In Limbo

There is a very unfortunate common experience among people who have had a traumatic brain injury, simply put: being in limbo. I suppose I could have used the term purgatory to capture the true essence of this experience, but that might imply some sense of fault or guilt. Head injuries are accidents; you can’t turn back time by thinking, if only I hadn’t been there at that moment, but, you were, and the injury happened. The state of limbo that I have heard so many people describe in various ways is the waiting period during which you just have to sit it out and see what’s going to happen with your brain. This might also be known as hoping for the best.

The consistent and best advice given from the ER department after having a head injury is to go home and rest. This is not, however, a very specific treatment plan, so this is the starting point of your limbo state. Not knowing what is wrong with you can cause a significant degree of frustration, anxiety, stress, anger, you name the emotion, they’ll all come into play as you wait out the getting better period. The problem is, as I mentioned yesterday, everyone’s experience to head trauma is unique. The only consistent treatment that will help is rest.

Head injury limbo begins with lots of sleep. This sleep is not like a refreshing Sunday morning catchup that you might have normally had after a busy week, it’s feels more like hibernation. These 12-hour stretches of brain rest are your first treatment after a head injury. Ideally, this may take a few days, even a month or more of the most severe need to sleep you have ever experienced. Eventually, the injured brain is able to begin to function on a more typical amount of sleep. This is a very pivotal point in the limbo state- if you want to move out of limbo, don’t make any sudden moves. This means, make very gradual changes in your activity levels. Don’t think you can bounce back to ‘normal’ just because your fatigue seems to be lessening. If you do, you will slip right back into the extreme fatigue and head injury symptoms again. Again, this is such an individual experience, there isn’t going to be one prescribed solution for everyone, so it is up to the individual to be aware of signs of fatigue and respect the body’s need to gradually heal.

I have described the healing brain in earlier posts as a collection of replacement brain cells, recruited to replace the broken ones. When I say new, think of young, like toddler-aged. If you have ever spent any time with a toddler and observed their fascination with their emerging world, followed by the ability/need to fall asleep in a car seat, or melt down in a temper tantrum, you may see a parallel in the state of a brain that is healing after a severe injury. We know that a damaged brain can heal in that new neural pathways can develop, new cells can take over for dying ones. But if you expect an injured brain to take on the full responsibilities of an adult, it would be similar to asking a toddler to take over your household. Even a genius child would be forgiven for a few mistakes and meltdowns. Respect your healing brain’s need to figure things out, and allow it to make new connections and learn, just as you would with a small child. Being in limbo is not permanent, but I guarantee that it will last longer if you forget that your brain needs time to engage the new cells and pathways. Give that toddler time to figure things out, as long as it takes.

I have no intention here of belittling the state of limbo that comes with a lack of direction and definitive answers about the healing process after a traumatic brain injury. I mentioned the alternative term of purgatory because unrelenting pain, confusion and having nowhere to turn for help is just that. I write this blog as someone who has likely shared some of the experiences that you may be enduring right now, and I wish I had easy solutions for you, but I don’t. I write here because I can say that the best thing you can do for yourself is to give yourself time. Head injuries are completely invisible. To the outside world, you may look exactly the same, but inside your head, everything is different. Changes in structure and chemistry are going to affect all cells. It’s going to take some time and a lot of energy to figure out how to work with your new brain cells, but welcome the new recruits and give them a chance to take on their responsibilities.

I’ll leave off today with a little artistic inspiration. I have started to paint recently-it’s quiet so it doesn’t hurt, as long as I don’t focus on it too long. I have a long way to go, but I like this part of a field of flowers I made recently. My auditory channels were most affected by my head injury, so I’m spending more time working on my visual strengths, and I really enjoy it. I urge anyone with a brain injury to give yourself some time to explore new hobbies, nurture those new brain cells, and see where they may take you.


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