Fatigue After Brain Injury: BrainLine Talks With Dr. Nathan Zasler

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“Fatigue is the single-most effect that has shaped my life.”

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Fatigue After Brain Injury: BrainLine Talks With Dr. Nathan Zasler

Victoria Tilney McDonough, BrainLine

From http://www.brainline.org/content/2010/02/fatigue-after-brain-injury-brainline-talks-with-dr-nathan-zasler_pageall.html

Tags: Fatigue, chronic fatigue, head injury, closed head injury, brain injury, effects of head/brain injury Dr Nathan Zasler, Brainline

MULTIMEDIA

BrainLine sat down with Dr. Nathan Zasler to talk about the issues of fatigue after a traumatic brain injury. Dr. Zasler is an internationally respected neuro-rehabilitation physician who specializes in brain injury.

BrainLine: Describe fatigue. What exactly is traumatic brain injury-related fatigue?

Dr. Zasler: Think about a car. It needs gas to run. If your tank is low, your car will start sputtering and then stop once you have reached the end of your reserve. It’s the same way with fatigue after TBI. Fatigue is caused by a decrease in physiological reserve, which includes a person’s physical and mental reserves. When your brain is “tapped out,” you feel tired. Basically, when a person’s brain is overtaxed, fatigue will set in.

Although one formal definition of fatigue that has been proposed states that it is the failure to initiate or sustain attention or physical activity that requires self-motivation, there continues to be debate about how best to define “fatigue.” In part, it’s difficult to define the term because fatigue is subjective — that is, it is solely based on patient report — and it is really more a symptom than a diagnosis. Just like it is difficult to tell if someone is in pain, it is also challenging to know if someone suffers from fatigue unless they tell you so. But generally, people with TBI have described fatigue as a sense of mental or physical tiredness, exhaustion, lack of energy, and/or low vitality. Unfortunately, we don’t have any definitive screening tools for fatigue, so there is no universal way to measure it.

Cognitive and physical fatigue can occur separately or together, but most people seem to have more problems with the mental side of fatigue after a brain injury. They say they are not as quick as they used to be, mental tasks that were once easy are much more difficult, and they tire far more easily even doing something that used to be simple like reading, studying, or working.

Although there are limited long-term studies, some research indicates that fatigue is usually short-lived after most mild TBIs. And in my experience as a physiatrist  (psychiatrist??), fatigue in patients with mild TBI usually lasts no longer than three to six months. However, for some people with mild TBI, their fatigue is more persistent.

BrainLine: How common is fatigue after a brain injury?

Dr. Zasler: In the general population, fatigue is a common complaint with some studies citing an incidence of 10 percent. But for people with traumatic brain injury, it is one of the most common problems post-injury. Fatigue affects not only people with moderate to severe TBI, but also those with mild TBI. And we still need more research to better understand this issue.

BrainLine: What does fatigue look like after TBI?

Dr. Zasler: The spectrum of fatigue is as broad as the spectrum of traumatic brain injury, itself. Everyone’s brain injury is different and everyone’s symptoms will be different. There are also many variables when it comes to post-TBI fatigue — from levels of severity to pervasiveness. Some people may be very fatigued all the time and others may only be fatigued after mental or physical exertion.

Most people who have fatigue resulting from brain injury only experience the problem at certain times and not all the time. They have more energy in the morning and tend to be more tired later in the day. People’s levels of fatigue also depend on how much they are pushing themselves physically or cognitively, and whether they are making time to rest periodically during the day and pace themselves.

Depression, anxiety, or stress can also contribute to the degree of a person’s fatigue or, alternatively, may even be the cause of the fatigue. Not everyone with a TBI will experience fatigue due to their brain injury. So, each person’s levels of fatigue, if present, may change over time during their recovery, in terms of both cause and level of severity.

BrainLine: Why do these problems occur?

Dr. Zasler: Unfortunately, we don’t really know. There have not been a lot of conclusive studies conducted on fatigue after brain injury. Much of what we are discussing is experiential. Some have theorized that damage to the basal ganglia — which are structures deep in the brain — are the critical areas involved in the generation of fatigue. Others have noted that other areas of the brain may be involved as well.

