An Unexpected Adventure: Recovering From A Head Injury

IMG_0322

THE EVENT

“This is not good”, I said to myself while lying on my back on the ground. A guy came up to me and asked if I was OK. I assured him I was even though blood was flowing into my eyes by then. I had slipped on the ice while walking to work at the ski school and had fallen head first onto the pavement. My hands were in my pockets, so nothing braced my fall. That moment was the beginning of yet another journey in my life.

Not sure if I was knocked unconscious. If so, it was not for very long. Everything definitely went black, but with a ring of rainbow colors around the point of impact. So I felt like my consciousness and vision didn’t leave, but went inward for a few seconds. I remember taking note of the darkness and the colors, and at the same time thinking, “this is not good” so I was definitely connected to reality on some level.

I was able to make my way to my office to dress for the day. I am a ski instructor of private lessons and have an office because I’m also the supervisor of training for the Ski School. I was to meet my students in less than an hour. The thing about the ski instruction industry is that you are only paid if you have been assigned students for the day or if students return to take more lessons with you. I could come all the way up to work and if there were no students for me to to teach, then no pay. If I were to take the day off I would also lose my pay for the day. Working through pain and sickness was so much a part of my MO over my career that I went into my ‘autopilot’ mode even though I was dizzy with a mighty headache and covered in blood. I did clean the blood off my face. (Fortunately I didn’t land on my nose or my teeth.) I was going to meet my return clientele, no matter what. I got dressed and went out to work. My supervisors and my students took one look at me and said,“you are not skiing today. You are going home.” I had been given permission to stop, so I did.

IMG_0376    

On the couch with my nurse

Symptoms and Effects

The thing with being “in” a head injury is that your reality is altered. I became totally in my head as if I was living in a tube in my mind. I couldn’t really see other than straight ahead and strangely that felt OK, and normal. The rest of my body was hardly connected except through extreme concentration. Outwardly I was a different person than before my fall though inwardly I was the same. I wasn’t as coordinated while moving (even though I knew what to do) nor could I pull the thoughts together to form the correct words that were needed in day-to-day life. I stopped being able to find the exact word I was looking for and had to settle for a second or third string word that didn’t quite describe what was in my mind. I learned later that when you bonk your head you can lose your peripheral vision so that the brain has less to focus on. It’s as if the brain brings all the energy back to itself and stops putting any of it out into the world. My brain had gone into an efficiency and energy saving mode.

Several weeks into the recovery I remember walking in a public place and really thinking about my walking and balance and was feeling quite good about it. I thought I was doing very well, though was concentrating very hard. A friend walked up and shocked me by saying, “Are you OK? It looks like you’re walking on eggshells.” That’s when it became clear to me that I was living in a different reality than before I hit my head. What felt like full functioning and full effort to me was only a fraction of where I used to be and I caught a glimpse of the journey ahead.

The split at the hairline of my forehead healed and there was no outward evidence of my accident, so a lot of people didn’t know I was altered. I did my best to fake it in spite of my headaches and dizziness and am fairly certain that people who didn’t know me well could not tell. I have tremendous resolve and focus and could put out energy towards my life for about 5 hours and then would have to go lay down. Being in a public place with lights and noise would give me a splitting headache right over my right eye. I started wearing sunglasses inside. The feeling of my headache was like a mining pick imbedded right above my right eyebrow.

I’ve always been a big exerciser and adventurer and my usual activities during the first summer after my wreck consisted of walking progressively longer distances with ski poles (for balance) a couple days a week and stand up paddling to the first buoy at the local reservoir that was about 100 yards out one or two days a week. (Before this summer I would paddle several miles each time). Getting on my bicycle terrified me because of the balance required. Physical activity where I got my heart rate up during that first year would cause headaches, as would putting my head below my heart. Basically, everything caused headaches and dizziness just some things worse than others.

