[BLOG POST] Tips to monitor your Brain Injury Recovery

Brain injury recovery takes place over a period of time. From one day to the next, positive changes are not always noticeable. In my early days of recovery, my doctor was prompting me to evaluate my recovery in terms of weeks and months. I was rather impatient and I remember thinking surely not…but turns out he was right. Adjusting my expectations was initially somewhat heart-breaking, but also the right thing to do to keep my motivation levels up and my mental health in check.

Brain injury recovery is a marathon and not a sprint.

As we are about to turn the page on another year, you may find that it is time reflect on the year that’s been and evaluate how far you’ve come in terms of brain injury recovery. In this blog, I’ll try to capture a few tips to help you evaluate how far you’ve come and empower you to keep looking for ways to take your recovery to the next stage.

How to carry out an end of year review?

I don’t think there is a right or wrong way to conduct an end of year review. Make sure to add your own personal flavour as no two brain injuries are the same. The aim goal is to keep you motivated so I think it will speak most to you if you can bring your creative flair to it. You may wish to draw images, add pictures or videos, graphs, add sections where you add the input of someone who has been supportive of your recovery and so on. Sky is the limit and why not have a little bit of fun while doing it right.

Whatever format you settle on, I think that a review should include a mix of the following so you get the most from it.

1- Evaluate your strengths

A good way to evaluate our strengths is to track your accomplishments. People involved in your recovery may be able to help you with this one as you may have already established some goals. Take a moment to look at those goals and see if you’ve achieved them. You may not quite have met those goals yet, but by monitoring the progress made, you’ll be able to establish how valuable any progress has been for you. Achievements will differ from one individual to another, but they may include aspects such as:

• Mobility and coordination
• Fatigue levels
• Cognition (processing time, attention, memory, concentration…)
• Return to work
• Ability to drive
• Gain made when exercising
• Socialising with family and friends
• Getting involved in the community
• Tolerance to sensory overload
• Ability to manage your emotions
• And so on…

Don’t be afraid to highlight your accomplishments and milestones as it’s something you should be proud of. If you can identify the positive impact that they’ve had on you, even better as this will become a building block for the upcoming year.

2- Areas for improvement

It’s important to be honest and critical when identifying areas for improvement but remember to be fair and kind to yourself. We are often our own worst critic so try to approach this section as if you were giving feedback to someone you love. Doing so may help you rephrase things in a way that will be empowering. Really see this section as an opportunity for learning.

An easy way to identify your weakness, is to have a think about what it is that you have struggled with. Once you have identified those, try to come up with a few ideas of how you could mitigate those struggles going forward.

3- Look to the future

This is the section where you can expand on what you’d like growth to look like for you in the year ahead. Try to use your strengths identified above and see how you can leverage them to work on the areas that can be improved. Where possible, try to be specific and describe how you plan to remain committed.

Depending on how thorough you want your end of year review to look like, you may wish to give some thought to establishing SMART goals which stand for:

Specific: What do you want to accomplish?

Measurable: How can I measure this?

Attainable: Is this goal realistic for me?

Relevant: Is this relevant to my recovery?

Time-bound: When you want this goal met?

If you prefer to keep things simple, having a read of the SMART goals questions mentioned above may help you describe how you plan to stay committed to your recovery without making this a laborious exercise.

One last thing…

You should be very proud of yourself for all the little milestones achieved throughout the year. As we know, brain injury recovery isn’t linear so it’s easy to get disheartened whenever we experience a set-back. That’s where an end of year review can be helpful as it can help clearly show that despite the ups and downs, the overall trajectory is aiming upwards.

I personally think that it is important to celebrate how far you have come. Think of a way to reward yourself for each milestone and don’t be afraid to share those milestones with others too. You’ve worked hard to get to where you are so keep the good work up and be excited to explore how you will grow further in terms of recovery and as an individual while navigating brain injury recovery.

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[BLOG POST] Knowing your Limits after Brain Injury

• Veronique Theberge

Knowing our limit after brain injury…well here is a million dollar question right? Although the threshold and some of the associated triggers are likely to vary for each individual, there are some common blocks we can build on when trying to answer this question. In this blog, I’ll try to explore some of the things we can do to identify and explore those limits.

