visual problems after brain injuryTag Archives

A Brain Injury Often Damages Our Vision System

by Linda W. Arms

Brain injuries often cause problems with our vision system. I’m not talking about a problem with the eye itself but about the work our brain does to allow us to see and interpret what we see. According to the Neuro-Optometric Rehabilitation Society, around 50% of brain injuries result in problems with our vision system. If you have had a brain injury, you have a good chance of having visual-related problems that in turn result in fatigue; and problems with cognition, balance, and coordination. I’ve had several issues with my vision system with improvement being a work in progress still today after 13 years. I can tell you these have had a major impact on my abilities to do things that I could easily to do before my injury, but I’m happy to say things are so much better today and I don’t notice too many problems on a daily basis like I used to.

Damage to our vision system cause problems such as:

Difficulty with eye movements
Double vision
Sensitivity to light
Reduction of visual field
Problems when shifting gaze from one thing to another
Difficulty focusing
Problems reading and comprehending what is read
Visual mid-line shift
Sensitivity to visually busy environments
Problems with walking and balance
Problems with motor skills
Dizziness

If you are having problems like these, your brain must work extra hard to get you through your tasks which then causes even more fatigue. A full comprehensive vision exam is frequently not performed on people after a brain injury and these problems are not identified. I know I had to be persistent to get my “eyes fixed”. I went to 3 different specialists who each worked with different parts of my vision problems.

I believe it is very important to visit an optometrist or ophthalmologist who specializes in neurological vision care. After my TBI, I visited two optometrists that did not have this specialty since I thought things were under control although I still had some problems. I didn’t return to either of them because I felt they did not understand the neurological issues. In fact, one doctor became very impatient with me when I told him a number of times I could not do some of the visual tests he was asking me to do – it just didn’t work. After that visit, I’ve made it a point to only see a neuro-optometrist for any type of vision care. You can find a specialist in your area by visiting the following page and scroll down to a box where you can locate a provider:

Neuro-Optometric Rehabilitation Association – Health Care Locator

The following chart, intended for children’s development, shows the components of the visual system and helps me see how they interrelate. Source: http://lynnhellerstein.com/the-developmental-vision-model/

Click on image to view an enlarged image:

The Center for Neuro Skills also provides a good overview of visual problems associated with brain injury:

https://www.neuroskills.com/brain-injury/vision-and-brain-injury/

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The “Brain Injury Uniform”

by Linda W. Arms, dated Feb. 23, 2018

After my brain injury, I went from wearing outfits chosen from my wardrobe to wearing a “uniform”. This change happened for many reasons. Making a decision about what to wear was more than my brain could deal with. Wearing an outfit was not something I could relate to any more. Even after nearly 12 years and great improvement, I still lean towards the uniform approach to dressing rather than making the effort to create an outfit for the day.

For so many of us with a brain injury, decision-making is challenging, even for little things. I preferred that others made decisions for me especially for anything that required a lot of thinking. Getting dressed for the day was challenging because I had to make decisions. Just think about some of those things you consider when you pick out what you are going to wear? Things like:

· What activity, event or occasion am I dressing for?

· Am I going to be inside or outdoors?

· What is the weather going to be?

· Does this color go with this?

· Where is it?

· Do these things fit together?

· And the list goes on…

This requires a lot of brain energy! It requires a lot of visual processing and sorting pieces of information to decide what to wear. If we have problems with balance or pain we have to be cautious in how we move. Sometimes, what we choose to put on, whether it is clothes, jewelry or shoes, the wardrobe items cause sensations or stimuli that we don’t want to deal with. We become quickly fatigued before we even go somewhere. This often causes our symptoms to get worse leading us on a downward spiral.

After my injury, I became quickly aware that I didn’t have the energy to make decisions about what I wore. I adopted a few simple pieces of clothing that I wore over and over again. I chose to wear a “uniform”. I didn’t have to decide. I didn’t care any more about making the best impression for myself. I didn’t care if I wore the same outfit the last time I saw this person.

