How Does One Get a Concussion? My Story.

On April 16th, 2019 my daughter and I were singing along to some music while we were driving to Ikea. I'd just secured our new long awaited Exhale Academy space in Oakville and was excited to get our product shelving.   As many of you know the temporary office at the Cornwall address was lovingly being called the womb.  The new space at the Cornwall address was literally just birthed, and it was beautiful.

As we were singing for some reason, my daughter noticed a woman we drove by.  We looked over saw that she was on her phone and commented that we'd better get away from her.  I moved a lane away, and we carried on singing like it was nothing. A few minutes later, I noticed that we were coming up to an intersection with green lights, yet everyone was stopped.  As I approached closer, I saw a police vehicle with lights flashing, and I came to a stop.  I was the first person to stop in my lane; the other lanes were already backed up.  As I stopped, I looked up into the rearview mirror, and I saw it coming.  Bam! Lots happened after this.  First of all, I lost all feeling in my arms and hands.  That was scary.  Then I felt my neck, upper back, and head seize up.  Every move caused searing pain.  Thankfully the police were on site, having witnessed the entire thing. Fire Crew was there within minutes, shutting down the intersection and turning my car off.  They also took the time to secure that my body was okay and calm my daughter.   Shortly thereafter, Ambulance services were there attending to myself and my daughter.  We were in good hands.  

Despite everything, I hadn't lost my sense of humour. My daughter and I were joking at the irony of the fun we were having singing away and then being smacked in the back.  I also had a laugh with the Officer when I told him that I saw him raise his hands and bang the steering wheel right as he saw the accident occur.  I could just imagine the superlatives flying out of his mouth.  The Officer was super friendly and just kept repeating that I did what I was supposed to do.  They estimated that the other driver was going roughly 60 - 80 km per hour when they hit my vehicle, and I was at a full stop.  The irony, as I was being brought to the ambulance, I looked over at the other driver and saw that it was the same distracted driving woman!  

Why did she change 2 lanes to get behind me? Were our lives meant to intersect?  I suppose so?  Was she meant in some way to bring my life to a grinding halt! I'm certain at some point in my life, I will consider this divine intervention, however, at this moment in time, I am struggling to understand the significance.   

I was taken to the emergency room.  I spent several hours in a neck brace having to lie down completely still until I was cleared of any neck or back fractures.    Again, my daughter and I stayed light-hearted, making fun of how unattractive I looked. I was finally cleared of fractures and told I had significant whiplash and that a good course of physio and massage would bring me back to normal functioning.  

The next day I rested as I was advised.  My family doc was away so I couldn't see him until the following day.  That next morning was unbelievable.  I have never experienced anything like this before.  I was so slow in my movements and speech, I could barely lift my head, arms, or keep my eyes open. I felt like I had very little control over my body. My head was hurting so badly, and my vision was blurry.  I couldn't read. I was nauseous, dizzy, and had to hold onto the walls to walk straight.  The world was spinning, and anything that moved by my periphery would make me feel like I was going to fall over or vomit.  Everything felt foggy, and I had a hard time stringing sentences together.  

Without me saying much, my doctor diagnosed me with a concussion.  I was baffled.  I thought you had actually to hit your head for you to have a concussion.  I don't remember hitting mine.  I have since been educated that you do not have to hit your head.  The velocity of the hit to the car creates a jarring of the soft tissue of the brain that hits that hard shell of the skull that has jagged edges and causes lacerations and bruising to the brain structures and thus inflammation.

I've learned that concussions can result from car accidents, falls, fights, passing out, being near explosions, and hitting your head.   It can be the result of a direct or indirect blow to the head and end in what is deemed a mild traumatic brain injury (mtbi).  This is diagnosed by a physician's assessment of your neurological, cognitive, visual, and vestibular symptoms.  Brain imaging can be used to assist in diagnosis, either a CT scan or MRI to check for complications in your brain or fractures in your neck.  If symptoms last longer then three months an individual is diagnosed with post-concussion syndrome.  

Apparently, the 15 most common symptoms of a concussion are:

  1. Headaches that are severe and compare to migraines with sensitivity to light and sound and ebb and flow with triggers. *Yup I've got those! Every day and they are excruciating.

  2. Decreased cognitive function, including difficulty concentrating, memory loss, slow decision making, lack of focus, and inability to recall regular routine. *Yup.

  3. Lack of Coordination, including dizziness, vertigo, difficulty staying balanced and coordinated, difficulty standing up and walking a straight line. *Yup.

  4. Pupil Dilation can occur after severe trauma to the brain…not sure…

  5. Nausea, including repeated vomiting, due to the headache, balance issues, and poor vision. *Yup.

  6. Blurred Vision. *Yup.

  7. Bruising where the injury occurred. *Nope

  8. Emotional Outbursts, or rather emotional high and low swings, get easily irritated and upset, suffer from depression, or seem highly anxious or agitated. *Not outbursts, but definitely disillusioned and feeling anxious about my recovery.

