Traumatic Brain Injury at the Intersection of Entrepreneurship: Kelly Tuttle

This is the Chris Project, where we discuss mental wellness, self-awareness, and mindset with entrepreneurs and experts. Set your perceived ideas and biases aside and let's go on our journey for yourself, for your family, for the world.

Welcome to another episode of The Chris Project. I am your host, Christian Brim. Joining me today, Kelly Tuttle. Kelly, welcome to the program.

Thank you for having me, Christian. I'm happy to be here.

Well, I'm eager to hear your story. You are an entrepreneur, as we discussed in the green room, but it sounds like you have some other experience besides entrepreneurial that might be of benefit to our listeners. So let's start with that. Tell us, tell us about your experience with TBI.

So my story starts with a thunderous clap of metal and the shattering of glass, and people coming out of their homes to see what has happened. And I was driving home from work and another driver pulled out in front of me on a rural road and I was unable to stop in time before my car collided into their car. And it was a bad crash. My car was totaled, airbags were deployed, but I thought, I can shake this off and get back into life. At the time, I was a mother of young children and the main income earner and benefit earner in my family. And so I went to work the next day, and my colleagues, who are registered nurses and nurse practitioners— I was a cardiology nurse practitioner at the time— noticed that I wasn't getting my words out right, that I wasn't acting right. And so they implored that I see my general practitioner the next day, which I did.

Pause for a second. So you had no recovery period? You just had the accident one day and went back the next day? Okay. All right.

Yes, it goes with my personality at the time. And so I went and saw my general practitioner. She recognized I had a concussion. She took me off work for 2 weeks. And I left thinking I'd be better. So I went back to work, went back to life. I was pretty miserable, you know, headaches, irritability, fatigue, neck pain from the whiplash. But I just pushed through because that's what I was always raised to do. You just pull yourself up by your bootstraps and you push through and you meet your commitments. No matter what. And I actually fell asleep at the wheel 2 months, 2 to 3 months later.

Were you nodding?

Uh, no, I was sleeping. I was sleeping a lot. And I ended up slamming on my brake and preventing my car from slamming into a tree. And this is how my brain was working at the time. I decided instead of letting my doctor know that I fell asleep at the wheel, I would just take a nap in my car in between work and home on the side of the road.

That was a solution.

Yes. Not the best, not one I would recommend for sure. And I fortunately had lunch shortly after that with a colleague who was at the time a neurology nurse practitioner. So she was curious about my recovery and asked me, you know, how it was going. And I said I still had a lot of symptoms, but that I fell asleep at the wheel, but it's okay. I'm taking this nap on the side of the road. And she's like, no, that is not okay. You need to see a physical medicine rehab doctor. You need to get a brain scan. And I hadn't had any of this before. So after jumping through a lot of hoops with my health insurance, I finally got that referral to the physical medicine rehab doctor.

Okay, I'm going to pause for a second. This is not necessarily germane to the conversation, but I am curious. You were in an auto accident that someone else caused and you had these medical complications, why was their insurance not paying for it? Why was there not like an ambulance chaser— sorry, personal injury lawyer— at your door saying, let's go, you know, recover for your pain and suffering?

Well, that's a really great question. What I had found was my insurance company told me they didn't have time they were based in Texas, to call a doctor in California to get the information. And when I realized that I was on my own, because I was afraid of being stuck with a huge medical bill— I work in healthcare, so I know that the bills that, uh, the care that my insurance company was paying for was supposed to be paid by a third party, right? And so I'd fortunately, you know, wanting to get better as fast as possible, I'd read several— not read, but listened to and skimmed through a few traumatic brain injury recovery books. And all three of the books said, if you think you should, you need a lawyer, hire a lawyer. And when my insurance, when my car insurance company told me that, I got onto, fortunately, the Brain Injury Association of America's website, BIA.org, I believe it is, and they had a list of lawyers. I called a lawyer in New York who referred me back to a lawyer in California. And that's when really some drastic steps were taken into my recovery because my lawyer knew about a specialist outside my health insurance. Now remember, my health insurance just told me, just go home, rest, and you'll get better. And when I went back—

Don't get me started on insurance companies.