It’s not a sprint it’s a marathon

I know the concept of OVER slowing down may be hard to grasp for many survivors, but you have to be patient when it comes to brain injury recovery. The brain injury has created many more detours for you to get from point A to point B so allowing yourself more time to complete a task or reach a goal can be really beneficial.

Breaking tasks or goals in smaller steps may also be very useful. Several reasons why this may be helpful:

• More efficient and targeted use of your brain energy
• It’s likely to be less overwhelming for the brain to process
• Gives you lots of milestones to celebrate along the way
• Can work wonders in keeping your motivation levels up

I used to be able to do it all and live life at 100mph, learning to slow down has been one of the hardest things to get my head around. I eventually grew to appreciate that slow and steady gets me places, but every now and again, I still need to remind myself of that.

Repetition is key

You may not be of the belief that repetition makes perfect, but it can sure lead to improvements. If you are trying to improve a skill following brain injury, let it be physical or cognitive, it can drain your precious brain energy really quickly at first and even lead to intense fatigue. It’s important to increase repetitive skills gradually. Thanks to neuroplasticity, you can form new pathways, but it also requires time and effort to do so.

I’d encourage you to prioritise and make a plan addressing the skills you would like to improve. If you have a rehab team, they can assist you and potentially draw a plan for you. If you don’t have the support of a rehab team, talk to your GP, he is likely to be able to help, or at least point you in the right direction. Another suggestion is to keep a record of what you are doing everyday and track a few specific skills that you are working on. It doesn’t have to be an exhaustive record, actually the simpler the better (e.g.: tracking minutes, number of reps, etc.). In addition to visually noticing improvements over a period of time, keeping a record has the added bonus of keeping you consistent, accountable and motivated.

Brain injury recovery isn’t linear. I used to be really disheartened when I’d have a set back. It felt as though all progress had been lost. Keeping a record in my notebook has allowed me to keep my focus on the overall trend. It helped with my motivation levels but also in keeping my mental health in check.

Identify your triggers

In time, you will be able to identify a range of situations that typically increase the intensity of your symptoms and/or that drain your brain battery at a much quicker pace. Identifying those situations ahead of time might allow you to better prepare and manage those situations.

Discovering what doesn’t work and then what works best for you in certain situations takes time. Learn from each attempt, check in with peers or specialists to get ideas and guidance about what could be worth trying, adjust consequently and give things another go.

If a given situation remains challenging, it might be that you need to gradually build resistance to it. Remember, it’s a marathon not a sprint.

Noisy settings were really challenging for me and would tend to deplete my brain battery in a matter of minutes. I could take days to recover from grabbing a meal with friends at a restaurant. Using ear plugs has been really beneficial in lessening the draining effect that noise has on my brain. Something so simple has been a real game changer for me.

Managing your fatigue level

Here is a common rule for all…pushing through does not work. In fact, it might induce a setback and result in taking you longer to get back to your baseline.

It is easy to do too much on a good day, but the reality is that the boom and bust cycle is not a strategy worthwhile following. So how can we best manage our fatigue levels?

• Stop before you get tired. By not dipping into the red zone, you can maintain a more even level of energy throughout the day.
• Frequent brain breaks are a great strategy to start implementing early on in your recovery. For various brain breaks ideas, read another of my blog “Think Smart not Hard in Recovery”
• Identify the activities in your daily routine that are the most draining for you and take them into consideration when planning your day. Make sure to leave yourself enough room to get through your entire day. If an activity is particularly draining, see if you can break in down in smaller pieces (e.g.: cleaning is a great example for this, instead of cleaning the whole house, do one room per day).
• Be mindful of your symptoms, as they increase, your brain battery is most likely emptying rather quickly. Just as recovery doesn’t follow a linear curve, you may notice your brain battery doing a steep dive too. The intensity of our symptoms have a way to let us know where things are heading. Don’t ignore them and be mindful of what they are trying to tell you.

I don’t know how many times I’ve hit the wall after pushing through. It could impair my overall functioning for days. It can feel quite rigid to follow a strict fatigue management plan at times, but once I realised it worked, I stopped viewing it so negatively. I still miss being spontaneous at times, but I know that some things are best not to be left to luck.