  9. Slurred Speech. Because a concussion sends the brain into a spinning motion, normal speech patterns often sound slurred, incomprehensible, or the individual will have difficulty speaking. *not anymore

  10. Disrupted Sleep. Either the individual will have great difficulty getting adequate rest, or they will sleep more than usual. *yup

  11. Amnesia. Either retrograde, that is forgetting things of the past, for instance, moments around the brain injury. Alternatively, you can have an anterograde loss, which is the inability to form new memories. *immediate memory has been affected

  12. Ringing in the Ears. This is a ringing, buzzing, or hissing noise in the ears. *on and off

  13. Fatigue is considered the most common symptom and is often extreme tiredness and lack of energy that comes on from doing much less than the average person. *yes

  14. Loss of smell and taste which also effects appetite * I'm not sure?

  15. Feeling not like yourself. Feeling like they are in a fog, feeling confused, feeling delayed in their response, feeling delayed in recalling the right words, or using the incorrect languages *Yes.

Interestingly, concussion symptoms may not show immediately after the injury and in fact, will typically present themselves after two to three days.  Often worsening first before getting better.  Additionally, recovery from a concussion is painstakingly slow.

Source:  Adapted from https://www.activebeat.com/your-health/concussion-symptoms-how-do-i-know-if-i-have-a-concussion/15/


Ahimsa

Ahimsa copy.jpg

I opened a book of mine today and out fell a piece of paper with the word Ahimsa. It fell into my hands at the perfect moment. Ahimsa is the first and foremost code of moral conduct upon which all the Yama’s and Niyama’s rest. Ahimsa, or nonviolence, asks us to step lightly, do no harm, and to honour the relationship we have with the earth, with each other and with ourselves.

A small poem was attached to the word. “May I be gentle with myself today and easy with whatever comes my way; kind to all creatures I meet and with loving compassion for all I greet.” Patanjali’s Yoga Sutra is a value I live by. Yet, when people are caustic or rude, it is hard to hold up the latter aspect of this Yama. No doubt we all find ourselves in moments when reactivity takes the place of reason. When our insides feel a burning. Where we feel wronged and misunderstood.

There is a deeper subconscious self that wants to say to those who hurt us “No, you have it all wrong! Stop and see yourself!” Then I realize that just as they cannot see themselves neither can I. Like a fish in water, they don’t know the water they are immersed in and neither can we have the clarity we wish to have.

I was then taken to thoughts of Gandhi and how he fought for liberation through non-violence and his quiet defiance incensed people such that he was assassinated. A passionate, gentle, brilliant man, leading his people to equality and rights, ended up dead because of other’s opposing views based on misperceptions, projections and singular agendas. Are we really this fragile as humans? Are our minds so blind that we can become so inflamed to do such egregious harm to another?

I was taught and believe that those who are challenging in our lives are our best teachers. I have also learned that with every interaction an individual teaches us about themselves. It is watching the actions of another that we learn so much. It is also in paying attention to our inner voice that we can observe how our own subconscious mind is triggered.

We all have a past with ups, downs, twists, and turns. Our childhood history creates an embedded blueprint of the way the world works. Whether accurate or not, it is the foundation by which all present and future decisions are made. It is not right, it is only ours. To add complexity to this is the fact that many aspects of memory are captured implicitly whereby our subconscious is functioning with the information as though it were fact, but our conscious mind does not have access to specific recollection or understanding. I typically educate my clients that when they feel incensed, they are likely accessing an implicit memory and that they would be wise to slow down and take care of themselves. It is in these moments that our child self comes to bare and we need to manage our distress by taking care of that part of ourselves.

Gandhi could feel his emotions and yet still drop into the quiet space between his thoughts to find Ahimsa. Through his deep meditation practices, he could access the silent voice of God to guide him. I then move to think of Victor Frankl, an influential psychiatrist who survived the Holocaust through his version of Ahimsa. Mr. Frankl was able to access this through the recognition that humans are both reactive and responsive. To obtain responsiveness, we must slow ourselves to disengage from the fight and flight centre of our brain. In so doing, we allow the incoming information to move to our response centre where we can access logic, reason and ethical decision making. Mr. Frankl was able to live by the fact that we do not have control over others, but we always retain control over ourselves.

Now let us apply this to a situation where someone you are interacting with has lost sight of a rational narrative. This is the tough one, but there is a simple answer. We may feel hell-bent on correcting the story, but it will only polarize you more rather than move the interaction forward in a healthy manner. Instead, our only path is to find the kernel of truth in their narrative and to attempt to understand what they are feeling rather than get lost in details.

So, are we this fragile? Perhaps instead of seeing this as fragility, we can acknowledge that this is the fierce way in which humans have survived. We had to react to stay safe. As evolved beings, we now have a chance to live with Ahimsa in our hearts and minds. Let this be so.

