A weekend away sounds like a great way to relax. For someone with traumatic brain injury (TBI) it is anything but. Let me explain how my weekend away experiences have unfolded.
Why would a motel not be relaxing? Taking advantage of amenities like an extra big bed, a big television with more channels than the one at home, and a pool, to name a few obvious ones. Sounds great.
While spending three days at Niagara Falls, which we have very much enjoyed in the past, I made a note of what was different. I noted how the experience was different from being at home. In brief I experienced headaches at an elevated level, increased level of fatigue and cognitive overload combined with some disorientation as part of low level sensory overload.
The three day visit to Niagara Falls began with a three hour drive, including navigating the 401 through Toronto. (See my blog entry “A Case for Backseat Driving.”)
The routine of checking into a motel doesn’t seem like an onerous activity. What makes it significant is that the routine is different. The challenges stem from being outside of a familiar environment and comfortable routines.
Doing the check in required responding to the clerk`s questions. Providing the reservation number which I had in hand was simple. I had anticipated that one. Next was the request for the car license number. Oops, hadn’t anticipated that one. Normally I would have had it memorized. After that I couldn’t keep track of the additional services and upgrades that were available so I just declined them all. Besides, I’m too frugal to splurge.
The check in wrapped up with the clerk giving instruction on how to get to our room, as well as some other helpful information. The instructions came at me too fast. She mentioned the pool hours. I couldn’t process the information quick enough. Resolving this would put me into a low level problem solving ordeal. Rather than deciding how to deal with the information overload, I simply thanked her and walked away.
As I walk away I’m thinking, “Forget about using the pool.” Trying to swim in cold water would definitely result in sensory overload since the three hour drive had brought me close to my threshold. “A hot tub on the other hand would be great.”
We were assigned a 200 series room number so we headed to the elevator. The clerk’s instructions had evaporated into the ether. We stepped into the elevator and pushed the button for the second floor. The door closed but the elevator didn’t move. I was puzzled. We stepped out of the elevator and were told we were already on the second floor. I hadn’t realized that the back entrance was on the first floor. We had come in through the front door which automatically put us on the second floor. They shouldn’t be allowed to build motels that way.
As I stepped out of the elevator I’m thinking, “If I was at home I could have been relaxing on the couch.” I would have unlocked the front door, stepped inside, tossed my jacket aside and settle into the couch to read. Simple. No brain activity required till I started reading.
Eating breakfasts and suppers at various restaurants means the brain is taking in new sounds and new pattern of sounds. There are no familiar routines to fall back on. When walking into a restaurant you want to know where the washrooms are, whether to wait to be seated, what part of the dining looks good. And then there are the many other things one naturally assesses when walking into a strange place. This is followed by figuring out the menu, while the waitress rattles off the specials of the day. If I’m alert enough I remember to make my choice when I hear something that sounds good. I then tune out of the rest of the waitress’s spiel. At the same time I make a point of repeating my choice to myself so I`ll remember it when I`m asked.
I’m thinking, “If I was at home I’d just eat what shows up on the table.” I would only have to decide whether to have a second helping or not.
The first time I experienced a motel stay following my acquired brain injury (ABI) was in a city only an hour from home. I was baffled by the fact that the visit was not relaxing. The trip to Niagara Falls happening almost a year later was not much different. I wanted an explanation for what I was experiencing. The experience is likely a bit different for each person with an ABI.
What in the World is my brain trying to do?
What follows from here is how my symptoms of headaches at an elevated level, increased level of fatigue, cognitive overload and a dose of sensory overload, might be linked to certain dysfunctions or confusion in the brain.
The autonomic nervous system (ANS) is the part of the brain that is designed as our early warning system meant to protect us from potential danger. When the body senses danger it gets ready for ‘flight or fight’. As the shot of adrenalin activates the body, the heart rate increases,
the muscles are activated for movement, the pupils dilate, etc.
When the brain gets the sense that the danger has passed the Parasympathetic Nervous System (PNS) takes over. The body gets the message that it’s time to calm down, and so the body goes through a restorative process to bring the body back into equilibrium.
When the brain has experienced an injury, it is at risk of developing ‘sensory defensiveness’. The ANS is triggered by threatening sounds like a car horn or screeching brakes. The ANS is also triggered by non-threatening sounds and sensations. When a person is in an unfamiliar environment, the brain is bombarded by many sounds and other input that it is reacting to. When the ANS is overworked, the PNS doesn’t do an effective job of bringing the body back into a healthy equilibrium.
When the nervous system is over-responsive to sensory input, the Sympathetic Nervous System is overshadowed by the Parasympathetic Nervous System. As a result too many non-threatening sensory inputs are not received as ‘rest and digest’ responses but rather ‘fight or flight’ responses.
If the PNS is seen as the accelerator and the SNS is the brakes, they would be working against each other. (It’s like driving a car with one foot on the accelerator and one foot on the brake. It would wear everything out very quickly as well as waste a lot of energy / fuel.)
The ANS is regulated by the hypothalamus. That’s the area of the brain just above the brain stem. A person without an ABI would have the Sympathetic Nervous System work in a complementary way with the Parasympathetic Nervous System.
With the constant acceleration and braking happening in the brain, mental fatigue begins to manifest itself in the form of the person becoming distressed and agitated. The distress and agitation can linger long after the sensory input has ended.
On a number of occasions it took me over three days to recover from the sensory input. The more prolonged the sensory input the longer it takes to recover. One such occasion was an hour long procedure at the dentist. I didn’t want the dentist to quit when he was almost ready to put in a filling. So it was a matter of holding myself together till the ordeal was done.
On another occasion I was at a musical event. About twenty minutes into the performance I realized I was going into sensory overload. Since I didn’t have the capacity to let myself out of my seat, passing in front of seven or eight people I chose to put up with the ordeal till the intermission.
Gradually I have learned what type of events makes me succumb to sensory overload. I will avoid folk festivals, musical performances, parades, dentists and movies portraying real life experiences of heartache and overcoming challenges.
With an Acquired Brain Injury a weekend away feels more like putting in overtime than having a relaxing few days. Is staying home the option? Should I just let life pass me by? Not if I can help it. Whenever there’s an opportunity I will definitely choose in favour of a weekend away.