Maxwell Mania: Sarah Maxwell's Recovery and New Car!

 Hello!

Back in early February, Sarah Maxwell explained that she had been posting less than usual because she was recovering from a concussion she got while exercising at home.   She had been doing back extensions, overshot when returning to the initial starting position and smacked her head hard on a post.  Her description of a concussion brought back lots of memories for me.

Back in November of 2015, I was in a car accident on my way home from my graduate school program. I was driving north on a busy two-lane road and stopped on a bridge across the Grand River while wondering if the powers that be would ever widen the next intersection to include a left-turn lane with designated traffic pattern because traffic always backed up like this during the evening commute.   I had stopped a bit tighter than I liked to the truck in front of me because I had came up on the stopped traffic suddenly and I looked in my rear-view mirror to see that whoever was behind me was going to stop.  

What I saw was a 3/4 ton or 1 ton red pickup around 0.2 miles behind me going the normal speed of 60 miles per hour.   The driver was looking in his rearview mirror and had not seen the slowdown.   I honked my horn to try and get his attention.   It didn't work - so I prepared for an accident.  I made sure my wheels were dead straight.  I didn't want to hit the truck in front of me - but that was a much less risky option than being pushed to the left into oncoming traffic or to the right into the Grand River.   I took a half-a-second to make sure my seatbelt was low on my hips with the chest restraint in the right spot since I'm short and the belt always seems to be moving on me. I brace my arms against the steering wheel since I'd prefer an arm injury over a head injury.

I looked up to see the driver of the truck realize that he was going to hit me and slam on the brakes, but his reaction was far too late to slow the truck down. I closed my eyes.   I prayed fervently that the accident wouldn't hurt on impact - I'm a wuss about acute pain - and tried to relax my muscles as much as possible.

I was amazed and relieved when the accident didn't hurt at all.  The shoulder restraint caught my torso long before I got near the steering wheel and the car seat was surprisingly soft when it stopped my acceleration backwards.   My car had been shoved forward a few feet by the impact, but my brakes had held and I didn't hit the truck in front of me.   My car was still running and I was able to move it out of the way of traffic.  

In the immediate aftermath, I felt fine.   The accident took place in a slightly more populated rural area of a rural county so we had to wait a half an hour for an available officer to drive in from nearly the other end of the county.    I was decidedly jittery - but no pain or any signs of a concussion.  In one of those strange coincidences, my brother-in-law drove one of the family's cattle trucks by the accident soon after it happened so he called my husband immediately and my husband got to the scene before the officer did.   My husband agrees that I was acting like myself with no signs of a concussion.    

We reported the accident.  I drove the car to our standard auto body shop where my husband who had followed me picked me up..  My car was less maneuverable than I had expected from what I had classed in my head as a "minor" accident - but I wasn't planning on driving it again until it was checked out.  It turned out my car was totaled; the chassis had broken in multiple places and the mechanic was surprised/horrified that I had driven it 10 miles after the accident.  

I was starting to feel a bit off by the time we got home.  I chalked it up to nerves, fading adrenaline and a long day so I laid down and took a nap.   I got up in the evening and started trying to finish my proposal PowerPoint presentation I was going to make to my committee the following week.   I was struggling to summarize each paper.  I kept looking at my notes and the original papers - but I was making a mess of the PowerPoint.     I figured that this was not a great night to work on that, figured I'd be better in the morning and went to bed.

As the night went on, I alternated between wake and sleep - and was showing more signs of a concussion that I was too addled to figure out.   I couldn't remember the order I was meeting with my committee members the next day at first and lost the times I was meeting with people later.   I got up to take some Motrin for the headache that was bothering me and couldn't remember what the bottle looked like.   I read the bottles - and couldn't remember if I needed acetaminophen or ibuprofen.  I think one of the bottles said something like "Compare the active ingredients to Motrin" so I took that one.    I really wished I had an anti-nausea drug because my stomach was upset, too.

By the time my husband woke up at 7:30 that next morning, I was struggling to string sentences together and really dizzy.   He loaded me up in his truck and took me the nearest urgent care.   The receptionist listened to me struggle to answer questions like "What is your name?" and "What brings you hear today?" and went directly to the triage nurse who got a doctor ASAP.  (My husband could hear all of that while he was steering me towards the reception room. )

The doctor recognized that I had a blown pupil on my left side and recommended that my husband take me to one of the two emergency rooms that were a 5 to 7 minute drive away for an MRI or CAT scan to rule out a brain bleed.   I remember the doctor saying something about an ambulance vs. my husband driving me and I knew he was telling us one to be safe - but was softly recommending the other - and I couldn't figure out which one was which.   I decided that I'd just ask my husband to make the decision and my husband told me that we were going in his truck.   When I asked him about  it a few months later, he said that the doctor said that they could arrange ambulance transport if we preferred - but we'd get there much, much faster if he transported me himself. 

We went to the ER.  I was moved into a room quickly.  Doctors did a neurological exam and sent me back to get some imaging done.  My brain looked great - which is pretty standard for a concussion so they loaded me up with some anti-nausea meds and sent me home with instructions on how to gently add more activities and how to know when to back off on activities.

The next few months were rough.   At first, I was exhausted and nauseated.  My speech was slow and halting.  I couldn't read without feeling horrible.  Doing basic chores like unloading the dishwasher took 3-5x as long as normal - and I could only do one thing before needing a nap or I'd get waves of nausea.