Final words on knowing our limits

One of the key points to remember is that there will be a trial and error period whilst trying to identify your limits. As I often tell my kids, it’s better to give things a go and not to get it perfect at first than not to try at all. It’s a learning process. It can feel disheartening to go through a set back if you gauged things wrong, but it also shows a lot of inner strength to adjust and give things another go.

The other point to always keep in mind is that those limits will change in time. So if some things don’t quite work for you now, it doesn’t mean that they won’t forever. Limits change over time and sometimes within a same day too. Being aware of how certain

activities impact us and adjusting accordingly

can be helpful in extending those same limits over time.

If you had recited this quote to me a few years back “Go slow to go fast faster” I would have said…yeah whatever, I’ll show you. However, many of my trials and errors have proved me otherwise. You can keep extending your limits, but a gradual approach is more likely to work with you instead of against you.

What other tips did you find helpful with your own recovery when exploring your limits?

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[BLOG POST] Dear Caretaker of a Brain Injured

• Veronique Theberge

Many think that a brain injury only happens to the person who sustained it, but the reality is that it also affect people in their network. Although it happens to a particular individual, it is very much a family affair. Getting our heads around it can feel overwhelming, but know that you are not alone experiencing this roller coaster of feelings and changes.

In this blog, I’ll break down how brain injury can affect family members/carers & I will put forward various strategies that can be helpful in supporting that dear person in your life. Lastly, I think that it’s also super important to touch base on ways in which you can best look after yourself as a family member or carer.

How does brain injury affect family members/carers?

Everyone’s challenges may slightly differ, but there are also lots of commonalities in how the whole family can be affected. To name only but a few:

• Less personal time
• Financial difficulties
• Role changes within the family
• Problems with communication
• Lack of support from family/friends

Brain injury is a significant and often stressful event and family members can also go through a range of emotions such as anger, sadness, anxiety, frustrations and guilt.

Some can also find it really hard to see how much their loved one has changed. There might be a grieving process for them too which is often referred to as ambiguous loss. Everyone needs to build their resilience in this type of situation so regardless of where you are sitting on the fence, there is always a learning curve.

How family members/carers can help?

There is a variety of ways in which you can support someone recovering from a brain injury once they get to come back home.

• Attend medical appointments or therapy with them
• Ask your loved one’s GP or treatment team about ways in which you can support them
• Work together on establishing a daily routine that works for all of you
• Ensure the person isn’t getting too fatigue or flag to them when fatigue is starting to set it.
• Communicate with them, keep them involved in decision making and make sure they remain involved in daily activities
• Be honest, but positive. A good way to do this is by focusing on the gains experienced.
• Avoid comparison between the “old me” and “new me” as comparison is indeed the thief of joy.
• Remain respectful; talking down can trigger other emotional issues such as anger, lack of confidence, negative self-image or low self-worth
• Keep a calendar on the wall so everyone is aware of what is on the upcoming agenda
• If memory problems are in play, create an album with pictures and names of familiar people and places.
• Break activities or tasks down in simple steps and review each steps as they come along
• Avoid situations or settings that could lead to sensory overload. E.g.: Have one or two visitors at a time, avoid crowded places, minimize incoming senses to process (visual, auditory, tactile)
• Give your loved one additional time to respond or complete a task.
• Ensure that their environment is safe. E.g.: Avoid clutter, adequate lighting, and limit access to potentially dangerous areas or substances. We want to avoid the potential of additional injuries.

It can be a fine line between giving too little or too much assistance. Make sure you get regular feedback from the person who’s had a brain injury as they will be able to guide you further and asking the questions may take away some of their insecurities too.

How can you look after yourself as a family member/carer?

It’s important to remember that you can’t pour from an empty cup so sometimes you have to take care of yourself first in order to be helpful to your loved one. Navigating brain injury recovery can be stressful for everyone involved. Managing your levels of stress and ensuring that you are sufficiently rested plays an important part in allowing you to support your loved one to the best of your abilities. They need you healthy and rested so here are some ways in which you can look after yourself too:

• Learn to relax (breathing exercises, mindfulness, meditation, etc.)
• Explore new coping strategies as the previous ones may not be adequate anymore

– Keep your schedule regular

– Exercise regularly

– Keep some time for yourself

– Join a carer support group

– Find the humor in some of the situations that arise

– Ask for additional support

– Delegate some tasks

• You can only solve one problem at a time. Identify the problem and discuss with your loved one different ways to solve an issue. Once you settle on a way forward, don’t be bound by it if it doesn’t quite get you the desired outcome.

