Traumatic Brain Injury - returning to my life - Update page two!!

[Vegas_Sky]

Hi everyone, I’d like to introduce myself and draw from your wisdom, experience, and compassion.

18 days ago I was at a three-day event in Idaho on a green horse that I’ve been riding for the past year. This was her second recognized event and she was great at the first one, so I wasn’t anticipating any problems. At the 12th fence on course (a ditch at the bottom of a fairly steep hill, about five strides after a small log) she refused suddenly and profusely, throwing me over the ditch. I sailed in a beautiful arch, headfirst, into the log revetting the ditch. I impacted directly over the left side of my forehead first, then the rest of my face, then my body. The impact rolled me onto my back. I was unconscious for only about 15-30 seconds before ground crew and EMTs arrived to transport me to the hospital, 45 minutes away. I remember very little from the accident scene through the rest of the night. I’ve also lost some of the events of that day. I was discharged from the hospital that night after clean CT scan and spinal radiographs. The ER physician told me I had a concussion and that I could ride in a week or so.

After I returned home from the show, I followed up with my primary care physician (who is amazing, by the way) because I was having significant physical and cognitive difficulties. She was the one who told me that this was not just a concussion, but more of a traumatic brain injury, which is compounded by my two concussions this year and five others throughout my life.

I am now back to about 70% functionality. I started school on Monday (I’m a senior pre-vet student at Oregon State University). Although I am exponentially better than I was during the first two weeks after the accident, I am still having significant issues. The headaches are gone for the most part, but the physical exhaustion still hits me everyday around 4:00 pm. I am also having some pretty major cognitive issues that are interfering with school - note taking, attention span, processing information, slow thinking, memory - typical TBI stuff. Fine motor coordination has suffered as well, but I would say that right now my two biggest deficits are Auditory processing and information organization.

I spoke with my primary care doctor again this morning, and we are both glad that things are still improving, but I am getting frustrated at the slowing pace of my progress - I seem to be at a plateau. My Dr says that it will take time, time, time for this all to heal, but patience has never been one of my good qualities and I am definitely an over-achiever.

So here are my questions for you:

For those of you with MTBI, how long was it before you were back to normal (or your new level of normal)? I’m getting frustrated with my lack of progress and I just want to go back to my life. I refuse to accept that my life is “forever changed” - certain aspects of it might be changed and I might have to relearn some things, but I WILL go back to living my life the way it was.

When did you start riding again? - Riding is not just my all-consuming, pathological, only-way-to-save-my-sanity passion, but it’s also my only source of income while I’m in school. I in no way want to rush things or risk a second injury, but I also need to make money and I have contracts to fulfill.

What are some ways you maintained fitness or regained fitness during the early stages of recovery? I have always been fit and athletic, but right now, because of the brain injury and back and whiplash injury, I am undoubtedly in the worst shape of my life. I’m still not cleared for physical activity (only what I have to do to walk around campus and get through my life), so I was thinking stretching exercises or maybe yoga?

What exercises did you use to recover cognitive abilities and/or adaptive techniques for those that are permanently gone? I’ve heard of some nice brain training software (Posit Science) and my Primary Dr has some contacts for rehabilitation centers if these problems keep interfering with school, but I want to know what I can do on my own as well.

How did you deal with it mentally and how do you tell others? I try not to tell many people because I “look just fine”, but keeping a TBI hush hush is not easy - people wonder why I have suddenly stopped riding or why am no longer the smartest person in all of my classes. It’s kind of rough for me to deal with too because I am a GO type of person - 18-20 hour non-stop days, 20 credit hours per term, ridiculous IQ, endless energy, motivation, and goals. Now that’s all gone (except the 20 credit hours this term) and I’m having to relearn how to live my life. How do you deal with that?

I’ve read so many of your posts, and the diversity of conditions and compassion of everyone here is just astounding. Thank you all for any help you can give and God bless.

[sparky6]

I would ask your school. I’m not sure what OSU’s departments are called, but at LSU we have Disability Services, Center for Academic Success, etc. They can direct you to resources, possibly on campus. I’m in grad school to become a speech therapist and if you’re having memory/cognitive/language/auditory problems you can receive services from a SLP. Maybe contact your school to see if they have any speech, occupational, or physical therapy graduate programs. Typically if they do there’s a clinic (or they outsource to local private practices-either way, faculty members will be able to advise you) where you can get an evaluation to know where you’re experiencing deficits and get advice on how to improve.

Your self-advocacy is important and it’s impressive that you’ve been so proactive. Keep it up! Unfortunately I don’t have advice on the riding aspect or the fitness, but I do have a friend (a rider) who had surgery on her foot and wasn’t able to get around for 6 months. She was going a little stir crazy and turned to yoga and said it was very helpful.