I know. And then when I went back and said, I'm not better, they referred me to mental health. Mm-hmm. And the mental health counselor said, no, your symptoms are related to your concussion. You need to go back to the doctor. I mean, this is terrible. And so I just was not getting the care from my insurance company or my doctor. And this lawyer made these referrals, and I started learning more about my injury and getting better. And at one point my husband said, you know, it's terrible to say, but your lawyer cares more more about you recovering than your doctor.

Money is a hell of an incentive. Yes. I mean, I don't say that flippantly. Like, everybody complains about— I even called them ambulance chasers. But, you know, the reality is, is that they serve a purpose. And, you know, the fact that they're monetarily incentivized is not necessarily a bad thing.

Yes. And, you know, these type of lawyers that, So you— if you were to hire a lawyer after a car accident, you want to get one who specializes in traumatic brain injuries. And these people, they attend seminars and education related to brain injury recovery and treatment, and so they are really on top of the knowledge related to brain injury care as opposed to a general practitioner-type doctor. Sure. Um, but yeah, so if this happens to any of your listeners, definitely go to the Brain Injury Association of America website, find a lawyer, because they list lawyers that specialize in traumatic brain injury.

So you got hooked up with some specialists. Uh, it's not necessarily important to the story, it's probably very important to you. Did you recover your— financially from the, the person responsible?

I did. I did recover my medical expenses and so forth and lost wages.

Good. Okay, so did any of this injury recovery, etc., uh, lead you to entrepreneurship, leading you to— I, I'm— I don't, you know, being an author, podcast host, etc.

Yes. So when it was— so when I saw that physical medicine rehab doctor, she took me off work for 3 months too so I could focus on my recovery. And she sent me to several therapists— speech therapy, physical therapy, neurotherapy. And when it was time for me to go back to work, the 2 weeks prior, I was freaking out because because I was like, I don't know what my brain needs to support it to function well while I'm at work. And so I was going through all these books, websites. It was exhausting. I was tired. I had a headache. I had difficulty remembering things that I read. So it was a real struggle. And I didn't want anybody to ever go through that. So when I wrote my book, After the Crash: How to Keep Your Job, Stay in School, and Live Life After a Brain Injury, I wanted all that information, the tools and strategies that worked for me and were recommended by specialists, to be in one book, one space, so that someone who wanted to go back to their job could pick it up and start implementing those strategies right away.

Mm-hmm. And so did you go back to work as a nurse or no?

I did. I worked for About a little over 7 years after my brain injury.

Okay. And then moved to full-time entrepreneurship?

I did. I ended up retiring early at 55 because I couldn't keep up with the workload. Right.

And I mean, that's a physically demanding job.

Yes. And my managers at the time weren't willing to provide resources to support my disability. So I just decided to do the early retirement and then do this instead full-time. And I've been happy ever since.

So that was how long ago that you— I'm not trying to— what's the word I'm trying to— I haven't had a brain injury and I— maybe I have and I just haven't realized it, but I still have trouble putting thoughts together. Interpolate. That was the word I was looking for. Your age. But how long ago was that, that you went full-time?

A year ago.

Okay. All right. So here's my question. What did that experience— because I find the brain absolutely fascinating. The way the brain works to me is one of the most— I don't want to say misunderstood. One of the things that fascinates me about the fields of psychiatry and psychology is that, you know, it's unlike other forms of medicine. It's primarily done by observation. Right? There's not a lot of— yeah, you can do an MRI. But like, there's no bloodwork to determine brain chemical levels, right? And so it's a lot of observation and guesswork. And like, there's just a whole lot that we don't know about how the brain works. So what my question is, is, is there anything you learned through that experience that changed how you, um, approached entrepreneurship? Like, is there something you learned that has shown up in your entrepreneurial journey? That's the, that's the best way I can phrase that question.

Well, definitely, I guess I would say resilience. Of course, just recovering from the brain injury, I would be developing my resilience. Um, but related to, um, my, uh, business, I would say that I have really been happy that I made the decision to do it because I'm constantly learning something new. And when you're constantly learning something new and you're pushing your brain, it encourages neuroplasticity and I feel like making that decision to write my book was one of the best decisions to boost my recovery because I set myself on a journey where I would be constantly learning and not stagnating.