It’s okay to revisit your options and try something else.

In conclusion, brain injury recovery comes hand in hand with trials and errors. You don’t know what you don’t know right? It’s okay to make mistake and review your perspective. The important thing is to take on board those to maximize how the family unit manages all the changes that may have occurred and optimize overall recovery.

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[BLOG POST] Nutrition and Brain Injury Recovery

• By Veronique Theberge

Nutrition and Brain Injury Recovery

I am by no means a qualified dietician or nutritionist, but given the absence of guidance & support from most health specialists when it comes to nutrition and brain injury recovery, I thought it was important to share a snippet of my personal experience. If it isn’t an area that you have already explored, it might incite you to carry out some research on this topic or to seek the help of a dietician or nutritionist to get further advices.

Some of the tips shared in the following blog are from my personal trial and error in applying some of tweaks that were suggested to me and for me by a qualified dietician and nutritionist. Although there are often lots of common grounds between brain injuries, please note that a specialist may suggest a different course of action for you. Other fact to keep in mind…not all dietician and nutritionist are made equal. My first attempt in meeting a nutritionist really wasn’t successful. A year later, I explored this option again and the health professional that I met had a really sound knowledge of chronic fatigue and brain injury which lead to welcomed changes. Therefore, it you are willing to invest, it is worth asking question around their area of expertise so you can make sure that they are equipped to help you.

How can brain injury affect your gut?

Whether a person sustains a concussion, traumatic brain injury (TBI) or acquired brain injury (ABI) the brain trauma experienced tends to cause an inflammatory response. The inflammatory reaction is not isolated to the brain itself and more often than not results in structural and functional damage to the gut. The neuro trauma can increase intestinal permeability and lead to an immune response where gut inflammation and intestinal dysfunction travels back to the brain (via your central nervous system) perpetuating this cycle of inflammation. The overall inflammatory response tends to affect how your brain functions and can have a huge flow on effect on your whole body. Left untreated, symptoms such as brain fog, hormonal dysfunction, chronic fatigue, cognitive deficits, decreased physical activity and depression can sneak in making the brain injury recovery even more complex.

How did the cycle of inflammation affect me?

The reaction described above matches to the letter how my original brain injury started creating havoc in my body. In my case, encephalitis greatly affected the functioning of my nervous system. My heart rate would fluctuate in the most erratic ways, I felt constantly nauseous and I had diarrhoea just about everyday. Taken individually, these symptoms may not appear too debilitating, but when you add the daily grind of having to factor those symptoms on top of fatigue, blurry vision, sensory overload and a long list of cognitive deficits, they soon started to be one more thing that would affect my mental health. It’s as though no breaks were allowed.

When you first start to recover from a brain injury, you are very much in survival mode. At first, you tend to deal with the most obvious issues at hand and this chain of reaction is often not addressed until much later into your recovery.

Where some may be re-learning to walk, others may be dealing with fatigue, aphasia and so on. In my case, managing my levels of fatigue took priority over many of the other symptoms. At the time our sons were aged 8-7 and 4 so getting adequate sleep at night and a good rest after lunch in order to be somewhat functional once they got back from school/daycare was crucial. Other symptoms such as my fluctuating heart rate and my vision issues were also sitting at the top of the list, relaying gut health, hormonal imbalances and other ways in which I could support my overall wellbeing towards the bottom of the list.

My personal experience has also been that many mainstream health specialists look at a problem from their unique field of expertise, therefore missing out on the overall effects on the individual recovering from a brain injury. The brain does heal, but at a much slower pace than the rest of your body so supporting its recovery in any way you can from the start is key to avoid or minimise the chances of seeing this cycle of inflammation from taking over.

Nutrition tips that can support brain injury recovery?

