Not quite the one-year celebration I wanted.

And so it comes, the one-year mark. The anniversary of the day I almost died by driving my VESPA onto train tracks.  This was the point at which I had pinned my hopes of returning to normal. At one year, I thought I would have my energy back, I would be back to social activities with my career going full throttle . I would have replaced running with hot yoga or barre and would be keeping up with the family schedule. But sadly the actual story is not going according to my planned narrative. One year after that fateful day on the train tracks, when I broke my back, neck, leg and nose and sustained a head injury, I am still getting to know the new person that inhabits my life, trying to find the mental stillness and acceptance to deal with a path forward that is unknown and plagued hourly by symptoms that make life uncomfortable.

While the first part of this story was full of drama-this part is not . In this part nothing really happens.  My physical injuries have continued to recover steadily, so that my broken leg, nose and back are now background noise. While I still get daily pain and struggle with many physical tasks, or sitting for long periods, I am largely at peace with those injuries and am in control of driving continuous improvement via physical therapy and exercise. Instead the current villains of the story are my head and neck, and the post-traumatic concussion syndrome that revealed itself after the orthopedic injuries started to heal.

Recovering from mild traumatic brain injury is like living in a holding pattern.  Doctors promise that over time, (they won’t say how much) things will get better.  They tell me that I should not expect to see an improvement in a linear fashion, that there may not even be improvement week to week, but that month to month, if I compare September to August, September should be better. The science (like the brain) is squishy. It’s the last great frontier of human understanding. And so, I am wandering around, with millions of others who suffer from mTBI (mild traumatic brain injury), in a foggy landscape, with only a sketch map, trying desperately to position the whole experience as some kind of adventure.

So what does this post concussion/ mTBI thing entail?

For me, it means that I have a whole load of seemingly unpredictable physical and mental symptoms.  I am nauseous for about 50 % of my day.  My brain says no to bright light, loud noises, concentration, moving visual stimulus, multiple sound inputs, stress, emotion and movement. It feels like someone is zapping an electric current through the back part of my head.  I get easily overwhelmed by stressful or noisy situations and suffer from several different types of headache. One of the headaches is akin to a hangover headache- pounding through my forehead, which is particularly egregious as I haven’t had a drink in several years. Another is in the back of my head and results in a continuous aching in the big bones that make up the back of my skull and sensitivity in my scalp. It means that lying on a pillow is uncomfortable, putting in a ponytail is painful and that sometimes my damn hair hurts.

In practice this means looking at a computer or cell phone, spending time with more than a couple of people, driving, concentrating on a conversation, watching action TV,  attending anything in the kids classrooms,going to a movie or slightly loud restaurant, walking around in NYC, spending time in the sun, reading, writing, ( I have done this in 15 minute bursts!) exercising, housework, sudden noises, trying to do complex cognitive tasks- e.g math and even beating an egg make me feel ill.  It means that most afternoons it feels like someone has attached weights to my head. I can put aside the discomfort and power through if I have to, but then suffer a rebound effect that puts me in bed with nausea, headache and general fogginess for several days. So, broadly, I live like the average senior citizen. I like early starts, one on one chats, procedural TV shows, coffee and cake dates, afternoon naps, books with large print, country walks, early bird dinners and going to bed by 9pm. Actually the AARP (American Association of Retired Persons) keeps sending me mail, so perhaps it’s time to surrender to the lifestyle completely.  Meanwhile, I avoid tight ponytails where possible and wear a baseball hat and sunglasses. Sometimes as I walk around,I like to imagine that people think I am a celebrity in disguise.

Many different baseball hats and disguises. If I am honest I don't look like a celebrity at all!

