Author Archives: lassesen

Unknown's avatar lassesen 5:58 am on September 8, 2015  

Coagulation: Thick Blood Supplements for CFS and Long COVID

Some readers may ask what is this about thick blood AKA micro clotting in COVID?

When I had my 2nd episode of CFS/ME, several papers had just be published by Dave Berg. He was not a MD nor a researcher. He owned and ran a laboratory that specialized in blood testing for infertility. The cause of one type of infertility is Hughes Syndrome or to put it into simple terms, thick blood. The blood is just thick enough that oxygen to the fetus is insufficient and results in spontaneous abortion. The modern treatment is low dosage of heparin (the body’s natural blood thinner) resulting in the fetus surviving. Heparin is not a single chemical, rather a bunch of different chemicals.

Dave Berg while working with MDs started to hear “oh by the way, Mrs. X while on heparin reported that her FM / CFS went away”. After hearing enough reports, he conducted a study of CFS patients (using his own labs and at his own expense) and found that most CFS had a detectable hyper coagulated state often connected to DNA mutations (i.e. inherited). These needed some external influence to become significant (i.e. an infection). A significant percentage went into remission from low dosage heparin alone. Others required heparin and either anti-virals or antibiotics.

As a side note, my mother had 2 sons and something like 7 miscarriages… I suspect “thick blood” was the cause. She did not have CFS.

Model

Some infection which prefers low oxygen levels has become established in the body. The infection manufactures chemicals to trigger coagulation (and thus lower oxygen levels to make your body friendly to it). Because of a person’s DNA mutations, not all of the coagulation is cleaned up — resulting in thick blood. At my worst, it took 12 tries at various locations to get one blood sample out of me, things were that thick!

With heparin or other appropriate blood-thinners, the oxygen increases and with some infections, the increased oxygen is sufficient to suppress the infection (which likes low oxygen levels), thus stopping further coagulation. The “infection” may be in tissue, or a combination of bacteria in the gut (or microbiome), it may not be detected in the blood.

My Experience

On my 2nd episode with CFS, the MD sat on the wall about coagulation — doing a “I will think about it”. I decided to try a simple experiment: I got a bottle of aspirin and read what the maximum dosage  allowed was (and for how long) and then did it.  About 7 days later I was climbing the ways with energy and improved thinking (I crashed fast once I stopped). The MD saw the changed and ordered extensive coagulation panels from Berg’s lab (later the MD sent to a local lab and got similar results — just to make sure that Berg’s lab was not misreporting). I was put on low dosage heparin and once my DNA results came back, I found that my DNA defect could be treated with Piracetam and Turmeric.

At the start of my 3rd episode, I hit the anticoagulants increasingly to keep me working while my new MD was running the mountain of exclusionary tests required before a CFS diagnosis could be given (as well as having symptoms for 6 months).  I knew what was happening — the MD did not believe me until the SPECT scans came back. I stopped the anticoagulants as soon as easy bruising started to happen — and totally crashed 3 days later. Antibacterial/antivirals were needed.

Coagulation is complex with many steps in the process. It takes just one step to over-produce or under-produce to create a problem. The typical mistake that people make is to address only the step that aspirin impacts (platelets)– that is usually insufficient (and if you take too many substances that impacts that step, you have a major risk of serious bleeding). Always consult with your MD before starting any supplements.

With that said, I will give my list of supplements which are available (in the US without prescription) and what each does according to PubMed. I will not try to explain all of the complexities or terms (sorry — that’s another topic, use wikipedia)

Thick Blood Supplements

Alpha Lipoic Acid

Boswelia Gum

Gum-resin extracts of Boswellia serrata have been traditionally used in folk medicine for centuries to treat various chronic inflammatory diseaseshttp://www.ncbi.nlm.nih.gov/pubmed/22457547 (2011). It has been found to have antibacterial http://www.ncbi.nlm.nih.gov/pubmed/22422529 (2012),  anti-arthritic http://www.ncbi.nlm.nih.gov/pubmed/21479939 (2011), anti-edemateous http://www.ncbi.nlm.nih.gov/pubmed/21855244 (2011),  antioxidant, antiplatelet and anticoagulant(equivalent to heparin)http://www.ncbi.nlm.nih.gov/pubmed/21771654 (2011). positive effects of BEs in some chronic inflammatory diseases including rheumatoid arthritis, bronchial asthma, osteoarthritis, ulcerative colitis and Crohn’s disease have been reported http://www.ncbi.nlm.nih.gov/pubmed/20696559 (2010).

