Concussion: What to expect, and Setting Expectations

2018-04-10 • SEND FEEDBACK •
Related: concussion, health

Legal disclaimer: Since we are not doctors, never follow anything based on health-related topics on this or related sites without first consulting with your doctor or other trusted health professional. OTOH, the study of brain injuries is at best in its infancy, like studying outer space with primitive telescopes.

Legal disclaimer: Since we are not doctors, never follow anything based on health-related topics on this or related sites without first consulting with your doctor or other trusted health professional. OTOH, the study of brain injuries is at best in its infancy, like studying outer space with primitive telescopes.

Thank you to supportive readers, and especially my loyal subscribers. The latter were critically important to me as I recover, and I am grateful to them. I also want to thank OWC / MacSales.com and B&H Photo for their ongoing support as I work through this.

Here, concussion = mTBI (mild Traumatic Brain Injury), a poorly-conceived term given the potentially severe long term consequences.

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The deep pothole that crashed me

f1.8 @ 1/350 sec, ISO 20; 2018-03-17 11:53:20
iPhone 7 Plus + iPhone 7 Plus back dual camera 3.99mm f/1.8 @ 28mm equiv (4mm)

[low-res image for bot]

This multi-paged report and chronological logoffers personal insights into what I felt and experienced coming off a base of exceptional fitness after suffering a moderate to severe concussion (mTBI)—what worked and what did not, inexplicable joy and disappointment without clear explanation, etc .

In some cases, what applies to a person of exceptional physical fitness might be muted or problematic for others. What might apply to the unique particulars of my brain injury night apply only tangentially to other types of brain injury, or injury to other areas of the brain, or pre-existing mental pathology. Every concussion (mTBI) is unique.

State of medical science understanding ofTBI is in its infancy

Including neurologists, there is scant knowledge or even currency of knowledge of how best to deal with a concussion, the one key recommendation having changed only a year prior to my concussion, in 2017.

And yet I knew with certainty based on objective observation in just two weeks what took researchers the whole of modern medical history to “discover”. That does not inspire confidence in the medical profession. Similarly, bodily injuries I’ve suffered have been quickly healed by a skilled chiropracter (albeit one who had trained to be a doctor), with doctors so ignorant of the healing process that visits are worthless unless the issue be something that only surgery can address (indeed I address that at one doctor of mine, in both ways!).

Indeed, six months after that recommendation changed, my own daughter had had a mild concussion and was given the bad advice which had been reversed in that change of guidelines. At the least, this demonstrates a lack of currency in medical knowledge and that a doctor when asked a core and fundamental question, might well be as ignorant as any thinking person willing to look into the matter*.

While there are a handful of centers in the USA and Canada with doctors having solid experience with mTBI, these are very few and far between. Most doctors, including neurologists, know no more than any thinking person does. Indeed, I now claim to know more about mTBI than 99% of doctors, having an analytical mind and studied myself closely as I recovered. No doctor, no matter how smart, can have much insight into internal mental processes—and that is key to recovery.

My core finding is that there is very little credible research into mTBI, little of it proven, and of that which is proven, few studies corroborate the others, leaving significant doubt. You are in essence ON YOUR OWN, unless you have vast funds for daily attention for hours. For example, the oft-quoted 7-10 day recover period is absurd: the idea that the brain completely heals itself as if running a race from start to finish and then all is done and over with... well that is not credible as anyone with a physical injury of ay kind knows well. For any significant injury, nagging issues slowly improve over time, and one loses the reference base of “before concussion”.

In my view, being mindful of one’s own mental and physical state e.g., viewing self as a separate set-aside mental process over daily activities is an essential part of self assessment. No doctor can possibly understand the subtle clues that you yourself can observe—keep a journal so as things come to you, write them down and ponder, particularly if they recur, noting events that might have precipitated.

