture.


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