BrainLine: What kind of information should people with brain injury give their doctor to help the doctor better understand their issues with fatigue?

Dr. Zasler: This is a two-way street, of course. People should give their doctor as much information as they can and, in turn, the doctor needs to ask the right questions and get as full a picture of the symptoms and situation as possible.

First of all, it’s important to establish the cause of fatigue; it may not be a result of the traumatic brain injury. It could be something else, and those other potential causes should first be ruled out. Other common contributing factors for fatigue can include:

  • lack of regular and restorative sleep
  • psychiatric issues like depression or anxiety
  • chronic pain
  • chronic stress

There are also less common causes for fatigue that should also be ruled out. They can include:

  • seizure-related fatigue
  • hydrocephalus
  • hormonal abnormalities, like hypothyroidism
  • nutritional deficiencies such as low B12, anemia, or blood cancers (i.e., leukemia)
  • renal failure
  • hepatitis

All of these causes, common and less common, should be considered and then ruled out as the sole or contributing cause of a person’s fatigue before considering TBI as the cause.

Once other causes of fatigue are ruled out and the fatigue is found to be neuro-genic —related to the damage to the brain’s nerve cells — some of the topics and questions that need to be covered in the doctor’s evaluation include:

  • When did the symptoms of post-TBI fatigue start?
  • Did the onset of fatigue symptoms correlate with any other event such as starting a new medicine or getting depressed?
  • What helps make the fatigue go away, or decrease?
  • What aggravates it?
  • What triggers it?
  • In what ways are you fatigued physically, and when?
  • In what ways are you fatigued mentally, and when?
  • How is your sleep?
  • How is your mood?
  • Do you suffer from significant chronic pain?

The more information an individual or their family can provide, the more information a doctor has to make a precise diagnosis.

BrainLine: Can you explain why making sure you get a specific or accurate diagnosis is so important?

Dr. Zasler: With any medical issue, an incorrect diagnosis can set a person back in his recovery. It is important to make sure that you are seeing a clinician who is knowledgeable about traumatic brain injury. You can ask for references from other clinicians, from TBI organizations like your state’s Brain Injury Association, and from other patients. And you want a doctor with whom you feel secure, someone who is truly listening to you and asking questions.

Don’t be afraid to take your time in selecting a doctor. One thing that surprises me time and time again is that no one these days takes the initiative to interview potential doctors before making a selection. You can set up an appointment with a doctor you are considering to get a sense of his bedside manner, knowledge, and philosophy. When it comes to TBI, the patient/physician relationship may continue for many years, so choosing well is very important.

BrainLine: What can make fatigue worse?

Dr. Zasler: If you have neuro-genic fatigue — that is, fatigue related to the damage in the brain’s nerve cells — here are some things that can make the fatigue worse:

  • not using pacing strategies appropriately, like dividing work into “chunks,” and not getting overly fatigued by working to long at a given task
  • not getting regular, restorative sleep
  • not taking the necessary naps or getting the rest you need throughout the day
  • not getting proper exercise or nutrition
  • taking medications that have sedative properties
  • having too much stress in your daily life

These suggestions are basic common-sense guidelines that clinicians should apply to help people with fatigue after brain injury. After all, the more a person learns about how and when his fatigue manifests itself, the more he can schedule his day around his levels of energy and create strategies to keep symptoms at bay.

BrainLine: Are there related problems that often occur with fatigue after TBI?

Dr. Zasler: The main ones are depression, anxiety, and stress. These often go hand-in-hand with post-TBI fatigue; one can exacerbate the other.

BrainLine: What advice or strategies do you offer your patients who are struggling with fatigue after a brain injury?

Dr. Zasler: Once I’m pretty sure that the fatigue is related to the TBI, I emphasize basic strategies like:

  • getting good regular, restorative sleep
  • making sure to get rest when you need it, not after you have become overly tired, stressed, depressed, or in pain
  • breaking activities into several steps through scheduling activities, “chunking” (that is grouping certain activities together) and pacing exercising
  • eating nutritious foods
  • asking for help when needed

BrainLine: What about medications for fatigue?