Rose tinted glasses and the red bead

Of course, in conjunction with an army of doctors and therapists I am taking a meandering path forwards.  In recent years, there has been much public discourse on the subject of brain injury and concussion, with the initial focus on football players and veterans. As a result the science is moving forward rapidly and specialist concussion clinics are opening to deliver a “multi-disciplinary” treatment approach.  I am lucky to live near New York City,  so that I can take advantage of one of these specialist clinics. I am under the care of the NYU concussion center where I am treated by physiatrists, neurologists and multiple therapists. At one point, when I included the teams that were helping with my neck and back injuries, I counted 13 health professionals that were involved in my treatment

 Concussion and brain injuries are very complex and I have learned that many diverse symptoms can be typical. And, while there are similarities between one post-concussion sufferer and the next, every person has a unique experience.  In my case we did a series of tests that revealed:

Vision disorders: While each eye works just fine, they don’t work together well.  My brain has forgotten how to converge the two images together properly (Convergence insufficiency) and very much dislikes refocusing after each eye movement.  (Saccades/Pursuit Dysfunction) In a world where we make more than 10,000 eye movements each day, this is problematic. During the recent US open, I discovered that my worst nightmare is watching a tennis match on TV. Tracking and focusing on a small object from side to side quickly made the electric circuits in my brain go haywire.

Vestibular disorders: My inner ear had become damaged such that the free- flowing crystals that usually tell the brain where it is in space had become stuck. This caused vertigo in response to over-stimulation and movement a condition known as BPPV. When I began my treatment- it was determined that I was a "fall risk"- i.e despite the fact that I like to think of myself as co-ordinated, I walked around like I was drunk most of the time.

Cognitive weakness: Thankfully tests have shown that mainly, my brain is functioning well cognitively. There is one exception, information processing- which can make me seem forgetful. This means that I have to concentrate harder on whatever information comes in for it to be retained. Concentration, as previously mentioned, makes me physically sick. Or maybe- because concentration makes me physically sick, I don't pay as much attention to incoming stimulus. All I know, is that I am allergic to thinking.

Cervical stiffness and arthritis: Following the break that I suffered to the bone that joins my head and neck and multiple ligament injuries, there is still some swelling and scar tissue. This may be causing some blood flow reduction to the brain and or putting pressure on the occipital nerve and thus causing referred pain and nausea. It's likely that this is also causing the "hair-ache".

Migrainous response to stimulus: This one is the most complex. Essentially, the impact of the initial accident likely caused some severing of brain axons – i.e. cellular level damage. This set off a reaction inside my brain where it has essentially gone into a state of emergency. Everytime a trigger stimulus is detected (e.g light, noise, concentration etc.) the brain calls in the National Guard who stomp all over everything causing the nausea and headache (sort of….)

Each one of these very nuanced conditions requires its own set of therapy to help rehabilitate and retrain the brain.  I have at least 3 types of therapy and one doctor’s appointment each week and daily exercises, which together add up to almost ½ of my time.  Everyday I am required to do the following seemingly simple but actually torturous exercises:

·      Walk 100 feet looking side to side and every 2 steps X3.

·      Repeat looking up and down. Explain to neighbors that I haven’t gone mad yet.

·      Focus my eyes on a series of red, yellow and green beads on a string.

·      Fight with the cat for possession of said string. (It really is a perfect cat toy)

·      Move my head side to side while looking at a stationary letter B.

·      Try to ignore the weird clicking sound inside my head as I do above exercise.

·      Read a 10 by 10 grid of random letters moving between my cell phone and letters on the wall.

·      Watch movies of grocery stores, or subway trains or optical illusions and other disorienting environments. https://www.youtube.com/watch?v=YWaGzTFRlWg

Just some of my exercises, and my rose tinted glasses.

Honestly, I hate these exercises. They all seem so easy in theory, but I struggle with them.  For someone who hasalways been able to rely on my body and mind to do whatever I want it to, the idea that I can’t do these remedial tasks is very frustrating. I have bad dreams of the nasty B and what I affectionately call the “fucking red bead”. Some weeks I tantrum and don’t do the exercises at all.  Obviously that’s that not a very helpful way to progress.

In addition to the exercises, my vestibular therapist has undertaken multiple maneuvers (The Epley Maneuver https://en.wikipedia.org/wiki/Epley_maneuver) to retrain my inner ear system to understand where it is in space. This means that I can now walk in straight lines and on good days around corners and up and down hills.  My neuro-opthamologist prescribed special glasses with pink tint lenses. These lenses not only soften the light (which means less nausea) but they also contribute to my rock star look and are a great conversation starter. The joke of seeing the world through “rose tinted glasses” never gets old, but more than that- when people look through my glasses, they are surprised at how pleasant the experience is.  Seeing the world with a rose tinted attitude is more of a challenge.

