Pain

I opened a new book yesterday, and this was on the first page. Hmm, timely.

At this point in my blogging career I feel I can give advice about dealing with pain. I’ve had two years to practice it! The good news is that my self-proclaimed expertise stems from the fact that today, I am not in pain. I have succeeded on a fairly regular basis to not be in pain every day. I’m very happy about this. This is a landmark event, worthy of at least a take out burger from my favourite local food cart. While I polish off the aforementioned burger tonight, I thought I’d celebrate with a post on pain, post-concussion.

The chronic pain I would like to address is the most common side-effect of concussion, the dreaded headache.  I heard a friend moan the other day that she’d had a cold for four days, four! (When was it going end???) Though I truly felt her pain, I have to say that one’s perspective on enduring pain tends to shift when you have pain that just doesn’t seem to go away, ever.

So today’s advice comes from the core of my rehabilitation team, Therapists: Physiotherapists, Occupational Therapists, Counselling Therapists, I even tried Acupuncture- when you put together all of their research on the pain associated with head injuries, the evidence is clear, you have to retrain the brain to look at pain in a different way. It doesn’t just go away. If you have had a concussion, you’ve already been told that there isn’t a medical treatment to repair the injury. Research in Neuroplasticity has shown  that you can grow neurons to replace the broken parts in your brain, but those neurons need training, and if the pain mechanism has been lit up by your injury, it’s a pretty safe bet to say that waiting to get better is not going to lessen your pain. In fact, the waiting game does the opposite.

Being a particularly stubborn person and not a very good patient, I tried to push my cognitive endurance through hard work and not only did that not really accomplish anything, it brought on headaches. The chronic headache of a concussion is like no other headache I can remember, it builds, tightens and spreads until you just have to give up and go to bed.  But there is hope for this kind of enduring pain:

Look up Lorimer Moseley:

http://www.bodyinmind.org/who-are-we/

You can watch his Ted Talk (he’s pretty funny) or read further, but I found his research to be extremely helpful.  If you’re not up to doing research, I’ll do my best to give you a summary of the advice from a document I found in the library:

Understand Pain, Live Well Again, a Guide to Pain Education for Busy Clinicians and People with Persistent Pain by Neil Pearson ( and yes, it’s based on the work of L. Moseley.)

His Key Advice: Anything the nervous system practices it can learn. When you have persistent pain, your body can start to send pain messages for normal body sensations, just as if they are dangers. These changes can be reversed through deliberate practice.

Keep in Mind:

1.You are able to influence what your brain pays attention to. If you pay attention to activity not related to your pain, such as deep breathing, your brain won’t notice the pain.

2. You can change the way your nervous system interprets signals from the sensory system. You can convince you nervous system that the pain you have is not dangerous.

3. You can develop strategies to handle pain when it is triggered (breathing, meditation, visualization, try them all and see what works for you.)

4. If you practice these strategies over and over again, you can train your nervous system to respond to pain triggers in a new way.

 

That’s all for today (I don’t want to give you a headache!) When you’ve had some time to process this information,  look up Lorimer Moseley on Youtube: He’s the real expert, I’m just someone who has benefited from his research.

 

You Are What You Eat

This expression popped into my head recently when I was talking to a friend about memory problems. I wasn’t actually referring to eating specifically, just building new habits. Successful head injury treatment is all about the way you move forward, not back. I have found that the most effective treatment for a head injury is more about education than medical intervention. Successful rehabilitation depends upon how much work you’re willing to put into learning new habits, and it’s really just up to you.  I have spoken with so many people who are frustrated with the lack of medical attention available to them. Any head injury is a serious injury, yet they seem to be left to their own devices with no answers to the questions they keep forgetting! I hope I can be of some help through my experience as a Special Education Teacher:

The bottom line in helping students with learning disabilities is to recognize any difficulties the learner faces, then to figure out how to work with what you’ve got. Well, a head injury can cause impairments to the brain’s function that are similar to learning disabilities. So my approach to my own head injury is based on my educational philosophy: I need to adapt if I want to continue to learn, work, and have an enjoyable life.