My journey sure hasn’t been straightforward. Although information and research on the perpetuating inflammation cycle is becoming more readily accessible, it feels as though it still hasn’t become part of the mainstream information that is shared with people recovering from brain injury. I’ve found that you need to do your research, be your own advocate and keep challenging the health specialists in order to start assembling all the pieces of the complex puzzle that is brain injury recovery. Below are some of the ways in which you can support your recovering brain:

• Looking into low inflammation food and diet has initiated a much bigger shift than I ever thought possible. Cutting out or reducing the main inflammation culprits such as dairy, sugar and gluten has been really beneficial and translated in a big reduction of symptoms that I was having to factor in every day.
• Investing in my gut health has also been beneficial. Adding probiotics to my daily routine has been a simple action that has contributed to the well running of my body. My body isn’t constantly wasting time and energy in trying to recalibrate itself. Therefore more energy is available for the brain to work on healing.
• Omega-3 can help fight inflammation, maintain brain structure and have an overall positive effect on mental health so introducing fish oil with DHA & EPA is something that may be worth considering.
• In the early days of brain injury recovery, fatigue can be one of the most debilitating symptom experienced by brain injury survivors. Because fatigue can be so intense, prioritising a balanced and healthy diet isn’t always at the forefront of our minds. Therefore, introducing a good multi vitamin into your routine can be a way to help minimise nutritional deficiencies. If fatigue persists or mitochondria dysfunction sneaks into the mix, CoQ10 may be worth looking into as the Coenzyme Q10 acts on cells energy generation.

Having your hormones levels checked after brain energy is also very important. If there is an imbalance, which is fairly frequent in both women and men following brain injury, it can contribute to persisting symptoms, affect your sleep, stress response and reproductive system.

Words of advice from my personal experience

My advice to other brain injury survivors and their carers would be to seek the help and support of a qualified dietician and nutritionist to address the inflammation cycle early in the piece. It is another thing to do, but it’s a piece of the puzzle that is often overlooked. The sooner you break this cycle from taking hold, the better are your chances to avoid other secondary symptoms from creeping in. Our experience has been that not all dieticians or nutritionists have sound knowledge of diets that can best support brain injury recovery, so it is best to ask questions prior to investing and meeting with a specialist to make sure they are equipped to help you.

Where to next?

Brain injury recovery is very complex and there are so many aspects to consider. What’s important to remember is that it’s never too late to start working on pieces of the puzzle that were left untouched. You don’t know what you don’t know right, so be kind to yourself! Be open to the idea of looking into less traditional avenues and be curious about the possibilities it might bring. It could lessen some of the undesirable symptoms, perhaps get you off a plateau, translate into an increase in energy and have an overall positive effect on your physical and mental health.

Remember that you don’t have to implement everything at once. It’s ok to work on a section of the puzzle at a time and there is always time to move to the next step at a later time. I personally would much prefer to take longer to implement a strategy but make it sustainable than to rush into something that won’t last.

Nowadays there is more information available online on holistic ways to explore during brain injury recovery, but it needs to also reach the traditional systems as they are often our first port of call. Being your own advocate is crucial and it’s key to finding pieces of the puzzle that will enable you to move forward and live the best life you can following brain injury.

I am four and a half year into encephalitis recovery and I only started on this journey eight months ago after coming across a specialist that had sound knowledge of brain injury recovery. With her guidance, some of the changes implemented have been a real game changer so my advice is to keep looking and don’t give up hope.

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[BLOG POST] Comparison, the Thief of Joy

by Veronique Theberge

Comparison between people, aptitudes, skills, etc is a concept that most of us would be familiar with. Of late, I’ve been spending time assessing how the ongoing comparison between the old and new me since encephalitis and acquired brain injury may be affecting my overall happiness and recovery.

The changes in lifestyle, in physical and cognitive abilities and in energy levels has been pretty drastic and to be perfectly honest quite a bumpy ride too. Comparison is no longer between what others can achieve versus where I stand, but between where I used to sit versus what my new reality allows for now. On more than one occasion, this has been really disheartening. It has affected all spheres of my life and comparison reached an all time high on a personal, professional and social level.

Has comparison between and old me and new me been a thief of joy? Absolutely.