The idea with all of the exercises and therapy is to re-habituate my brain. To identify the triggers (light, sound etc.) that cause problems and then re-expose the brain little by little to these tasks, creating new pathways.  It’s like a combination of  allergy diagnosis and fitness training.  Triggers are often hard to identify because they might be a combination of stimuli (e.g light + stress or movement+ noise). Once the triggers are identified then the “retraining” process begins.  As with physical fitness, the idea is to gradually increase strength. Being an all or nothing kind of girl I find this particularly hard.  

 On the other hand, as a student of self, I have found it super interesting. My way to manage this phase of my recovery is to learn as much as I can about this emerging science. (Sometimes to the point of obsession. I even had my neurologist print out some incomprehensible clinical papers- which my healthy brain would not have been able to make any sense of! http://journals.sagepub.com/doi/abs/10.1177/0333102416681571 ) I had a particularly enlightening moment in neuro-cognitive testing when I was asked to remember a list of random words or to repeat numbers backwards. I immediately felt the physical symptoms of nausea and headache.  However, in the same session when I was asked to fill in one of those personality questionnaires. A questionnaire with crazy questions like-

 “ Sometimes I feel like I want to have a fist fight”,

 “ Sometimes I’m not sure if I’m ashamed of being bashful” (?).

Even these confusing backwards questions did not result in the same nausea and head vice response. This immediate cause and effect response to hard cognitive tasks was actually gratifying as it proved to me how real the issues are and helped to further my understanding of what I can and cannot do.  The power of what these tests did to my brain were further illustrated by the fact that after 2 hours of testing, I had to go home to bed and did not recover properly for several days.

After several months, it became clear that the nausea was not going to go away with the visual and vestibular therapy and so I have been working with my neurologist on alternative approaches.   He has theorized that the nausea and headaches are a migrainous response caused by cellular level damage. Treatments have included high doses of anti seizure medication-which are proven to help migraine (sadly so far no effect) and anti nausea meds which have given me side effects of a kind of crawling sensation in my legs. Next up is BOTOX that will be injected into sites that include my forehead, base of my head and neck. Botox is one of the newest ways of handling chronic migraine; it works by disabling the nerves in the tissues that surround the brain and thus numbing the pain. Since the brain itself is a numb organ, i.e. it doesn’t feel anything, it is the muscles, nerves and blood vessels that are outside the brain that make migraine hurt or in my case make me feel nauseous. And even if it doesn’t work, there are obvious side benefits for an almost 45year old woman!

The most difficult thing to handle about all the treatment is the rate of progress.  Unlike recovery from injury in other parts of the body, where tissues literally mend themselves, brain cells do not spontaneously regenerate. Instead, a process called neuro-plasticity occurs. New connections are made between brain cells that create new pathways to do the job of the damaged cells. But they do this REALLY slowly.  Over months and years. Plus they only do this in response to hard work. This makes it incredibly difficult to track improvements.  Over the course of the last 5 months or so, my eyesight has become 20% better (but has about 2x as far to go) but sometimes I struggle to make words stand still on a page, the BPPV (vertigo caused by inner ear dysfunction) is theoretically gone- but any kind of head down pose (e.g downward dog) still sends me into a headspin and there has been little progress on the migraine treatment.

Although my neurologist is confident that I will get better, when I ask him when, he leans forward across his table, looks me right in the eyes and says empathetically,

“It’s impossible to tell.”

Making it work

If the hero of the first part of my story was my community, then the heroes here are my work colleagues.  After a month of trying to lie low, I realized that just going back and forth to doctors’ appointments and therapy was going to make me crazy and depressed.  I couldn’t bear for my daily activity to be entirely about being a patient. And so, one day, I wandered into my work place and my CEO's office with a ridiculous request.  I wanted to work just a bit, a few hours for a few days a week, when I felt up to it.  I will forever be impressed and be filled with enormous gratitude that not only did she work with me to come up with something that would work, she also championed the idea with peers and colleagues.  For an industry that has occasionally been held up as “what not to do” in the workplace, her willingness to endorse this progressive approach is very powerful.