Shopping for food was one of the worse things. I’ve never been much of a list maker for food shopping except for what we really needed. I’d write down ‘milk, eggs, greens, bread’ for example but no specifics. I usually walk along the aisles picking out things that we would need and look for inspiration for meals that way. Going into a store with all the bright lights and looking at all the choices of say, greens or cans of soup would just tire out my brain and give me a headache. I just couldn’t concentrate and would often leave before completing the task. So for months either I would make a list for friends or family and they would shop or I would think everything through at home and have a meticulous list to walk into the store with, complete with brand and type. My coping mechanism was to think it all through ahead of time, often the day before (so I could rest my brain before the actual shop), in order of the aisles I’d be walking through (which I visualized in my head). That way I could walk through the store and pull items off the shelves without having to make any decisions. I did not veer from my list. That strategy took away the multi-tasking and over-taxing of my brain.

The first time I drove up to work (about 45 minutes away) at the Telluride Ski Area, I had to pull over at the halfway point to rest for half an hour before continuing. My brain would just get so tired. That was about 2 weeks in.

The craziest thing is that making eye contact and actively listening to people was the most difficult thing to do. So essentially making my brain do two things at once would overload it. If it was a two-way conversation, in that the other person cared as much about hearing from me as I from them the headache was tolerable. But I started to call my headache spot the ‘Bullshit Meter’ because if the other person was doing all the talking, or their body language did not match their words (broadcasting insincerity). Ouch!!

Wasn’t able to read a book for 3 years. Started out not being able to even read a magazine article but kept at it and finally got through a few of those. Forget reading anything on the computer. I was in a book club throughout (still am) and the wonderful women would choose a book that I could find on audible.com. I listened to the book of the month while everyone else read.  I became a better reader by listening to books for a few years because I grew to appreciate the descriptive writing and rhythm of the story better. I now really prefer to listen but I’m reading my books now because of the novelty. Amazingly, even setting up audible.com on my phone or iPad, and finding and choosing a book was so uncomfortable for my head that I would have to do it  by closing one eye and looking at it sideways and taking breaks. Having a head injury is really a pain.

This accident happened at the beginning of March and I somehow continued working until the end of the ski season (after a week off), about one month, by my sheer will. I taught my return clientele and near as I can tell, faked most of them out.  Though at least two students who I taught a lot knew something was up. I would teach and then go to bed at about 6 PM to rest and be in the dark. In retrospect, and from all I’ve learned about head injuries since, it was really dumb for me to be out skiing every day. What if I fell again? I shudder to think about it now. But I was in the middle of a head injury at that time and was incapable of making good decisions for myself. I was on autopilot with what I knew best, teaching skiing. I think it was therapeutic for me to be on the mountain and moving around.  (Please read this article for more understanding http://www.outsideonline.com/2108551/impact-zone)

On April 5th, when the ski area closed, I collapsed on the couch. The next challenge then was that my son was graduating from high school in a few weeks and all the Moms were volunteering to put the graduation weekend together. My headache became overwhelming in the organizational meetings so in the end I was released from helping out. I still hosted a graduation party and house guests, faking my way through it and completely collapsing for a few days after that. (My friends and family did all the shopping and cooking for me.)

Maybe all that activity made my symptoms last longer, or some medical research says that you have to exercise the brain after injury just like say, a knee, but you know… there was too much to do to stop my life.

“Did you get an MRI?” people would ask. “Ummmm. No.” “I had a head injury and was unable to be my own advocate for a while.”  We live in a small town in SW Colorado and don’t have the resources of a big city. With how my brain was functioning at the beginning of all this I just thought that with my high deductible insurance I didn’t want to spend thousands to have a doc tell me what my emergency room doctor friend told me on the day of my wreck, “You have sprained your brain, it’s bruised and swollen a bit and it needs to heal.”

Should I have sought out more help from a neurologist or other mainstream doc? Perhaps. But I didn’t and through piecing together my own alternate therapies with out-of-pocket payments I was able to recover and feel like I got great value for what I spent. That said, I am also very grateful to my doctor friend who helped me on several occasions during my recovery. If he had given me any kind of different advice I would have followed what he suggested.

Recovery and Therapy

As soon as I was a little bit better I started to seek out some help to speed up the recovery and get to the bottom of my injury. In our town, we have lots of healers and I went to an Osteopath (doctor of structure) a bunch, spending hours on his table. He told me that a person’s skull is made up of moveable plates and when you bonk your head you can bind them up so that your brain doesn’t have enough space for healing. His work relieved some pain with a very gentle manipulation of my skull with his hands. It felt awesome to have that kind of touch on my head.

