12 Ways to Recover from a Traumatic Brain Injury
Over the last 60 days of 2021, we successfully crowdfunded printing and shipping costs for Liberatus Volume One. During that time, I was personally in contact with 184 stakeholders, from quick texts to conversations lasting up to 90 minutes. Ultimately 31% of those stakeholders backed the campaign, and today, there are more than 200 copies shipped to supporters across the political spectrum and across the country.
In the final months of 2021, I went all-in for the campaign to make sure we made it across the finish line, based on the high-quality work of all of our creators. To create it, we filled 224 pages with photos; long-form stories, firsthand perspectives, and interviews; and policy research to help us all become leaders for American unity. During that time, to make sure my immediate needs were covered financially, I had active accounts on the Uber and Instacart platforms. The weekend before Christmas, I spent about 30 hours over three days, as I recall, driving for Uber and earned about $998 for the week. Uber, by the way, isn’t a situation where you drive people across town real quick—it’s a situation where you drive for hours, giving customer service and conversation to passengers, playing music, following GPS, keeping track of where traffic is and how, if at all, to navigate around it, avoiding hitting pedestrians—whether in crosswalks or in the middle of K street pushing a grocery cart (I’m not making this up), cleaning up pet hair out of the back seat when necessary, finding grocery stores for restroom and snack breaks, concentrating despite weather—from bright sun to pouring rain to dark unfamiliar streets, and on and on. In short, it’s a job that requires a high level of alertness, concentration, and high-quality customer service to do it right.
I first learned my way around DC driving for a Member of Congress, and I’ve had up to four Members in my car at one time. In the past, I have worked regular 12+ hour days on the Hill covering both scheduling/operations and policy; I pulled an all-nighter to effectively lead the team to put Mark Bauer on the ballot in Texas in 2020, and worked six days a week leading both an Instacart team with a roster of about 60 members and the Liberatus team while training for and running ultramarathons.
Running and fitness were how I stayed sane-and still are—and how I would rig the days to make sure I got as much out of them as I could. On the days that I would drive for Uber in 2021, I would run first thing in the morning, work on Liberatus through the morning and early afternoon—then restart the day by swimming in the pool mid-afternoon. After an early dinner, I’d drive through the late afternoon and evening.
It’s surreal that almost three years have passed.
Time now is condensed; the passing of time feels like a collapsed heap of rubble, not a coherent sequential order.
A family member told me that you rebuild your life brick by brick. What follows are some of the bricks that I recommend for healing from a traumatic brain injury. I woke up one day in a hospital, in a different body. I could feel that something more painful than running an ultramarathon had happened, but I don’t have any cohesive, clear memories. There are some memories that are cut out from any timeline—they are out floating in the universe somewhere, disconnected from any before and any after, but I assume from the moment of impact and shortly after.
They say I was hit from behind by a running horse on a hiking trail. It’s clear to me that an overwhelming amount of force hit my body, and these are the bricks of rebuilding—the damage happens in an instant; recovery takes years.
1. Do resume and increase activity after two weeks and keep pushing. The ER gave me notes that say things like “don’t do crossword puzzles” and “don’t do homework.” It’s still not clear to me how to not think—and there was no clear timeline for how long to “not think.” While I rested early on, I have since learned that after two weeks it’s better to start pushing. Ultimately, I did, but it wasn’t clear to me for a long time if pushing was hurting myself or if it was recovery, and I had to figure that out on my own. My right leg was a mess after—and I still feel the injury every day—so I especially recommend getting back in the pool as soon as possible. In addition to being calming and fun, I’ve also found it helps with balance and was recommended to me by my vestibular therapist.
2. Do get to a concussion clinic very soon after the injury. Doctors who have worked with brain injuries know what to check for and don’t minimize anything. I should have had more tests done right away with more therapy recommendations—especially for balance, gaze stability, and eye convergence.