Upon the advice of my sister (my wonderful coach through this whole experience) I took some time this week to make an inventory of the post-concussion problems that seem to have stuck with me, and matched each problem with the strategies or tools I use to deal with them. Your symptoms are likely to be unique to you, but see if you can adapt my strategies to create solutions for your own specific hurdles. The bottom line of today’s post is this: Accommodate your brain with the tools that are available to replace the injured areas, and then put in the time it takes to build new habits to help you to build new, lasting memories. 

Open the link to the chart below:

memory problems and solutions chart for blog

 

Microbreaks

I learned a new term yesterday that I’d like to to share because I think it’s a key element in Brain Injury Rehabilitation. The term is Microbreak. These are very short breaks of only 1-2 minutes that really help an injured brain deal with processing issues, aka, brain traffic jams. I take short breaks when I can, but my Occupational Therapist told me that these frequent pauses in activity are actually more important than longer breaks because they allow you to keep your focus and complete tasks. They are also a sneaky way to train the brain to learn new things without triggering your symptoms. I  found out that these breaks I’ve worked into my own routine are actually important not only in making me feel better, but they are also making me more functional.

I have to say, taking breaks and not working through to completion on anything has been one of the hardest adjustments I’ve had to make since my injury. If you’re the type of person who really enjoys a hobby or the satisfaction of a job well-done, you’ll know what I mean. Even if it’s just reading, there is something very enjoyable about spending an extended length of time focused on that activity  (especially if some other task, like laundry is competing for your attention!) I have always loved the feeling of staying up late to finish a good book, partly because of the calm focus of being completely absorbed in that one thing, but also for the sheer enjoyment of doing something I want to do. This kind of sustained attention is one of the pleasures that I miss the most. However, I think it is a skill that can be developed again, thanks to the use of microbreaks.

If you want to lengthen the amount of time you can focus on anything (post head-injury) you have to be careful not to push your limitations, that just hurts. Pushing through the pain reinforces the association your brain makes between the activity and fatigue. If you ignore the pain, it actually shortens the length of time you can focus on the activity. Look up this very helpful website on chronic pain: https://www.retrainpain.org. if you’d like to learn more about this topic.

Back to my point: Short breaks, threaded throughout the increasing length of time you focus on a task will allow you to increase your focus over a period of weeks (not days.) I have found that if I increase the time, allowing little breaks (like a short walk up and down stairs) I can focus longer. I usually have to hold the increased length of time for a week or so to adjust to my new tolerance level. Once the new length of time starts to feel ‘normal’ I add on a little more focused time and try that out for another week. It’s an incredible test of your patience, but with the little breaks built in, this just becomes a new way of working, or reading, or whatever it is you’d like to do more of!

Don’t wait to feel better

Most head injury support seems to be focused on the early days post-accident. My focus is now on long term rehabilitation. If you want to do more with your day than rest after a head injury, it’s also important to make a deliberate plan for adding on. The trick is to gradually introduce new challenges to this threshold level of stimulus that your brain can tolerate. There is a real art to finding the rate of increase that will help you to improve your overall function. The experts on this are Neurologists, Speech/Language Pathologists, Occupational Therapists, not me, I’m just reporting on the advice I have been given from these experts. For your own support, seek help from professionals. A blog is just a personal account, hopefully a resource for people who are looking for a place to start to get help.

Daily Challenges: It is important to continue to work at increasing your overall functioning long after having a head injury.  Any increase in the level of activity you attempt must be taken at a very gradual rate. Whenever you introduce a new activity, give yourself a few weeks to include that activity within your day to day routines. It’s normal to feel an increase in symptoms initially when you add to your day, but after a week or so your brain will start to have learned the new activity well enough not to set off the ‘alarm’ of symptom flare-up. If you find you can get used to new activities in this way, then you’re adding on at the right speed. If your symptoms are intolerable, cut back.