In case you are unfamiliar with what an Osteopath is or does, here is a description: https://augustana.net/academics/core/advising/advising-resources-for-students/pre-health/allopathic-vs-osteopathic-medicine.

Another local doctor in town put me in a hyperbaric chamber to aid healing. I crawled into a big tube that was around 3 feet in diameter and 8 feet long for an hour at a time for maybe a dozen times. The tube would be sealed up and be slowly pressurized until the inside of the tube was below sea level. At the same time I wore an Oxygen mask that gave me a very high concentration of O2. Here is a quote about the benefits of this chamber: “the increased pressure in the chamber in conjunction with breathing 91% oxygen-enriched air through a mask allows the blood, plasma and other liquids of the body to absorb additional oxygen, greatly increasing oxygen uptake by the cells, tissues, glands, organs, brain and fluids of the body. “ (Please read https://balancenaturalmedicine.com/therapeutic-services/hyperbaric-oxygen-therapy/   for more information.) During the treatment I could feel the painful part of my head buzzing.

After I got over the initial fear of being in an enclosed space I craved the chamber. There was a pad and pillow inside to lay on with a blanket to cover me. As the doctor would pressurize the chamber there would be a loud hissing noise and I would have to do the open the mouth thing to pop my ears several times. Can’t quite remember but I think it took about 7 minutes or so to become fully pressurized and then I just laid there for an hour breathing deeply. When the session was done and I crawled out often I would just sit on a chair because I felt so relaxed. I swear this helped my brain to heal.

balance-natural-medicine-hyperbaric-oxygen-therapyHyperbaric Chamber

Initially my emergency room doctor friend prescribed some kind of drug to make me lie still for a few days. (can’t remember what it was). It made me feel very groggy and sick to my stomach. So that didn’t work for me. Fortunately marijuana had just been legalized in Colorado and I discovered CBD pot (medicinal and non-psychoactive) which helped the pain and mellowed me out so I could hang out better because it seemed like I had an inability to stay quiet and rest. There is just too much to do in life and I didn’t want to take any time off from it.

Amazingly, noise canceling headphones helped too. My brain would get over-stimulated by noises or bright light. I couldn’t go into a restaurant for a few years because of all the stimulation. I remember going to a friend’s birthday party in a busy restaurant a few weeks after my accident, not fully realizing my new state of being yet, and got so overwhelmed that I had to get up and leave. If I had had my headphones and sunglasses on my experience that night would have been so much better but it would have been a sight.

You hear lots of stories of people with head injuries who are having such a hard time with their altered reality and headaches and inability to feel comfortable living their usual life that they become depressed and hopeless. That first year I flirted on the edge of the dark side just a few times that I remember. Once, my family went out to dinner without me. I had been having a ‘bad head day’ and wasn’t feeling up to making the trip to a loud restaurant. I remember laying in bed curled up in a fetus position just crying at the sheer challenge of living in this state. Another time was when we were dropping my son off at college and not only was I emotional about him leaving home, but I couldn’t do a good job helping him settle in because my head hurt so much. I have a good ability to keep the faith and in both cases was able to talk myself out of any depressive thoughts. Not everyone has that ability and I can totally see how a person could go to the ‘dark side’ and into depression. I am soooo empathetic now. I just kept looking for ways to help get myself better.

I never lost my ability to think and organize but after a year my headaches were not going away. And I would get an instant headache when looking at my Iphone or my Apple laptop. I went back to a flip phone which really helped. For several years I connected my computer to our TV, sat 5 feet away and could use my computer and do my work that way. My Osteopath and I finally figured out that my headaches were visually triggered and he sent me to an Ophthalmologist who specializes in head trauma to see if we could figure out the headaches.

I learned that an Ophthalmologist differs from optometrists and opticians in their levels of training and in what they can diagnose and treat. An Ophthalmologist is a medical doctor who has completed college and at least eight years of additional medical training and is licensed to practice medicine and surgery. An ophthalmologist diagnoses and treats all eye diseases, performs eye surgery and prescribes and fits eyeglasses and contact lenses to correct vision problems.