Over the last several months I have worked between 10-20 hours per week, split between my home, the office and with clients. During this time, my colleagues, my clients and the teams that I have worked along side have shown incredible patience and compassion. Some days I have been all-in and ready to go, while other days, I simply haven’t been able to show up. When I have been unable to look at a screen they have printed stuff out for me, or created documents out of notes that I have written down longhand- on paper- with a pen. They have patiently waited for me to catch up when I have missed days, collected my forgotten belongings when I left them behind in the office, (a post concussive is very forgetful) rearranged in-person meetings to conference calls or found quiet locations when I have been struggling with light and noise sensitivity.  They have picked me up and put me into car services when I have crumbled under too much sensory input and have offered wise words of wisdom and support when I have become despondent. Clients have had to get used to seeing me in a baseball hat and my crazy pink glasses. More than anything they have allowed me to feel like I am being useful, that I am able to bring my expertise and, here and there, they have allowed me to try on my old life.

I have also discovered that with enough adrenaline (the adrenaline that got me through that 6 weeks in January and February) I can do pretty much anything. I facilitated a 3-day workshop for 20 senior marketers for 3 days in June, traveled to Mexico for a one-day workshop in July and stumbled my way through MCing a 4 day 100 person conference in August. Each time powered by a cocktail of adrenaline, anti-nausea and pain relief medication and caffeine, I was able to glimpse the old me. It was incredibly gratifying to know that I can still do it when pushed and worth every-bit of the profound rebound effect. Each time, I had to spend two days in bed nauseous and wiped out, for every one-day that I had asked my body and brain to perform.  But as my doctor says, my brain won’t get better unless I push it, and maybe next time, I will only spend 4 days in bed recovering and the time after maybe 2days.

My work often involves facilitating and leading large groups- not so easy when you think you might throw up any minute! But the adrenaline is a good distractor.

One thing I know about my chosen career,  however, is that just being able to perform well on occasion is not enough.  In the always on and rapidly changing world of marketing and consulting, stamina and a voracious appetite to keep up with what’s new are critical drivers of success.  Even in this digital age, it’s important to be able to jump on a plane any time to cultivate relationships and my current “allergy” to screens, reading and concentrating is debilitating, distressing and exhausting. So while I am incredibly grateful that my cognitive function seems to be mostly intact and it’s great to for be able to contribute to key projects, its clear that while working literally makes me physically sick, it’s going to be a long time before I can take on anything other than a very limited schedule.

For all but 2 of the last 22 years ( while I was having babies), I have been very career focused. While my family and my role as a mother to 3 fantastic boys are incredibly important to me, I have channeled much of my identify and self worth into work based goals and and have always been driven by a relentless need to push forwards, a need that borders on the workaholic. This means that I am finding it very hard to step back and take the time I need to recover, even though a year is not a long time in the grand scheme of things. I don't really know how to take care of myself or to give myself permission to be a different person,for now. On bad days, on top of feeling unwell, I get super frustrated. Frustrated that I I don't have the stamina to do the work that I had planned and neurosis that I am falling behind and letting people down. On other days, when I am feeling strong , I try to focus on how incredibly lucky I am to be able to have this flexible approach to my work and enjoy the downtime that comes in between.

Finding strength in friends, family and flowers

If physical injury is loud and dramatic, head injury is quiet and private; it’s much harder for people to understand.  With physical injury, there are obvious signs that everyone responds to.  In my case, this meant the neck brace, the leg brace, crutches, and bruising.  Now I look normal and so naturally people are relieved and excited to see that I am better.  Occasionally, I have conversations that go like this,

“ How are you feeling? Are you feeling better?”

“ Well, yes much better, but now I am dealing with head injury stuff”

“ Well you look great”

“ Thank you, but I feel kinda nauseous all the time and still can’t go back to work”

“ I am so glad that you are feeling better”

 At this point- it seems rude to reinforce the disabling symptoms that are still interrupting my life.  I will say this is not the norm, in general people continue to be incredibly supportive and understanding, but when it happens, it’s particularly jarring.  Of course, when I do see people, I am usually feeling better vs. worse, which re-enforces the idea.