Bromelain

Coagulation-inhibiting effects http://www.ncbi.nlm.nih.gov/pubmed/2203073 (1990)

Centella Asiatica [Gotu kola]

This is used in Spain

  • “The anti-thrombotic active constituents from Centella asiatica. [2007]”
    • “Thus, C. asiatica was shown to promote blood circulation to remove blood stasis. Consequently, C. asiatica is a useful medicinal plant for the prevention of lifestyle-related diseases such as hypertension, cardiopathy and cerebral apoplexy caused by arteriosclerosis.”

Coenzyme Q10

 Ginseng

Acts similar to aspirin for coagulation

Grape Seed Extract

Grape seed extract is rich in proanthocyanidins. Proanthocyanidins are available from other supplements (cranberry juice, cider). It may or may not offer protection for glutamate excitotoxicity (depends on grapes being used) http://www.ncbi.nlm.nih.gov/pubmed/21283677 (2011).

Licorice

Spezzata (pure Licorice – Glycyrrhia).  http://www.ncbi.nlm.nih.gov/pubmed/9196073 (1997)

  • Increases plasma recalcification, thrombin and fibrinogen clotting times
  • Reduces thrombin-induced, but not collagen-, PAF- or convulxin-induced platelet aggregation.

Lumbrokinease

Nattokinase

Nattokinase is from a fermented-soya desert food in Japan called Natto.

Maximum dosage: 4000 Fibrin Units  http://www.pureprescriptions.com/expert_opinion/Nattokinase-Information.asp http://digitalnaturopath.com/treat/T447441.html

 Piracetam

For coagulation http://www.ncbi.nlm.nih.gov/pubmed/8457235 (1993), reduces

  • von Willebrand’s factor
  • inhibition of thromboxane synthetase
  • inhibition of anti-thromboxane A2
  • 30-40% reduction in plasma levels of fibrinogen
  • reduces cell membrane deformability (red cells, white cells and platelets)

 Turmeric

The active ingredient of this kitchen spice is curcumin. Turmeric appears to be more effective than curcumin, the extract[1].

NOT RECOMMENDED

Evening Primrose Oil

Depending on your DNA, it may help or make things worst.

1.1.1     Sunflower Oil

More readings on thick blood

  1. https://atomic-temporary-42474220.wpcomstaging.com/treatment/thick-blood-clots-dimension-of-cfs-etc/hemex-protocol-and-dave-berg/dave-berg-cfs-radio-program-1999-08-29/
  2. https://atomic-temporary-42474220.wpcomstaging.com/treatment/thick-blood-clots-dimension-of-cfs-etc/
  3. https://atomic-temporary-42474220.wpcomstaging.com/treatment/thick-blood-clots-dimension-of-cfs-etc/hemex-protocol-and-dave-berg/transcript-of-townhall-with-dave-berg-hemex-labs/comment-page-1/
  4. https://atomic-temporary-42474220.wpcomstaging.com/treatment/thick-blood-clots-dimension-of-cfs-etc/hemex-protocol-and-dave-berg/townhall-with-david-berg-3/
  5. https://atomic-temporary-42474220.wpcomstaging.com/treatment/thick-blood-clots-dimension-of-cfs-etc/hemex-protocol-and-dave-berg/dave-berg-talk-4/
  6. https://atomic-temporary-42474220.wpcomstaging.com/treatment/thick-blood-clots-dimension-of-cfs-etc/hemex-protocol-and-dave-berg/
Unknown's avatar lassesen 5:14 pm on September 7, 2015  

Core CFS Supplements

Supplements are a challenge for many CFSer. Often their criteria is the very subjective “if I don’t feel better, then they are not working”. If there is improvement and it takes 4 weeks, they may not be able to remember how they were, and thus perceive no improvement.