I wanted to be comfortable instead of looking my very best for whatever I was going to be doing. I didn’t want to have to deal with whatever restrictions or problems I might have with what I was wearing. I wanted to make sure I wore flat shoes since my balance was off and I didn’t want to be challenged with walking and staying upright. I didn’t wear jewelry because my dexterity and visual processing wasn’t very good. I couldn’t easily manipulate small objects with clasps and other connections.

After my brain injury, I also lost many of the roles I played in my life. I didn’t have to wear the outfit appropriate to the role I was filling for the day. My old outfits did not fit the part any longer. I had been a professional but my career clothes were unnecessary. My career was no longer a part of my life. The fact that I would not be working in my profession became very clear to me early in my recovery. My career clothes were some of the first items I gave away. Not only did I not fit the role any longer but I also didn’t want to be reminded of that fact. It was painful to see those clothes that I had no use for and that I had once been proud of.

I was a social person who enjoyed nice dinners out. I was a woman who wanted to look nice. I was outdoorsy, and enjoyed hiking and skiing. I liked special occasions or events where you had an excuse to dress up. After the accident, my predominant role was an injured person trying to survive the day. I forgot about career, socializing, looking nice and interests in outdoor activities. All my other roles were gone and the few remaining took a secondary position in my life. I had some special pieces of jewelry that I no longer wore – I didn’t feel worthy to be wearing them. I was a sometimes childlike, sometimes old person-like, injured human being who could only deal with simple things. As a result, I adopted my uniform and put aside most of my other things.

Over the last years, I am much more capable and I try to be more creative with my wardrobe. I have the capacity again to want to wear different outfits and accessorize with jewelry and other things. Sometimes, however, when too much stress is in my life or I’m tired, I revert back to my uniform. It makes life so much easier!

fashion women shopping 14

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More Is not Better!

by Linda W. Arms

I thought I’d shared this post again since we’re in the beginning of the holiday season. This is the time where there is SO much of everything which is often very taxing for a person with a brain injury.

Post Dated Sept. 15, 2013

After a brain injury, more of many things, is not better. It is not better to see more things around you; it is not better to be given more choices; it is not better to have more things to do; and it is not better if someone tries to explain something to you in multiple ways so you can get what it is they are trying to tell you. After my brain injury I definitely want less of most things. I can do so much these days but I have definitely lost my edge. Some of you have lost even more, so I expect you don’t enjoy more of everything either.

For most aspects of our lives, it is better to simplify and remove the multiples of things we don’t need. This could mean simplifying things around the house by removing the clutter. Remove things that you rarely use from your closets, cabinets, shelves and drawers. Having to look at so many things requires your brain to work harder. Make it easier on yourself by relocating things you rarely use.

Having too many choices is overwhelming. If somebody told me you can do A, or B, or C, or maybe D; it just made my head spin. I couldn’t and didn’t want to think about each possibility and make a decision as to which option I preferred. It felt like torture.

Having many commitments of your time and energy is also too much for many of us with a brain injury. Just knowing that I have many things on my “to-do” list is often overwhelming for me and causes the brain fog to set in. I can only focus on a few things at a time. I have a big to-do list but I pick just a few items to put on a daily/weekly list. I don’t look at the big list on a daily basis. It’s more like once every week or two.

Words – too many words – can be so fatiguing. Sometimes people feel they need to keep talking to us to explain things over and over and in different ways so we understand. For me, I just want simplicity and a slower speed when people speak to me. I sometimes feel I’m drowning in the words that are coming at me, causing fatigue and frustration. I have had various people speaking to me who were much too talkative and they are close to me so they know my problem. They speak way too fast, using too many words making it so uncomfortable for me that I now refer to it as “brain rape”.

Of course, there are things I want more of, like chocolate, but overall I want to enjoy life at a slower pace, with less noise; less clutter; less electrically produced light; less fast, complex talking; less crowds; less movement around me; less choices and so on. I expect that as time goes on, I’ll be able to handle more of things. During the last 7 ½ years, I’ve slowly increased my abilities to handle more. It just keeps getting better.