Dr. Zasler: Medications can sometimes be quite effective. There are different medications that range from more mild, pro-arousal agents like Provigil or Nuvigil to other non-stimulant agents like atomoxetine (Strattera). In the most resistant cases, traditional psychostimulants like methylphenidate or dextroamphetamine can also be considered. In general, drugs are not what should be tried first. They are something to consider for people who don’t seem to be improving with their TBI-related fatigue or when their fatigue is very functionally disabling. The potential for keeping people on long-term drug treatment is certainly present, although to my knowledge this has not been studied in persons with TBI and fatigue. We need more research in this area to determine which drugs might be effective, and for whom.

For a list of current research on fatigue, click here.


Nathan D. Zasler, MD, FAAPM&R, FAADEP, DAAPM, CBIST
Dr. Zasler is an internationally respected physician specialist in brain injury care and rehabilitation. He is CEO and medical director of the Concussion Care Centre of Virginia, an outpatient neuro-rehabilitation practice, as well as Tree of Life, a living assistance and transitional neuro-rehabilitation program for persons with brain injury in Glen Allen, Virginia.

He is board certified in physical medicine and rehabilitation (PM&R) and fellowship trained in brain injury. Dr. Zasler is a clinical professor of PM&R at Virginia Commonwealth University in Richmond, Virginia, as well as a clinical associate professor of PM&R at the University of Virginia in Charlottesville, Virginia. He is a fellow of the American Academy of Disability Evaluating Physicians and a diplomate of the American Academy of Pain Management. His main areas of clinical and research interest include neuro-medical issues in acquired brain injury (particularly mild TBI, neuro-psychopharmacology, and low level neurologic states), differential diagnosis in acquired brain injury community-based care issues, and chronic pain rehabilitation, including headache.

Dr. Zasler is a practicing clinician who is involved with community-based neuro-rehabilitation and neuro-medical assessment and management of persons with brain injury, neuro-disabililty, and chronic pain.

 www.tree-of-life.com.
BrainLine


Nathan D. Zasler, MD, FAAPM&R, FAADEP, DAAPM, CBIST is an internationally respected physician specialist in brain injury care and rehabilitation. He is CEO and Medical Director of the Concussion Care Centre of Virginia, an outpatient neuro-rehabilitation practice, as well as, Tree of Life, a living assistance and transitional neuro-rehabilitation program for persons with brain injury in Glen Allen, Virginia. He is board certified in Physical Medicine and Rehabilitation and fellowship trained in brain injury. Dr. Zasler is a Clinical Professor of PM&R at VCU in Richmond, Virginia, as well as a Clinical Associate Professor of PM&R at the University of Virginia, Charlottesville, Virginia. He also serves as a consultant in neuro-rehabilitation to the Northeast Center for Special Care in New York. He is a fellow of the American Academy of Disability Evaluating Physicians, and a diplomate of the American Academy of Pain Management. Dr. Zasler is a practicing clinician who is involved with community-based neuro-rehabilitation and neuro-medical assessment and management of persons with brain injury, neuro-disabililty, as well as chronic pain.

www.tree-of-life.com.


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Specifically, with regards to medical issues, always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the Web Site. If you think you may have a medical emergency, call your doctor or 911 immediately. The Web Site does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Web Site. Reliance on any information provided by the Web Site or by employees, volunteers or contractors or others associated with the Web Site and/or other visitors to the Web Site is solely at your own risk.

From  http://www.brainline.org/content/2010/02/fatigue-after-brain-injury-brainline-talks-with-dr-nathan-zasler_pageall.html

Submitter’s Note:

I suffered a severe closed head injury as a  boy (age 15) and was in a coma for a LONG time. Subsequently chronic fatigue has shaped my entire life, however have learned to “work around it” and develop my own strategies to cope (mostly sub-consciously*). As a result I’m now a writer and am sharing this excellent  article by Dr Zasler at 5am (my “little window of opportunity…and getting smaller by the day”, as dear M calls it).  Early morning after rest is by far my best time for concentration… and  then I gradually slow down for the rest of the day

If these articles help anybody in the sometimes very difficult, yet always amazing  journey of life, then I’m very happy.

“We share what we know so that we all may grow.”

* that’s yet another story!