I’ll use my own day to day plan to give you an example:

1. I give myself two hours to get ready in the morning, one for rehab exercises, and one for breakfast/shower/dressing/getting out the door on time.
2. Brain Exercises: I start each day with three brain-type exercises on my phone: Red Herring, 7 Little Words and Lumosity, and a coffee. The first two apps are free, Lumosity has an annual fee. The key to using these types of specific brain exercises is doing them absolutely every day and in just treating them as fun games. They all target memory and attention in a very contrived way- they aren’t going to cure anything, they may not even transfer to real life, but they give me a daily workout on the things that are difficult for me so I feel they’re worthwhile. If I have time, I’ll add either meditation or some sketching. Any relaxed, enjoyable and mindful activity is an excellent way to prepare for a successful day.  Without a purposeful start to the day, I tend to have a frustrating day full of mistakes.
3. Cardio: If I leave this out, I really notice the difference not only in my energy level, but in my ability to think. Even if it’s just a short walk outside, getting some exercise every day is really important for your brain. Increased blood flow=more oxygen=better thinking.
4. Work/hobbies/errands/social time: Over the long term, the core of each day is not focused on rehab, so I have to approach every activity in my day with my overall brain rehab in mind. For example,  I don’t rush anything. As soon as you rush yourself, you’re adding more work to the already increased brain activity and that’s when you start to mess up on the little things. I plan for breaks throughout the day and I limit the amount of time I spend on any one activity-even having a visit with a friend. A break in between activities is quiet time alone. Initially, I used a meditation app on my phone called Headspace to help me with this. You can set it for a 10 minute meditation to take a quick break. I don’t really need the guided meditation anymore now, but I think that’s because I used the app to learn how to quiet my brain down. In summary: Plan your day, include breaks, and don’t rush or multi-task.
5. Long-term commitments: I think it’s really important to find something beyond your own rehab to focus your energy on. I’m talking about volunteer work, and exploring new interests. I have made a deliberate effort to make the best of my situation both by trying to help others, and by exploring new interests. My first volunteer activity was in starting this blog when I was  in a brain injury rehab program. I’m a teacher-if I can’t teach in a classroom, I’ll find a way to share information that I feel is important. I have also worked with a local health resource person to form a head injury support group. She manages the organizational details, and I provide a way for people to share. My personal exploration of a new interest is through art. I think it’s important to look not only at the deficits caused by a brain injury, but also the changes that may be beneficial in some way. For me, my visual strengths seem to be making up for the problems with my auditory function. So, I’m learning how to paint. It’s fun, it’s quiet, and it’s also a very gentle way to increase my ability to focus using a part of my brain that feels strong.
6. Long-term lifestyle changes: No accident is something you’d chose to experience, but even the most minor accident gives you an opportunity to learn and to grow. A head injury causes you to slow down and pay closer attention to things that matter. It forces you to make deliberate choices on the way you spend your time. I would imagine that even just slowing down to plan out your day with rest breaks for your brain is probably a very big shift for most people. It’s not a bad thing to shift to a proactive approach to life, rather than a reactive one. Below is a peek at one of my early paintings. I took a painting class and really enjoyed the opportunity to focus on making something. I strongly recommend trying something creative like this-who knows where it might lead?

Endurance

I think the best thing I can do to help people who have suffered a head injury is to increase the general awareness about the effect of this type of injury. My best description (today at least) is that recovery from head injury is an endurance event. No recovery can be rushed, so if you’ve hit your head and you’re still dizzy after a couple of weeks, you might as well take some time to make some sense out of this injury. That’s my purpose with this blog. I write from first hand experience, and hopefully you’ll be able to see that many things are still possible after a head injury, it just takes time. If you have entered the world of head injuries from the other perspective, worrying about a loved one who has had a head injury, the best thing you can do to is to be patient and to help out with the things that aren’t working so well. It might take some time to notice any long term effects of a brain injury, so patience is the best kind of support you can give.