Just remember to give youself recovery time and time to adjust. “New normal” were the key words in your post. “Mild TBI” is relative-brain injuries are serious (even concussions are on the TBI scale). It’s going to keep being an adjustment, but it was mild, you’re highly motivated, and you’re doing a great job of staying on top of the situation and getting as much information as you can. All of those factors improve your prognosis.

Hope some of that helped. Good luck and speedy recovery.

[Tiffani_B]

No advice, just jingles that you’ll continue to improve! Your post was very well focused and written, so I’d say it seems like you’re on the right track!

[mustangtrailrider]

It will take time! hhahahah

Not what you want to hear. It may be weeks to months before you are at your “new” normal.

Your had a serious tragic event. It was major trauma to you physically/mentally.

It will take many months before your get to your best.

I might think a neurologist consult might be in order, some one specializing in brain injuries.

I had major concussion last year. I didn’t lose consciousness, but I was confused/altered mental status for 6 weeks post injury. I was riding less than two weeks later. I couldn’t grasp simple decisions. I didn’t miss work, but I didn’t have a choice!

I was good as new 2 months later. I didn’t realize how significant my head injury was until the fog cleared. I had a major insult, but not as major as you had.

Good Luck, not much advice, but a whole bunch of support! Take it one day at a time. Walk. Relax. Breathe. Focus on one thing at a time. Don’t try and multitask right now…Keep lists. Keep things simple. You will get past this.

[citydog]

Definitely contact your school’s disability services office. They should be able to hook you up with notetaking help, and extra time for exams and assignments should you need it while you recover. Don’t be afraid to drop a class if you need to, even if it wasn’t part of your original plan.

It’s only been 18 days? Yeah, you’ll need more time. :yes:

Good luck.

[Vegas_Sky]

Thank you all for your support and suggestions. I’ll keep saying it because it will always be true - your compassion and empathy is utterly astounding!

You’re all right - time is going to be my best friend and biggest enemy: time is the one thing that will truly heal me, but I am just so impatient…perhaps this is meant to teach me patience :sigh:

Citydog and Sparky - I will definitely contact disability services. I already talk with Counseling and Physchological Services for my ADHD and Anxiety issues, but I’ve never asked for a referral to Disability Services because I do not want vet schools to think I have any sort of disability (admissions are ridiculously competitive as it is and because of the nature of a DVM’s life, they are not obligated to make the “reasonable accomodations” that you see in undergrad programs and therefore tend to shy away from disabled applicants), but if I’m lucky I can chalk it all up as a temporary disability due to MTBI and hopefully wean myself off support services by Spring Term. I’ve yet to speak with my counselor since the accident, but I will ask for a referral to Disability Services and ask about any other help that we might have on campus. I know we have a large physical therapy program here, but I’m not sure about occupational, vocational, or rehabilitation. I also have the contacts from my primary dr, but that goes through my insurance and gets kind of expensive, whereas services through school are free or greatly reduced.

I’ll also try to make time each day for stretching and/or yoga. I get all the cardio workout I can tolerate each day (and then some) by walking around campus carrying my books! I don’t think I’ll have to drop any of my classes - I have a year-long research project and several light/easy classes and only two truly difficult senior level courses -the only two I actually have to study for! And this is good - since it’s my senior year, I really can’t drop anything if I want to graduate in the spring.

Again, thank you all for your support. You inspire me to be the best that I can be each day!

[medical_mike]

Your symptoms are beyond what…

your in house school health system can reasonably provide care for.

With all due respect to your PCP, You ARE in need of a concussion specialist who can take a team approach to your problem…

My guess would be as a division one school with a nationally ranked FB program, there is some type of team in place to handle concussion problems like you have.

I would go to the schools athletic training program director, explain your situation and while not a student, they should provide you the name of the person(s) involved in treating concussion.

BTW… concussion = MTBI

It is good that you are improving, however there is a ton to consider and in the rest of the sporting world, concussions such as yours are managed more effectively with a team approach.

Best of luck,
Medical Mike
equestrian medical researcher
www.equicision.com

[JER]

[QUOTE=medical mike;5130449]

With all due respect to your PCP, You ARE in need of a concussion specialist who can take a team approach to your problem…[/QUOTE]

:yes::yes::yes::yes: Please see a specialist. There are doctors/therapists who do this for a living and will have lot of familiarity with everything you’re going through. A specialist can also give you a realistic time frame for improvement (but everyone is different).

