My recovery: it'll be over when I say it's over!

People often ask me something along the lines of, "How long did it take you to recover from your brain injury?"  I usually respond with, "My recovery isn't over yet: I still think I'm recovering now."  The natural follow up question is, when will your recovery be over?  Back in 2008, I wrote a verbose post on this blog, How Long Does TBI Recovery Take?  In it, I talked about the length of my recovery depending on what goals I set myself.  One activity recently reminded me of the concept, though: my running.

Running in the hills above Wellington city, New Zealand.

Using my running as an example, I want to explain my new answer to the question of when my recovery will be over: it'll be over when I say it's over!

I had my accident shortly before I was to reach my goal of racing Ironman triathlon in 2005.  Being a goal-focused person, I was desperate to build back up to it.  As I started running again, I quickly realised how physiologically complex the activity is to do.  Gradually, I relearnt how to control my muscles well enough, particularly those in my core, to run properly.  Eventually, I was running well enough to support my finally completing Ironman in March 2010.

Even through Ironman, though, I carried a number of running issues.  A key one was that my right quad muscle group would seem to run out of push after about 20-30 mins of running.  The issue wasn't bad enough to stop me doing Ironman: If I walked ten paces, it would come right and I could start running again.  However, I love my running and it was hindering my enjoyment of it.  Once I'd finished Ironman, I was keen to get it sorted out.

In the second half of last year, I restarted my recovery process: I saw physios, tried new things like yoga classes, stretching and muscle exercises and talked to lots of relevant people.  After about six months of trying stuff, I made a breakthough: I realised it wasn't my right quad muscles I needed to worry about, it was my right gluteus maximus (as well as another muscle close by, the gluteus medius).  For some reason, exercising those two made a big difference to my issue with my quad.  Although they haven't solved it completely, just yet, I think they'll allow me to run well enough to train for and complete off-road running events (as per my photo).  (Off-road running seems easier on my quad muscle issue.)

Since I built myself up for Ironman (twice!), you may be thinking I'm someone who likes big goals.  You'd be right!  In New Zealand, one big goal involving off-road running is the 60k (37.5mi) Kepler Challenge, following the Kepler Track in the South Island.  Guess what I'm aiming to be next November?  ;-)

Herein lies my idea.  There are things like running that I really want to enjoy.  It is up to me to do all I can to recover for them.  No matter how long it's been since my brain injury, my recovery will only ever end when I decide to stop working out how to recover more.  It'll only be over when I say it's over!

Cheers,

Mike

Finally Running Home an Ironman!

During a quiet training ride, just two weeks before I was to race Ironman New Zealand 2005, I had a spot of bad luck: I was involved in what should have been a minor traffic accident.  Because I was on a bike, however, it was anything but.  I suffered a severe traumatic brain injury and missed my race, what would have been my first Ironman, because I was still in hospital in a coma!  I lost my health, I lost my career, I almost lost my life!  Through all of it, though, I never lost my desire to race an Ironman, slowly but steadily rebuilding my strength, fitness and abilities.

On March the 6th this year, five years after I should have, I finally ran home an Ironman!

(This is my favourite photo from Ironman because, while it shows me running towards the finish, it doesn't actually show me crossing it, as if my race isn't over.  I like it because, as I explain below, I don't feel like "my race" is over yet!)

For me, Ironman (which involves a 3.8k swim, 180k cycle and then a 42k run) wasn't what I'd expected at the start of the day.  I had a good swim...

(A shot of the mass start involving over a thousand swimmers - I'm in there somewhere)

... and a reasonable bike ride... 

(looking settled)

... only to have problems on the run!

(feeling the pain!  That is a frown, or as much of one as I can manage!)

Unfortunately, I became quite ill about a quarter of the way through the run.  However, after the saga that's been my build-up to Ironman, I wasn't going to let a bad stomach get in the way of finishing.  Things gradually improved, particularly when four supporters came off the sidelines and starting running with me.  Gradually, my running style came back together and I truly enjoyed the final stages of the race, running home in a time of 12.54.

(me with my fantastic support crew afterwards!)

How does it feel to have finally completed my goal and raced an Ironman?  In a word, fantastic!  Ironman has been such a saga these last five years; although my race wasn't the best, I feel like I've been released, like I can now go on to other things.  And there are indeed other things!  Of course, finishing my 50,000 word Masters thesis is currently my biggest goal, but really there's a whole bunch of things I want to improve at.  My recovery - my race - isn't over yet!

I remain committed to the process of recovering.  Ironman was only a step along the way and I hope for all the best in furthering recovering.  I wish other recoverers out there well and hope I hear stories of things other people have gone on to do, following their brain injury.

Cheers,

Mike 

Listening to Your Body: Sweating and Cravings for Salt

Your body is exceptional at telling you what it needs. All you have to do is listen!