Supplements Shown to Improve CFS – Reported  by PubMed studies

I am filtering the studies to CFS, IBS and FM since they tend to be co-morbid. There are many supplements that were found to have no impact. I would recommend these supplements be used (and lab results increased to the desired level) before trying speculative supplements. Many supplements help other conditions but not CFS/FM/IBS – and in a few cases may make things worst. Be careful with items “that are good for you (general population)”, they may be contraindicted for CFS.

Very few things are reported to help all CFS patients — with the exception of Vitamin D.  To get to and keep at the recommended level, I find that I need to take 15,000 to 20,000 IU of Vitamin D3 per day. If you are low, it can take months even at that dosage to raise your level. Many things are reported low in CFS, and too frequently supplementation has no impact on symptoms.

In my next post I will look at items that help with “low level” hypercoagulation (which is reported in some 90% of CFSers). By low-level, I mean not sufficient to cause stroke or deep vein thrombosis (which a hematologist would deem to be “significant”), but sufficient to cause mental fog and fatigue.

Zinc

Vitamin-D

Comment: a level of 50+ ng/mL appears to be a critical threshold for improvement, this is the level where parathyroid hormone stimulation occurs.

B12

  • 40% are good responders, 60% are mild responders for B12 Injections [2015] – unbelievably, there appears to be only one study.

Coenzyme Q10

Ginseng

Glutamine

A non-essential amino acid.

Licorice

Spezzata (pure Licorice – Glycyrrhia).

L-carnitine

  • Improvement seen after 4 weeks [1997]
  • 60% response rate [2004]

Magnesium

Melatonin

NAC N-Acetyl-Cysteine (NAC) or acetylcysteine

 NADH

Nicotinamide adenine dinucleotide (NADH). This is precursor for niacin

Dehydroepiandrosterone (DHEA)

  Evening Primrose Oil

To Be Avoided

Glutamate

Monosodium glutamate (MSG) is often added to food to improve favor.

Unknown's avatar lassesen 7:51 pm on September 6, 2015  

So what do you do…

A reader asked for a “cook book” summary for the best items for probiotics and foods. Supplements are another issue which I have looked at on early posts. Again, a grain of salt should be taken because the studies are parse and few.

Probiotics

See https://atomic-temporary-42474220.wpcomstaging.com/2015/02/24/probiotics-with-demonstrated-health-benefits-and-other-gems/ for research links

Foods

From Wikipedia’s FODMAR list

“Vegetables: bamboo shoots, bell peppers, bok choy, cucumbers, carrots, corn, eggplant (aubergine), lettuce, leafy greens, pumpkin, potatoes, squash (butternut, winter), yams, tomatoes, zucchini (courgette)

Fruits: bananas, berries (not blackberries or boysenberries), cantaloupe, grapes, grapefruit, honeydew, kiwifruit, kumquat, lemon, lime, mandarin, orange, passion fruit, pawpaw, pineapple, rhubarb, tangerine, tomatoes

Protein: beef, chicken, canned tuna, eggs, egg whites, fish, lamb, pork, shellfish, turkey, cold cuts (all prepared without added FODMAP containing foods), nuts (not cashews or pistachios), nut butters, seeds

Dairy and non-dairy alternatives: lactose-free dairy, small amounts of: cream cheese, half and half, hard cheeses (cheddar, Colby, Parmesan, Swiss), mozzarella, sherbet, (almond milk, rice milk, rice-milk ice-cream)

Grains: wheat-free grains/wheat-free flours (including gluten-free grains, which are free of wheat, barley and rye) and products made with these (e.g. bagels, breads, crackers, noodles, pancakes, pastas, pretzels, waffles); corn flakes, cream of rice, grits, oats, quinoa, rice, tapioca, corn tortillas.