Lots of eye tests later, she explained (in my lay terms) that my head injury had caused swelling in the brain. The swelling had caused the optical nerves to get squished thereby minimizing information being sent from the eyes to the brain and back. My eyes were seeing double and were unable to track together. The result?? Headaches.. You can’t believe how happy I was to hear that there was a reason for my symptoms!

First thing was they gave me glasses with special lenses that helped immensely. I had a ‘see-close’ pair and a ‘see far’’ pair to my prescription. The glasses had a special prismatic lens which basically moved my eyes into the direction they needed to go. They altered the world enough so that my eyes did not have to work as hard to focus. The pain eased substantially. I wore one pair of the glasses constantly with both on cords around my neck so I could be switching them back and forth as needed. Dorky, but necessary. I was psyched!

For the next three months of summer I drove 1.5 hours each way every Wednesday to see my eye therapist. And would do the therapy I learned every day of the week after that. I was very committed and the perfect patient because I did everything they told me to do. At first I would get a headache driving there but by August those were going away. One of my exercises was training my eyes again to be able to focus near and then far. Driving would wig out my brain because of looking far at signs and then close at the speedometer, and then if I was listening to music or a book on tape my brain could not handle all that multi-tasking.

The therapy included exercises to: focus far to focus close, balance on a balance board while playing catch (to train brain multi-tasking), focusing on different quadrants of my view (high left to high right to low left, etc), throwing a ball that bounces off one of those bouncy nets back to you to activate the ability to focus on something coming at you from far to close, tracking a swinging ball hanging from the ceiling, exercises to improve peripheral vision and on and on and on.

We were retraining my brain to connect to my eyes properly and it worked quite well.

Lessons Learned

My therapy was finished by September and they sent me off into the world on my own for several months. I go back every Spring for a checkup and the doctor tells me that our work ‘stuck’.

It took almost 2 more years after the eye therapy was complete to feel ‘normal’ again. I continued wearing both pairs of glasses and have slowly weaned off of wearing them all the time. Sadly my Osteopath moved away but am continuing to work with a Chiropractor to keep my head and neck aligned. I still have to stay hydrated, eat healthy food and keep my blood sugar steady, get good sleep and not overdo it in any realm to stave off headaches. That is good life advice for me, head injury or not.

Now, 4 years later I’m 95% headache free and can find my words and exercise to almost the level I could before. I still forget things but really, is that a head injury or age? It was a lot of work but I didn’t give up or give in. And I learned a lot. Here are some things that I learned from my journey that work for me:

-never walk with your hands in your pockets (especially on ice)
-spending time with people who talk about themselves and don’t listen to you can make your headaches worse, so be around people who feed your soul
-limiting screen time can reduce headaches and anxiety
-stay hydrated
-get enough sleep
-eat good food for fuel
-good red wine and dark chocolate help your outlook
-go outside, and get your heart rate up every day
-be your own advocate
-accept help when friends and family offer it
-travel and adventure even if it hurts, it expands your brain
-appreciate your life!!!!

Above all, be mindful. I think about all my adventuring in my life from skiing steep runs, to mountain biking single track to rafting and SUPing rivers, to climbing mountains and I have never really had a serious accident. It seems when I’m doing something dangerous I’m usually really paying attention. This, my most life altering injury, happened when I was walking and evidently not being mindful about where I placed my feet. A friend of mine who is good at physics figured out that when my head hit the pavement it was going 35 miles an hour since my hands were unable to break the fall. From falling while walking….

Writing about this experience was important in completing my healing process. It turned out to be surprisingly difficult to write, and incredibly therapeutic at the same time. As you can imagine I now have incredible empathy for head injured people and I hope that my personal experience and journey can help others. My hope is also that you now have some understanding of what head injury patients could possibly be going through. As evidenced by my case, the pain and other issues continue on even after the outside wound heals up. I am a better person for it and that is all the silver lining I could ask for.

Thank you to all my family and friends for your incredible help and support!!