One particularly undesirable effect of my brain injury is, when I exercise, I sweat... heaps. As long as I drink lots of liquid, I have no problem with it (although I'm less keen on running into girls I want to impress when I'm like that :-). However, I'm only slowly getting used to the new ways my body operates.

As I started triathlon training more regularly, I was exercising more often and therefore sweating more. About the same time, I started experiencing periods of cravings for potato chips. I'd never before had intense desires for particular foods (both before and since my accident), so I was very perplexed by such episodes.

Eventually, I realised that what my body was after was potato chips for their salt to replace the amount of salt I was losing in my sweat. Eureka! I increased the amount of salt in my diet by adding it to meals every so often. I haven't since experienced trouble with cravings for chips.

I certainly don't propose every recoverer will have a similar craving caused by sweating more! What I am saying is, listen to, and think hard about, what your body's saying to you. A TBI will likely change some/many of the ways your body works. As you get used to the new you, it might help to pass close attention to what it's trying to tell you.

Cheers,
Mike

Having Faith I Will Figure It Out

In my most recent post, I talked about how I've relearnt heaps just by retrying an activity. I talked about trying to relearn it enough just to enjoy it again. Part of what guides me in that is having faith I will figure it out.

Of course, my injury has affected what I can do. I know what I enjoyed before my accident; unfortunately, I can't do all of it in the way I used to. I get into it, but it can be (very) frustrating as I often feel I'm starting from the beginning.

I can't give up hope, though. I try and think hard about what, specifically, I enjoyed about doing the activity. What will I need to relearn to start enjoying it that way again? Often, my constraints from my injury will mean I need to adopt a new approach. Is there an approach that will still allow me to enjoy the activity as I used to?

I guess, once again, my running's a good example of this. Like I said in my last post, I got into it, but then found the rate at which I was improving tailed off. It became more and more frustrating not feeling like I was making any sort of progress with it. What kept me going was having faith that, sooner or later, I would work it out.

I thought hard about what I needed to enjoy it: it wasn't the speed; it wasn't the hills or the views; it was the endorphins. Running properly was important to get those. In the end, I had to get some expert advice to help me do that from a physiotherapist who specialised in brain injury and running.

It's been quite a journey and, although not over yet, one big help along the way has been the faith that, eventually, I'd figure it out.

Cheers,
Mike

Get Into It!

It's been awhile, sorry guys. I hope everyones' recoveries have been progressing well! As I said in my post before Christmas '08, I've been thinking about a whole bunch of things on TBI recovery. Unfortunately, I've had a bit of trouble finding time to write about them. Apologies and please wish me luck for finding more time to write from here on.

I'm restarting posting with something relatively simple, Get Into It! Much of the progress I've made in a whole range of activities is due to one thing: just getting back into it.

For the great majority of things, even when I can do them properly, I can't do them nearly as well as I used to before my accident. I need to relearn them and, basically, I want to relearn them enough to enjoy doing them again. If I restart doing it at whatever level, that doesn't normally take too long.

It doesn't matter to me whether I enjoy it less than I used to. Of course, it's frustrating to have to restart learning it again, but only one thing's important to me, am I still enjoying it at some level or other? Maybe I'll one day have my old level of enjoyment back, but, right now, do I still like to do it?

Sometimes, I'll restart something, but have real trouble relearning it. That's when it becomes more important to find the right people to talk to. There must be someone around who can help me with whatever I want to relearn. It's just a matter of finding out who that is.

The best example I have that sets all of this out is my running. I had loved this before my accident; popping out somewhere interesting for a few hours' hard running; the views. the feeling of drive during it, the endorphins afterwards, it was a great feeling. My running afterwards was much less so.

Yet, I got into it and was making progress relearning it. Eventually, however, I stopped making progress and had real trouble with it. In the end, I saw a physiotherapist who specialises in brain injury and running. He made all the difference, improving my form out of all sight.

Even now, though, I'm not sure I enjoy it as much as I used to, but I love it enough to back out doing it again.

Cheers,
Mike

Talking to the Right People

In this post, I wrote about how difficult TBI recovery is. That concept implies one important thing: It's difficult to recovery well without professional, compassionate help. Medical staff might not understand everything, but they'll still understand a massive amount more than what the untrained will! Talking to them first can save endless frustration when coping with some difficult TBI recovery problem.

Since they can be of so much help, how best to use them? Simple, talk! Find the right person, talk to them and try to ask them the right questions! Have a think before you go to them: what would you like to know, what don't you understand, how best could they help?

Didn't get the answers you wanted or, just as importantly, didn't get them in the way you wanted? Remember to think, hang on, I'm the Boss! Remember how complicated TBI recovery is. That'll mean there's a massive amount of people that might be able to help you. Don't stop trying different people until you find answers you're happy with.

