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Post-Traumatic Brain Injury Recovery     

Version 2.0

By Patrick Alles


An Abridged Update

My direct and formal therapy and rehabilition ended at the end of December 2014. I had returned to work half time in early December, and increased to full time at the end of January 2015. I learned early on that it was going to be a challenge to get used to the nature of working again, even though I was informed that for a while I was expected to focus on a narrow aspect of my work to start, and that as I began getting comfortable I would start adding to my workload in the areas at a medium and advanced level as part of my recover.

My first two weeks back were used simply to read and delete email – over 2,000 messages that had accumulated during my absence. After that, I could focus more on specific communications related to current work topics. That’s where I learned how much longer it would take to compose, edit, change, adjust, rewrite, take a break, recompose, review, and repeat – ad nauseum – until I was comfortable that what I wrote was appropriate and then - only then - was ready to hit “send”. An average message of 3-5 minutes to write and send prior to the injury immediately jumped to a 15, 20, 25 or more minutes to make sure I put some together appropriately. That was in January and February and well beyond, but I can report that I now write much better, but still take more time to ensure my message, wording, and spelling is accurate.


As long as my work in my office was quiet, it was generally productive. Managing data, reports, charts, and the like was effective and meaningful. At any time the work environment was distracting through interruptions in my office, conversations in the halfway, phones ringing, meetings in colleagues office, and so on, I experienced substantial difficulty and distraction. After a while, I decided to use headphones or ear plugs to attenuate the noise and maintain focus. One colleague has a high volume of talk on phone, in meetings, and in the hallway that I describe as create a “shutdown” effect on my ability to focus well. I eventually was able to change offices to an environment that was “transformative” and made it much more conducive to focusing on my tasks at hand.

Current Challenges to Speech Therapy

In many respects I believe I have made great strives to improve my reading and comprehension of material I address. That includes newspaper, books, music, movies, and a few TV shows. I knew after returning to work that my strongest aspect was reading, and that it easily dropped off as I tried to write, attend meetings and comprehend what is being discussed or asked of me. The notes I wrote during meetings often described my long and winding road to recovery. Those areas were weak at the beginning and took months to improve. Improvement is the first step to adapting and ultimately overcoming.


It wasn’t until the summer of 2015 that I learned aphasia was often a result of a brain injury and could make it difficult to read and speak effectively. I’m aware that many aspects of aphasia are not problematic, but that a few are and I have been working on efforts to improve my speech language.

“French” Reading, Writing, Listening, Speaking: these are the four areas of French language that I learned in high school and college that were needed to gradually adopt in order to become affluent and maintain my knowledge of the language:

Reading (aka, "lisez")

Listening (aka, "ecoutez")

Writing (aka, "ecrivez")

Speaking (aka, "parlez")

Note: I am exploring the effects of “aphasia” on these four areas of language both prior to and after the TBI


Reading seemed the easiest category to adopt in French then and is true now for English. The other categories still have challenges - in French and in English. For reading, I describe my current challenges with aphasia as follows: “light” reading is good, as that includes general items such as a menu, lyrics, a news story, emails, etc. “Medium” reading is a much deeper level of written documents and can include news stories, books, magazines, etc. They are not a challenge as long as the nature of the topic and the depth of their writing is comfortable for me. “Heavy” or “academic” reading is where I experience aphasia.

More specifically, I know that aphasia has the ability to cause me to “trip up” on a word/words, a sentence, or parts of a section. It happens often when the time of day I am reading is late, I’m tired, or I haven’t had any coffee. If I’m reading the same book during a day where I’m cognizant and enjoying a Starbucks I seem to have much less of an issue. Reading such a book quietly is not nearly a challenge as if I am reading out loud. That is where aphasia is much more obvious and difficult. I now read stories and book chapters out loud to myself as a way to monitor where I’m “tripping” and to make note of the words or reasons why I’m tripping.

Additional Aspects

How I process sound

  • Affects the ability to concentrate in meetings, doctor's appointments, reading comprehension, music or entertainment.

  • Affects the ability to focus on a project

  • Pain from sound shuts my brain connections; neurotransmitters have a loss of connection as information transports across "bridges"

  • Understand the details of what people say to me. This is compromised in situation with multiple sources of noise confusion my attention on the primary source; when the person speaking to me mubbles, or doesn't speak loud enough to be understood, or uses words that make it difficult to understand the meaning of what is being asked or expressed.