Any injury to the body takes time and patience to heal. A sprained ankle, for instance, is going to be more likely to heal fully with rest, ice, then stretches and exercises to rebuild strength and function. Pain, bruising and swelling are the very handy indicators of progress in your recovery process when you have a minor injury. A minor injury to the brain, however, is less predictable. The length of time it takes to heal fully requires far more patience than I personally have, so I have started to look for subtle clues to indicate progress.
The first progress indicator I can consistently observe is energy/fatigue levels. Even six months in to my healing process, my energy levels can still dip right back to those of my early post-concussion days. The rate at which they get there are a good indicator of progress. The slippery slope of one step forward and two back is generally an indication that I am getting ahead of myself and need to monitor my energy levels more closely. Knowing that the brain makes huge caloric demands on the body, I think it is very important to try to keep your energy up with consistent, healthy eating. I know I’ve hit a wall when I walk in the front door, open the fridge, and grab handfuls of spinach. When you do find that you’ve hit the wall with fatigue, you need good food, then rest. If you don’t allow yourself these breaks, the two steps back will spiral even further backward. Two indicators of progress in energy level are how easily you can get to this level of feeling empty, and secondly, how well you can bounce back. If you do keep your blood sugar steady with consistent healthy eating, yet still frequently feel like your energy has crashed, then you’re doing too much. Don’t get discouraged by it, but use it as a good indication of progress.
Because I think it’s good to limit a list to three items, I’ll focus on two more areas of progress here: Output and Input. I start with output because it’s easier to manage than input.
Monitoring your output refers to your level of functioning or performance in tasks. I think it’s helpful and encouraging to take time out once in a while to take an inventory of the everyday tasks you are now able to do again (and not dwell on the list of things you can’t yet do.) Just as you’ll find with changes in your energy level, your ability to jump back on to the treadmill of life requires you to work at the same speed as the rest of the world. If you push yourself, you’re going to fall back (off the treadmill) but slowly increasing the length of time you can work at regular speed is not only encouraging, it’s also essential to regaining your normal level of functioning. ( My Braincamp OT told me this, so I know it’s true.) As your ability to do everyday tasks gradually returns to normal, it’s also important to take on new challenges. This is your chance to build new neural pathways. I have referred to a heightened sensitivity to stimulus in an early post on paying attention. Think of this time as an opportunity to develop your artistic brain. I have been playing with a few things this summer- photography, sketching, cooking, even just listening to really good music. Treat your healing brain as you would an infant-give it every opportunity to develop in a well-rounded healthy manner. You’ve got the time.
The final area of progress ( for today) is taking in information, or input. It’s funny, but as a teacher, I have always considered input to require less cognitive work than output. Anyone can listen, right? Well, right now, I am finding the opposite to be true. Incoming stimulation is still hard for me. I have friends who are brilliant, fun, engaging speakers, I just love them, and, I have difficulty being around more than one of them at a time. Following conversations, especially in a crowd of people is tough, but you have to do it. The alternative is a very slow regression away from a social life, or even work life. Output is easier to monitor because you can control the rate at which you are performing. If you are writing an email, you can give yourself lots of time, take breaks, and consider your words before you press send. Over time, your functioning will speed up. Monitoring progress in your ability to take in information should be approached in the same way. Don’t expect to be able to step back into work and get frustrated when you get a headache after two minutes. If you want to return to your ability to handle incoming information, you have to gradually expose yourself to increasing levels of stimulus. I don’t formally track my progress, but I do consciously push myself to increasing numbers of people. When my head hurts, I escape as quickly as possible, do something physical like a brisk walk, and then I look forward to my next opportunity to challenge myself to incoming stimulus. There are going to be days that are tough. For me, the hardest hurdle is being able to enjoy music again. Besides my family and my cat, the thing I love more than anything else is music. I’m not yet able to sit and listen to live music without a serious headache. It kills me, but, I can play music. I sat and played piano by myself for an hour this week. I can still cry, remembering how good it felt. It was a huge milestone in my healing progress, and that is what I’m going to hang on to. I guess I want my thesis for today to be focus on what you can do, and move forward. Having a concussion sucks, and it will get better.
PS- I ate the above -all of it, instead of dinner one day during braincamp. It helped.