Mm-hmm. That's brilliant. I had a, I had a friend had a traumatic brain injury many years ago and From her perspective, what she says is that she had a personality change. Now, I don't know how much of that was truly caused by the brain injury, or those were just— that was the meaning she ascribed to the changes that she made. Right. But they were significant, like significant life changes. In your research and experience, is that common where people like change personalities?

Yes, very. It can happen. In fact, my personality changed before my car accident. I was a very big go-getter, goal-setter, accomplisher, out traveling, out doing stuff, volunteering in my community. And then after my brain injury— and I was a t-shirt, jeans kind of gal. And, um, after the car crash, I was more of a stay-at-home, uh, appreciating my home, my family, being grateful, being more mindful, spending more time in the present rather than worrying about the future or, or hanging out with regret in the past. So those were changes just to me, but because of the chemical changes, the organic chemical changes that happen in the brain, and then changes that happen in your life, you can have changes in your behavior and your personality. And brain injuries do increase your risk of suicide and suicide ideation. And so caregivers do need to watch their loved ones who are recovering closely I believe it was the Brain Injury of America said that 1 in 5 brain injury survivors still had suicidal ideation 5 years after their brain injury. It's a big deal. People have killed themselves after a brain injury just because things can change. Your personality changes. The chemistry, the way your brain function changes. And usually the survivor, it's hard for them to articulate what's going on in their brain. And, and, and caregivers and people in general are just not knowledgeable about the impact of a brain injury or a concussion. And so they may not understand, maybe not say the right things or do the right things. And this can impair relationships of the brain injury survivor. It can impact your work because you can't keep up, or you have— you're irritable, or you have a burst of anger at work because you've pushed yourself too hard. Your brain's tired, it's ready to shut down. And if you lose your relationships and you lose your job, then you're at risk of using drugs and alcohol, and, you know, the spinning can continue to go down. And there's a large percentage of the incarcerated population that are TBI survivors.

Let's define some terms here. Is, is, is like a concussion considered a traumatic brain injury or not?

It is. So they're synonymous. Usually the concussion is used in the acute early recovery. The doctor will say there's a concussion, but if you're— it's really a brain injury.

So the brain injury continuum would be like you fell down, hit your head, you have a concussion all the way to like, you know, maybe an industrial accident or a soldier where they like lose part of their brain or there's some direct injury to some part of their brain. So that— is that accurate?

Yes. So there's lots of ways that you can develop a brain injury and some of you— of them you listed. So there's falls, there's vehicle motor accidents, blast. Injury from the military. Domestic abuse survivors are TBI survivors also. It can happen at work. So I've had nursing colleagues I've known who've been punched and knocked to the ground who have sustained brain injuries. You know, same in any industry where there's a high risk of bodily injury. So you don't have to actually hit your head to sustain a brain injury. It could be just an acceleration-deceleration type instance, maybe some twisting. What happens is that the gray matter, which is the top part of the brain, and is heavier than the white matter, and they can shift. And that shifting shears the brain, the brain cells' connections to each other. And then there's, you know, the little bit of movement in the brain that can cause damage. And then the worst is, you know, when there's twisting, because you'll get more of a shearing of those connections. But other ways people don't realize or forget is strokes. If you have a brain tumor, because that tumor is going to get— push on cells, it's going to cause brain damage to those cells around the tumor. Hypoxia episodes, either through cardiac arrest or near drowning, poisoning, lead poisoning, carbon monoxide poisoning, and infections like meningitis or repeat COVID-19 infections.

There's the answer. I did have a brain injury. I had, I had viral meningitis as a child. There. I've named it. I feel like there's something wrong with me. That was the— but thinking back about that, that was like the worst headache I've ever had in my life was meningitis. Like, that was awful. Is there a lot of crossover in treatment with brain injuries and PTSD?

Well, you know, you You— yes, because when— usually how someone obtains a brain injury, where we were— and when I, when I was talking about like the traumatic brain injuries, there can be PTSD because a traumatic event happened, right? You were either in a car accident, you fell down the stairs, you— so you can still have PTSD even if you're not in the military and been exposed to blasts. Or being hit in the head. But even being hit in the head, I read about one brain injury survivor. She was at the bottom of stairs and some kids were playing up on top and they dropped their basketball on the top of her head. I mean, it's just— it can be traumatic.

