Oops!... I Did It Again: How to use Protocols if you experience another head injury
If you are healing from a head injury, nothing is more disheartening than another head injury. So if this is you, before you start reading this newsletter, consider listening to it here on Soundcloud and resting your eyes.
No matter what the reason is for your head being hit, you might be tempted to blame yourself. Trust me, that is a dark path and not a productive direction to go in. So if the unthinkable happens and you re-injure your head, practice these two simple self-care Setback Protocols:
Acknowledge that it happened, it is truly unfortunate, and you will do what you can to prevent it from happening again. Let your mindset be passive, accepting, and receptive. Do not entertain thoughts that this was your fault. That will only make it more challenging for you to feel better.
Rest as much as your body wants you to. Personally I find that Total Sensory Deprivation for either a 20 or 90 min nap helps me press reset and dramatically reduces my headaches, eye strain, and feelings of exhaustion. Let your family know you are taking a nap, close your blinds, turn on white noise, even cover your head with a pillow to muffle any sounds. Try saying "I'm resting now" to yourself at least once a day. You might enjoy the feeling of a weighted blanket when you practice your Total Sensory Deprivation, so that your movement is restricted and there is a light, hugging pressure all over.
Think of Acknowledge and Rest as your basic Setback Protocols. They are adaptable and applicable to all kinds of situations where you want to support your brain health, such as:
you bump your head getting into a car and feel woozy two hours later
your symptoms flare up because you went to an out of town wedding over the weekend
you get hit during hockey, feel a lump on your skull, and have no symptoms but don’t want to chance prolonging your healing process
Acknowledging and Resting aren’t easy in the short term but they will help immensely in the long term. Before you put any headstrong effort into getting better, seriously consider the benefits of totally unplugging and letting your body tell you what it needs. This is a hard job when societal messaging pushes us to be productive, progress-oriented multitaskers. Immediately following a head injury, the fact is that pushing yourself to heal by returning to work too quickly, taking on complex tasks, or challenging your eyes and cognitive functions can delay your healing.
If you struggle with the idea that the only thing your mind and body have to do after a head injury or flare up is accept rest, consider Rowan’s Law. Rowan’s Law was named for Rowan Stringer, a high school rugby player from Ottawa, Ontario, who died in the spring of 2013 from a condition known as second impact syndrome (swelling of the brain caused by a subsequent injury that occurred before a previous injury healed). Rowan is believed to have experienced three concussions over six days while playing rugby. But she didn’t know her brain needed time to heal. Neither did her parents, teachers or coaches.
The coroner’s inquest into Rowan’s death resulted in 49 recommendations, including:
Increased education for parents, coaches, athletes, and teachers surrounding concussion injuries
Concussion policies in place at all school boards and sports associations across Ontario
Increased education and training for healthcare professionals to better treat and manage concussions
For an in-depth conversation about Rowan’s Law and how it has influenced concussion safety, check out this episode of The Agenda: Steve Paiken interviews Dr. Carmela Tartaglia, neurologist and Chair of Brain Injury and Concussion Research, U of T; Dr. Neilank Jha, neurosurgeon; and Steve Podborski, a Canadian skier. Dr Tartaglia in particular, presses how important it is for the province of Ontario to catch up on brain research:
“This is the era of the brain and people are starting to pay attention. If you have a brain injury you change. Your brain is who you are. You are defined by your brain.”
As a survivor of brain injury, I take her words of caution to mean we must listen to our bodies because they need rest to heal AND we need to take responsibility for this misunderstood and underestimated injury until the research catches up. I first learned about protocols when researching Rowan’s Law. I immediately loved the idea of following a set of rules and procedures that are known best practices for a given situation. This takes the pressure of trying a bunch of different things, making decisions, and therefore expending energy that should be conserved in the period immediately following a head injury or flare up.
Once you are feeling more like yourself, finding it easy to laugh, seeing a silver lining, then you can switch gears. You might choose to strengthen your eye and neck muscles or spend more time in social situations where there are multiple sources of noise to test your ability to isolate sounds. But right after an impact or flare up is time to follow the Setback Protocols of Acknowledge and Rest.
When I hit my head a second and third time shortly after my first head injury, I had no idea I might be worse off than before and need far more rest. Between my first and my second head injury I took about 20 minutes of true rest. I sat on the sidelines of my indoor soccer game, then gathered myself up to leave. Between my second and my third head injury, I was told I would need 2 weeks of rest. I needed 2 months or more but the healing process was interrupted by a third blow to the same spot. I was in worse shape and needed more rest than ever before.
But it all made sense when my Chiropractor, Professor John Crawford explained it to me. We met 2 months after my third head injury. I admitted I was desperate to lessen my pain to an Occupational Therapist acquaintance. She put us in touch and little did I know that this would be a turning point: I would start to get better instead of feeling worse most days.
Professor Crawford shared that the brain is soft like jello and it actually keeps jiggling for a long time after the initial blow and takes a while to settle. A healthy brain is vulnerable and delicate; an injured brain is even more so. I had attempted to return to work multiple times by commuting into Humber College. When he learned about the daily drive from Guelph to two alternating locations in Toronto, Professor Crawford called me a warrior. It gave me pause so I remember it to this day. He said:
“You can’t continue to do that drive or you will never get well. We need to reverse the injury cycle. What you actually have to do is stop everything. No driving, no work, no screen time, no reading, no TV. Nothing that demands anything cognitively of your brain. I don’t even want you to read the grocery store flyer. You need to take a chair out into the yard and look at a tree for a few days.”
For one week, I went to a family member's cottage on a ravine, watched the birds, played with our dog, and listened to classic rock on the radio. It was not idyllic: it was genuinely hard to be still and accept rest. My partner came to stay a couple nights and barbequed for us which was a wonderful distraction. And this week of sensory deprivation and lack of activity helped me immensely.
When I look back on it, I see that I had to stop and acknowledge what I had been through. Then I had to truly rest, not just cut back on screen time and then get frustrated when I got a headache immediately anyway.
So if you ever feel like you need a set of instructions for what to do if you hit your head or have a flare up, keep it simple: Acknowledge and Rest.