Also, this wasn’t clear from your post so forgive me if you already know this: the amount of time that you were unconscious (or that you were unconscious at all) is not nearly a significant finding as the amnesia you have (both retrograde and anterograde, in your case). You can be unconscious from an accident and not suffer a TBI. The same cannot be said of amnesia.

Take it easy, don’t stress yourself and plan on giving yourself a lot of time to recover. It’s like the old rule about training a dog – if you think it’ll take a month, give yourself three months.

Good luck and feel better soon.

[HannahsMom7]

Vegas Sky - congrats on your outstanding approach to dive in and continue your life! I am a stroke survivor and some of what you say sounds familiar.

I believe the posters above have given you excellent advice, I have nothing to add except good wishes.

I didn’t hurt my body when I stroked, so I got advice from my doctor to ride when I met him 1 1/2 weeks after the stroke happening. I didn’t ride until maybe a couple of months later when I could creep around the barn. But I didn’t have as bad a stroke as some people get.

It seemed to take “forever” to get used to the new me and I slept a lot while I was healing - you might need more sleep now than you usually do.

I also just told the folks who needed to know; why tell all?

hang in there- Rita

[Zu_Zu]

Jingles for you ~ Jingle Jingle Jingle & AO ~ Always Optimistic ~

[DressageGeek_Ribbon]

You’ve gotten terrific advice, so all I will add is my best wishes.

(But if, in your driven on the go style, you go to the primary literature and want me to either download for you and/or read, just let me know!)

[mustangtrailrider]

Please seek advice of a teamed approach as Medical mike pointed out…

Other than that…good Luck. May you recover quickly.

[Equilibrium]

I don’t have anything really good to add, but please take Medical Mike’s advice. And I will say this is one of those things you can’t just push through in normal horse person fashion. You probably need more sleep than normal and I would give that to yourself any way you can.

I would also say don’t worry about one anyone thinks and don’t think of yourself as the not so smart one in class. You will only make yourself anxious and that’s not helpful to getting better.

You will be fine!

Terri

[Carol_Ames]

10 years and counting!

Find your local/ state brain injury Association; check also with the UsMEA, medical equestrian assoc. They will both be very helpful.

[IBWmassage]

My husband experienced a “relatively” mild TBI during his last deployment. It was labeled mild because he was able to continue in his job with minimal impairment.

The first time I saw him was 6 months later. He had not told me of the TBI, but within 3 hours I could discern differences in his speech pattern, attention span, and general mannerisms. It took me a week to convince him to see a Dr, but he ended up going through the Army’s TBI clinic at Ft Lewis WA. They documented a number of deficits that he really wasn’t aware of.

Having watched from the outside, I will strongly, emphatically suggest that you seek the BEST, MOST specialized care you can. The long term effects of TBI can be subtle and still have a profound impact on your life.

In my husband’s case, he has significant recall issues, struggles with word association, developed a stutter (although now it’s only when he is stressed) and is much more easily frustrated. He also began having panic and anxiety attacks that he’s still learning to manage. These are all things he still experiences, although he’s learned to work around them and compensate. His TBI was in Jan of 07. It has not held him back career-wise, but he has had to work harder than before and be smarter about his efforts. He is much more impacted by fatigue than before the TBI, and is less able to “rate” himself- although he’s finally really getting better with that.

As amazing as your primary care Dr may be, brain injuries are something that should really be in the hands of those who specialize in it. It was such a relief when DH finally was seen by neuro/TBI specialists. They were much more able to pinpoint the underlying issues, see through the frustration and side effects (headaches from having to concentrate on his recall rather than directly from the injury, that sort of thing). Their questions were so targeted that we realized symptoms we hadn’t known were a part of it. They were able to give him specific and targeted rehab exercises.

My DH, like you, is driven and motivated. Very intolerant of his own shortcomings. I will tell you that recovery from a TBI takes time. And you don’t have a choice in whether you take that time or not. If you try to push yourself beyond what your healing brain can handle, it will force you to give it time- and that will set you back even farther. Figure out what your body needs. If you are exhausted at 4, lie down at 3 and rest for a couple hours before continuing on with your day.

This is a time where your body needs you to be kind to yourself. Be upfront with those to whom you have obligations (you mentioned riding related contracts). Your future ability for horse related income will not be helped if you rush yourself and make mistakes or get hurt again.

[stryder]

Your brain can continue to heal, long past what you’d expect. It’s on its own time-table. You’re young and in good shape - this should help.

Rest is very important. You’re a busy student and used to long hours, but your brain heals best while it’s at rest. It’s time to think of your energy as money, a constrained resource, and save your “money” for highest-value activities. You’re used to having boundless energy and perhaps you will regain it, but you don’t have it now.