Hmm. So in the treatment, is— I mean, because I understand that the brain, like the rest of the human body, is resilient and adaptable. Do you— is it possible to fully recover from a traumatic brain injury?

I think that there's people out there that do feel like they have fully recovered. And there are some people who do get better after 2 weeks or a couple months. But there's a lot of people who don't and end up with symptoms throughout their lifetime. And one of the examples that I use to kind of paint this picture is that when you break your ankle, you expect to be in a cast for 6 weeks or 8 weeks, do therapy, and then you'll be better and you'll be able to walk on your ankle, right? Mm-hmm. But your ankle may ache in the winter, or it may swell up, or it may be prone to twist more easier than your other ankle because of that. Injury. And it makes me think, well, why would you think the brain wouldn't have residual effects after? Because it's a more delicate and intricate processing organism, and it's squishy.

Yes. Yes, that's a very good point. Like any physical injury, you may recover, but you're never quite the same. Right? Right. Athletes will attest to that, you know, ad nauseam. So that sounds like then that requires some adaptation on the person's part to continue to function or achieve what they want to. So what adaptations have you had to make?

Well, I just wanted to go back to what we were talking about. And I'll go back to your question is that the other thing is, is that brain injuries are cumulative. So if you, if you fall off your bike as a child and, and maybe struck your head on the concrete, the sidewalk, that's a brain injury. Um, and then if you're a young, a young adult and you're in a car accident and you get whiplash, then that's another brain injury. And so once you have a brain injury, you really want to avoid adding additional salts to it. So knowing that, you would want to monitor your blood pressure, avoid diabetes, make sure your cholesterol looks great, because you don't want to hit 60— your 60s and then have a stroke. And what I saw in practice, because I did change my career, I became a neurology nurse practitioner. Was that you really want to preserve your cognitive ability into your later years, and keeping your brain healthy and brain injury prevention is key in doing that so that you can have a great, you know, golden years and retirement and so forth. But going back to your question about using strategies, I had— the key thing is to know your symptoms. And having a brain injury, part of that is there's an energy deficit, and that's because the brain is using a lot of energy to heal, clear out debris, make new cells, make those connections, change, you know, real estate of where they used to do something. It'll change it to another spot that can work. And then there's also a change in this— in this— how the cells produce energy. So if you go back to high school and you think about your Krebs cycle, which is— I hate doing—

but you went to a different high school than I did because we did not talk about— maybe we didn't, I've just forgotten.

It's good to forget. What you get out of that is you get those energy resources called ATP, and our cells run on ATP. That's the energy we get. You go through the Krebs cycle and you add oxygen and all that stuff. Well, that process happens in the mitochondria of the cell, and when you have a brain injury, cells die and those mitochondria get damaged or die too. And so then you have a brain that is has less power to keep doing the things that you're doing. And so knowing that it's an— there's an energy deficit, it's important to support the brain with external tools. For instance, I had sound sensitivity. I'm very sensitive to sounds, couldn't focus or concentrate if there was any noises around me. So when I was at work, I would wear noise-canceling headphones or earbuds to help with my focusing. I had, um, uh, light sensitivity. So when I was at my desk and not in front of my patients, I would wear dark glasses. Um, I had shields to block the fluorescent light, um, from shining on me and creating an additional glare on my computer. Those are some of the things I implemented. And I was easily distracted by things that move around. So I had privacy panels on each side, asked for an additional one on the opening of my cubicle so that I wasn't distracted when people were walking in and out of the space that I was working in.

That's very interesting because one of the things that I've noticed with entrepreneurs is they tend to have these— and I may be using the wrong term— but neurodivergent attributes. I remember standing at an entrepreneur conference and she, the speaker, had us all stand and then she read off these symptoms. And she said, like, if you have any of these symptoms, sit down. And by the end of the list of symptoms, everybody was sitting down. And she was like, well, I just described the symptoms of bipolar disorder, something like that. I don't remember exactly. And that's not to say that I think that all entrepreneurs have bipolar disorder. What I have noticed, though, is that there are themes with entrepreneurs of neurodivergency that seem to happen. I'm wondering if— because the things that you describe, sensitivities, distractions— distractions, 100%, like sounds, motion, and not about light sensitivity. But I guess I'm curious, in any of your research or experience, you've drawn any not causation, but correlation. Is there any correlation in, in that data around, um, things that show up for entrepreneurs versus things that show up in traumatic brain injuries?