Beverage options: water, coffee and tea, low FODMAP fruit/vegetable juices (limit to ½ cup at a time)”

To the above I would add:

  • Peanuts
  • Any food taken from the ground that are not on the list, especially bitter foods. The reasons are:
    • A normal healthy gut bacteria profile is very close to that found around underground foods — reflecting where our ancestors got their food supply (and how their gut got populated by bacteria by eating unwashed root vegetables).
    • Some foods have been breed to be less bitter (sweeter) than the natural wild variety. There is considerable evidence that the “bitterness” reflects compounds that are actually healthy for us.
  • 100% Rye Bread if you are of northern european extraction. There is a “rye/wheat” line across northern Germany. North of this, traditional wheat would not grow hence rye bread has been a norm for milleniums.
Unknown's avatar lassesen 6:49 pm on September 6, 2015  

Prebiotics – a review

Prebiotics “is a general term to refer to chemicals that induce the growth or activity of microorganisms (e.g., bacteria and fungi) that contribute to the well-being of their host.” In general, they have been shown to help the growth of one or more bacteria families deemed helpful. As readers of this column know, some commonly deemed healthy bacteria actually pushes the CFS microbiome in the wrong direction – for example Lactobacillus usually suppress E.Coli (which CFS patients are extremely low in). A prebiotic that encourages the growth of bacteria that further shifts an unhealthy microbiome in the wrong direction. “A prebiotic is a selectively fermented ingredient that allows specific changes, both in the composition and/or activity in the gastrointestinal microflora that confers benefits upon host well-being and health.” The gotcha is whether there are benefits for an unhealthy person?

This is the gotcha that is often forgotten:

What is good for healthy individuals (whose microbiome is balanced) may be wrong for people dealing with health challenges!”

This is actually stated well by a article published this year, “Substantiating the safety and mechanisms of action of probiotic/prebiotic formulations is critical.” [2015]

Since prebiotics have only been know since 1995, our knowledge about this “miracle food” is limited and likely very colored by rose-colored glasses (as are all new medical wonders). The ideal study to find are those that are well done with a specific condition such as Chronic Fatigue Syndrome. Be aware that “no results” or “negative results (making it worst)” have a tendency not to get published. I could find zero clinical studies on pubmed for this condition.

  • “Specific probiotics also have immunomodulatory and metabolic effects. However, when evaluated in clinical trials, the effects are variable, preliminary, or limited in magnitude.’ [2015]

Trying to tease our the studies

Most foods contains prebiotics naturally. Even something like coffee can qualify – “induced a significant increase in the growth of Bifidobacterium spp. (P<0·05) …also induced a significant increase in the growth of the Clostridium coccoides-Eubacterium rectale group [2015]”. Prebiotics are generally extracts from foods (often from food that are not in a modern western diet).  The key to this Gordian knot may be looking at what increases biodiversity in the gut. IMHO, changing diet is better option than keeping a bad diet and taking prebiotics.

My general impression has been that every disease that influence the gut (or the reverse) has decreased biodiversity. This is the criteria that I am using.

Bottom Line

My perception was turned upside down by doing this research, namely:

  • Gluten Free Diet does not help a shifted microbiome get back to normal. It may reduce symptoms but moves you away from getting healthy as a result!
  • Prebiotics have no effect on biodiversity
  • A diet low in specific prebiotic substances is likely healthiest!
    • FODMAP -> A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols

You may disagree with this — if so, please find PubMed studies that support you and post as comments.  Common alternative medicine and beliefs may be very wrong and based on belief or naive scientific reasoning.

Unknown's avatar lassesen 2:41 pm on September 6, 2015  

Recovering from Brain Injury

Traumatic Brain Injury or CFS Brain Injury do not differ in recovery techniques. Dr. Daniel Amen (well known from PBS) did a SPECT scan on one of my loved ones when she had acute CFS, his reading of over 50% of her brain having abnormality in blood flow. His best opinion of what he saw was massive inflammation caused by an infection (viral or bacteria).