Don’t worry about the world ending today…

it’s already tomorrow in “the little scenic and tranquil haven” that is New Zealand (or “Godzone” as it is sometimes affectionately known)

darkness tunnel

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About craig lock

About the Author Craig has a 'passion' for writing books that tell stories about people doing positive things in this often so hard, sometimes unkind world, occasionally cruel, yet always amazing world - true stories that leave the reader feeling uplifted, empowered and hopefully even inspired. https://www.createspace.com/3779691/ and http://www.amazon.com/-/e/B005GGMAW4 Craig Lock loves to encourage and empower people to be the best they can possibly be, and to create what they want in life. Craig has learnt plenty from the "school of life" (still "battered and bruised") and also from a few "hard knocks on the head". He is an extensive world traveller (on a "shoestring budget") and failed professional emigrater who has spent most of his lifes savings on airfares. He is still sliding down the razor blade of life on the beautiful undiscovered island that is New Zealand, somewhere near the bottom (rude!) of the world near Antarctica. There he talks to the 60 million sheep! Craig has been involved in the corporate world (life assurance) for over twenty years in South Africa, Australia and New Zealand. However, through a strange set of circumstances and finding himself in a small town near the bottom of the world ...and with nothing else to do, he started writing. That was five years ago. Five published books later and having written another twenty manuscripts (on widely differing subjects - well what else is there to do here?)... this is where Craig is in the "journey/adventure" that is life. Craig has taught at the local Polytechnic, as well as running a successful creative writing course (not teaching sheep!). He was the author of (as far as we know) the first creative writing course on the internet Craig has many varied interests and passions. He is particularly interested in the field of psychology – studying the human mind and what makes different people "tick-tock grandfather clock". He is fascinated by the "overlap between psychology and the dimension of spirituality". One of his missions in life is helping people make the most of their hidden potential and so finding their niche in life... so that they are happy. Craig’s various books probably tell more about his rather "eventful" life best (no one could believe it!). He writes books with serious messages and themes, then as a contrast "rather crazy, wacky stuff"…to keep him sane here. As an ‘anonymouse’ person wrote: "All of us are born mad; some of us remain so." Well nothing else much happens in quiet provincial New Zealand, other than headlines like "Golf Ball Thrown at Policeman" (it missed, btw!) and "Beach Toilet Closed for Season." True! The various books* that Craig “felt inspired to write” are available at ebooks (digital books) http://www.amazon.com/-/e/B005GGMAW4 http://www.amazon.com/s/ref=la_B005GGMAW4_sr?rh=i%3Abooks&field-author=Craig+Lock Paperbacks (see https://goldendawnpublishing.wordpress.com/2016/12/20/paperback-writer/ and https://wanttowriteabook.wordpress.com/2013/06/07/paperback-writer-the-beatles/ https://www.createspace.com/pub/simplesitesearch.search.do?sitesearch_query=%22craig+lock%22&sitesearch_type=STORE https://www.amazon.com/Craig-Lock/e/B005GGMAW4/ref=pe_584750_33951330_sr_tc_2_0?qid=1476388259&sr=1-2-ent http://www.creativekiwis.com/index.php/books and http://goo.gl/vTpjk All proceeds go to needy and underprivileged children – MINE! “When the writer is no more , the value of your purchase will soar! “ “Together, one mind, one life (one small step at a time), let’s see how many people (and lives) we can encourage, impact, empower, enrich, uplift and perhaps even inspire to reach their fullest potentials…and strive for and perhaps one sunny day even achieve their wildest dreams.” PPS Don’t worry about the world ending today… as it’s already tomorrow in scenic and tranquil ‘little’ New Zealand
This entry was posted in brain injury, closed head injury, fatigue, Head (brain injury), head injury, head injury and fatigue and tagged , , , , , , . Bookmark the permalink.

27 Responses to Fatigue After Brain Injury: BrainLine Talks With Dr. Nathan Zasler

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  3. craiglock says:

    Thanks for the follow/link/like

    CAN’T KEEP UP…BUT THANKS FOR THE “THANX”
    MANY MORE COMMENTS OVERNIGHT and many hundreds of thousands already on my various other blogs at http://craigsblogs.wordpress.com/2013/09/28/craigs-blogs-and-writings/…true!) …obsessive or WHAT! *So hope it’s not slowing down your loading speed!). Am really pleased you are enjoying my writings, as the reason I write is to share.
    So sorry can’t reply individually to all you good people scattered around the planet, but DO try to read as many as possible daily (and even moderate a few when I get a “mo”),

    * “Don’t bend; don’t water it down; don’t try to make it logical; don’t edit your own soul according to the fashion. Rather, follow your most intense obsessions mercilessly.”