That's probably the most important thing to take from my process of relearning how to run. Someone as serious as a physician or even a neurologist was unlikely to help me with it. After all, I knew how to move the right muscles. The problem was moving them in the right order!

I tried two different exercise trainers who normally help healthy people with running, but neither were at all familiar with problems related to brain injury. In the end, after some encouragement from a friend, I tried talking to a physiotherapist who recommended another physiotherapist who specialised in the relevant area. Only with that, did I feel I was in competent hands that would help me with my running trouble.

Cheers,
Mike

Phrases for Mike to Avoid: Again and Back To

In the post, Mike's Path to the Third Level of Acceptance, I put parts of two phrases in bold: "when I start doing this again" and "once I get back to that". I did so because these have become words, even now - over three years since my accident - I need to work to avoid using. I try to avoid them because of what I'm learning about accepting my TBI. When I use 'again' or 'back to', I imply that, because I used to do it, I'm certain I'll once again do it.

Yet part of me accepting my TBI is accepting that I might never again do what I once did. So I might never again do what I did previously.

I'm never able to stop being careful to accept my TBI and not use these words. Most recently, I've been tempted to use them when I talk about my running and swimming pace. I'm relearning how to be a triathlete (I wrote a little about it here). As I restart training, my mind quickly turns to my pace and how it compares to my pre-accident pace.

Before my accident, I could run a kilometre (about 0.62 of a mile) in four minutes and swim it in 15 and I used to be able to do both kilometre after kilometre. Now, I'm recovering from a TBI and, despite an amount of training, I can only manage about 70-80% of that pace.

I think it's a technique thing more than a fitness thing; I can only maintain that pace for a single kilometre before it starts dropping away and I'm not much faster when I try and sprint over shorter distances. Since it's a technique thing, the cause is very likely my brain injury; the brain is unable to perform what's being asked of it. Deep down, I have to admit that that means the brain may never relearn proper technique.

It took awhile for me to accept that I might never reach my pre-accident pace for any sort of long distance race. Now, though, I do my best not to imply that I will definitely reach it. I use phrases like, "if I become able to run four minute ks once more".

This post isn't meant to invite sympathy. First of all, I am incredibly lucky to have survived my accident and be recovering as well as I am. Secondly, you can be certain I will fight tooth and nail to reach those paces and achieve my pre-accident goals. But I accept that I've had my brain injury and I might never reach them and I might never do what I once did.

Cheers,
Mike

Swim, Bike, Run

With part two of my amazing interview with Johanna, I started the post label, Competitive Sport. I made it a label as I planned to add more posts about my own experiences trying to play competitive sport post-accident. Now, Johanna is a special person and what she has done, post-accident, is absolutely amazing! Unfortunately, I cannot claim to have had anything like her success, but my sport is a big part of me and something that has been and still is a very big focus of my recovery.

My sport has three disciplines: swimming, biking and running; yep, I'm in to triathlon. In this post, I wrote about being close, prior to my accident, to racing in the New Zealand Ironman triathlon and how I am very keen to have another go at the race. That keenness has meant I've started a very big process of relearning to do each discipline. Funnily enough, that process has involved relearning each in the order they actually appear in events: swim, bike, run.

Physically, swimming is the easiest as it involves no weight bearing at all. No surprises I relearnt to do it first. Initially, I had problems with breathing, but they were solved once I learnt how to keep my breathing smooth by taking a breath and then releasing it slowly each time. Next came biking; as with swimming, I needed to learn how to keep my breathing smooth here too. I also needed to learn more about my balance and about not riding when badly fatigued (in the post, Mike's Regrets, you can read how I found out my balance while biking is much poorer when I'm tired).

Last, but not least comes running! Running is by far and away the most difficult discipline, physically. All three disciplines require rapid muscle movement, but only running requires it while the muscles are bearing weight. As with my walking, I had to start from scratch and completely relearn it. To help me do that, I needed to see a physiotherapist working in Australia. He specialises in brain injury and running and gave me valuable exercises to help me, but I am still very much relearning this discipline now.

To have another crack at Ironman, both my fitness and my technique have to be top-notch. That means I have a long way to go, but I will, of course, keep you updated on my progress as it relates to recovery from TBI.

Cheers,
Mike

Proving People Wrong

Part Two of an Interview with Fellow TBI Recoverer, Johanna O’Connor – Her Sporting Achievements

This post obviously follows on from Part One of Johanna’s interview.

Johanna, can I now ask about how you returned to competitive sport?

After the accident, the doctors had said to me, with the damage I had to my shoulder and knees, I would not be able to swim or run again. After a month of being out of hospital, I went down to the pool- mainly to get me out of the house and stop me from going crazy. I started aqua jogging in the pool and cycling (on a simulator) to strength my legs.

