Dialectical Menialism

Dialectical Menialisms III – Back(lofen) and Forth

CHOICES! Keanu Reeves via Neo asserted that choice can be a form of oppression when the choices lead us to an undesirable outcome. Indeed, Geddy Lee boldly posited that “if you choose not to decide, you still have made a choice”. And who can forget the words of the bazillion-year-old knight in Indiana Jones and the Last Crusade, when he cautioned that “you must choose, but choose wisely…” That malevolent Walter Donovan chose poorly and, despite having just taken a drink, very quickly became the most dehydrated human in the history of forever. I, myself, have discussed the perils of being stuck between two choices in my critically acclaimed series “Dialectical Menialism” (found HERE and HERE). Since discovering this critical, yet sorely misunderstood facet of existence, I’ve been hypersensitive to any and all choices I’m faced with from the very specific (for example, when battling ninja robots, should I use a sword or nunchucks? Or what color sweetener packet should I use at Panera to sweeten my dark roast?), to the very broad (for example, “yes” or “no”? And the proverbial “up” or “down”).

It is concerning this very quagmire that I blog to you today, dear reader. You see, I’m part machine (more info HERE). Put briefly, I’ve a medicine pump in my abdomen delivering a constant supply of liquid baclofen to my spine, thus bypassing the stomach, the blood brain barrier, and so on. The “up and down” comes from the dosage – too high= lethargic zombie mode, too low= hypertonic spazz mode. I’ve crunched some numbers that I just made up and labored to produce some graphs to represent this conundrum.

Staggering data that affirms the supposition that more baclofen leads to a more sleepy, yet less spastic Jarrett. Conversely, less baclofen is associated with an increase in both wakefulness and muscle tension – diabolical!
Respondent were asked “would you say that higher doses of liquid baclofen result in elevated wakefulness?” If the respondent wasn’t already asleep, the answer was a very groggy “no” for ALL RESPONDENT! The chance of all or nothing is statistically remote
No surprise here. Respondent answered “yes” when asked “does a higher dose of liquid baclofen result in a decrease in spasmodic muscle behavior?”
This graph shows the (egregious) negative linear relationship between increases in dosage of liquid baclofen and a decrease in wakefulness.
The reciprocal of the “Crushing Fatigue…” graph. This line demonstrates the negatively positive linear relationship between decreased dosages of liquid baclofen and a reduction in the occurrence of NOT experiencing spasticity (what? The line has a positive slope, and one of the answers is a negative…)

These data were collected over the last six years by the Institute of Jarrett Existing and processed and quantified earlier today when I dreamed this up.

A few things to note –

  1. I use “Hypertonicity”, “spasticity” and “muscle tension” interchangeably. There are subtle differences, I know. But for my purposes, they refer to a muscle’s irrational, yet overwhelmingly persistent need to constantly contract (constranctly?)
  2. I forgot what the second one was for the moment…
  3. …Oh yeah, I don’t know that I mentioned the dialectical part of this post in plain terms. You see, with this pump I’m stuck between a state of soothed fatigue and wakeful muscle spasms. Where’s the balance? Hmmmm…I’m starting to think there isn’t one, but I have to choose, but I must choose wisely …if you choose not to decide and that proves to be the wisest choice, have you chosen wisely? Moreover, does choosing not to choose some option confound the design of the machines that control us? I have a machine in me, and I’m tempted to say that it doesn’t control me, but it certainly limits my options. So that’s what Neo was talking about…
  4. There is no spoon.






brain injury, cavernoma blog, cavernous angioma, living with tbi, writing

Finding Direction (literally and figuratively)

Please excuse my recent absence from contributing to this blog. You see, this entry is the 129th post to this blog and 1+2+9=12. The 12th letter is L. L is the Roman numeral for 50, therefore I had to wait 50 days (give or take) to post again.

Truthfully, I’ve had a lull in my desire to write. My muse has been elusive (emusive?), but I still like to put words together in a meaningful fashion.