    ~ Franz Kafka

    I do really appreciate your liking, linking to and/or following this blog (and “writing in”), so “thanks for the thanx”

    “As we live and move and have our being, so from this vision, we create heaven in our own lives… and perhaps even heaven on earth.”
    – craig (as inspired by Acts 17:28 and the words of Felicia Searcy)

    “Aim at the earth and you may not get off the ground.a
    “Aim at the stars and you may reach the moon.”
    “Aim at heaven and you’ll have earth thrown in…
    and you may even hit the stars.”
    – craig (as inspired by the famous quote by CS Lewis – 24th May 2012)

    “When once you have tasted flight, you will forever walk the earth with your eyes turned skyward, for there you have been, and there you will always long to return.”
    – Leonardo da Vinci

    When (or if ever) you arrive in heaven, let faith, hope and love be the wings that carried you there.”

    – as adapted from the inspiring words of Jonathan Edwards, former minister in New England, Massachusetts

    “The Greatest Race: Living by (with) faith, hope and love is the highest podium any person can reach, God’s podium that anyone stand on.”
    – c

    from http://www.sharefaith.wordpress.com

    “Having pursued the goals, the dreams set before us and run the race with persistence and endurance, after giving it all. Then one day standing on the summit of life, breathing in the pure sweet oxygen of achievement, totally satisfied in running the greatest race, the race of life one that ANYONE can run and win.”

    from http://racetothechequeredflag.wordpress.com/ and http://www.godandformula1.wordpress.com

    “If a man is called to be a street-sweeper,
    he should sweep streets even as Michelangelo painted,
    or Beethoven composed music, or
    Shakespeare wrote poetry.
    He should sweep streets so well
    that all the hosts of heaven and earth will pause to say,
    here lived a great street sweeper
    who did his job well.”
    – Dr Martin Luther King, Jr.

    PPS
    Instead of trying to reply to each one of you, I’ll just keep on writing

    “If the doctor told me I had six minutes to live, I’d type a little faster.”

    The various books* that Craig “felt inspired to write” are available at http://www.amazon.com/-/e/B005GGMAW4

    http://www.amazon.com/s/ref=la_B005GGMAW4_sr?rh=i%3Abooks&field-author=Craig+Lock
    https://www.createspace.com/pub/simplesitesearch.search.do?sitesearch_query=%22craig+lock%22&sitesearch_type=STORE

    http://www.creativekiwis.com/index.php/books and http://goo.gl/vTpjk

    All proceeds go to needy and underprivileged children –
    MINE!

    Don’t worry about the world ending today…
    as it’s already tomorrow in scenic and tranquil ‘little’ New Zealand
    ”Since I can never see your face,
    And never shake you by the hand,
    I send my soul through time and space
    To greet you. You will understand.”

    – James Elroy Flecker (1884-1915)

    Like

  4. craiglock says:

    Reblogged this on Living With Head (Brain) Injury.

    Thanks for the follow/link/like/reblog/comment and/or kind thought(s)

    from
    https://drive.google.com/file/d/0BxslrCi5v2WzMnFoX2tfMVYzMjA/view?usp=sharing

    and

    https://drive.google.com/file/d/0BxslrCi5v2WzMnFoX2tfMVYzMjA/view?ts=58cc29feHi

    This is craig and this is a quick word of sincere thanks to you ALL. I came

    across the following post from international best-selling author, Bryant

    McGill on his Facebook page, which I felt “inspired” to share. Brant’s

    writing summed up/put these thoughts far better than “lazy-bones” I ever

    could have done, so am sharing these beautifully-written and heart-felt

    sentiments in the same spirit (through copy and paste ( CONTROL C AND

    V)

    Personalized, “adapted” and abbreviated (edited) from

    https://www.facebook.com/bryantmcgill/

    Thanks (sincerely) for “the borrow” Bryant.