Initially, it’s hard to notice what is different after a head injury. I think this is because the injury to brain tissue causes a functional change, not a physical or visible change. The injured brain may be slower to integrate new information, to make connections to previously learned information, and sometimes there is just too much incoming information to process in the moment. This is very difficult to articulate, but when your brain has been disturbed enough to impact neural function, everything feels different. Everything, that is, except your personality. A person with an injured brain can still have their original knowledge, memories, talents, values, none of these core aspects of a person change, it’s their sensory and operating systems that have changed. This is why a head injury is a severe  injury.  The disconnect that I have experienced and observed is in continuing attempts to interact with the world in way that feels normal,when symptoms, limitations and confusion keep interfering. It can take some time and repeated missteps to realize that things have changed, and the last person to realize this is likely to be the person with the injured brain. I now understand why the best medical advice after a head injury is to rest, then to wait and see.

Instead of trying to fix the brain, it’s best to focus on everyday functioning. There may be times when a person with a brain injury is functioning well, and times when things just don’t seem to make connections. This is where endurance comes in. It takes practice and learning through mistakes to figure out how to function after a brain injury. The best source of help I have found in adapting to the changes in my own brain has been through Occupational Therapy. I’m slightly embarrassed, or maybe I should be proud to report that I have had the pleasure of working with seven Occupational Therapists over the past two years.  The information I try to convey in this blog is from a gradual integration of the information I have gained through these wonderful, caring professionals. If I meet anyone who is having trouble making sense out of the changes in the way their brain operates after a head injury, my best advice is to get an Occupational Therapist.

I hope that an increasing general awareness of the nature of brain injuries will allow more people to access the help they need. When I hear terms such as epidemic and long term disability associated with head injuries, I still can’t believe I have had one (given the fact that I can write a blog.) Well, I can write, but it’s hard work for me now, this took a few hours. I will continue to push my own limitations because that’s what I’ve always done and I’ll share here because I know how scary it can be when you can’t just shake off the effects of a blow to the head. I will leave you today with a picture from a sailing trip we took a few years ago. We met this man rowing his boat from Washington state, up the entire coast of British Columbia. He had a good raincoat and hat, some camping gear, really strong arms and incredible endurance. ( and he looked a lot like Santa Claus!)

Maybe his image will help inspire you with your own endurance today.

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.

Location, location…

It’s all about location, especially when you’re looking at head injuries. There are many common signs of head injury, but that doesn’t mean that everyone with a head injury will have the same problems.The more I talk to people who have had some kind of head trauma, the more I realize how unique each person’s experience is. An injury to the top of the head is nothing like damage to the front of the brain. Likewise, a person in a car accident does not necessarily have more significant injuries to the brain than a person who has been thrown off a bicycle.  Every head injury is unique, depending upon a whole list of factors that led up to the precise location and timing of the accident. I think any generalizations or assumptions about head injury based upon common knowledge of concussion can get in the way of individual treatment. If you have had a concussion, and you have enough energy to read here without causing yourself any pain, I hope you’ll find this interesting. If your head hurts though, turn off your computer and do something else. This will still be here tomorrow.

I’ve talked to people who have dramatic changes to their emotional stability, people who have lost their sense of smell, others have lost their sense of direction. For some people, the unrelenting headaches take over their lives, and other people blow up in anger or burst into tears over the slightest stress.  All of these signs are in relation to the areas of the brain affected by trauma. In order to help yourself through brain rehabilitation, it’s first going to be important to recognize the effect of your injury on your own brain. The brain itself doesn’t feel any pain, so it’s not like a doctor can tap around on different areas of the brain to see where it hurts. They also can’t go inside and fix any broken parts. The true test of brain injury is in its function, and this is something that you can learn to do yourself.

In my own experience, I found that this was something I needed help with at first.  It’s very difficult to recognize dysfunction in your own brain when you have a brain injury. Setting aside any pride that might interfere with your ability to accept help, ask someone you trust to help you recognize signs of problems in your brain. Keeping a journal may be helpful (or it may drive you crazy) but there will be some consistency in the reactions your brain has to certain tasks. If you can start to make note of the problems you are having and the circumstances in which they happen, you will be making the first step toward independence in your own brain rehabilitation.