How am I to proceed without inspiration? If inspiration won’t come to me, I’ll go to it and force it to do my bidding. I will be inspired by the word itself. By that I mean that I’ll think of a topic relevant to my recent goings on that starts with ‘I’ and stew (mmm…stew) on that topic until I can’t stew (mmm…stew) no mo’.

After that, I’ll move on to ‘N’ and wax eloquently. After ‘N’ comes ‘S’, and so on in that fashion until I’m I.N.S.P.I.R.E.D.

That said, I’ll begin with ‘I’. I’m reluctant to discuss this, for fear that something will happen to spite this trend, but this being a blog about my brain, I have to report that there is nothing to report. In other words, the trouble spot in my head has been INACTIVE. This is due in no small part to the brainstem cavernoma resection performed by Dr. Jonathan White almost five years ago (read more HERE and HERE).

Fortunately, I only had one cavernoma (more info about this little evil thing HERE and HERE). There are people out there with more than a few of these dastardly raspberries in their heads. There’s a faint possibility that mine will grow back, that’s why I’m happy to report that nothing is going on.

Inactive is the exact opposite of my NON-STOP attitude toward recovery. My advice to anyone faced with a major life change is to go go go. Things are different now yes, but when you stop, you let the life change beat you (Jarrett ain’t gonna get beat so easily).

For instance, even though I still try to talk myself out of going EVERY time, I go to the gym and work out/therapize myself at last twice a week. I wake up super early to prepare for work. Sleeping has become a necessary evil. I don’t enjoy it like I used to; I only do it because my body tells me to. If I could live without sleep, I would. Also, my daughter never stops, so I have to keep moving to keep up with her (more about her later).

On the topic of movement and direction, I’ll move to ‘S’ and tell you about the anomaly of SOUTHWEST. A while back, I had to replace the battery in my car. Being without juice for a brief period, the compass in my car reset. After not calibrating it for a few weeks, the car did it itself. I’m not sure if the car was playing a joke on me, I live near a magnetic anomaly or my car just doesn’t understand that there are four directions, but no matter which way I drove, I was going southwest.

Therefore, I’d leave for work in the morning going southwest. I’d turn left and head southwest for two miles. Then I’d turn right and drive southwest for about three miles…I think you get the point.

In essence, if you were to ask my car for directions, it might say something like this – “start out by going southwest, after you get to the third stoplight, turn and go southwest until you get to an overpass, then do a U-turn and drive southwest for half a mile and you’ll see the donut shop to your right (southwest).

Ok, this is fun, one more – the GPS on my phone and my car discuss directions. My phone says, “head north for about two miles. Then you’ll see the exit for HW 56,  take a right, and head east for three miles, at the second stoplight go north. Go straight through next light, then turn left and park by the north gym to get Jarrett to work.”

My car would repeat these directions back, “head southwest for about two miles. Then I’ll see the exit for HW 56,  take a right, and head southwest for three miles, at the second stoplight go southwest. Go southwest through next light, then turn left and park by the southwest gym to get Jarrett to work.”

My car has since expanded its horizons and embraced all four directions. During that time though, giving directions was easy. “How do I get to X?” I’d chuckle and say, “Just go southwest, silly!”

This entry is getting overlong. Therefore, ‘P’ will stand for PATIENCE. You see, you’ll have to patiently await the rest of the list. I will continue to be INSPIRED on my next entry (a few weeks).

Until then, stay busy and head southwest, unless you need to go southwest.



baclofen pump, brain injury, brain surgery, brainstem, cavernoma blog, cavernous angioma, living with tbi, Rhyme Time

Medical Vernacular Spectacular!

Part of having a condition like mine is learning a lot of big words. I like big words and I like to write silly poems – seems reasonable to assume that I would double like a poem about big words. I haven’t written the poem yet, but I’m sure I’ll like like it. To that end, I’ll quit introducing and start writing the poem you’re about to read. One last note – I’m going to stick to a simple AABBCC rhyme scheme – Shakespeare I amn’t. I’m going to italicize the terms to set them apart.