    “Be bold and unseen forces come to one’s aid”

    This is a personal message to ALL you good people around the world, who

    follow my various blog pages and posts and read and comment my various

    writings on WordPress and in my books. I want you to know that I really

    appreciate all of you. I would love to respond to nearly every comment. I

    can’t do that; however I do care that you take the time to read (and absorb)

    what I’ve written and may even have commented. I do read as many

    comments on my 200 + blogs as I can, but probably have missed countless

    thoughts of yours, so have not replied. Sorry and thanks for the

    understanding.

    “Just as you grow and learn, I am also growing and learning from you

    all…and really like people to THINK.”

    I just felt compelled to let you know that I really appreciate you for reading

    and perhaps following my various writings. Never think for a moment, that

    just because I don’t respond to comments or messages that I am not paying

    attention. I am paying attention and I am grateful.

    I am a full-time writer, which means you are a very important part of my life.

    I wish all of you the freedom, respect and happiness you each deserve. Thank

    you all for being a part of my life. Your presence, feedback and contribution

    “out there in cyberspace” has added immeasurable to my ‘little’ life here in

    “isolated and far-off Sleepy Hollow”, near the bottom of the world and

    through the medium of the net we can be and remain connected in spirit.

    craig

    and see

    To every underdog with a dream

    Bryant McGill of SimpleReminders.com

    http://www.simplereminders.com

    for Bryant’s full message see https://www.facebook.com/bryantmcgill/

    Best wishes from the First City to see the light

    “Together, one mind, one life (one small step at a time), let’s see how many people (and

    lives) we can encourage, impact, empower, enrich, uplift and perhaps even inspire to

    reach their fullest potentials…and strive for and perhaps one sunny day even achieve their

    wildest dreams.”

    “Together, one mind, one heart, one life, one small step at a time, let’s

    inspire the world.”

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  11. craiglock says:

    THANKS FOR THE COMMENT

    Thanks and pleased you like it, as the reason I write is to share.

    With the volume of comments, I’m receiving daily on this blog, only a few of the BEST comments can be approved daily. Thanks for the understanding.

    Regards c

    PS

    for answers to questions see
    https://headbraininjury.wordpress.com/2016/02/26/questions-and-answers/

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      Thanks , but with hundreds of blogs and over 200 books written, together with my very limited cognitive energy, I’m already pushing myself to my absolute limits trying to keep up. Anyway my books and not my blogs put food on the table!
      Regards
      c

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  19. Pingback: Managing Fatigue after TBI – Traumatic Brain Injury (TBI

  20. Pingback: Neurofatigue – Traumatic Brain Injury (TBI

  21. Pingback: Traumatic Brain Injury: Understanding Fatigue | Living with Head/Brain Injury (TBI)

  22. craig lock says:

    Thanks for the comment/follow/link/like/reblog and/or kind thought(s)

    (but if you are following me, my close friends say it would be far more entertaining with a video-camera*!)

    * By the way, do they still make them in today’s ever-faster changing world..or is it all done with mobile phones?

    “total non-techno” c (who doesn’t possess a mobile phone, after a rather eventful’ experience some years back, whilst trying to walk and talk at the same time )

    Men…Some Mothers Do ‘Ave ‘Em!

    Thanks for the follow/link/like/reblog/comment and/or kind thought(s))

    Hi

    CAN’T KEEP UP…BUT THANKS FOR THE “THANX”

    I’ve had many many hundreds of thousands (“zillions”) of comments on my various other WordPress blogs at https://craigsblogs.wordpress.com/2011/09/09/craigs-list-of-blogs-updated-sept-2011/
    in recent years …true!) …a few of my blogs went “balistically viral” a few years back.

    Obsessive or WHAT! Am really pleased you are enjoying my writings, as the reason I write is to share. However I am unable to keep up with the comments and was spending entire days just on replies on my various blog pages.