If you magically eliminate the infection causing CFS today, it will take months for the inflammation to subside, with recovery ongoing for many years. You may get your energy back quickly, but cognitive function will likely be slower. People who went to immediate remission from fecal transplants, found their energy jump quickly as did cognitive ability (which does not mean full recovery of prior cognitive ability — often there is a need to retraining).

First, I will give what has been documented to help/work. Then, I will give my spin from my own experiences. As I stated in my last post, mild Traumatic Brain Injury (TBI) such as far a car accident, is in general far less challenging than the CFS Brain Injury.

PubMed Findings 

Regardless of the cause, pro-active treatment can greatly reduce the long term consequences. What treatments are available?

Note: “Recent systematic literature reviews have concluded that there is minimal evidence to support any specific treatment” [2015]  “Although the long-term effects of brain damage caused by differing modes of head injury seem to appear identical in the long term (Belanger et al., 2009)” [2015]

  • Hyperbaric oxygen therapy: “Analysis of SPECT imaging revealed rectification of the abnormal brain activity: decrease of the hyperactivity mainly in the posterior region and elevation of the reduced activity mainly in frontal areas.” [2015]
  • Brain “fog,” inflammation and obesity: key aspects of neuropsychiatric disorders improved by luteolin.[2015]
    • ” Brain “fog” characterizes patients with autism spectrum disorders (ASDs), celiac disease, chronic fatigue syndrome, fibromyalgia, mastocytosis, and postural tachycardia syndrome (POTS), as well as “minimal cognitive impairment,” an early clinical presentation of Alzheimer’s disease (AD), and other neuropsychiatric disorders. Brain “fog” may be due to inflammatory molecules, including adipocytokines and histamine released from mast cells (MCs) further stimulating microglia activation, and causing focal brain inflammation. Recent reviews have described the potential use of natural flavonoids for the treatment of neuropsychiatric and neurodegenerative diseases.”
  • “Piracetam may reduce it, as may bright blue light.”[2014]
  • Neuroprotective effect of levetiracetam on hypoxic ischemic brain injury in neonatal rats [2014].
  • “Data show that treatment using dietary and parenteral zinc supplementation can reduce TBI-associated depression and improve cognitive function, specifically spatial learning and memory.” [2013]  Zinc dosage: 30-40 mg/day see this post
  • “we review relevant experimental and clinical data on supplemental substances (i.e., curcuminoids, rosmarinic acid, resveratrol, acetyl-L-carnitine, and ω-3 (n-3) polyunsaturated fatty acids) that have demonstrated encouraging therapeutic effects on chronic diseases, such as Alzheimer’s disease and neurodegeneration resulting from acute adverse events, such as traumatic brain injury.” [2014]
    • “Although both animal models and human studies of brain injuries suggest they may provide benefits, there has been no clinical trial evaluating the effects of n-3 fatty acids on resilience to, or treatment, of TBI. ” [2013]
  • ” The study included weight loss (if appropriate); fish oil (5.6 grams a day); a high-potency multiple vitamin; and a formulated brain enhancement supplement that included nutrients to enhance blood flow (ginkgo and vinpocetine), acetylcholine (acetyl-l-carnitine and huperzine A), and antioxidant activity (alpha-lipoic acid and n-acetyl-cysteine)…. [resulted in ] statistically significant increases in scores of attention, memory, reasoning, information processing speed and accuracy ” [2011]
  • Effects of mild exercise on cytokines and cerebral blood flow in chronic fatigue syndrome patients [1994].
  • “The use of atorvastatin and magnesium sulphate was associated with a lower incidence of new postoperative neurological deficit.” [2013]
  • “Through these varied mechanisms, gut microbes shape the architecture of sleep and stress reactivity of the hypothalamic-pituitary-adrenal axis. They influence memory, mood, and cognition and are clinically and therapeutically relevant to a range of disorders, including alcoholism,chronic fatigue syndrome, fibromyalgia, and restless legs syndrome. Their role in multiple sclerosis and the neurologic manifestations of celiac disease is being studied. Nutritional tools for altering the gutB microbiome therapeutically include changes in diet, probiotics, and prebiotics.” [2014]
    • “So far, psychobiotics have been most extensively studied in a liaison psychiatric setting in patients with irritable bowel syndrome, where positive benefits have been reported for a number of organisms including Bifidobacterium infantis.” [2013]
    • The gut reaction to traumatic brain injury. [2015]
  • “Mast cell (MC) activation disorders present with multiple symptoms including… gastrointestinal complaints, irritability, headaches, concentration/memory loss and neuropsychiatric issues.” [2014]
  • Treatment of chronic fatigue with neurofeedback and self-hypnosis [2001].
  • [Neuroprotective mechanisms of cannabinoids in brain ischemia and neurodegenerative disorders] [2015] – no human studies have been done.