As I’m taking a step back to write this blog, I’m thinking about some of the words that I used, about comparisons that I have made between the old and new me, and I can see clear as day how so many of those comparisons would have been harmful. I can see how they would have detracted me from achieving a state of happiness. I can say in all honesty that comparison between the old and new me has triggered several negative thoughts.

Social comparison

Attending social events following a brain injury is not an easy undertaking and I have avoided a fair share of them over the years. One would think that by not attending an event that there would be less ground for comparison, but I found that to be quite the opposite. In fact, I found it has heightened social comparison.

FOMO is a real thing and digital technologies do not let you get away with much unseen unfortunately. It has often made me aware of the immense gap between the number & type of event that I can manage compared to everyone else. When I have put myself out there, it’s often highlighted my newly acquired challenges and the ways in which I have adapt in order to survive the simplest of gathering. Those few examples describe really well how social comparison may have had a negative impact on my overall recovery and wellbeing.

Professional comparison

In the early days of recovery I was extremely lucky to have the support of a stellar employer. They were amazing! We settled on a return to work schedule that catered for my health challenges and we amended the plan as recovery went on. However, limited time in the office and reduced cognitive abilities meant that in order to see some projects come to fruition, some tasks and responsibilities had to be dispatched amongst other colleagues. I understood the reasoning for this, but it felt unfair. It felt unfair that a brain inflammation and its resulting brain injury robbed me of some of my professional aspirations. It highlighted, once again, some of my shortfalls. I started perceiving injustice in my professional life and the culprit was for the most part the new me and its ongoing limitations. I remember all too well comparing my cognitive aptitudes, productivity and the state of my executive functioning between the old and new me…and for the most part, I did not like the state of it one bit!

Personal comparison

With managing limitations left and right and learning to live life as the new me, it didn’t take long for the negative to outweigh the positive between the old and new me. I was more times than not pretty disappointed with the massively scaled down version of the old me. I’ll go as far as saying that at times, I hated this new me. Unsurprisingly, this sort of internal dialogue and belief lead me to think that I was failing all the times. It felt as though I was falling short on so many fronts. Looking back, I realise how harsh and unkind I was to this new version of me which was in reality working harder than ever.

How could the reflection of the person in the mirror be the same yet FEEL so different? Comparison was truly the thief of joy but at the centre of it all were two different versions of ME that I could simply not reconcile.

As I’m reading and reviewing this blog , I so wish that I could have told that person in the mirror something – ANYTHING – to have her believe that things will be ok in the end. That rediscovering and healing myself will happen, but that it will take time and occur in many shapes and sizes. The thing is, I’m not sure that I would have believed then what I know now anyway.

If you are stuck in this exact phase of your recovery, I won’t sit here pretending that getting to know and appreciate the new you will be easy. I get you, I understand the frustrations, I understand the complexity of the challenges that you are faced with and all their associated emotions. I truly feel for you and above all, I wish I had a magic wand to fast track this process ten-fold. I think it’s a journey and that at some stage we come to realise that we have to trust the process.

Tips to manage comparisons

Below are a few ideas that I’ve come across in an article from Psychology Today* that I’m thinking may help you manage some of the harmful comparisons between the old and new version of yourself following brain injury:

1. Recognize that you’re likely using an unrealistic target when evaluating yourself and adjust accordingly.

2. Consider what you’re trying to achieve when making a comparison.

3. If comparisons have you feeling down, spend some time thinking about positives: how much a skill has improved over time, how much worse a situation could be than it is in reality, or others who may see you as a role model right now.

We have to remember that comparisons can go both ways. Finding ways to use comparisons in a positive way can actually be helpful. Again, I’m not saying that it’s easy, but with the right mindset, we can gradually start turning things around.

Final words on comparison

So next time when I ask myself if comparison between and old me and new me has been a thief of joy, I think I’ll tweak my answer in the following way…Yes of some of my joys, but time has been my ally. As the new me started finding its place and purpose, I discovered so much about myself and this definitely translated into growth that would have never come about otherwise. Trust that somewhere along the way, you will start embracing the new you and that comparisons between the old and new you will fade away.