Source: http://notoriousbig-river.tumblr.com/post/43170184610

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Holiday Challenges With a Brain Injury

by Linda W. Arms, November 5, 2013

We are now in the middle of the holiday season which can challenge those of us with an injured brain. It is a time when so much more is expected of us than most other times of the year. We along with our loved ones, friends and caregivers should all remember that it’s best to simplify so we can enjoy things more. It’s been nearly 9 years since my brain injury and I’m doing much better but I have to remind myself to keep things simple instead of doing all the things I “should” do, or the things I did before my injury.

This season brings so many more demands on our brain. We have to do a lot of extra things such as buying gifts, putting up decorations, doing more cooking and interacting with more people at social events. We have to maneuver around very busy stores, and the entire holiday hubbub on the roads and parking lots. The holidays can also be an emotional time because we might think back to our past selves when we could do so much more. We might feel our loss even more and feel that familiar grief.

Brain injury survivors and caregivers should take extra care during this time for rest, finding quiet spaces and doing less of what is expected during the holidays. Those of us with a brain injury probably are much more settled and can enjoy this time better if we don’t have ALL those decorations, especially flashing or moving lights all around us. They are overwhelming for our poor brains to process and contribute to sensory overload. Plus its a lot of work to put up so many decorations and take them back down. I put up just a few decorations and I can feel a strange anxiety of having those extra things to look at as I process my surroundings.

You also need to learn to say no to some things. I’ve turned down large family get-togethers in these past years because of all the challenges of interacting, a lot of noise and making your way through the groups of people. And then, of course, we have to remember that when we over-do-it one day we have to pay for it the next.

Ask for help. Instead of doing most of the cooking for a special meal, make it pot luck. Everyone contributes a dish or two. Instead of running to a lot of stores for gifts, buy online. Reduce the amount of gift giving. Many people are happy to opt out of gift exchanges or to cut back from earlier years.

Simplify the decorations, the gift giving, the meals and everything else that is part of the holiday season. Find ways to enjoy the holidays with quieter moments. Keep it simple and you’ll enjoy it more. And remember More is Not Better

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Seeking the Gift – (Bliss after a Brain Injury?)

by Linda W. Arms, dated November 4, 2014

For several years after my brain injury I felt a certain sense of peace and contentment. Did any of you experience a similar thing? I know brain injuries are all so different and I know it seems odd, but I feel there was a gift that came with the injury. My brain could not handle much more than getting me through the day while in my home doing less than 5% of the things I used to do in my life. Even though I was in a fog and knew I was just a small piece of my former self, I enjoyed a sense of bliss.

Prior to the accident I had a career, I had a social life, I had many interests. My life was full of activity and I could never have enough to do. I was very driven and always wanted perfection in what I did and the people around me. It was difficult for me to relax. I was doing yoga for several years up until the accident and it helped me find some calmness. I read all sorts of self-help books to learn how to be more mindful and content but nothing worked. Until I got hit on the head, that is.

I was turned “off” when the trauma occurred. A door shut on what my life was. My world shrank to a tiny portion of what it was. My mind could only deal with things in the moment and only simple things. I struggled to get through each day and often slept up to 14 hours a day.

I could only focus on a very small piece of what was before me. Since my brain was no longer cluttered with a million other thoughts, I saw the world very simply. My mind was often empty with no thoughts. I learned to connect to the quietness and nurturing of nature. I could let the beauty of what I was seeing or feeling into my relatively empty brain and really experience it. I was living in the moment. I did not worry. I did not get angry (or display many other emotions). I was at peace (sort of).

I watched butterflies, stared at flowers, felt the breeze, smelled the soil in my garden. I enjoyed very simple things. I saw and experienced many things most people around us are not capable of in our busy world. I watched the blur of activity of other people racing around in their lives and I thought “they are not really living”. They do not see our world. I could not see or feel our world before my accident. Although, in rare times, I stopped for a split second and saw the glimpse of a beautiful flower, it was a fleeting, shallow experience. As a result of the brain injury, I can sit and enjoy the sky, the birds or flowers or just feel myself exist and feel connected to the world around me.