To rephrase for the cognitively impaired reader:

  • Low histamine diet (or at least a wheat free diet)
  • Bifidobacterium infantis (Align) and Prescript Assist probioitcs. Note that taking random probiotics may actually make things worst!
  • Items that improves oxygen delivery to the brain
    • Exercise
    • Hyperbaric oxygen therapy
    • Piracetam and other nootropics, ginkgo and vinpocetine
    • alpha-lipoic acid and n-acetyl-cysteine (NAC)
    • Anti-coagulants: Grape seed extract, heparin,
    • Niacin
    • NOTE: hypercoaguation (too thick blood) is very common in CFS (read more here and
      Dave Berg Talk #4 ) and thus there is a double advantage of taking these.

Personal Experience

The items that resulted in the greatest observed improvement for me in cognitive function within minutes (in order of precedence)

  1. Piracetam (and other racetams) – up to 6 x 800 mg /day
    1. One source of supply is https://smartpowders.com/brand/smart-powders/ and  http://smartmoleculeshop.com/
  2. Niacin (flushing type — often 500mg 2-3 times a day. Consult with a MD before starting)
  3. Aspirin / Grape Seed Extract

Note on Racetams

Racetams can be prescription in some countries and over the counter(OTC) in others. For one CFS episode, my source for piracetam was a CFSer in the Czech republic and India (purchased on site by a friend — manufactured in Europe).  Today, I have a 3 kg jar of if in storage from when it was available on some US web sites. As often happens, because it is effective FDA reclassified it as a drug and stopped OTC sales (hence purchasing the jar when word got out of FDA’s decision). The other racetams are still available but far more expensive, usually the cheapest form is powder and make your own “00” capsules.  for example: Aniracetam 750 mg 60 capsules – $40 for 45 gm  versus $22 for 100 gm of powder.

You should make sure that you read up on each, for example this site, http://nootriment.com/aniracetam-powder/   Each one has slightly different impacts and I ordered each one to determine which had the greatest apparent impact. For me, piracetam won! There are some studies supporting this “caused significant decrease of the CF severity, which was more prominent in the MS group, while in another group it was associated with a decrease of depression severity” [2006][2007]

Adapt and don’t lament where you were

Exercising your mind without stressing the mind is ideal. CFS patients tend to be Type A ([Relationship between chronic fatigue syndrome and type A behaviour[2009]). This personality type tends to push the envelope – whether this pushing is the result of excessive parental pressure when young or because of specific bacteria in the microbiome or … is unknown.  This personality trait also results in “push and crash” cycles that often result in zero or negative progress over time.

A classic mistake in recovery is pushing beyond your actual physical and mental envelope which can often result in actual setbacks and depression over your current state. I grew up with a handicap and learnt to strongly discipline myself in order to have a continuous series of small positive successes that built instead of a serious of major failures that destroyed confidence and produced stress…  And stress is well known to cause relapse in both CFS and brain trauma.

For example, you may start with easy Sudoku and once you literally get bored with it, then increase to the next level of difficulty. I recall sitting at my computer for hours playing the same game (pre-Sudoku) for months and then I found that I suddenly had become bored with it (while other symptoms were improving) and found a slightly more challenging game.  Again, the criteria is not pushing your limits (or even trying to find them!), rather boredom, keeping in your envelope.

