Did that Really Happen


Sea Star on the Move

A sea star or sand dollar might take about ten minutes to move half its body length. This is what’s so amazing. Before seeing the sand dollar below I had no idea that they even moved. Without mindful observation I was just seeing dark sand dollars and white, sun bleached ones. Once I realized the dark ones were alive, I found many more that would leave a trail as they scavenged the ocean bottom.

To improve my quality of life, while living with ABI, involved recognizing signals that my body gave me as being significant. To recognize my body signals is as significant as realizing that a dark sand dollar is a living, moving organism.

Sand Dollar on the Move

In the past half year I have become more in tune with the signals my body sends me. What is most beneficial is recognizing the signals soon enough to allow me to take measured to avoid sensory overload. Early on I would not recognize the early onset of sensory overload and would stop participating in an activity once I had ‘crashed’. The problem with living that way is that it would take me up to 4 days to recover from a crash. While recovering, life comes to a grinding halt due to elevated levels of fatigue, headache and convincing myself to take measure to not contribute further to the sensory loading.

In time I have become attuned to some of the early signs. Since the early signs are subtle, they are easily overlooked if I am intensely focused on an activity. At other times I miss the early signs because the onset of sensory overload comes on gradually and the fatigue which builds up gradually dulls my awareness of impending sensory overload.

Unfortunately, with an Acquired Brain Injury (ABI) the signs are initially quite subtle. If the pain registers as immediately as hitting ones finger with a hammer that would make detection easier. However, if the side effects of an activity while living with ABI were as obvious as experiencing a pinched finger, it could signal that I’m in a catastrophic state. I base this on the notion that the greater the pain the more urgent the remedial action must be to prevent serious or life threatening harm.

In the past year and a half I have gradually begun to indentify and make note of some useful early warning signals. Here is an inventory of what I have learned:

Humming (visible)

This was one of the first signals that I recognized as an early warning. I would find myself humming or more accurately, just vocalizing to create a vibrating sound. The vibrations were soothing or relaxing. At first when I would vocalize I failed to make the connection that this was a signal that I was approaching sensory overload. Eventually I made the connection but that didn’t mean I recognized it every time it happened.

Eyes watering (partially visible)

This was also one of my first signals I recognized as an indicator that I was reaching my limit. If I didn’t heed it at this point I would soon find myself in tears. That’s much harder to miss.

Walking pace (partially visible)

This one dawned on me about five month into ABI. I was shopping with Jane, pushing the grocery cart and found it took concerted effort to keep up with her. When I would take a side aisle to retrieve an item I noticed that my pace was much slower than usual. By the time that shopping excursion was done, about forty minutes in all, I was in sensory overload. Even though this experience made it clear that this was a useful signal, time and again I would fail to recognize it.

Losing focus (partially visible)

Initially when I would lose focus I would think I had lost interest in what the person was talking about. At first that seemed no different than pre-ABI. Gradually I began to recognize the loss of focus as a signal to remove myself from the situation. Attempting to appear interested and forcing myself to concentrate on what was being said would eventually catch up with me. This could entail listening to a story telling, a drama reading or some other form of a verbal presentation.

Double vision (invisible)

At certain times I have noticed having double vision. The first couple times it happened while I was driving. The first time I figured it was a result of not wearing my glasses. When it happened again I was puzzled. I have been able to determine that it is related to driving. That is the only time I have experienced the onset of that signal. I have not been able to make a connection between the length of time I have driven or the type of roads I have driven.

Restlessness (visible)

This signal is somewhat similar to being unable to focus except that this signal included physically needing to change positions or move around.

Increased level of breathing (visible)

It took me a long time to recognize this signal. The subtlety with this signal is that it’s very normal for one’s breathing to change as one’s level of activity changes. I stumbled across this one day while dealing with some details of setting up for a picnic. While the setting up did not involve lifting anything heavy, my rate of breathing would indicate that I was moving some heavy weights around. Then, out of curiosity I checked my pulse rate and found it was at a level that indicated I was doing a low level activity.

Headache level (invisible)

After having gone through a few months of natural healing, the intensity of my headaches was starting to fluctuate throughout the day. I began to recognize the change in intensity of my headache began to relate somewhat to the demands the activity was placing on my body. My headache would indicate that the demands were becoming too high. The changes would happen whether the demands were physical, cognitive or emotional.

Mental fatigue (invisible)

At times, when attempting something complicated, I would find myself just not able to get my ‘head around it’. I knew I had to back down from what I was doing. At times my mental fatigue is accompanied by a “buzzing” sensation in my brain. This sensation is different than the tinnitus or constant ringing in my ears.

Social withdrawal (visible)

At times I’ll recognize myself withdrawing from a conversation. While this happens occasionally in a one-on-one conversation, it is more likely to happen in a group conversation. A close friend or spouse is usually quicker to recognize this signal before I do. The best way to counter this is to walk away.

Emotional sensitivity (partially visible)

This signal is not an easy one to gauge. One factor in my response to a situation is the emotional intensity of the event. One helpful point of comparison is seeing how others are responding to the same event. However, that has its limitations because everyone comes to an event with a different background. I know that attending a Remembrance Day ceremony is emotionally very intense for me regardless of where I am on the sensory loading scale that day.

Visible and Invisible signals

I refer to these indicators as signals. As signals, some of them are behaviours that happen in response to how I’m able to handle myself in certain situation. Some of the visible signals are only noticed by a careful observer because they can easily mask as neuro-typical behaviours. Though some casual observer might notice that something is ‘off’ but not realize what is happening.

Even though some of the signals are visible an acquaintance wouldn’t necessarily think anything of it.  If someone notices me withdrawing from a conversation or humming they wouldn’t necessarily see it as something to point out to me to make me mindful of how I’m doing.

With the high number of signals I have identified over the past year and a half, it might be surprising that I often miss the early warnings. The main reason is that many of these signals are not like an in your face PA announcement. The signals are subtle and don’t stand out from other sensory input I’m processing.

I have posted these signals on my kitchen wall. I hope that seeing them listed will help me be more mindful of these signals as they surface.

Being attuned to my early warning signals is my most reliable means of improving my quality of life. The complicating factor is a condition which is called anosognosia, being unable to recognize my own condition. Living with ABI means there are times that I`m not aware of my condition. That is when I need to trust the observation or sometimes the intuition of my caregiver. Sometimes I accept my caregiver`s decision without comment. Other times I engage in a discussion to convince her I’m fine with attending a particular event. At times I think I`ve won the debate only to realize later that I actually lost.


Author: Jasper Hoogendam

After 36 years as an educator my career ended due to a TBI. Renewable energy as part of 'walking lightly on this earth' has been and continues to be my interest since my teen years. Since early 2015 I have been learning to live with ABI (Acquire Brain Injury). I don't want to let my ABI limit the goals I set for myself. I'm living with a different brain, not a lesser brain. In sharing my day to day successes and struggles, I am better able to understand how my life had changed and begin to accept the change. In sharing my experiences I'm hearing from caregivers and fellow ABI's. I'm encouraged when my experiences are helping others understand some of the complexity of living with ABI.

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