Take some time at the end of each day to reflect on the problems you encounter and look for connections. (Do this after eating, you’ll need the fuel.) What were you trying to do when the problems happened? This is a very challenging task on a tired, injured brain, so it’s probably easier to discuss this with someone who is close to you. In my house, the close calls I had with nearly burning the kitchen down were some pretty good warning signs. I love to cook, so I had to take a new approach. By eliminating multi-tasking, I can cook again. This was initially a huge frustration for me, I had to take my own advice quite literally but as soon as I started to have some success with my new approach, I could work around the dysfunction.

The second factor to consider in function is fatigue. You may find you can overcome some of your dysfunction by pushing yourself but this is a really bad idea. Exercising your brain through learning is good, but pushing yourself through pain to build up endurance has a reverse effect with brain injuries. The nervous system reacts to harmful stimulus in a protective way. You may not be able to recognize the stress you are causing to your brain when you push yourself to function ‘normally’ for you, but your nervous system does, and it will become increasingly sensitive to these triggers. That’s how symptoms get worse, instead of better. If, when you are taking a moment to sit down with someone who spends a lot of time with you and you feel like things are getting worse instead of better, then that is a sign that you are not aware of the demands you are putting on your injured brain.

So, today’s advice is to take stock and find ways around your injury. Parts of your brain may not be working, but other parts can take over if you let them. If you live on your own, you may not have anyone observing the day to day mess-ups, but you can take the time to be honest with yourself and look for patterns of fatigue, mistakes, and physical symptoms. You can build up endurance, but it has to be incredibly slow.  The best way to build up function again is through very gradual increases in activities that are difficult for you. In the meantime, find ways to work around your brain dysfunction, avoiding the broken pieces, and you’ll be not only more highly functioning, you’ll be happier.

 

 

Work

Day to day in my post-concussion adventure, my life looks pretty normal. I can drive a car, make meals, exercise… if I had a half-decent golf swing I’d be ready for retirement. But I’m not there yet, I want to work again. The problem is that work is like a treadmill that is always on. I’ve stepped off that treadmill, and it’s going to take some careful timing to get back and stay there. Picture Lucille Ball attempting this and you’ll have some idea of what I might look like in this challenge! Honestly, I’ve tried it a couple of times and fallen off, but I’m not giving up yet. If you have taken time off work due to a head injury and you feel ready to go back, keep in mind these two things:

Assessment & Preparation.

1. Assessment: A cognitive assessment is a good reality check.  The physical symptoms you feel post-concussion are hard to miss, but the impairments to the brain are so elusive that they can even be missed by the person attached to that brain. It’s hard to know what you don’t know. So, if you are feeling like you’re coming out of the concussion fog, that’s awesome. This is a good time to see where you are in terms of processing strength. (Another analogy, but your brain is similar to a computer, so before you put your own personal computer into full time work, make sure you know your capacity so it doesn’t crash.) The cognitive assessment I had involved memory, attention, concentration, multi-tasking, listening and following directions. I failed miserably on a number of the tests but that’s ok, at least I know what I need to work on now. The next time I write, I’ll share some specific strategies for memory, attention etc, but for now, make arrangements to get an assessment. It should involve standardized tests so you can identify areas of strength and weaknesses. If your employer has a wellness program, this would be a good place to enquire about an assessment. Your doctor may have to make a referral for you. Keep in mind, the purpose of this test is not the same as CT or MRI imaging tests, which look for physical injuries. A cognitive test is more of a functioning test, to isolate specific processing tasks that your brain needs to do to work efficiently. If you push those weak areas, you’ll get a headache, so it will help to know what you need to work on.  I’m sure there are private clinics available for cognitive testing, but see what you can find through your employer (or union if you have one) first.

BTW, I said I hate analogies, but sometimes an analogy is less overwhelming than reality, so for today, substitute treadmill for your job and personal computer for your brain... and Everest, well, you know what that is.

 

2. Preparation: The results of your assessment are going to give you target areas to focus on for your brain. The agency that does the testing should be able to provide guidance for you in the types of exercises you should do. These are going to be very individual, so I can’t really address them here, but this is typically the role of an Occupational Therapist. Private clinics offer technology to address brain impairments, but I don’t think these exercises have to be fancy or expensive, just appropriate for your individual needs.