Return to Work Strategy

I think that giving you examples from my own experience may illustrate the need to “downgrade your expectations and slowly, safely, work upwards keeping in a safe envelope.

Example 1

  1. On a triple honors program with top marks in the nation on Physics and Mathematics contests (including better scores than Bill Gates), life path was suppose to be a Ph.D. and then a Professorship somewhere.
  2. Adapation:
    1. Stop working on scholarship, paid for university by becoming a store clerk and dropped honors courses so I could get my degree, a lower level goal
    2. Instead of going to Grad School, did a professional year in Education to become a High School teacher
      1. Lots of pressure not to be so foolish…
    3. After 3 years teaching, became bored and mind seem to be recovering, so started a part time MBA program
    4. Did well and changed to a more demanding M.Sc. in Commerce completed, got accepted for a Ph.D. (but opted to work a few years in business instead, again, avoiding pushing the envelope and opted for the “low road”)
    5. Eventually moved to Microsoft as an employee, fully challenged etc..

Example 2

  1. Onset happened while at Microsoft (bad boss and stress scenario)
  2. On disability pay and appears to be recovering
    1. Did volunteer/unpaid work for local company. Started at 2hr/day and slowly worked upwards over several months to a full 8 hrs.
  3. Took my time to find the “right job” – the job was one that required little new learning and heavily use of skills from prior to CFS onset. Goal was to minimize the need for learning with a recovering mind. Worked there for 3 years (during which my position went from Software Architect to Principle Software Architect to Engineering – Manager). I was offer the job of President, which I turned down because it was not a “safe choice”, it was stretching my proven limits — this is a no-no

Example 3

  1. Onset happened while at Amazon (flu and “the amazon culture” was the triggering event)
  2. On recovery, again looked for a job that required little new learning and heavily use of skills from prior.

Some example Strategies

  • Say you were a biologist or chemist, instead of stepping back into the same position, find work as a laboratory assistant (yes, you may be overqualified, but the brain injury is a significant factor).
  • If you were in sales management, perhaps consider returning to being a sales associate.
  • If you have a master’s or a bachelor’s degree, consider becoming a substitute teacher, doing single days of work at different locations allows you to determine your limits in a safer way
  • Do not set yourself to become embittered by setting your threshold for a job unrealistically high. You may have a Ph.D. but working at MacDonald will do you a lot more good than not working.
    • I know CFSers with a lot of secondary issues, back problems, headaches, noise sensitivity etc who have adapted to their restrictions and are building a personally rewarding employment opportunity.  “Adapt or become embittered!”

Yes — it is unfortunate that you cannot resume where you were! But really — would you prefer resuming with the same position and then do a disastrous job doing it which will undermine your confidence and possibly result in a very bad reference for your next job????

Once you have a job, if you find the job has challenges, see if your MD will give you an Americans With Disability letter. In general, most firms (except Amazon) will respect it and work with you to be successful.

For interviews, have a cover story ready for your choice of going for a ‘job downgrade’ — do not mention disability (they cannot ask if you will need an accomondation). Often demands and needs of a family member can be a good cover story for why you are applying for a job below you past work history. That is 100% truthful — the family member may actually be yourself!!

Bottom Line

After Brain Trauma, you are almost like a recent immigrant from another country. You need to learn your current capabilities (realizing they will evolve/improve constantly) given your current abilities (which most people tend to deny the loss of — unfortunate), as well as getting “re-credentialed” — you have been off the job market for a while and things have moved on. You do NOT want to add the stress of an aggressive learning curve to your recovery.

Today, I will typically go for several brisk 5 mile hikes in the mountains every weekend to keep up my physical state. Piracetam, aspirin and niacin are part of my regular supplements on work days — they still result in a significant improvement of cognitive skills for the day. I often have joked, “well, I am of the hippie generation, so doing mind altering drugs is expected — just how I need to alter the mind has changed and the stuff is legal ;-)!”