*https://www.psychologytoday.com/nz/blog/multiple-choice/201903/is-comparison-really-the-thief-joy

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[BLOG POST] Sound the Foghorn

I realised very quickly following encephalitis and acquired brain injury that cognition encompass of many aspects such as memory, concentration, attention, processing speed, problem solving, thinking processes and of how a brain injury can easily disrupt the very fragile equilibrium under which it operates. All those aspects of cognition rarely operate as a standalone process either. They continuously bounce off each other and rely on one another for us to make sense of the life that unravels in front of our eyes every day. But what happens when brain fog creeps its way in?

At times, I literally feel the brain fog creeping in. It’s as if all aspects of cognition start to deteriorate one by one right in front of my eyes. I always find this heartbreaking. It feels awful and can often drag me down physically and mentally too.

What is Brain Fog?

Firstly, I think it’s important to mention that you don’t need to have a brain injury to experience brain fog. Brain fog can indeed be experienced by many of us. Some of the root cause of brain fog can include hormonal changes, lack of sleep, food sensitivities and depression. However, it’s also important to note that brain fog linked to brain injury slightly differs from other common causes of brain fog.

Following a brain injury, inflammation, bruising and damage can disrupt how the brain functions. In order to get from point A to B, an input may now need to go through a series of detours which can in turn slow down the transfer and processing of information. When old pathways can no longer be accessed, your brain will re-route the information either by using other existing pathways which role differ from the original ones or by creating new pathways. In either case, this tends to tire the brain quite quickly. Other times, a pathway will keep working overtime…as if there is no on/off switch. The effect of having a part of the brain working even when not required will result in the same effect which is, the brain will tire more quickly than it should. That’s often when people recovering from a brain injury will experience concentration difficulties, slow thinking, trouble remembering stuff, struggle to process information and so on. If you are or know of a person recovering from brain injury, that’s when you may have heard them use the term brain fog to describe what they are experiencing.

Commonly, people can describe it as being stuck in a think fog, as a dark cloud coming over them, feeling fuzzy, feeling as though they are there but not quite there or that their brain struggles to keep with what’s happening around them.

People recovering from brain injury rarely experience brain fog on its own. Their brain fog can be triggered by another symptom such as fatigue or a headache, but they can also occur concurrently with a range of other symptoms. These can include: memory loss, visual disturbances, depression/anxiety, dizziness, nausea, physical pain, hormonal disorders and as previously mentioned fatigue and headaches. The brain energy spent on trying to manage those other symptoms means that the energy tank drains at a much quicker rate and that the brain energy available to run the cognitive functions is now being used to try to manage other symptoms. That’s when brain fog can significantly affect a person’s cognitive functions.

Tips for brain fog

In order to help reduce brain fog when recovering from a brain injury, we really need to look at the brain fog itself, but also at the concurrent symptoms as alleviating those may help reduce the severity of the brain fog experienced. As a rule of thumb, the following areas can trigger or increase the severity of some of your symptoms so it’s worth exploring which part of your lifestyle could be tweaked:

• Sleep hygiene: Having good sleep routine (avoiding overstimulation, consistent bed time, 7-8 hours sleep, eliminating blue lights, avoiding caffeinated drinks, avoiding strenuous exercise when close to bed time, etc.)
• Nutrition: Many research claim the benefit of Mediterranean diet to reduce inflammation, so this may be something to explore. If shopping triggers some of your symptoms, you may need to think of ways in which you can tweak your shopping habits (e.g.: online shopping, off-peak shopping time, etc.)
• Exercise: Regular exercise has clear benefits on a person’s health. Exercise allows for oxygen-rich blood to reach the brain and regulate the production of chemicals that can assist healing. Remember to exercise at levels that aren’t increasing your symptoms else it is counter-productive and can have the opposite effect i.e. increase your brain fog. This may mean opting for a gentle walk one day and for a higher intensity form of exercise on a day where your symptoms allow for it.
• Medication: Some medication can help clear the brain fog temporarily, but as they wear off, they can cause you to crash. On other hand, some medication can trigger brain fog as well so if you are on medication, talk to your GP to find out how they could be a contributing factor.
• Relaxation: There are several relaxation techniques out there that can help reduce stress and consequently help calm your nervous system. Explore several of those techniques and see which ones tend to work better for you. Examples include deep breathing exercises, visualization, meditation, yoga, spending time in nature, mindfulness, listening to music or using the creative part of your brain. Once you find something that works for you, try to incorporate them in your daily routine.