It’s been almost 9 years since my brain injury and I am so much better. My mind is now very active and I’m getting back to the many interests I had. My peace and contentment have faded. The bliss is usually not there. But now, since the brain injury, I know what that peace and contentment feels like. If I concentrate I can feel it for moments but it takes work. I have to look for that gift of bliss. I have to work on it. I certainly know I don’t want to lose it. So now I’m back reading those self-help books and using other resources to help me keep the gift going.

I know my brain injury was a terrible thing for me and my family but I also found a silver lining that I will hold on to for the future and am grateful for. Have any of you discovered a gift as a result of your injury? Or maybe a new talent?

With peace….

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Linda Arms

November 4, 2014

Life with TBI, My Story

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How to Be Successful When Making a Phone Call Having a Brain Injury

by Linda W. Arms, dated March 29, 2014

Many things become difficult after a brain injury. We take our ability to perform everyday tasks for granted until after our brain becomes damaged. Simple things become a challenge. For me, simply frying an egg and turning it over was extremely difficult and exhausting. A phone call was a multi-day undertaking.

Making an appointment was very challenging for me since speaking, comprehending, thinking, and processing visual input were difficult. I would prepare a day ahead by looking at my calendar and figuring out which days I could potentially go for an appointment. I had to consider also how I would get there since I couldn’t drive. I would note which days and times would work. I would write down what it was I needed to ask and the phone number. Just this process by itself was overwhelming and left me unable to actually place the phone call. Usually the following day I would review my notes and make the phone call. I was often successful when I followed my process, however, if the appointment times that worked for me were not available I couldn’t think through alternate dates while I was on the phone. I would write down the options I was given for appointment times and tell the person I would need to call back.

Here are some tips for being more successful when making a phone call. During the extremely challenging years of my recovery I did this to help myself get through a phone call and accomplish what I needed to do.

Prepare before making the call. What do you need to accomplish? Are you trying to make an appointment, are you trying to find the answer to a question you have, are you trying to purchase something? Prior to calling, write these things down so you can stay on track during the phone call. Remember there are many things that can lead you off track like the phone menu system of the business you are calling, or the person who answers may ask all sorts of things of you before you can get to what it was you were calling about.
Write the phone number on the same piece of paper that you are writing your notes on. This way you don’t have to search for the number right before you call. If you get interrupted, the phone number and your notes are in one place so you don’t have to go through the effort of re-thinking and locating information.
Review any paperwork, like an invoice or catalog, you need to be familiar with prior to making the call. With a brain injury, it may be difficult to have a phone conversation at the same time that you are reviewing written information.
If making an appointment, have your calendar ready. Review your calendar prior to making the call so you know which days will work for you and which ones will not. Write down the days and times that will work or circle your calendar. Remember there’s a lot going on during a phone conversation. Prepare yourself ahead of time with the information you need.
Prior to making your phone call you may want to look at the business’ web site to be better prepared and informed about their product, business hours, location, etc. This may help you to know what questions to ask during the phone call. It may be difficult to think about all these details when just calling an office and not being prepared.
Make your phone call from a quiet location that is free of distractions.
If you can, make notes during your conversation to keep you on track with what you are learning and what you need to ask.
If the person is speaking too quickly for you, ask them to please slow down.
If the phone call doesn’t end up like you rehearsed just tell them you can’t make a decision now or aren’t sure if that appointment date will work. Tell them you’ll call back. Give yourself time to think through the problem that presented itself during the phone call and call back when you are ready.

I still do this but can now do it right before I make my phone call. My brain needs all the help it can get so I know that by preparing in advance I can be more successful. What about you? Do you have some suggestions to add regarding making a phone call with an injured brain?

