My Story
March 2016
My brain has not been pulling its weight lately. Here’s what it feels like.
the impact
My go-to first round question used to be ‘never have I ever had a concussion.’
In December I slipped, fell down a few feet, and landed directly on my forehead. When I came to, maybe only a second later, my first thought was “ok that was really hard.” Then, “I need to get up so everyone thinks I’m fine…and wow this is how NFL players must feel when they want to stay in the game after a hit.”
That night I threw up and the following two days were two of the worst of my life. Every source of light and word spoken above a whisper caused sharp pain. My balance was off and trying to think made me nauseous.
Maybe I was too out of it to realize something was really off. I assumed it was a shitty hangover with a little something extra that would pass in a few days. That Monday I went to work with a hat and my boss told me to go to the hospital.
The first few weeks I wasn’t so much in denial as unable to process what was happening. Yes, I was sleeping eleven hours a day. Yes, after a lifetime sans headaches my brain hurt all the time. I couldn’t focus for more than a paragraph or two. I got pulled over for driving erratically. At work, by the afternoon I was so nauseous I couldn’t sit up straight.
But I’ve lived with the same brain for twenty-five years. For awhile it was impossible to conceptualize what WebMd meant by concussions causing “cognitive problems involving memory, concentration, and thinking.” My brain has never been impaired for more than a few hours at a time.
Imagine you’ve woken up from a long night out where you only got a handful of hours of sleep. It’s like that, but different.
cognitive issues
So the generic symptoms are pretty draining. I get nauseous after looking at a screen for long. Concentrating on anything unfamiliar is a struggle and eventually gets painful. It takes real effort to follow and participate in a conversation longer than thirty minutes, and I need a break after an hour. Extended exposure to noise is mentally fatiguing and makes my ears ring for days. I can’t drink or exercise. Very few things used to put me in sour moods for long but now my emotional ‘flex’ tops out at what I used to have after five hours sleep.
Putting all of the above aside, the cognitive slowdown has been the most unnerving. It’s so much more nuanced than what a concussion protocol could reveal.
Imagine being unable to think in sentences with multiple clauses without pain. Paragraph-long thoughts out of the question. Where your brain used to unconsciously play out multiple scenarios at once, now you have to deliberately work your way through each one. The effort it takes to work through different options makes you more likely to stay on one track, both logically and emotionally. Visualizing complicated scenes in my mind’s eye is painful. New information, particularly about unfamiliar topics, hurts to toy around with and doesn’t stick.
The creepiest side effect has been making typos on easy words. I’ve made more “its/it’s, their/they’re” errors in the past few months than I have in the past ten years. Homonyms consistently trip me up. When trying to draw a sad face I put the eyes underneath, making it an upside down happy face instead. It’s as if my brain has to expend so much energy getting the other parts of writing right that it doesn’t have enough in the tank to do anything else. Assuming that this pattern applies more broadly, I’m scared to know what else my brain is missing.
Progress is uneven but it’s there. Every day is a crap shoot, but definitely I feel better than I did a month ago.
Mid-June 2016 — Relapse
Relapses are real and really demoralizing. The pleasures I am used to — exercise, video games, music, socializing, watching sports, reading and listening to articles and books — I have since had to ration. On about four occasions after I spent two or three weeks feeling pretty good I have indulged (the Kanye fashion show, shooting hoops and jogging in the park, two hours of Overwatch followed by a west coast playoff game which I found incredibly joyous for whatever reason), only to condemn myself to two plus weeks of more severe tinnitus, nausea, and headaches before I get back to where I was prior.
Most recently, kayaking on a still lake and sitting on a pontoon boat over Memorial Day weekend has brought me to my lowest physical point since the first weeks after the concussion. The worst part with this one was that I feel like it wasn’t even my fault — the other times I was aware I was taking a calculated risk to test my limits but I had no idea my body would react this badly to being on water. This has also dropped me to a dramatic new low emotionally — partially due to the dramatic deterioration in my symptoms as well as the intense frustration of feeling like after six months (as long as it took 66-year-old Hillary Clinton to recover!) my brain isn’t any less fragile.
I recently got into Tim Ferriss who said somewhere in a podcast that titration of addictions is sometimes much harder from a willpower perspective than cutting off whole hog. Cutting yourself off from really human behaviors like listening to music, dancing, exercise, socializing and even thinking without paying an emotional price, particularly for someone whose natural brain state is one of hyperactivity, is just impossible without paying an emotional price. It’s also depressing knowing that I’m most likely to overexert myself when the endorphins start flowing and I’m happy and in ‘flow’, so I have to be wary of those times.