3. Do not take medications with side effects. Ultimately, this is up to the person to decide. Over the first two months, my sense of sound and light were horribly out of whack. Sound, like music playing or traffic on a nearby road, wouldn’t sit in the background—it was full force, full volume competing with all other sounds for attention. Bright light also seemed to agitate everything, so I would wear sunglasses in the grocery store or even at home. The first neurologist I saw recommended an anti-depression medication that doesn’t work, but does work to calm brain chemicals that get out of whack following a concussion. It also gives you constipation and severe depression—which is why I don’t recommend it. I also took medications for memory—that brought back some memories, or brought others to the forefront of my mind, including a nightmare I think I had the night after the injury, and some other negative memories. I do think it helped with general clarity—but it also increased dizziness.
4. Do try BrainTree Nutrition. Created by neurologists and former NFL athletes, my impression is that BrainTree has helped significantly in terms of mental clarity and alertness. My impression is that I experienced some limited benefits in the first week of taking their supplements for mental clarity and stress, and that these accelerated after two months. My cognitive focus also is affected by weather significantly now, so a good weather month can also be the reason why I might feel good and clear-headed. I am also experimenting with their Brain Water mix for days when barometric pressure is changing or when storms are moving through the area, and my impression is that this may mitigate some of the effects.
5. Do keep a journal of how you’re doing. The biggest reason for this is that it will help track trends—in my case, time was condensed and I experienced memory loss, so it was always difficult to say if something happened two days ago or two and a half weeks ago—and there were several instances when I would go back and look at my notes and be surprised by how much time had passed. Most importantly though, it gave me a way to track how consistently I experienced various issues, which itself is empowering because it means that I regained a sense of what was going on.
6. Do know that what we know about the brain isn’t necessarily very advanced, and terminology can be weird. One of the biggest examples is describing brain injury survivors as “irritable.” It’s an outside-in perspective. If you’re sitting next to a campfire, and the smoke suddenly shifts direction with the wind and starts blowing in your face and you jump up, cough, and move to another side of the fire, are you irritable? Nope. Real changes mean real reactions, and this is why talking with doctors in places like concussion clinics—who really understand what’s going on and don’t blow it off—is so helpful.
7. Do eat healthy and stay hydrated. It matters all of the time, but it matters more after a TBI.
8. As noted above, do get in the pool ASAP. It’s calming, great exercise, recalibrates balance, relieves stress, and improves sleep.
9. Do your PT routine, if you have a physical injury—and know that improvements will take time. I have no idea the number of needles that I’ve had shoved into my leg, but dry needling certainly helped. It also took 2.5 years to regain feeling in my lower right calf, and now that it’s back I can feel a trigger point I stretch out every day. Ultimately, between physical therapy and vestibular therapy, I have I think 66 variations of exercises and stretches to do—currently I’m focused on what I think will help the most and conversing with my therapists about that question specifically.
10. Do give herbal tea a try, like spearmint tea or Evening in Missoula, spend time in nature, including cold plunging in the ocean, take deep breaths, and give it time for the stress to wear off—in my case, the psychological stress has been mostly survival after the fact, not the event itself, although the stress my body sustained was extreme, and as my vestibular therapists says—The Body Keeps the Score.
11. Do get a brain DTI. I personally found it validating and clarifying to have a scan that shows all of the issues that seem vague (and not necessarily believed by others) show up on a brain scan. I was confident that if technology existed, it would show some kind of damage, and I was surprised by the fact that a DTI can show precise damage to precise brain areas which control precise functions. My doctor noted that DTIs have been used for members of the military after concussions sustained by attacks by Iranian rockets, and help put imagery and language to what would otherwise be mystifying to many.
12. Do speak up for what you need. On the day that I woke up in the hospital, I found out I was being sent home as soon as I woke up. So I ultimately got up and walked out—I immediately chose to focus on recovery and the steps necessary to recover, even though moments before I had no clue what had happened, or where I was, and I intentionally moved my arms and limbs to make sure they could still move. For brain injury survivors, there can and should be a straightforward plan with the goal of resuming normal life. Speaking up for what you need is about making sure that the plan gets put in place to thrive; it’s about tenacity.