Once you start to progress with your brain’s capabilities, you can think about your transition back to work. The very nature of work is changing so rapidly today that any job you did pre-accident is likely to have changed in some way while you were away. Little things like updating passwords, new software, even changes to personnel will all be adjustments to face once you return to work. Beyond adjusting to these changes, work is, well, work. Your full-time job recently has been to take care of yourself while your brain heals, and you are now preparing to add a second job to your workload, so don’t dismiss it as back to normal because you used to do that job. Your world is about to get bigger again so you had better be prepared.

Slow exposure to the work environment is going to be the key to fitting back in. You can’t slow the treadmill down, but you can step on in small doses. Prepare yourself for work by rehearsing it. Try to think of a typical task in your job that requires you to focus for some length of time, and practice it at home. Work for 5 to 10 minutes-if your head hurts, you’ve worked too long, stop before pain takes over, and take an activity break. Get up, move around, breathe (meditate if that works for you) but shut off the task you were asking your personal computer to do for a few minutes by doing something completely different. You can gradually prepare to do the types of tasks you will need to do when you actually step back onto that treadmill if you rehearse with similar mental challenges, allow yourself rest breaks, and gradually build up your stamina.

I mentioned the level of difficulty you’re going to face as you get near the top of Everest in my last post. This really is the most difficult stage of healing from a head injury. (Sorry if you hate me now, but I’m there too!) You can stay where you are right now, that’s ok.  But if you are like me, with some ridiculous drive to push yourself to continue to learn throughout your life, well, these are the first steps.

I’ll end today with a picture of some kiteboarders I saw on a California holiday a few years ago. Watching these supreme athletes flying back and forth with such skill was truly impressive. But when they came to shore, we realized that most of the boarders were over age 50. I asked one man how he got into this extreme sport and he said it was easier on his knees than the sports he did when he was younger, so this was his new thing. I’m not likely to try anything so adventurous soon, but this image continues to inspire me to learn new things. Good luck with your own healing and I’ll be back soon.

Healing is work

I met with a counsellor about six months, and he so angered me with a  comment meant to inspire me: “You’re almost there, now this is where the real work begins.” He told me that this head injury was my Mt. Everest, and although I had made it to base camp, the hard work was about to begin. I was so mad. And he was so right! (@#$%^)

I hate analogies. Even without at head injury, I have always preferred people who get the point. But I have to say, I finally understand his point, and it was a pretty good analogy. Six months ago, I was sure my concussion had healed- it was only a concussion, after all, not a serious brain injury, so I thought. Surely, it should have healed after three months. I was so wrong. I can now, with absolutely no doubt in my mind, state:

If you are trying to heal from any kind of head injury, no matter how severe the impact to your head, you have to work at it. It doesn’t just happen automatically.

Someone surely has written a book on this, but it’s just so hard to read when you have a head injury, so it wouldn’t matter anyway. If you are looking for ways to help someone with a head injury, or if you yourself have stumbled upon this post, please consider these discoveries that I have learned through my own brain work:

1. Actively work at a program of brain workouts : Rest is important, but resting all day does not do anything for neuroplasticity, and over-use doesn’t give nerve cells time to heal. Figure out what will work for you. Choose activities that stimulate the brain in a healthy way: journaling, logic puzzles, Sudoku, reading, listening to podcasts or music, drawing, even just colouring, all are gentle ways to stimulate your brain. When you are first injured, you’re going to be able to handle about 5 minutes at a time (thus the name of my blog.) Over time, you’ll be able to last a little longer, but if you push it, your endurance will not improve. Watch for warnings (headache, dizziness, ringing ears, pressure on your temples etc.) If any of these symptoms increase, get up and move around, and don’t go back to the activity until your symptoms start to calm down. Listen to your body.
2. Pay attention to any secondary injuries: I don’t think you can have a head injury without straining at least some of your soft tissues. Neck and shoulder pain doesn’t just go away. The muscles holding up your head just get tighter, pull on other parts of your body, and if you don’t have treatment on them, you’re going to end up with pain in weird areas, like a hip or a heel, and then it will hurt too much to exercise, and then you’ll be in a bad mood. So, try Physiotherapy and MASSAGE THERAPY… I am literally going to bake a cake for my massage therapist tomorrow- I can tilt my head up and down now for the first time in ages, and I feel like a new person today.
3. Structure:  You’re going to hate this one. When you have an injury to the brain, there is a bit of a spacey state of mind that is not an altogether bad thing. In fact, the things that normally stress people  ( money, being late, worrying about money or being late) well, they don’t really seem to register when you’ve had a head injury. Having a poor memory is sometimes a blessing!  But if you want to get better, it is important to create some structure for yourself.  Make plans for your days, write everything down, and get as organized as possible. Do your best to avoid having to make decisions on the spot. As your brain heals, you will gradually be able to think critically again, but for now, create a structure for yourself around the basics: Eat well, get exercise, work at activities that are good for you and be patient with yourself.

