A third of a year

In addition to being the autumnal equinox, today also marks the four-month anniversary of the car accident that left me with bruises, some cracked/bruised ribs, and a concussion. All of the physical injuries have healed by now, except for some residual soreness when I push on the left side of my rib cage, but the concussion continues to be a pain in the head. While the overall trajectory is up, I still have bad days when I can't do much of anything. I feel like I have an invisible disability because I don't look sick or injured, but I'm definitely not functioning normally. For example, I can physically walk from the far end of any parking lot to the front door of a store, but having to negotiate walking through traffic and cars looking for parking might get me killed.

Headache: The headache has gotten much better in the past couple of weeks. I never was on anything but OTC pain meds and now I'm not taking anything on a daily basis. The headache has become more localized lately, and moves around. Usually when I'm aware of the headache it feels very concentrated through the top of my head. Sometimes it's concentrated around my temples, and sometimes it feels like a really tight band around the crown of my head. The constant dull ache has ebbed, though, and that's a good thing.

Now that I don't always have the headache I've been paying closer attention to what triggers it. This helps me avoid situations that I know will be headache-producing. Unfortunately, not all of the triggers can be avoided, or at least avoided without major inconvenience. For example:

  • Noise. Background noise remains extremely problematic for me. Any restaurant with a "lively" atmosphere or acoustically reflective surfaces will be hell. A social gathering in which multiple conversations are going on at the same time makes my head hurt. I don't think my brain is currently capable of distinguishing between background noise and sound that I'm supposed to pay attention to. It all gets overwhelming very quickly, and once my brain can't manage my head hurts.
  • Light. Light itself is not a headache trigger, but rapid shifts between light and dark definitely are. Strobe lights would be awful, and riding in a car at night is bad, too. The lights of cars, traffic signal lights, and lighted buildings on the side of the road--my head can't tolerate any of them. Even riding as a passenger with my eyes closed I can't keep from seeing the flashes between light and dark from behind my eyelids. Wearing dark sunglasses at night helps a bit but doesn't eliminate the problem. A similar thing happens in daylight when I'm riding in a car through alternating strips of sun and shade, as in a forest.
  • Mental activity. Having to concentrate for more than about 10 minutes at a time starts my head throbbing. This means not much work is getting done. No real science, either. I have started spending a couple of hours at the marine lab two or three days a week, just to get back into the swing of things. This week I've been cleaning things tanks, tables, and the little dishes I keep some of my animals in. In the process I've gotten nice and dirty, which makes me feel like I've accomplished something.

Cognitive deficits: In my nonconcussed state I have a pretty good sense of cardinal direction and elapsed time. These are still scrambled. From anywhere in the area I should be able to point to the ocean without thinking, but now I can't. I can navigate to places I know well, but getting any place new to me is a crap shoot. The same thing has happened with my sense of time, although that does seem to be improving a bit. I still have to use timers and clocks more frequently than I used to.

I still feel extremely slow and stupid. In writing and in speaking I often can't find the words that I know are there, and I can't explain things very well. I've asked friends--people who are used to conversing with me--if I seem slow to them when we're talking and they've all answered 'no,' so my own perception of how long it takes me to find words must be warped by my messed up sense of time. Or maybe they're just being kind to me.

The neurologist has told me that I shouldn't try to learn anything new while my brain recovers. To pass the time I've been knitting and listening to audiobooks. It would be nice to say that I've been doing housework while I can't do much else, but that would be a lie.

I've come to appreciate exactly how much concentration it takes to drive, and exactly how little attention most drivers pay to what's going on around them. There's a lot to keep track of--the general flow of traffic, pedestrians, cyclists, and distracted drivers in other cars. It drives me crazy to see drivers fiddling with radios or phones, or simply not paying attention. Any time a car makes an unexpected movement my heart jumps. I don't trust anybody on the road these days. The guy who hit us wasn't driving distracted, so far as we know, but now I know how little time it takes to get into a really bad accident even when you're not doing anything wrong. I no longer listen to anything while I'm driving, and I'm not driving any distance at all these days.

Executive function: Making decisions is incredibly difficult and painful. I can answer 'yes or no' questions better now than I could a month ago, which is a welcome improvement. I deal with the complexities of a dinner menu by ordering the first thing that catches my eye. If I put much more effort than that into the decision my head starts hurting. I've been telling people not to give me options other than 'yes' and 'no,' and it actually does help me cope.

In a similar fashion, prioritizing and multi-tasking are also difficult. I can just about manage a short string of consecutive activities if I tackle them one at a time. I've also gotten worse at knowing how long a given task will take, even if I've done it many times before. That's probably the wonked-out sense of time at work.

Psychological effects: These have improved, except for the stress of driving or even riding as a passenger in a car. I have minor panic attacks when something unexpected happens. It's much easier for me, psychologically and mentally, to ride with my eyes closed. I think this is a minor case of PTSD. For the most part I don't feel depressed but sometimes I think I'm not making much progress and that's a bummer. Patience is not one of my virtues, but I am trying to be patient with myself. On the days that I feel good I can get things accomplished, which makes it easy to overtax my brain and bring on the headache. I'm having to learn how to pace myself and not do too much at once. My brain seems to allow one excursion a day, and I'm honoring that restriction as much as I can.

So, I'm getting better but slowly. I still have a long way to go.

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