The first activity I added back was walking.  I figured the last thing I needed was a bout of depression or anxiety and I knew my legs would start cramping if I didn't exercise so I started with very slow, gentle walks preceded and followed by naps.   

I had my husband set my Kindle font much larger than normal and load some easy reading books at junior high Lexile levels so I'd be able to read to relax again.   

I took up sewing and crocheting in earnest.  My procedural memories were still working fine so I could whip out a cloth diaper for my soon-to-be born nephew or crochet a baby hat even if I couldn't work out the math for what size I should cut the cloth.

I remember the first time I cooked a meal after the accident.  I chose a super-easy one pot meal  where I needed to make a box of couscous, add a can of drained tomatoes and top with sliced pre-cooked sausage.  That's an meal I've made while cooking another meal and cleaning the kitchen all at once; just doing that single, easy meal made me feel like I'd run a marathon.

I remember I could handle talking on the phone far better than reading, writing or watching TV - which came in handy while dealing with all of the appointments that came from the head injury.  I remember the rather freaked out expressions on my professors' faces when super-slow, halting speech Mel came into to school to fill out some paperwork to get a medical withdrawal.  I remember getting completely confused, disoriented and scared on my first trip to a slow grocery store on a weekday morning; I couldn't process all of the stimuli.

The accident was in early November.  The soonest I could get in at the regional concussion clinic was mid-January.     The timeline of when I was able to do different things is fuzzy - but by January, I was able to read and write again as well as talk on basic topics without noticeable impairment - and the headaches, nausea and fatigue were gone.  The part that was killing me was waiting until I could perform at the academic level I was used to - and the slow process of learning to drive again.   

I re-learned to drive by taking my husband's pick-up truck around the local roads at night.  My most vivid memory of that is having to figure out which lights I could see mattered because they were headlights compared to lights that didn't matter because they were street-lights.   The most bizarre thing about the concussion was that my procedural memories were all intact even though my declarative memories were shot.   In other words,  I had no problem getting into a truck, starting the engine or driving the truck - the only thing I struggled on was processing what I was seeing and what that meant.

The concussion clinic was anti-climatic.  I was given a short battery of very basic memory tests - the type where the proctor tells you three common words and sees if you can remember them a few minutes later - and a slightly more challenging processing test.   I passed both with flying colors and was pronounced to be functioning at the expected level for a 34 year old woman.  I remember saying something like "but I'm nowhere near functioning like the 34 year old woman I was before the accident" to the doctor who went over the results.   She was sympathetic - but said that the fact that I had healed as far as I had meant that my other skills would return given more time.  She compared it to how healing would look different from a desk worker compared to a professional athlete after a bad leg injury; the desk worker would be able to use their leg for their job much sooner than the athlete - but that's because the athlete is asking the leg to do a whole lot more than the desk worker.

The clinician was right.  I was able to start reading academic history books again within the next month, could make decent notes on education journals by February and was pretty much at my previous level by early March.  

That's a four month recovery from someone with a known history of brain damage due to prematurity. 

 Needless to say, I was freaked out when Sarah Maxwell disclosed that she was having headaches and nausea some days six months after her concussion - and had a major relapse when she smacked her head on some cabinets.  (Ouch!  Been there; done that; no relapse, though.)   I was really worried that her doctor told her that her self-care regimen was fine and was working a bit on the headaches.

Thankfully, in her most recent post, Sarah said that the doctor pretty quickly let her know it was time to see a specialist.   My family doctor got me signed up ASAP - but my family doctor is in the same hospital network as Mary Free Bed - a really good inpatient/outpatient rehab hospital that houses the Concussion Clinic.  Sarah had a 5 week therapy and medicine regime with them and seems to be doing really well now.  

Ironically, I had been wondering about how credit scores for stay-at-home daughters work.  It's not unheard of for someone who is 25 to not have much of a credit history - but Sarah is 39.   Most of us have at least a car loan or a student loan or two we paid off by that age.   By Sarah's age, a lot of middle class families have a mortgage as well.     

As I was thinking about that, I realized the biggest hurdle isn't the part-time, family based employment for the Maxwell daughters. 

No, the issue is their father's obsession with living completely debt-free - even though he admits that he was unable to do that in "Buying A House Debt-Free: Equipping Your Sons."

That line of thought smacked firmly into the fact that Maxwell's unmarried daughters have been sharing the family car.  Notice that Sarah refers to the family car in the singular tense - there's only one for Steven, Terri, Sarah, Anna and Mary to use.   

Now, the Maxwells will tell you that the girls don't have cars because they don't need one -  but that's highly unlikely.   Leavenworth, Kansas is not known for their public transportation options and the Maxwell's neighborhood looks to be residential without any commercial buildings in easy walking distance.

More honestly, the Maxwell parents raised their daughters to be minimally employed and unable to socialize with peers due to excessive sheltering and fear of being attacked or seduced.   Those traits will make it seem like their adult daughters don't need cars - but the lack of independent mobility also works to keep their daughters infantilized by adding complications to finding outside work and forcing their daughters to justify all social outings to their parents.  

I'm glad that Sarah Maxwell got her very own car.  That's a first step towards adulthood and a small step towards more freedom from her enmeshed family.