I will leave you today with a picture from my part of the world. It’s nothing flashy, just a nice way to end the day.

Beth.

Support for Learning

There are many ways to learn. I know that multi-tasking is something we do to fool ourselves into thinking we’re accomplishing a lot, but really, the approach to learning that has always proven most successful for me is to do just one thing. I love any activity that requires intense focus. For me, this usually means busy hands. Baking, drawing, writing, gardening, swimming, skiing, playing piano-I can’t even list the number of solitary focused activities I love to do. I’m very lucky to have these interests, but the monkey wrench thrown into my enjoyment of all of these pursuits is concussion. Sustained attention takes energy and a brain that has been altered by an injury needs support.

This is where my professional background can come into play. I have taught students who need support for their learning for a little more than 25 years. My current assignment (me) is going to rely upon my knowledge of accommodations to support learning. When I have written individual education plans for students, I usually have the classroom environment in mind. A typical classroom may be full of noises and activity, but it is a somewhat controlled environment. There are routines, rules and prescribed expectations for behaviour that are set out and agreed upon by the teacher and students. So when I approach learning for myself now, I approach it in the same way  I would set up a classroom.

My current challenge is to teach myself how to draw. It’s mindful, relaxing, and very satisfying. I have organized a space and time to allow myself to succeed in this learning. If you are working on your own healing from a head injury, I offer this 4-pt checklist to help you succeed in your own learning:

1. Get organized: Set up a table/desk workspace free from distraction. Take some time to organize materials you will need, keep it tidy, and just for you.
2. Background: I need music. I always have a radio or laptop with some type of music that I don’t really listen to, but it blocks out the sound of the ringing in my ears. If you are suffering from over-sensitivity to external stimulus, pick one modality (one sense). For me, music is the obvious choice, but for you, it could by scent- aromatherapy can be very relaxing. A fan, a heater, a lovely fireplace, whatever is calming to you will help you to tune out distractions that may seep into your learning environment.
3. Balance: Fatigue is a big issue for a healing brain. If you are at the point at which ten minutes is enough, then that’s fine. You can extend your tolerance for learning by alternating the types of activities you do within an hour, or even a day. I approach learning by alternating the types of activities I’m doing. It’s really important to get up and take breaks from whatever activity you are focused on, so keep an eye on a clock (set a timer if you need to) and move from visual to auditory activities, as well as small and gross (large muscle group) activities.
4. One thing at a time: It is really hard to focus on one thing at a time, and I think I have mentioned this in a previous post, but make a decision to complete a task, and stick to it. Then, when you get distracted and find yourself doing something completely off-task, don’t get mad at yourself. Similar to meditation, it’s important to catch yourself off-task, then get back to what you were doing. It’s the awareness of focus that matters, not the ability to maintain it. That’s what you’re rewiring your brain to do through the new activity that you’re learning.

I’m going to leave you today with a link to some background music to augment your learning, whatever it is you choose to do. My niece just posted her own study playlist on this site. I really like it, but if it’s too mellow for you, I’m sure you’ll find something here to enjoy while you work. Concussion recovery is a field of study, and if you have found yourself immersed in it, approach it like a student.