In my view, the single biggest factor in recovery is keeping a positive cheery attitude. Embed this into your daily psyche, knowing that many good things are possible and that life will get better. Eliminate those from your interactions (including doctors) who have cognitive commitments to treating you as a semi-invalid who at best can recover only to nearly as good as before, and INSIST upon the idea that while some things may degrade, other benefits may accrue, if only a sensitivity and empathy and patience for others. And that by utilizing positive attitude, mindfulness and a willingness to open one’s mind to odd yet pleasant changes, there may be something of great value to be achieved. Profit from experience.

Finally, be a patient patient, and be kind to yourself—the hardest thing to do (for me) is to back off from work almost entirely. Fight that inclination if it shows any sign of stress or strain.

* Doctors unwilling to say “I don’t know”—professing knowledge—these are fools and charlatans working in siloes. They lack a conceptual whole-view of the body and mind and gut as anything more than a disconnected and unrelated bag 'o parts. This is the #1 flaw in modern medicine today. Discard any doctor who has an answer for every question, or who makes the fundamentally flawed mistake of applyling statistics to a specific individual.

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Do NOT hope for the best, expect it!

So long as it is realistically possible, that is. Do not engage in false hope or expectations, and thus guarantee disappointment. Stay within the realm of the possible, which can be way out in left field / far out, but not impossible.

First, a little story. Nearly 20 years ago, my first daughter was born 12 weeks early with no warning. Dr Sunshine (his real name) pulled me aside to in essence tell me that she would be dead within a day or so. All the particulars logically pointed to that. I am neither religious nor mystical nor anything similar, but somehow I knew that all would be well with an unshakable certainty. Not for a moment did I even consider death as an option. How could I know/feel that? Who can say. Today she is healthy and strong and intelligent, a tough cookie who made it, including near-fatal sepsis a month later.

The point of that story is that I had the same feeling with my concussion, which I think manifests in my chronological log going back to the first days (see prior pages). And while my daughter is a separate individual, my point is this: the right attitude in and of itself increases the odds of a positive outcome. The mind and body are not separate, but support each other, interacting in incredibly complex ways that science has only begun to probe. This basic fact is lost on much of the medical profession, though that is slowly changing.

Think negative thoughts and the body responds, with problems. Think positive thoughts, and the body responds positively. Those who reject this baseline fact see only half the world and must experience cognitive dissonance at the placebo effect being not only real, but superior to many medications. I would say this: any doctor who treats the body as a lump of flesh independent of the brain doesn’t really know what s/he is doing, at least for many maladies. As just one example, does the brain control blood or vice versa?

The key, I think, is to stay upbeat and to not hope for the best but to expect the best, and to reject the ignorance of most doctors (no offense to doctors in this context!), few of whom have the patience or skill or training to understand mind/body interaction, let alone the training to have insight into the most complex injury of all (traumatic brain injury) and that in a unique individual. This has been my experience with other doctors with non brain injuries. I am not a statistic; I am a discrete individual and so are you and no woman bears 2.037 children, to drive the point home.

Reader comments

Mark writes:

I must confess that when I saw you begin to chronicle your injury and recovery “experience”, I was not sure how you were going to hold your readers to such a personal, private issue. After having had the benefit of reviewing your quite public introspection and thinking on the many sensations you endured/felt/lived, I wish to commend you for this rather distinct body of work. Surely neither you nor I (please allow my use of “I" to serve as the “We” of your readership) ever thought we would be engaged in considering such a critical medical issue on our favorite photographic site. [content since expanded and moved here onto WindInMyFace.com]

I often take inspiration, not just from the finely honed technical analysis you afford us, but also from the Art you create and then analyze. To take the torn fabric and Art of one’s life, particularly a traumatic injury and then subject your recovery approach from same to a similar level of scrutiny affords all of us an opportunity to take hope that should a proportional challenge befall us, we too might find wellness.

Clearly, given the depths to which you have gone to afford us insights into this recovery from a severe concussion, you have remained, throughout, true unto thy self. Some might not (yet) appreciate or value such participant observer, clinical musings. As events would have it , the pen in your hands- absent a lens, have revealed much: the Content of Your Character.

May your recovery prove to be solid and vibrantly sustainable. Much respect for your efforts. I have no doubt that many will benefit from considering your experience and fortitude. M