The medical field uses words that are big and complex,

For instance, raising you for at the able is called dorsiflex(ion) :).

The above word is one of the many that end with I-O-N,

Proprioception is a word that I use often;

It’s a big word for knowing where your limbs are in space.

Circumduction is another I-O-N, it affects walking pace.

When the knee doesn’t want to bend, the leg swings;

If I’m not careful, I’ll start to kick things.

Yet another I-O-N is ambulation;

Or you could say “walking”, if you value concision

Walking is made more difficult by the symptoms of spasticity.

Incontinence is when you have trouble going pee-pee,

“Pee-pee” is a silly word for releasing fluid that is pent.

The fancy term for pooping is “bowel movement”.

There is also a tube for moving pee-pee and other fluids hither and thither,

The fancy word for this tube is catheter.

There’s an intrathecal catheter delivering medicine to my spine ,

The catheter carries medicine from a baclofen pump to help me feel fine.

At first, the needle caused my spine to leak,

But thanks to a blood patch twas fixed in about a week.

To get the blood for the blood patch, the nurses set a Mid line,

The needle went so deep into my arm, I felt like dying.

Medtronic is the company that makes my pump.

Ataxia, or loss of balance, makes it difficult to jump.

Seeing two of something is called double vision or diplopia.

Seeing two of something is called double vision or diplopia.

Dysphagia is one of the fanciest medical terms I know,

It’s easier just to say “it’s hard to swallow”.

Let’s not forget the word for constant muscle contraction,

Hypertonicity is the word given to this action

I owe this list of words to the Pons region of the brainstem,

Without having a major hemorrhage there. I wouldn’t have learned them

This concludes the list

Did you get the gist?

I know I left some off, but I’m happy with this list, short as it may be. I think I explained the meaning of the words pretty well, but here’s a list with definitions just in case –

Dorsiflexion: This is when a door opens – I jest. Quite simply, it’s bending your ankle so that your foot/toes goes up

Proprioception: Obviously this describes a professional at “priocepting”, and as we all know (right?), prioception is the ability to perceive of a Toyota Prius. Actually, it’s your perception of the relative position of some body part.

Circumduction: The Romans came up with this one. Circ is Latin for “Pringles” (they’ve been around for a while). Um is Latin (and every other language ever for “WTF?”). Duction translates to “talking with one’s mouth full”. In essence, when in Rome, it’s not cool to talk with a mouth full of Pringles. Truthfully, it’s when the leg swings outward because the knee won’t bend enough to clear the ground.

Ambulation: Walking

Spasticity: Tremors caused by constant muscle activity

Incontinence: When you’re not on a continent. Examples – swimming in the ocean, flying on a plane or exploring outer space. A less awesome and more truer answer is when you can’t pee

Bowel movement: Pooping (heh, poop)

Catheter: This one was adequately covered above – it’s just a tube

Baclofen pump: A hockey puck shaped machine that delivers sweet, sweet baclofen (muscle relaxer) to the spine

Blood patch: The use of blood to patch a leak in the spine. I asked them if they could just use tape. They laughed derisively and said we could, but then we won’t get to set a…

…Mid line; thereby IMPALING my right bicep to harvest blood from a deep vein

Medtronic: A science fictiony name for a company that makes baclofen pumps

Ataxia: The IRS’s answer to whether or not there’s a tax for some object. E.g. “Is there a tax for asking stupid questions?” IRS reply: “A tax, yeah.” That, or loss of balance.

Diplopia: This one means double vision, I don’t get it. When I think of the word “plop” I think of poop splashing into the toilet.

Dysphagia: Saying disparaging remarks to some named “Phagia” – she(?) will punch you in the throat and make it difficult to swallow.

Hypertonicity: Similar to “spasticity” – constant muscle contractions.