Along with the fact that this invisible injury is harder for people to understand, comes the fact that I can’t tolerate groups, both of which mean that over time I am becoming more socially isolated.  In order to stay connected, I am learning the art of the “drop in drop out” for larger social situations.  I spend the enjoyable time picking out my outfit and getting ready, drift by for an hour and then leave as the nausea and head pain start to creep in. However, I am also conscious that I often have very little to give in social situations. I am far away from my pre-injury socially fun self.  I now feel like the needy friend that always talks about her own problems.  Meeting new people is almost impossible and I have been completely absent from the children's classrooms and an infrequent visitor to the side of their sports fields. As a result I am sure that the parents of new friends my children have met in the last year probably think of me as the snooty and aloof mom.

While, I have been unable to join many organized social gatherings, I am lucky to have a network of women friends and family that will spend one on one time with me and listen to my woes.  Thus over the course of the spring and early summer my social activity became walking with these good friends in our local nature as I slowly increased my mileage, helping to heal both my body and my mind.

Interestingly, on the advice of someone else who had experience with long term concussion symptoms, I have learned that I feel strong and hopeful outside in nature.  In the spring, I had the need to put my feet on British soil, to see my sisters, to visit my parents and connect with old friends. I spent the week taking in the best of British nature, walking in arboretums, along rivers, in nature preserves and visiting the grounds of country houses. I sat in cafes and gardens, drank endless cups of tea, and ate Victoria sponge, fat British chips and toast with Marmite.  I returned to the US feeling more grounded and ready to tackle the next stage just as the spring flowers were making my hometown look like something from a picture book. The Dogwoods, the Cherry blossoms, the Forsythia and the Wisteria all bloomed at the same time, and I was filled with hope that for the next phase of my recovery. I started to discuss flowers with bewildered colleagues who wanted to talk about project timelines and brand positioning.

Finding strength in nature and family. This spring was full of flowers.

Of course, my main support system has continued to be my family. Kevin has continued to take on the bulk of household responsibility and has supported me unconditionally. The boys have also been compassionate and strong. Time at home with my boys has of course been another important silver lining of this period . We have continued to have our Au Pair who manages their day-to-day schedules, which leaves me free to cuddle with them in corners and have long chats.  My eldest Zac ( 12) doesn’t typically open up, but being able to sit quietly with him has enabled me to learn more about his inner "tween" brain, as he navigates the rocky social waters in middle school and starts to obsess about the things that adolescent boys obsess about. ( I probably shouldn't publish it!)  Finnegan, (10) my middle son, is a meticulous planner about the small stuff in life. Over the course of the long months at home, I have been able to help him carefully handpick school supplies and organize his new bedroom- mapping out exactly where each piece of furniture will go. Sebastian (8) has often kidnapped me for afternoons of drawing together, in which I draw and he makes suggestions for colors.

I have been impressed by the level of empathy that the boys have developed over the course of the last year.  Notwithstanding the invisibleness of my current condition, they understand it fully and completely.  Zac, who despite his tweeness, is still a frequent hugger, the other day, said to me,

“ Mom- you can ask for a huggie too y’know- when you are feeling sad”

Finnegan has his own theory of how brain injury works- calling mine a “ double concussion”- because I hit the front and the back.  He has a spiritual perspective on life, which always surprises me,

“Mommy”, he says, “ it’s not fair, I don’t know why God did this, because you don’t deserve it, you don’t deserve it at all”.

Sebastian, just instinctively understands when I am sad, and crawls into bed with me.

Cuddling with my boys....the best therapy of all ( as long as they are not too wriggly)

Staring feelings in the face

Of course, as I take on this meandering, unpredictable and slow journey, I have a whole lot of feelings- and frankly feelings that I could do without. On any given day I might feel sad, angry, frustrated, depressed, resigned, helpless or grateful and hopeful. Most days I am living with an undercurrent of anger.  I am still angry with myself, for putting myself in this situation to start with. I am angry at the adrenaline seeking me, that needed the glamor of the VESPA and that wasn't as equipped to drive it as I needed to be. I am also angry at the situation, that there are no definitive answers or magic pills, that the path forwards is mainly patience. In my worst moments, I worry that I will never get better.

