'Nature, time and patience are three great physicians.' - H.G. Bohn

Just over two years ago I was in a hurry.  I’d been to a store and was returning home to entertain some visitors.  Clutching my purchases in one hand, I opened the car door, pushed down on the armrest and launched myself inside – and hit my head a resounding blow on the top of the door frame.

And that’s all it took to change my life for over two years.

When I say I hit my head, I should probably clarify – I hit my head hard! I sat, stunned, for about 20 minutes, blinking back the tears and feeling quite disoriented.  After a long while I drove slowly back home, feeling very strange, with a lump on the top of my head growing larger by the minute. I had a thundering headache, but didn’t really think much of it that night as I went to bed.

The next day was the beginning of my two year encounter with mild traumatic brain injury (mTBI).  I couldn’t wake up properly.  I couldn’t concentrate, my headache was intense, I kept feeling nauseous, giddy and what was even worse for me – I couldn’t put words together in a sentence.  After seeing my GP I was told to rest for at least a fortnight, and rest I did.  I slept for most of the next two weeks – that was to be the beginning of twice daily naps for the next six months!

The early management of my concussion went really well – apart from some stubbornness on my part to get back to work after that initial fortnight, and persistent problems with concentration, attention, word finding, fatigue and headache – I could see myself improving day by day.  I had great support at work from the workplace rehabilitation coordinator, my manager and the clinical team with whom I work.

I also had wonderful help from the clinical team who carried out my post-concussion care.  I was fully assessed by the neuropsychiatrist, neuropsychologist and occupational therapist.  They helped identify the specific deficits I was experiencing, and then worked with me to institute strategies so I could cope.  They communicated with my manager and my GP, and helped me feel I was making progress.

I headed into trouble around four months after my injury.  I became profoundly fatigued after trying to work half days, then felt frustrated and overwhelmed at the difficulties I had keeping up with my work demands.  I became depressed.  For some months I had to reduce my expectations, the hours I worked, the things I did outside of work.  Balancing work, parenting, household tasks and ‘life’ became an enormous challenge. I needed help.  It felt like a long, dark tunnel without a light at the end.

It’s at this point the support of the post-concussion health care team became so very important – at every point they reminded me that people do recover from this.  They supported me to reduce my expectations – then helped me feel OK about doing so.

I wish I could say my recovery went well after my depression lifted, but it wasn’t quite like that.  I still struggled at times, especially with fatigue and ‘multi-tasking’. 

My biggest challenge came when my employer suggested that my recovery was not going as well as they would like, and that I may need to consider moving to another area with fewer demands.  This was about 12 months after my original injury, so it probably shouldn’t have been such a shock – but I can remember the feeling of being terribly afraid that my job was at risk.  At the time I was working about 6 hours a day, carrying out most of my normal duties within those hours – with the exception of some tasks that I found I struggled with.  After some energetic negotiating, a plan to complete my return to full duties was put in place, and about 15 months after my ‘mild’ brain injury, I was finally back at work full time.

Was I fully recovered?
No, even today I have daily post-concussion headaches, and fatigue.  The headaches don’t respond to medication, so I’m glad I have a range of coping strategies at my fingertips to help myself carry on.  At least once a fortnight I spend an afternoon sleeping, and most weekends I’ll need to rest for an hour in the day.  I haven’t had a ‘normal’ social life since the accident because noisy environments and late nights are too exhausting to manage (especially if I want to do anything over the weekend!).  Some work demands continue to be difficult – like keeping track of multiple deadlines or working in a group environment.

There are so many things I’ve learned as a result of this experience. 

The need to be quite firm with family members who kept on suggesting I seek different opinions for treatment, because there is no real ‘treatment’ for post-concussion syndrome, except rest and gradual resumption of activity. 
The fact that as the person with the health problem, I was the only one with ‘all the information’ – communication between the various people involved in my rehabilitation wasn’t always clear, and I needed to be able to communicate effectively with them all.  Not easy for me, but how much more difficult for someone who doesn’t know the health care system and isn’t as assertive as I was.
The need to maintain balance between recovery to return to work, recovery to be an effective parent, recovery to be a good partner – oh and to have enough energy left over to return to normal leisure and social activities.

There are some good things I’ve learned from mTBI.  Balance in my life is much more important to me.  I make sure I spend time each day doing something without words – like dance or photography.  I am better at saying no to people’s requests, because if I get overwhelmed and fatigued, I don’t have energy reserves to draw on. 

I have learned the value of providing realistic reassurance to the patients I work with.  So often I was reminded that people with concussion do recover, and this kept me positive and able to persist with my rehabilitation.  I remember that as I work with patients now – most people with chronic pain do live a good life, return to work and move from being a patient to a person again.  If I can remind them of this, it too might help them persist with their rehabilitation.  The skills that I use to cope with my limitations post-mTBI are assets in my life, and I hope that the patients I work with will view the skills they use to cope with chronic pain are also an asset to their lives.

There are many other things I’ve learned to, but the final lesson is that even in our modern health care system, the three great healers of nature, time and patience are the most important treatments for mild traumatic brain injury.