    Though I’m rather “driven”, I still get really, really fatigued (there’s a few books there). so sorry can’t reply individually to all you good people scattered around the planet, but DO try to read as many as possible daily (and even moderate a few when I get a “mo”), I got swamped with comments on my various blogs, so have had to close them off on all of my blogs, except for one or two of particular interest to me

    see
    http://www.headbraininjury.wordpress.com

    http://www.traumaticbraininjurytbi.wordpress.com

    https://headinjurytbi.wordpress.com/

    https://livingwithheadinjury.wordpress.com/

    http://www.livingwithheadbraininjury.wordpress.com

    https://thenurseanewbook.wordpress.com

    and

    https://anoneextraordinarylife.wordpress.com/

    and my friend’s blog at http://www.brainheadinjury.wordpresss.com

    Sorry and hope you can understand.

    * “Don’t bend; don’t water it down; don’t try to make it logical; don’t edit your own soul according to the fashion. Rather, follow your most intense obsessions mercilessly.”

    ~ Franz Kafka

    I do really appreciate your liking, linking to and/or following this blog (and “writing in”), so “thanks for the thanx”

    “As we live and move and have our being, so from this vision, we create heaven in our own lives… and perhaps even heaven on earth.”
    – craig (as inspired by Acts 17:28 and the words of Felicia Searcy)

    “Aim at the earth and you may not get off the ground.a
    “Aim at the stars and you may reach the moon.”
    “Aim at heaven and you’ll have earth thrown in…
    and you may even hit the stars.”
    – craig (as inspired by the famous quote by CS Lewis – 24th May 2012)

    “When once you have tasted flight, you will forever walk the earth with your eyes turned skyward, for there you have been, and there you will always long to return.”
    – Leonardo da Vinci

    When (or if ever) you arrive in heaven, let faith, hope and love be the wings that carried you there.”

    – as adapted from the inspiring words of Jonathan Edwards, former minister in New England, Massachusetts

    “The Greatest Race: Living by (with) faith, hope and love is the highest podium any person can reach, God’s podium that anyone stand on.”
    – c

    “Having pursued the goals, the dreams set before us and run the race with persistence and endurance, after giving it all. Then one day standing on the summit of life, breathing in the pure sweet oxygen of achievement, totally satisfied in running the greatest race, the race of life one that ANYONE can run and win.”

    from http://racetothechequeredflag.wordpress.com/
    and http://www.godandformula1.wordpress.com

    “If a man is called to be a street-sweeper,
    he should sweep streets even as Michelangelo painted,
    or Beethoven composed music, or
    Shakespeare wrote poetry.
    He should sweep streets so well
    that all the hosts of heaven and earth will pause to say,
    here lived a great street sweeper
    who did his job well.”
    – Dr Martin Luther King, Jr.

    PPS
    Instead of trying to reply to each one of you, I’ll just keep on writing

    “If the doctor told me I had six minutes to live, I’d type a little faster.”

    The various books* that Craig “felt inspired to write” are available at http://www.amazon.com/-/e/B005GGMAW4

    https://www.amazon.com/Craig-Lock/e/B005GGMAW4/ref=pe_584750_33951330_sr_tc_2_0?qid=1476388259&sr=1-2-ent

    http://www.amazon.co.uk/-/e/B005GGMAW4

    http://www.amazon.com/s/ref=la_B005GGMAW4_sr?rh=i%3Abooks&field-author=Craig+Lock

    https://www.createspace.com/pub/simplesitesearch.search.do?sitesearch_query=%22craig+lock%22&sitesearch_type=STORE

    http://www.creativekiwis.com/index.php/books

    and http://goo.gl/vTpjk

    All proceeds go to needy and underprivileged children –
    MINE!

    “When the writer is no more , the value of your purchase will soar! ”

    Don’t worry about the world ending today…
    as it’s already tomorrow in scenic and tranquil ‘little’ New Zealand

    PPS

    “I wish you well on a rainy day
    I wish you rainbows to brighten your day
    To feel your quiet moments with a special kind of warmth
    to remind you that happiness can happen
    when you least expect it.

    I wish you rainbows to make you laugh and smile
    to show you the simple beauty of life
    and to give you the magic of dreams come true.

    I wish you rainbows
    I wish you well.”

    – Larry S. Chengges

    ”Since I can never see your face,
    And never shake you by the hand,
    I send my soul through time and space
    To greet you. You will understand.”

    – James Elroy Flecker (1884-1915)

    Like

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