“This is not good.”
Those are the words that rattled in my head as I lay on the ground. A passerby asked if I was okay and – even though blood was flowing into my eyes – I assured him I was. I had just slipped on ice while walking to work and fallen head-first onto the pavement. My hands were in my pockets so nothing braced my fall. A new chapter of my life had just begun.
A friend of mine who is good at physics calculated that my head was moving at 35 miles an hour when it hit the pavement. My world went black, but with a ring of rainbow colors around the point of impact. I was conscious, but my focus went inside my head for a few seconds. I remember taking note of the darkness and the colors, so I was connected to reality on some level.
I managed to gather myself up and stumble on to my office. I am a Ski Instructor (and Supervisor of Training) for the Telluride Ski School and 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. If I take the day off – no pay. But working through pain and sickness is standard operating procedure for my career, so I went into autopilot even though I was dizzy with a mighty headache. I was going to meet my return clientele, no matter what! I cleaned the blood off my face, got dressed, and went out to work. But then my supervisors and students took one look at my eyes and said, “You are not skiing today. You are going home.” I had been given permission to stop, so I did.
On the couch with my nurse
Living in an Altered Reality
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. I could only see straight ahead and, strangely, that felt normal. Only through extreme concentration did the rest of my body feel connected. I learned later that when you bonk your head you can lose your peripheral vision so that the brain has less to focus on. My brain had gone into an efficiency and energy saving mode.
I found I had trouble pulling thoughts together to form the correct words for 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.
Several weeks into the recovery I remember feeling quite good about how I was walking, even though I had to concentrate very hard. Then a friend shocked me by saying, “Are you OK? It looks like you’re walking on eggshells.” In my new reality, what felt like full functioning to me was only a fraction of where I used to be. 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. 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 was suffering. I have tremendous resolve and could muster energy for about five hours of daily life before having to lay down. Being in a public place with lights and noise felt like somebody was driving a mining pick over my right eyebrow. I started wearing sunglasses inside.
Adventure and exercise are key parts of my lifestyle, but that all changed. The first summer after my wreck consisted of walking progressively longer distances a couple of days a week (with ski poles for balance) and stand up paddling about 100 yards round trip one or two days a week. Bicycling terrified me because of the balance required. Any activity that increased my heartrate or caused my head to be lower than my heart started the drumroll inside my skull.
Basically, everything caused headaches and dizziness, some worse than others.
Shopping for food was one of the worse things. I’ve never been much of a list maker – I’d write down “milk, eggs, greens, bread” but no specifics. I’d just walk along the aisles and look for meal inspiration along the way. That didn’t work anymore. Looking at all the choices would exhaust my brain. I couldn’t concentrate and would often leave before completing the task. My coping mechanism was to think it all through ahead of time, make a meticulous list, and visualize the order of aisles I’d be walking through so that there were no decisions to be made. I did not veer from my list.
The craziest thing is that making eye contact and actively listening to people was the most difficult thing to do. If it was a sincere two-way conversation, 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 if their body language was broadcasting insincerity – ouch!
For three years, I couldn’t read a book or anything on the computer. The wonderful women in my book club would choose a book that I could find on Audible, so I listened while everyone else read. (I became a better reader by listening to books because I grew to appreciate the descriptive writing and rhythm of the story better.) Amazingly, even setting up Audible on my devices and finding a book was so uncomfortable that I would have to do it by closing one eye and looking at it sideways.
My accident happened in early March and, by sheer will, I continued working until the end of the ski season (after a week off) a month later. The first time I drove to work (about 45 minutes away) I had to pull over at the halfway point to rest for 30 minutes before continuing. My brain would just get so tired.
As best as I can tell, I faked most of my clientele out, although a few knew something was wrong. I just didn’t let on how wrong it was. By 6:00 each night I was in bed, in the dark.
When the ski area closed, I collapsed on the couch. My next challenge was high school graduation weekend for my son. Fellow parents were organizing the graduation weekend, but the meetings became overwhelming for me, so eventually I was released from helping. I still hosted a graduation party and house guests, faking my way through it and completely collapsing for a few days after that.
From all I’ve learned about head injuries since, I now know it was really dumb for me to be out skiing every day. What if I fell again? I shudder to think about it. But given my altered reality, I was incapable of making good decisions for myself. I was on autopilot with what I knew best, teaching skiing. Maybe it was therapeutic for me to be on the mountain and moving around.
Maybe my continued activity made my symptoms last longer. Or maybe, as some medical research says, you have to exercise the brain after injury just like a knee. I just had too much to do to stop my life.