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A Brain Injury Can Damage Our Vision System

by Linda W. Arms

Brain injuries often cause problems with our vision system. I’m not talking about a problem with the eye itself but about the work our brain does to allow us to see and interpret what we see. According to the Neuro-Optometric Rehabilitation Society, around 50% of brain injuries result in problems with our vision system. If you have had a brain injury, you have a good chance of having visual-related problems that in turn result in fatigue; and problems with cognition, balance, and coordination. I have several issues with my visual system that I am still trying to resolve after 8 years and I can tell you these have had a major impact on my abilities to do things I was easily able to do before my injury.

You will most certainly have a variety of problems if your vision system is not functioning properly since we use nearly half of our brain for vision-related activities. After a brain injury, our vision system is sometimes overlooked and as a result, we struggle to improve. In my case, the problems with my vision system started being addressed after about 6 months and I was in some type of vision rehab therapy for nearly 4 years. In the last several months, I started noticing problems again with vision and having that discombobulated sensation that I thought was gone. I’ve had to start vision therapy again to help correct the problems that seem to have resurfaced although I suspect some of the problems never completely disappeared.

Damage to our visual systems cause problems such as:

Difficulty with eye movements
Double vision
Sensitivity to light
Reduction of visual field
Problems when shifting gaze from one thing to another
Difficulty focusing
Problems reading and comprehending what is read
Visual mid-line shift
Sensitivity to visually busy environments
Problems with walking and balance
Problems with motor skills
Dizziness

I believe it is very important to visit an optometrist or ophthalmologist who specializes in neurological vision care. In recent years, I visited two optometrists that did not have this specialty since I thought things were under control although I still had some problems. I didn’t return to either of them because I felt they did not understand the neurological issues. In fact, one doctor became very impatient with me when I told him a number of times I could not do some of the visual tests he was asking me to do – it just didn’t work. When I noticed more vision problems recently I made it a point to find a neuro-optometrist. You can find a specialist in your area by visiting:

Neuro-Optometric Rehabilitation Association – Health Care Locator

Click on image to view an enlarged image:

The Center for Neuro Skills also provides a good overview of visual problems associated with brain injury:

http://www.neuroskills.com/brain-injury/post-trauma-vision-syndrome-1.php

http://www.neuroskills.com/brain-injury/post-trauma-vision-syndrome-2.php

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More Is Not Better

by Linda W. Arms, dated Sept. 15, 2013

Source: http://notoriousbig-river.tumblr.com/post/43170184610

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Caution! Caution! Brain Injured Drivers!

by Linda W. Arms

I just drove behind a car with the sign “Caution! Caution! Student Driver”. It reminded me of when I started driving after my brain injury and how slowly and cautiously I would drive, just like the student driver I was following. I expect many of you have been in this same circumstance after your brain injury.

There have been a lot of us out there on the road. Does that make you comfortable? Driving is a challenging activity for many people after a brain injury. In fact, many of us were not to drive until some time had passed and we were functioning better. What about the people who haven’t been getting treatment after their “mild” brain injury but are dealing with cognitive challenges while not really aware of their impairments or are just “dealing” with it?

No one had to tell me not to drive. It was very obvious to me that I had a severe problem. My reaction time was slow. I had a number of visual disturbances. I wasn’t coordinated. It was hard for me to focus. I couldn’t remember my way around. Everything was a distraction. I also had problems with PTSD so any loud sound, sudden movement, or something unexpected left me shaking, in tears and made me want to shrink into a dark hole. Obviously, I was better off not being behind the wheel. Usually, if I had to drive for more than 20 minutes, my eyes would water constantly, something that happened when I was fatigued.

When I started driving again I sometimes had a weird sensation that I was nothing but a giant eyeball looking intensely at things before me. I know my hands were gripping the wheel and my jaw clenched because my teeth would hurt afterwards. All my energy and focus was on the act of driving. I’m glad those days are behind me. I drove as little as possible back then because it took too much of my limited energy.