Pons: Latin for bridge due to its position between the cerebellum and the cerebrum on the brainstem (that sounded pretty scientifical, eh?)

Hemorrhage: Internal bleeding, which, when paired with the term above, can create everything above that. Basically, it’s at the bottom of everything (symbolic, no?)



acute rehabilitation, brain injury, brain surgery, cavernoma blog, cavernous angioma, living with tbi, pate rehabilitation, Topic not about Brain Injury, twin creeks

Jarrett = Four Years Old

Hello, Internet!

Welcome to a very special edition of this blog (I know I say that a lot, but this one is more specialer, I promise).

Today is my “rebirthday”; it was on this day in that foul year of our Lord, 2009, that I underwent brain surgery. According to my calculator, that makes me four years old.

To commemorate this day I thought I’d list four positives I’ve experienced in the last four years –

1. Parking: I’ve a handicapped placard – I’ve found that the real advantage to having this blue piece of plastic is not so much parking closer, but narrowing the selection of parking places.

You see, most of you chumps have to drive around the whole parking lot to find a space; I need only check the front few spots.

Moreover, you’re more likely to get stuck behind that assclown that plugs up a row to wait for a spot (if you’re one of these people, I hate you).

Occasionally, someone will swoop in and take a spot before me. I find myself sizing this person up – Are they really handicapped? I think he/she’s just using his/her grandma’s placard.

I’m starting to sound hateful, let’s move on…

2. Helpful people: I often get asked if I need help with this or that. Writing about this makes me want to redact my previous comment about “you chumps”. But I don’t want to change it, so just erase it from your mind like so much Men in Black flashing phallus thingy.

Speaking of Men in Black, a fella that looked just like Will Smith came to help me fight off some aliens that were trying to steal my cheese grater.

I jest. He actually looked more like Puff Daddy (or P. Diddy, whatever he goes by these days).

Back to the point, seeing a person hold up a row in a  parking lot gets me thinking that people are self-centered, then a nice young lady asks if I need help carrying a large box to my car and shatters that perception.

3. New friends: I’ve met some pretty awesome people that I wouldn’t otherwise know. I’ve been lucky to have very lucky to work with very knowledgeable, caring therapists – I feel so honored to have met these people, I’ll attempt to name them all –

  • Emily x2 (OT, PY)

  • Laura (OT)

  • Heidi (PT)

  • Steve (PT)

  • Samara (PT)

  • DJ (PT)

  • Jennifer x3 (OT, OT, speech therapist)

  • Elizabeth (OT)

  • Leslie x2 (PT, speech therapist)

  • Leslynn (speech therapist)

  • That red headed (OT) whose name I forgot

  • That blonde (speech therapist) whose name I forgot

  • Kenya (speech therapist)

  • Paula (counselor)

  • Joni (PT)

  • Bonnie (PT)

I can’t think of anymore. If I forgot someone, I’m truly sorry. Wait, I’d also like to mention Sandy, my driver from my days at Pate. A very heartfelt and genuine thank you to you all!

4. Continuous possibility for improvement: The medical community says the optimum window for recovery from a brain injury is 18 months or so.

That same community also endorsed the use of leeches to suck out sickness, I can and will continue to improve.

I don’t make improvements as quickly and dramatically (dramatiquickly?) as I once did, but I’m certain that one day I’ll be able to do many of the things I once did (if not, at least I’ll look good as I fail 🙂 ).

So, not only is the being alive a nice part of waking up, but I also get to face each day with the possibility that I will finally (insert activity) again.

There you have it, folks! Having a TBI is no bueno, but there are some perks.





baclofen pump, brain injury, brain surgery, brainstem, cavernoma blog, cavernous angioma, living with tbi

Two B minuses = A+ and the Pain Refrain

Sorry for the delay, I basically holed up in my apartment for a week to study for the second A+ certification exam – I passed with another B-! Now that I’m A+ certified, I can get on with my summer. I did so by swimming the day away with my kid.