The frustration at just not being able to control the path forwards is also ever present. I have always had vivid dreams, and this period has been no exception. For as long as I can remember, my dream self has been able to fly. It’s really one of the best things ever. I highly recommend it. However, since my accident, I have not been flying. Instead, my dreams have been full of vertical mountains that I have been trying to climb or drive up unsuccessfully. I frequently dream of swimming in water that is so thick that I can’t take a stroke. I am not sure that it takes a genius to interpret the overall feeling of frustration that these dreams represent.

Despite this active dream life, in general I sleep well, and I am lucky that each morning, I wake up early, feeling good. If I am heading into New York for work or therapy, then mornings are the best time. Alternatively I can manage a few hours of work, do my exercises or meet a friend for coffee.  All of these activities result in nausea but I push through so that each day can have some kind of positive productivity. But as the day wears on and the chronic pain from my back and neck creep in, the nausea becomes heavier, or the back of my head feels like it might explode- I start to feel sorry for myself.  The afternoons are a time to “get through” and the time that all these feelings push through. If I am working on a deadline, I might power on feeling sicker and sicker, knowing that I need to get to the end- but frankly this always ends up badly. The best plan is usually to take a nap.  Sleeping, for me, is like rebooting the computer, plus I can skip the bad part of the day- including all those scary feelings and start over. The kids eat dinner at around 6pm. I know that if I can get to dinner time then the end is in sight.  I take to my bed at the same time as the children, around 9pm, knowing that the next morning, I am going to feel strong again.

I deal with this afternoon anger in a multitude of ways, some healthier than others. Some days I simply yell at my kids. I get mad with them for making too much noise, (why is it they need to have 3 different types of music going at once?) or not picking up their stuff.  Some days, I catch myself before I feel crappy and pre-nap, other days I wait too long or do too much and crawl into bed nauseous and sad. Sometimes, I have the strength to channel this energy in more productive ways. Practicing what I have learned about neuroplasticity and the power of positive thinking, I try to write a gratitude list each day. Literally things like“I am alive, and not in a wheelchair”, “the sun is shining” or “what a great cup of coffee”. After reading Sheryl Sandberg’s book,Option B- which focuses on post traumatic growth and how we can become stronger and more resilient through adversity,  I have also started a “small moments of joy” list.  It helps me to remember and underline times of enjoyment. It’s interesting what makes it into the list.  Sometimes it's the obvious stuff- when one of the children is so happy to see me that they run down the street and throw themselves at me, but I am also learning to notice the joy in the small stuff.  The other day I noted the moment I caught my two cats lying in identical positions next to each other basking in the sun.  The idea with a "joy" list- is you start to remember the happy moments, savor them, store them up and then reinforce them as you write them up at the end of the day.

In addition to these” power of positive thinking” methods, I am also enrolled in a clinical trial with the NYU headache center to integrate relaxation techniques into my treatment- both as a way of managing my chronic pain and my emotions. Each day, I undertake a 20 minute guided relaxation exercise and then journal my symptoms and feelings. I love it as if I skip days; they call me and remind me. Overall, I don’t see a difference in my pain, but I think its super helpful in keeping me grounded and dampening my inner crazy.  It’s also fun to do with the boys. Although sometimes it's hard to find a quiet spot in the house.

Gratitude, audiobooks and relaxation exercises- tools to help power through feelings and re-inforce the positive.

Historically, the way I have dealt with feelings is to move into high action mode, specifically cardio exercise.  Of course, with the injuries that I had sustained and now the heavy head, I hadn’t been able to really get out of breath and had been cautioned not to push too hard.  As mentioned before, walking has been great therapy, and a long walk with an audiobook has often been a good way to deal with glumness. However, one afternoon in June, I simply didn’t know what to do with myself. I was so angry I could understand the desire to pull out my own hair, take drugs or punch the wall. Knowing that none of these responses were likely to move me forwards, I decided that trying to push my self hard physically might be a great plan and that perhaps getting more blood in my brain might help my recovery.  (Note this was not based in any science, it was just my own non-proven theory.) So that’s what I did. Starting with low impact exercises, on the elliptical, stationary bike and swimming- I have pushed myself up to a level where I sweat, push my heartbeat up and sometimes even shout out loud. The first ten minutes are always awful, getting more and more nauseous, but then the endorphins kick in, and I have a few hours of feeling positive about the world and pain free.  There is a cost later in the rebound nausea, and if I do several days in a row then I suffer overall increase in symptoms- but the impact on my mood is profound.  In the post exercise energy boost, I can reintegrate into the family, cook dinner and I feel like I have accomplished something.  Gaining in confidence, I have even started to run. Starting with mixing 50 walking steps with 50 shuffly, limpy old person running steps and gradually adding more and more running steps, I have now hit two miles.  My pace is now close to 12.5 miles an hour, which is about 50% slower than before the accident   I feel sick from beginning to end and every step I wonder why I am doing it. I can literally feel the hardware in both my back and knee and my head throbs, but at the end of it, I feel like I am slowly taking myself back, that I am me.