I suffered a concussion in December 2007, when I was lawn-darted from a horse. I don’t remember anything about the ride, and only bits of what happened next. I didn’t lose consciousness. It was only when I kept asking, “what happened?” that my trainer realized I needed help. My helmet was broken. They called my husband, who took me to the ER for xrays. I’m sure I joked the entire time.

I need more rest than ever. My reading comprehension and problem-solving are not what they were. I’m not saying I always was the smartest person in the room, but frequently I was, and this is hard for me. Some days are better than others. And getting more rest allows me to have better days. I am much older than you, and suffered minor concussions when younger. I think they’re cumulative, so now my damage is greater.

I try to do as many puzzles as I can, and I play chess on my computer. I think that’s helped me. This is the new normal.

As others have mentioned, visit the athletic department and use the university’s resources. Coaches are getting good training now in brain injury. Visit www.cdc.gov and search for concussion.

Good luck.

[Vegas_Sky]

Medical Mike, JER, and IBW - Yes, I think you’re right. I am really only now coming to a full understanding of how severe this accident was. Everything else that has happened in my life I’ve just bounced right back, but not this. I will either get a referral to a specialist or seek out the resources on my own. My insurance is very good - free access to school resources plus the amazing coverage from my parents’ policy. I don’t have to have a referral for my insurance to cover specialists. But my PCP has already hinted that she wants to send me to a brain rehabilitation center, so I will also ask for that.

I’ll talk to my parents as well - I don’t think that they fully understand the severity of the injury, and if they do they haven’t really talked about it. The whole accident really scared them. But they will be able to help me I think to find the resources I need. If I could get a neurologist or doctor that has experience with TBI, then I think that would really help with my recovery, like you have all said.

I think I might also ask to work with a physical therapist, not only for the back/neck injury, but also for general return to fitness - I am in such horrible shape!

Thank you, thank you, thank you all for your support and well-wishes! It is such an encouragement. I will be more proactive in my recovery and seek out the resources I need. And, of course, I’ll keep you all posted God bless you all, you work miracles every day.

[AKB]

When you go to see a neurologist or other TBI specialist, talk with them about when you can ride. Your balance and coordination are probably not back to normal, so you are at increased risk of a fall. Your brain is probably still at increased risk of a second impact type severe injury if you ride and fall. In other words, I think you likely should not be riding.

You may need to take a semester off or have as light of a semester as possible. If you can keep up your grades while studying in a fog, that is ok. However, if you can’t maintain the grades, you may be better off taking some time off. That would probably defer your vet school for a year.

You are only 2 1/2 weeks out from the head injury. Try to be patient, and to get some good help from rehab people who can help you work through this as quickly as possible.

[CHS]

My TBI was 30 years ago and I’ll never be 100%. I have chronic vertigo, migraines, memory loss, and balance issues (from the vertigo), oh and I lost my depth perception but learned how to compensate. I was in ICU and out of a coma for a week though. Hopefully yours isn’t as bad. I got bucked off and landed on my head (no helmet). I started convulsing when I hit the ground. I also broke my arm. I was riding a few weeks after I got home from the hospital with my arm still in a cast. Good luck and I’ll be jingling for a full recovery for you!!!

[Fantastic]

From one TBI’er to another

HUGS to all of us TBI survivors! This thread makes me emotional!

What Medical Mike said, and all of the others: seek the best medical advice and support team that you can!

In 1987 while in college, I had a TBI while skiing. I landed on the top of my head instead of my feet after going over a jump. I fractured C3. Thank God I survived! I actually walked away, and went over 5 more jumps on the way down the hill!! :eek: (yep! crazy horse girl here!)

Of course my life has never been the same since, and the injury continues to effect me in one way or another - more often than not. Thankfully, I fully function. Like you, I did not initially recognize just how serious the injury was - I blocked a lot of it out, and simply didn’t realized or expect the implications I’d later have.

I have had all sorts of issues related to this injury that have come and gone through my life - migraines, miofacial pain disorder, cronic spasming, body pain that morphs from one form into another, etc. My head and neck will forever be fragile and in need of extra awareness and protection. I get easily get whiplash and brain jostling from light bumps to the head that would not effect a healthy person.

For me, riding, staying active, and working out does help tremendously.

This TBI will be something that you are likely to deal with one way or another for the rest of your life. No one ever told me this, way back when. I was in no way prepared for the reprecussions, and really wish I’d been more educated on the matter back then. Live and learn.

Be patient, seek support from fellow TBI’ers, eat a balanced diet, and stay positive!

group hug!