You don’t have to implement these tips all at once. Doing it gradually can be a more realistic and sustainable approach. If you come out remembering one tip from this blog, please let it be not to push through your brain fog. Brain fog is likely to creep in once you’ve gone above your current limits so it’s important to stop and take five. Those limits will move in time, but by pushing through, you are likely to increase your brain injury symptoms and experience those dreadful set-backs. Stop what you are doing, take a little break, try one of your relaxing technique or have a rest. Try some of those tips and be consistent in your approach, hopefully it can translate in an improvement of your overall health.

• encephalitis survivor,
• acquired brain injury,
• Anxiety,
• Brain injury,
• depression,
• encephalitis,
• encephalitis awareness,
• encephalitis recovery,
• Fatigue Management,
• Healing,
• Brain fog,

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[BLOG POST] Driving After Brain Injury

Following encephalitis and acquired brain injury, driving has been a very tricky thing to reintroduce into the mix. In the early days of recovery, my vision problems played a big role in my decision to simply not attempt to get behind the wheel. My vision could be blurry, full of black spots, at times I would lose my peripheral vision, I’d struggle to refocus and I’d often had what I call delayed vision. Vision obviously plays a big role with driving, but I also discovered that other factors were to be considered. My reaction time was greatly reduced so I was mindful that all my reflexes were far from being optimized. Driving is also one of the most cognitively demanding exercise. It requires a huge amount of concentration, attention, and multi-tasking. In normal circumstances, much of the multi-tasking used to happened instinctively for me, but following brain injury, I discovered that it was no longer the case.

Whilst taking into account all these reasons, my partner and I made the decision for me not to drive in the early stage of recovery. I’d walk or bike places, I’d be driven places or simply stay home. Having a young family, driving meant that I’d typically carry a very special cargo with me and we established that it simply wasn’t worth the risk. Risking getting myself injured was one thing, but risking others being injured wasn’t something that bode well with me. With me not driving came a HUGE loss of independence and it made the family daily routine quite tricky. The weeks had to be planned down to a tee to figure out who/how we’d get the kids to their after school activities, who/how I’d get myself to appointments, do the groceries and so on. It was all very limiting and highly frustrating.

As months went by, I was slowly starting to regain some brain capacity and some of the residual effects were lessened or not “showing up” as frequently so we started to introduce short distance drives within a 5km radius, then 10km radius and so on.

Even then though, I’d base my decision to drive on the amount of brain energy available at that particular point in time. I soon discovered that I could get to a specific place ok, but that completing an additional task (e.g. grocery shopping) meant that I was using up a lot of my brain energy. Therefore, I didn’t always have the brain capacity to drive back safely. That lead to several hard to managed scenarios. How do I then get back? If I get picked up, how do we bring the car back and so on. So after a few trials, we put driving places that included additional cognitively demanding tasks on ice for a while longer. To manage this limitation, I’d grab rides into town with friends & I started doing pretty much all of my shopping online (so lucky to have that option nowadays). I almost always found a way to get out and about, but that loss of independence was another loss I had to learn to accept and manage on top of everything else. It had a negative impact on my sense of self-worth, my feeling of accomplishment and so much more! I knew I was making the right decision, but it also triggered lots of mixed feelings.

Years have now passed since the original brain insult, but driving remains an activity that isn’t considered lightly. Sometimes, I’ll find myself napping in the car before coming back home, some days I’ll postpone a trip into town for another time, I’m still planning my weeks around when/where I may have to drive, driving distances are still managed very carefully and I’ll still grab rides when possible. Every now and again, I still need to be rescued and I’m still avoiding driving at night as if my life depends on it…because it probably does.

It’s really hard to explain to others what this delayed vision feels like. But I hope the following photos give you a bit on an insight as to how the world truly appears to me when the brain slows down and stops processing things normally. It is always pretty scary when it happens and I think you’ll agree with me saying that driving therefore not always an option.

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