After a brain injury, many activities that were part of our everyday life are very difficult or impossible. Driving is one of those things. It is extremely important to know when you are not capable of driving. Ask your doctors, your family members, and others who know you well if they aren’t the first to tell you not to drive. Be sure to ask yourself. I knew many times in some of the earlier years that I should not be on the road. There were just bad days were the brain injury symptoms were especially bad.

Since my brain injury I’ve often thought about other people who get hit on the head or have some other event that causes a brain injury. In the first couple hours or so, you might not have too many symptoms other than some pain or other minor problem. What happens when these recently injured people get behind the wheel for a long drive, or the pilot who goes into the cockpit and starts his flight; or the engineer getting into the train to travel cross county? What happens when the effects of the injury set in? Makes me want to ask the captain of the plane if he was hit on the head recently! We just don’t make a big enough deal of it when our head is injured!

So be safe. Think about how you are feeling before you get behind the wheel. Are you rested? Can you focus? Does your vision feel off? You may just be having an off day and you can drive tomorrow. You can also ask for a ride.

Here are some links to useful resources about Driving with a Brain Injury:

Driving after Brain Injury: Issues, Obstacles, and Possibilities from Brain Injury Association of America

Driving After Traumatic Brain Injury from BrainLine.org

Driving After Brain Injury from Minnesota Brain Injury Alliance

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Frightened by My Own Shadow – A Reminder from My Injured Brain

by Linda W. Arms

One evening recently I was walking through my house and was frightened by my own shadow. It was a big reminder of my earlier years after my brain injury when I was often frightened by things. Often I think I could not process things quickly enough to understand what it was I was seeing. Part of it also was that I was often hyper-vigilant as a result of PTSD (post-traumatic stress syndrome). Whatever the cause, these responses of fear are a bit unnerving and zap some energy from my brain. It even affects my physical energy for a few moments; there is a wave of physical weakness.

In the last weeks I’ve had many things on my mind and I am less aware of my surroundings. A few days ago, I walked around the back of my house and saw the reflection from the water in a tiny pond that’s been there for the last 20 years. When I first saw the reflection I was frightened because I didn’t know what it was. It didn’t fit in with the rest of what I saw like grass, trees, and plants. I don’t think it was a PTSD thing this time. I think my brain could not process the visual input fast enough to tell me “it’s OK, it’s just light reflecting on the water”.

How many of you have had these experiences after your brain injury? I remember some of my rather strange reactions that now I can even laugh about. A couple of years after my accident, I moved my car out of the garage and parked it in the driveway. I wanted to sweep the garage. After sweeping for a few minutes, I looked up and saw a car in the driveway. It frightened me because I thought “who is parking there, what do they want?” A few moments later I realized it was my car that I had moved out there less than 10 minutes ago.

Another time I was walking through a home goods store and I suddenly saw something that really scared me and I even made some sound. Again, a few moments later, I recognized that it was steam coming from a room humidifier that was on display. It sounds crazy and I felt embarrassed by my reaction since there were other people around. The incident caused me to have more difficulties getting through the store. The scare zapped that fragile brain energy.

I’m not sure what causes these responses; only the brain fairy knows for sure. I think in the earlier years, PTSD played a role in my moments of being frightened by something. Today I think it’s mostly that my brain still can’t attend to too many things at once. If my brain is busy thinking about a problem then it can’t also be processing a lot of visual input or other things it should be doing. I have to say I’m rather disappointed that I have had this response so frequently in the last weeks but I realize it will get better. It makes me realize I have to be extra careful doing things that require a lot of attention. I have to remind myself to stop thinking about the problems, put them aside, and focus on what I have to do at the moment.

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The Brain Fairy is Always Lurking

by Linda W. Arms

After a brain injury, every day brings constant reminders that our brain is not working well. For many of us, everything becomes a challenge. Every movement we make, speaking, seeing, reading, counting, driving, cooking, cleaning, walking, hearing, thinking and so much more becomes difficult. Nothing feels normal. With these challenges, we become even more fatigued and less able to do the things we are trying to do. It becomes a vicious cycle that we cannot move out of. Slowly as we get better, we start experiencing a “new normal”.