,

 Exercise is definitely not fun when I am doing it- but I am always glad after it's done!

After consulting with my doctors (after the fact- of course), it seems that my gut feeling was on target. A controlled amount of cardio exercise can help with recovery. We have agreed that I can continue with this approach as long as I promise not to work out on consecutive days and that I will run infrequently.  With their blessing under my belt, I am slowly reaching some significant physical milestones. Open water swimming is one of my favorite things to do. The limited visibility and fresh zing of the water make it both meditative and invigorating and so on a recent family trip to my father-in-law’s Vermont house, I took on swimming one of my regular summer open water routes. Flanked by my boys in one canoe and my husband in another I was able to undertake the 1-mile lake swim from the house to the beach. We went old school- with no cell phones, so there are no pictures- but I will remember the experience vividly, with my most loyal support team cheering me on. Another day, I was able to join my family on a 3 mile, uphill rocky hike, in the rain, and this week , I took my first outdoor bike ride. I have been riding a stationary bike for a while, going outside adds the variables of emotional stress ( it's most similar to riding a Vespa) as well as movement and stimulation (I wont' say how nauseous I felt, it won't do anybody any good to know that!) In a few weeks our whole family is planning on undertaking a miniature triathlon. (My goal is simply to finish- with or without throwing up) It is a ¼ mile swim, a few miles bike and 1 mile run, so very different to triathlons past.  All these big milestones give me a re-bound effect that mean I have to lie down for a day or so afterwards. But the sense of accomplishment is very helpful for my mental health, and my doctors say that as long as I space them out, I am letting my brain move forwards to the next stage.  I want to emphasize that the engine that drives me forwards on these physical challenges is not blind ambition or personal strength but those scary feelings of frustration, sadness and anger.  As I work my body on the trail, in the pool or on my bike, I can allow the intensity to settle in, mingling with my increased heartbeat and eventually I can push through to the other side.

Life in the slow lane.

So, I finish this essay in the same place that I finished the last one. I continue my quest for strength and patience to accept where I am.  I struggle with an inner debating society that wants more certainty- will I get better or do I need to learn to live along side chronic pain, nausea and fatigue and retool my life accordingly?  I continue with my limited work schedule, with the understanding that sometime soon, I’ll be back- with a vengeance, able to take on everything I had planned. But sometimes, I am wonder if this perception of complete recovery might well be leading to more frustration.  Many days I dream of becoming an artist, a jam maker or fortune teller. At this one-year mark, I wanted to have a plan of action. However, at this stage, I continue to live in a holding pattern, a life of in-betweens that I share with thousands of people who suffer from post concussion symptoms.

While I have added back some exercise into my routine, overall, I am trying to be at peace with living more slowly, giving up my relentless drive to move forwards.  This is not easy – at all.  Society and has trained us that busy is virtuous and synonymous with success.  We wear our busyness, our exhaustion and our packed schedules like a badge of honor.  A friend of mine likes to say that we have become “human doings”- not “human beings”

In this crusade for “beingness”, I look to be satisfied with today.  My goal is to enjoy a schedule that many would kill for, a schedule that includes yoga, baking, a bit of work, writing in small doses and endless cups of coffee. To be grateful that despite a disruption to our financial security, we won’t lose our house or starve anytime soon. Where I can, I look to believe that because of this adventure our family will end up stronger, more compassionate and more accepting. And, if plan A doesn't work out, we will ( as Sheryl Sandberg described in her book) kick the shit out of Option B. More than anything, I work to be thankful that on September 15th 2016, I made it off the train tracks and to the hospital to begin this long journey to wherever……