“Did you get an MRI?” people would ask. “Ummmm. No.” I live in a small town in southwest Colorado and don’t have the resources of a big city. I just thought that with my high-deductible insurance, I didn’t want to spend thousands of dollars to have somebody tell me what my 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 traditional doctor? Perhaps, but I didn’t. By 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 directed me away from my chosen path, I would have taken his advice.
Initially my emergency room doctor friend prescribed a drug to make me lie still for a few days. It made me feel groggy and sick to my stomach, so that didn’t work. 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 just hang out better. Turns out 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.
Next, I went to an Osteopath (doctor of structure) and spent 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. It felt awesome to have his touch on my head.
Another local doctor put me in a hyperbaric chamber to aid healing. I crawled into a big tube that was around three feet in diameter and eight feet long. I did this for an hour at a time for about a dozen times. The tube would be sealed slowly pressurized to a point that was below sea level. At the same time, I wore an oxygen mask that gave me a high concentration of O2. According to my doctor’s website, “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.” 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 and a blanket to cover me. As the doctor would pressurize the chamber there would be a loud hissing noise and I would have pop my ears several times. It took about seven minutes to become fully pressurized and then I laid there for an hour, breathing deeply. After the session I felt so relaxed – I really believe this helped my brain to heal.
Noise canceling headphones helped as well because my brain would get over-stimulated by noises as well as bright light. I remember going to a friend’s birthday party in a busy restaurant a few weeks after my accident and got so overwhelmed that I had to leave. If I had had my headphones and sunglasses on, my experience that night would have been so much better, but I would have been a sight.
I would get an instant headache when looking at my iPhone or my computer, so I went back to a flip phone which really helped. For several years, I used my computer by connecting it to my TV monitor and sitting five feet away.
My Osteopath and I finally figured out that my headaches were visually triggered, so he sent me to an Ophthalmologist who specializes in head trauma. Many eye tests later, she explained that the swelling in my brain had caused my 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. I was thrilled to hear there was a reason for my symptoms!
The doctor gave me glasses with special lenses that helped immensely. I had a “see-close” pair and a “see far” pair. The glasses had a special prismatic lens which basically moved my eyes the direction they needed to go. This way my eyes did not have to work as hard to focus. The pain eased substantially. I wore one pair of the glasses constantly but both were hung around my neck so I could be switching them back and forth as needed. Dorky, but necessary. I was psyched!
I saw my eye therapist weekly for the next three months and did daily eye therapy. The therapy included: exercises to focus from far to close; balancing on a balance board while playing catch to practice multi-tasking; focusing on different quadrants of my view (high left to high right to low left, etc.); throwing a ball into a bouncy net to practice focusing on something coming back at you from far to close; tracking a swinging ball hanging from the ceiling; and exercising my peripheral vision.
I was committed, which made me the perfect patient. We were retraining my brain to connect to my eyes properly and it worked quite well.
You hear lots of stories of people with head injuries who are having such a hard time with their altered reality, headaches, and inability to live their usual life that they become depressed and hopeless. That first year I flirted on the edge of the dark side a few times. Once, my family went out to dinner without me because I had been having a “bad head day” and wasn’t feeling up to making the trip to a loud restaurant. I remember lying in bed curled up in a fetal position, crying at the sheer challenge of living in this state. When we dropped my son off at college, I was overcome with emotions about him leaving home and me not being able to help him move 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 much more empathetic now.
My therapy was finished by September and my doctor 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 two more years after the eye therapy was complete to feel normal again. I continued wearing both pairs of glasses but have been slowly weaning myself off. Sadly, my Osteopath moved away but I continue to work with a Chiropractor to keep my head and neck aligned. To prevent headaches, I stay hydrated, eat healthy food and keep my blood sugar steady, get good sleep and not overdo it in any realm. That is good life advice for anyone, head injury or not.
Four years later, I’m 95% headache free, 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?
My recovery was a lot of work, but I didn’t give up. 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
-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 thought about all my adventuring in my life – from skiing steep runs, to mountain biking single track, to rafting and SUP-ing rivers, to climbing mountains – and realized I have never had a serious accident. It seems when I’m doing something dangerous, I’m really paying attention. My most life-altering injury happened when I was simply walking and not being mindful about where I placed my feet.
Writing about this experience was important in my healing process. It was surprisingly difficult but incredibly therapeutic at the same time. As you can imagine, I now have tremendous empathy for people with head injuries and I hope that my personal experience can help others, both the injured and those that care about them. I am a better person for my injury 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!
For more information about sports-related traumatic head injuries, read Impact Zone (Dan Koeppel, Outside Online, August 29, 2016).