I think our “new normal” is a combination of us forgetting how it used to be, and that we have actually gotten better. We also adapt by changing things around us and how we do things. We stop doing certain things because it just isn’t possible or isn’t that important for us to spend the energy on. We become much more functional and after a while we don’t think about our brain injury every single day. Sometimes it takes years to get to this point.

Many of us don’t want our brain injury to define us so it is important not to constantly think of ourselves as “damaged” or that we can’t do something. Sometimes we have to redefine who we are and what our life is to be. Maybe we can’t do that job we had before. Maybe we can’t climb mountains. But there are other new and different things we can do.

Living with our “new normal” is fine and works most of the time. Sometimes, however, the brain fairy comes back for a visit. The brain fairy that causes all that trouble but also heals things in our heads is always lurking in the background. Sometimes that visit brings back many symptoms we thought we’ve overcome. A frightening experience like two large dogs barking, running and jumping at you causes you to have that sense of visual discombobulation or you feel unbalanced; your mind goes blank and the fog returns or something else just isn’t feeling normal again.

Sometimes, the brain fairy returns for a longer visit such as when you are faced with big life disturbances such as family problems, money problems, illness or other things that weigh heavily on you. The stress, the emotions, and the mental work required to deal with these things is more than your injured brain can deal with. Symptoms return, fatigue sets in, everything becomes much more difficult. It is a time to step back and take care of yourself. It is time to ask for help. Remember the early months or years after your brain injury when you did nothing much other than try to heal. You rested more, people helped you more, you did less, you put less things on your “to do” list, you didn’t do some things you used to do.

For whatever reason the brain fairy returns to you, remember it will pass. Sometimes it is a short visit. Sometimes you don’t know when it will end. But remember that eventually it will get better again. Pace yourself. Be patient and good to yourself in the meantime.

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Cooking is a Cognitive Challenge

by Linda W. Arms

Many of us used to think that cooking was a fairly simple task. I thought so before my brain injury. Even though I was very busy with a demanding job and other things in my life, I enjoyed cooking. I was never one to follow recipes. I preferred getting ideas from meals I ate in restaurants and looking in food magazines. I liked to create my own things and made many complex dishes for my family and guests.

I don’t really care to cook that much anymore. It was one the things I immediately stopped doing after my brain injury because I didn’t have the physical or cognitive energy. My family took care of cooking for me, including the shopping and the cleaning up. I just couldn’t do it. I was very weak at the beginning. My motor skills were off. Stirring and other rotating hand motions made me nauseous and dizzy. My vision had a number of problems that weren’t yet fully diagnosed. The tasks involved in trying to cook a small meal were too overwhelming for my brain to process easily.

I just didn’t cook. It was just too hard and it made me feel worse. I tried many times to at least help by doing a few tasks but often that was too much for me. We just don’t realize how much is happening when we cook something. You have to decide what ingredients and dishes you need. You need to wash and cut things up. You need to figure out the order and timing of things. You need to use motor and visual skills as you use utensils and do other cooking tasks. You need to use memory. You need to process things and sounds that are around you in the kitchen; you need to tune those things out and focus on what you’re doing. I’m sure that’s just a small part of it. But you get the idea. Lots of stuff happening for our injured brain to process.

Over the last years I slowly expanded my cooking activities. I would do easy things at first. Someone in my family would help by cutting things up for me. Someone was also always standing by to save me. They also were quiet while I cooked. They knew that any talking; or having the TV or radio on would cause too many problems for me. I had to have silence and no distractions while I cooked. S..l..o..w..l..y over the last seven years, I am doing more cooking and even talk at the same time! It sounds silly but that’s how it is. I expect some of you can relate.

I don’t really enjoy cooking that much anymore. I still have to approach it differently than I did before. It’s a lot more work. I usually always burn one part of the meal. It’s kind of a joke these days. I’d like to also thank my husband for stepping in and cooking many of our dinners these days. He’s become a wonderful cook!