I would say that I'm a big podcast listener, and I follow a lot of entrepreneurs and, um, work-from-home type podcasts, and I have seen a pattern. Not that I've seen research to support this, but I have seen a personal—

yeah, we're just making shit up here. I mean, we're not, we're not breaking new scientific ground here.

I have noticed, um, a lot of them that I follow have a history of ADHD or some, some type of neurodiversity, and I, I feel like the corporations, large corporations, I could, I feel I could speak for, not small businesses or medium businesses, but large corporations are not accommodating to neurodivergent individuals. For instance, like for me, I needed a private office to work in and I was told there is none. You have to work in this open workspace, which was a nightmare. And I've heard other stories where, you know, people just did not do well in the corporate— under corporate employment, and that's why they kind of left and are doing their own thing. And I kind of attribute some of my entrepreneurial steps not only to the brain injury um, but also being Gen X, you know, I— when I was a kid, I was left at home alone. And if something— and that was before cell phones and the internet and all that stuff— so something went wrong or didn't work, I had to figure out how to fix it.

Well, I'm still trying to figure out— I, I was having this conversation with my wife recently, and we've had it multiple times, like, when we were kids, and like plans didn't happen, how the hell did we communicate with each other? I don't know. Like, you know, show up at the arcade on Friday night. And then if you show up at the arcade and no one's there, like, how do you know where everybody went? I don't know. We figured it out. But like, yeah, I have noticed, like, there are alternatives to being completely connected all the time. That's just an aside. So You do see similarities. I would agree with that statement about large corporations. I would say the education system as well, like, divergence of thought is not wanted. It's not wanted. They do not want you to think outside the box in any way. So, you know, I think whether you had it naturally or you had some of these, uh, things because of, of a traumatic brain injury, I don't, I don't think that's necessarily a bad thing because I think we need more divergent thought rather than more convergent thought.

Exactly. So one of the things, um, that was, um, a problem at my job as a nurse practitioner was my time with my patient was limited. And so I had information I wanted to share with them, but I didn't have time to do that. And, and sometimes, you know, if when you're sick or you're stressed or anxious, you're, you're not open to hearing it at that moment too. And being in the doctor's office is highly stressful for a lot of people. So it was— that was frustrating, and I felt like, um, I wasn't able to do my job as a nurse. Like, nursing, we go to school to learn how to educate patients about their disease processes and how to live with them, and that's— and not being able to do that was disheartening. And when I wrote my book, I realized, oh my gosh, I broke out of the exam room, and I can reach people with all the information I've been wanting to share with all my patients out of the exam room. And so it was more of seeing a problem and breaking out of the box and meeting the needs that are— that I knew were out there.

I love that. That's, that's That's almost a gift, right? Like that before the brain injury, you couldn't do the job the way you wanted to do it. But now you can. That's— I love that. How do people find your book if they want to learn more, listen to your podcast, etc.? What's the best way to connect?

The best way to connect is my website at kellytuttle.org. Org. That's T-U-T-T-L-E. Um, my book, you can find it at Amazon. It's also on Audible, so if any of your listeners like to listen to their books, it's on Audible.

And you narrate it?

Yes, I did. Nice work. That was fun.

That was an unusual challenge. That was—

it was. Oh yeah, because I, I have some aphasia, and so sometimes Even though I want a word to come out, it doesn't come out right. So that was really interesting. It was a lot of work, but it was worth it because I know a lot of people needed the Audible version to be able to get, to get to the information. But my book is also— you can get it at any of your favorite indie stores. And the title again was After the Crash: How to Keep Your Job, Stay in School, and and Live Life After a Brain Injury. And my podcast is The Mindful Return by— with Kelly Tuttle.

Perfect. Listeners will have all of those links in the show notes. If you like what you've heard, please rate the podcast, share the podcast, subscribe to the podcast. Until next time, remember, you are not alone.