This is my aspiring path. To listen to the silence. When I sense the wisdom arising I will be ready waiting with a dedication to Ahimsa.

May you be at peace and free from harm.

Namaste

Time Heals They Say!

Time heals they say. Does it really? Specializing in treating trauma has helped me to see that sometimes time gives way to more awareness that may not feel like healing at all. In fact, this awareness may be scary especially if we are unprepared for it. We may react to events and circumstances with strong feelings. We may feel we cannot explain our responses to what would otherwise seem innocuous to others. Yet, there we are, feeling rattled or perhaps even out of sorts. It is a bewildering thing.

To add to this, what may have caused one person to be traumatized may not for another. This inevitably makes the traumatized individual feel like something is really wrong with them, when in fact, it is not that something is wrong with the person, but that their coping resources were limited at the time of an event such that it left their mental and physical system feeling overwhelmed.

I remember driving away from St. Michael’s hospital on a warm spring day in 1989, despondently looking out the window of the car while I searched for THE TREE that my dad was fond of. Only hours earlier I was hugging my dad before surgery, and now I was leaving the hospital with the reality that I would never see him again.

I remember having this fleeting thought that maybe my dad was better off. Surely he would go to heaven, he was a good man, and perhaps he’d even be able to sit on the park bench by his tree instead of staring at it out the hospital windows.

Just 60 minutes earlier I had demanded the doctor let me see my dad. He advised against it, but I was a determined fifteen-year-old who needed to have physical proof that I was not in a terrible nightmare. After some time, we were escorted to the surgery room where my warm and loving father lay cold and lifeless; it was so overwhelming. That moment was more then I could bear. I was so angry at myself because before we found out about my dad passing, I was there filing my nails like a regular bored teenager in a time when cell phones did not exist, and every magazine had been read.

In what I can only describe as a flash I literally cognitively left my body. I went cold, emotionless and almost frozen. The only moment I remember between leaving the hospital and the next day was looking out for that damn tree as we slowly drove away. My body had never experienced, nor was it prepared to deal with this kind of devastating emotional and physical pain. I literally felt my heart hurting from my grief. I just went numb.

Today…

I look at a tree and say

“Hi Dad!”

This was indeed traumatic for my family and me. I didn’t know this at the time. What I did know was that I was hurting and there was no way for me to find words to adequately describe my anguish. Has time healed this wound? It is 30 years since my dad died. There is not a day that goes by that I don’t think of him. There isn’t a day that I don’t wish for him to be here with us, to meet my beautiful husband and 4 kids. But does it hurt as much as it did way back then? Well, no. That said, seemingly small things will happen that can rattle me, yet thanks to a committed mindfulness meditation practice I now can see me in my reaction rather than becoming the reaction. That took years to develop, life experience, wisdom, excellent mentoring and a dedicated practice.

When we first start to work through traumatic events, a mindfulness practice can be agitating and actually not recommended. Tolerating sitting in silence can be a challenge for the average person, let alone someone who has a trauma history. When there is trauma in your past, your entire nervous system has learned to be hyper-vigilant to potential danger. It would be rare that your nervous system would relax. Doing something like mindfulness would feel counterintuitive to your body in this state. However, it is the direction that we want to move in. Mindfulness enables meta-cognition, which in short is the ability to observe oneself as though you are the individual in the interaction but also a bystander. Meta-cognition is an incredibly powerful process that is central to trauma recovery. I firmly believe that with meta-cognition we can heal. We develop a sense of curiosity and questioning around our quick reactions, instead of turning to them as though they are fact. We are able to humbly admit that we don’t know what we don’t know, that we are not our stories, that we can postulate a narrative, but it will only be built on assumption and historical thinking.

What to do, how do we heal from our suffering? There is not one way to do this. What we do know for sure is that trauma recovery includes body, mind, and spirit. It requires having a therapeutic individual holding space for you in order for your nervous system to relax. It takes seeing that the world can be safe overall even though unsafe or disturbing things have happened.

So in reflection, I can say that time decreases the intensity of the original shock and over time you get really good at holding yourself together while you tell the story. Whether we heal is dependent on our processing the events we have been through. It isn’t enough to just meditate, or to hide away, or to ignore it, or better still to tell and retell your story. It is about carefully allowing your nervous system to learn that it can stay regulated while it touches the edges of what was once utterly overwhelming. Working with a carefully attuned clinician that is trained to observe and influence the nuances of your nervous system is critical to this kind of work.

Today, when someone reacts with me, I remind myself that at some level we have all experienced times when our nervous system was utterly overwhelmed. It might not have been something catastrophic or chronically painful, but it was enough for us to feel unsafe and unsure. I look at that person reacting, and I ask myself, “if this behaviour were the result of unresolved trauma what might they need right now?” And, always, I am reminded that what we all need and want is to be seen, heard and deeply understood. We can do this for each other and help one another heal.