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Why is Eating So Much Work?

by Linda W. Arms, Feb. 7, 2013

After a brain injury, everything seems to take so much energy out of you. One of our most basic needs, nourishing ourselves, can be a lot of work. Obviously cooking involves a lot of cognitive activities but even eating can be challenging. After my TBI, it was difficult to sit at a table and eat. I would often eat part of my meal and be so exhausted that I would have to lie down.

Think about everything that is going on at the table while you’re eating, especially if others are with you. Another person is moving their hands to pick up the fork, cutting with a knife, moving food to their mouth, reaching for a dish of food… They are picking up glasses to drink. They talk. Maybe a radio or TV is on in the background. There are plates, glasses, napkins, and other things on the table and all around you. All of this is being processing by your injured brain. On top of all this, you have to feed yourself. All those little actions that have to be handled by your brain. Can you see why it’s exhausting?

I had visual problems after my brain injury that took a few years to be resolved. It was very uncomfortable for me to sit at the table and eat. I wasn’t particularly hungry and then adding the stimulation of being at the table was too much for me. Even my own hand movements of eating and cutting the food were too much visual stimulation. I would sometimes feel nauseous from the hand movements. For some reason, clear glassware on the table caused a problem for me also. I think my brain couldn’t quite figure it out, looking through it or whatever but the more there was on the table the more difficult it was for me to look at it.

I also had a sensitivity to sound and light. Think of the sounds at the table that your brain has to process. Bright lights around you add to the level of stimulation. I used custom fitted musician earplugs to muffle the sounds around me but, unfortunately, having them in my ears while eating did not work very well. The sound of me chewing was very loud which was disturbing. The chewing sounds would also drown out anything someone was saying to me. I knew I had to eat but the experience was not comfortable or enjoyable. I’d eat a bit and then take a rest. This is a lot for an injured brain to deal with just being at home where your surroundings are familiar, imagine the additional burden when you are out at a restaurant! Just remember it gets better as your brain heals. Know your limitations, and try to control your environment to keep things that trigger your symptoms from taking over.

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Brain Injury and the Vision System

by Linda W. Arms

Brain injuries often cause many problems with our vision system. I’m not talking about a problem with the eye itself but about the work our brain does to allow us to see and interpret what we see. Problems with our vision system cause or worsen many of the symptoms associated with brain injury such as fatigue, cognitive problems, balance problems, and coordination. In all the testing and rehab efforts, our vision system is often overlooked and as a result, we continue to struggle to improve. In my case, the problems with my vision system started being addressed after about 6 months but the final rehab effort did not occur until my 4^th year into rehab. I had a number of problems with my vision and I suspect they had some of the biggest impacts on the difficulties I had in functioning.

Damage to our visual systems cause problems such as:

Difficulty with eye movements
Double vision
Sensitivity to light
Reduction of visual field
Problems when shifting gaze from one thing to another
Difficulty focusing
Problems reading and comprehending what is read
Visual mid-line shift
Sensitivity to visually busy environments
Problems with walking and balance

If you are having problems like this, your brain must work extra hard to get you through your tasks which then causes even more fatigue. Frequently a full comprehensive vision exam is not performed on people after a TBI and these problems are not identified. I know I had to keep pushing to get my “eyes fixed”. I went to 3 different specialists who each worked with different parts of my vision problems. Today I only have the “discombobulated” sensation occasionally thanks to the various therapies. I still cannot look through binoculars without my head wanting to shake. I’m not perfect but a heck of a lot better than I was.

Testing for these vision problems is not routine after a TBI. It is important to find someone who specializes in diagnosing and treating vision problems that result from a brain injury. The military recently added these specialized tests in their polytrauma centers for TBI, however, testing is not the usual protocol for most TBI patients who do not end up in one of these types of centers.

The Center for Neuro Skills provides a good overview of visual problems associated with TBI:

http://www.neuroskills.com/brain-injury/post-trauma-vision-syndrome-1.php

http://www.neuroskills.com/brain-injury/post-trauma-vision-syndrome-2.php

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