That said, I was inspired to write this after a friend commented on my poem about medication. She called me a “tough cookie” (mmm…tough…oh wait…). I thought to myself that ain’t nothin! At that very moment, I conceived an idea for a poem. My head, being so impregnated with rhyming verbage birthed the following verse –

Medical procedures can hurt,

Notably with all the needles doctors insert.

The following words list some of my pains;

but despite the the hurt, I’ve made many gains.

Early on I was bound to a wheelchair,

now I walk freely from here to there.

One of the most painful procedures that comes to mind,

is when some nurses couldn’t find a vein and had to do a mid line.

They stuck a needle deep into my arm,

they finally found a vein from which to farm…

…the blood needed to patch a hole in my spine,

after that I felt fine!

Until the day came to remove the staples from my belly incision;

you see, I got an implant for a direct baclofen infusion.

I felt a small sting when each staple came out,

it’s a good thing I had painkillers, so I didn’t have to pout.

I raised a pretty big stink when a nurse placed an IV,

she stuck me several times before leaving it in the band of my arm, you see.

Whenever I’d bend my arm, the needle would stab and poke;

The pain I felt was very real, it weren’t no joke!

Speaking of poke, I frequently get 10 or more injections of botox;

the injections go anywhere from my arm to the place where I wear socks.

This list is certainly missing a few ouchies;

give me a break! I’ve had brain surgery, geez!

brain injury, cavernoma blog, living with tbi

One Pair of Glasses to Rule Them All!

ITEM! I picked up my glasses with the prisms for double vision. I don’t really have double vision anymore, so when I wear them everything looks like it did when Frodo put on the ring in LOTR. A HUGE eye stares at me all the time, even when I’m in the bathroom – RUDE! I wonder if I’m invisible? Come to think of it, there’s a strange inscription on one of the arms/ear-pieces. ; I’ll just look a little closer. WHOA! It says “One pair of glasses to see real good, one pair to focus. One pair with prisms in them, don’t forget to pay us!” Actually, they somehow help. Not sure how, like all things I can’t explain it must be some sort of magic.

brain injury, brain surgery, cavernoma blog, cavernous angioma, living with tbi

Scary Stuff

It’s nearly the fourth anniversary to the day of when I went to the ER and a CT scan found a cavern in my mind. The very odd thing is that this past Friday – the very DAY I went to the ER (for the record: Day- Friday, date- May 22nd, year- that foul year of our Lord, 2009), I started experiencing double vision – not an initial bleed symptom for me, but has been for many (EXAMPLE). It was only a few weeks after the bleed and for a month or so onward that I saw two of everything.

All the more perplexing is the fact that I feel no other symptoms. I have an electrical feeling in my head every once in awhile – seems to me that if it were a bleed, it’d be non-stop pain that only gets worse.

I want to think it’s nothing, but what else could it be?

Expecting the worst, I’ve tried to spend as much time as I can with my daughter. I lost enough time with her the first…uhh, time. I got her the Skylanders: Giants starter pack for the Wii. We played that for most of the day yesterday – should’ve been playing it on Saturday, but the neurosurgeon on call at UTSW suggested I rest for the…uhh, rest of the day. I just can’t bear the thought of missing anymore time with her (that’s right, she’s a girl that LOVES Skylanders).

It turns out that my double vision might be the result of medication changes. Even if that’s the case, I’m taking this as a kick in the rear to love on my kid every chance I get, and to lighten up on myself. The silly stuff I write about with Taskmaster Jarrett can be funny, but it’s exhausting being so concerned about every single second. With that I offer this –

TBI is…Take a Breather before getting Inundated – Eventually, being productive became less about the quality of work I was producing and more about if I had started the task efficiently or if I had gotten enough done (quantity). It was only recently that I realized that I was more concerned about the number of things getting done and how fast, rather than taking a minute to make sure that I was happy with what I was doing.

That’s all for this week, I’ll make more jokes next week, promise.