Three months after the accident, I visited a knee surgeon. He explained to me that he could not operate yet as my legs where not strong enough, but he also made the fatal mistake of explaining to me that 'I could do no more damage than I already had done, so go out there and make the most of it'. This statement stuck with me. I also had time while I was sitting around, to think about what I had lost. I felt as though I had lost basically everything that I knew; my studies, my sport, my partner, my life.

So the very next day after seeing the surgeon I started training again (swimming, board paddling, and running) mainly for Surf Lifesaving competitions. I had previously been a pool swimmer doing 11+ pool sessions a week and had had an interest in Surf Lifesaving. That interest started just before I turned 19 when I was asked to compete at a New Zealand regional competition and after this competition was asked to be part of the New Zealand development squad. From there I socially competed in Surf Lifesaving. In February 2003, about six months before my accident, I was part of the NZ Under-23 team to represent New Zealand at the Tri Nations [Ed's note: This name refers to an event between the nations of New Zealand, Australia and South Africa]. This was my first NZ representative team.

What has your progress in the sport been like since your accident?

I trained hard and eight months after my accident was the trials for World Surf Lifesaving Championships, to be held in Italy in September 2004. At the New Zealand trials, I was the best performing woman. During those eight months, I had switched everything else in my life off and trained hard. Training is how I dealt with my emotional distress. It led to more physical pain, but dealing with that made me train harder still. It all definitely helped me to sleep at night without going through the hours of emotional distress of what life used to be like and the emotions of losing the first guy I ever loved.

I was named on the team to go to the World’s. My main event was the Surf Swim. I gained fourth place. At the time I was extremely disappointed about that, I only wanted first place. [Ed’s Note: Johanna may have been disappointed, but the rest of us are in awe of fourth place! This was, after all, the World Championships and it was less than twelve months after doctors had told her she would never swim again!]

Looking back on all I went through to get fourth place, though, I can honestly say I came a long way. I am happy with this thought, but now it has created the hunger in me to get that first place. Since then I have continued to perform and have now been on 8 New Zealand Representative teams. [Ed’s Note: Johanna most recently competed as part of the twelve-strong New Zealand team at the International Surf Challenge in Sydney, Australia in December, 2007.]

Your training must have been so difficult, especially at the beginning. What kept you going?

What started me off was depression!! I had lost everything I knew, I didn't get to go to my partner’s funeral, I was stuck on the couch with ankle to thigh leg braces on, I couldn't go anywhere. My life for the first few weeks of being at home was my room, bathroom, and lounge/kitchen. After sitting around for so long I was uncomfortable at how my body was changing- I used to be a thin, athletic person, and I was turning into (as my friend put it) a normal looking girl. All the things I had taken for granted like; standing up by myself, showering myself, and all the others e.g driving car, general walking etc. It was horrible - I was relying on other people all the time! I hated this. I wanted to do it when I wanted to and how I wanted to!

The doctors were telling me about not being able to swim or run again hit me hard - real hard. I could not handle it. Then came the knee surgeon’s words, 'You can't do any more damage...’. He also said I probably wouldn't be able to run till Feb, and we were in October. The very next day, I was training with the mentality, "I can't do any more damage". I tried to run and swim again. Swimming was painful. I went from before the accident doing 8-9km in 2hours, to swimming 1km in 40min's for the first week ,which built up to 2km in 1hour in the 2nd week and slowly progressed from there. [Ed’s note: If that swimming pace makes readers feel uncomfortable, I can assure them that, despite training, my own pace has never been anything close to that good! :-)]

Running: wow this was slow! I had no strength (I struggled to walk up stairs) but I slowly got faster over time. At the World’s in 2004, I was even managed to run in the beach running relay.

Training was extremely difficult; the pain was some times so intense. This would be from scar tissue stretching or knees failing on me or the continual shoulder pain or running 2 days after a piece of bone being removed from my hip to reconstruct my face, plus the many other operations I encountered. The pain is indescribable, but for the reasons explained, I pushed through, even though I couldn't walk after some sessions due to my knees giving out. Having a head injury helped me to concentrate on myself and getting myself better.

My head injury damaged my social ability and my reasoning, so I was stubborn, I would not listen to people telling me not to go training. My intolerance made it hard for me to deal with people. When people kept telling me I couldn't do this or that, I hated it I could do it and I would prove to them all that I could. So another reason I was able to push through the pain, was to prove to myself and the people around me that I was no push over, and once I realised I could do it I wanted to prove them all wrong, including myself.

When it comes down to it this was my second chance - the chance Jared never got. I had to make the most of it and get myself right.

Thanks for taking the time to talk to us, Johanna. Best of luck from us here at Howtorecover with your further adventures. We are very sure you will make the most of your second chance! Those readers interesting in hearing more of Johanna's story can start by trying this online newspaper article.