Thankfully, I’m now out of the 10-day dark room jail sentence my new doctor issued and can start to resume a semi-normal existence.
July 2016 — A New Approach and Silver Linings
The setback (and Tim Ferriss’ body book that’s all about how ‘conventional wisdom’ science is twenty years behind and that we should experiment with our bodies to figure out what works) prompted me to ditch my old doctors’ ‘just don’t try to push yourself too hard and wait it out’ and take a new approach. Now I’m doing every therapy under the sun and hoping something sticks.
*Sensory deprivation floatation tanks that Navy SEALS apparently use for concussions. You’re floating in salt water and it’s so quiet you can hear yourself blink. I walked out of the session the most zen I’ve ever felt and the feeling lasted for days. It also eases off the symptoms pretty dramatically, giving your brain space to breathe, and they stay settled down for days afterwards. I really recommend this for anyone who’s stressed or anxious or just wants to feel like they’re going to the moon.
**Biofeedback Heart Rate Variability breathing (20 minutes of breathing really slowly twice a day). Too soon to tell but it’s supposed to activate some nervous system that’s locked in the on position post-concussion. Here’s a good explanation of how it works — basically some scientists in the 70s hung out with different Yogis from all over the world, asked them to get “calm and centered,” and watched as everyone from Japanese zen masters to Tibetan monks slowed down their breathing to a really regular 5 breaths per minute. It helps relax the fight-or-flight nervous system that isn’t able to properly calm down post-concussion. Here for more on the autonomic nervous system.
Meditation with my new best friend Andy from Headspace
Stretching with the Flexivity app
low-intensity body-weight exercises
**Cardio at super low heart rates. I tried cardio before but I would always end up pushing myself too hard, get a terrible headache, feel bad for the next few days, and not try to exercise again for another month. A new doctor pointed me in the direction of this Buffalo Protocol where you do twenty minutes of cardio at the heart rate just below where your symptoms kick in, then increase 5–10 bpm every week.
*I have these incredibly ugly glasses from Theraspecs that help with fluorescent light. [Note--this can screw up your sleep schedule if you use them during the day as it filters out the light that helps regulate your circadian rhythms. It also may create a dependency that ends up reinforcing your light sensitivity. Use with caution, maybe limiting to supermarkets and watching tv at night.]
So I don’t feel like I wasted a year of my life, it’s important to find/create silver linings. First off, I’m thankful that I can see good doctors, live at home in a supportive household, and don’t have major responsibilities I’d be stressed about shirking to recover. Had this happened in high school, college or god forbid a few years from now with a family, I would have been much more stressed about missing experiences and disappointing people relying on me.
Since I can’t develop any skills I’m really excited about (I’m working on drawing and cooking which is fun but not going to change the world…), and I already have a ton of different therapies to do every day, I’m most focused on habit-formation. This interview with Naval Ravikant, more than anything else, got me out of a funk. (It’s worth overlooking Tim Ferriss’ terrible interviewing style — Ravikant is just gold.)
"I had a health issue a few months back, which is a great wake up call. Everything great comes from something bad. Krishnamurti has this definition of suffering, where he says suffering is a moment when you see reality exactly as it is. When you face reality, that’s when you’ll change. It’s hard to look at suffering as a teacher but that’s how you should prepare yourself for it…I had a bacterial infection and my internal state was unhealthy. In one week I dropped alcohol, dairy, caffeine, red meat, went completely zero carb. All my bad habits disappeared overnight because my body was giving me a tight feedback loop. If I ate the wrong thing, I felt terrible.
That was a gift! When I’m 41, my turns around and tells me what to eat to be healthy. If I ate perfectly, then the symptoms were much better."
Learning how to make a habit, more than learning to code or whatever, is probably the useful thing I can come out of this experience with. For starters, I’m trying to stop putting off important tasks and hard conversations, be on time, and wean myself off iPhone dopamine hits.
To help remind me to do all of this, I’ve started on Habitica. It has a silly RPG scheme after downloading ten different habit apps this one has the most versatile features, the best app, and the deepest social integration. Plus you start to think of your little avatar as a Tamagotchi you don’t want to see die.
