Living with Mild Brain Injury

The Difficulties of Diagnosis and Recovery from Post-Concussion Syndrome

Pauline O'Connor

• Publisher: Routledge
• Year: 2020
• eBook ISBN: 9781000334715
• Topic: Psychology
• Subtopic: Diseases & Allergies
• Index: Psychology

This important book presents a unique, personal account of the impact a mild traumatic brain injury can have. It tells the story of Pauline, who was 33 when a late football tackle caused a bleed in her brain which went undiscovered for 18 months. The account includes descriptions of hidden symptoms of concussion and post-concussion syndrome, pitfalls in diagnoses, the uneven progress of recovery and the effect of the varied reactions which others have to an acquired brain injury.

The author incorporates memories alongside extracts from clinic notes, diary entries and emails to reflect the disjointed progress of diagnosis and recovery as- although similar- no two head injuries are the same. Through this book, the reader gains an appreciation of the confusion experienced by many brain injury survivors, which sheds light on why some may develop unusual behavior or mental health issues, and how such issues can be alleviated. Brain injuries are poorly understood by the general public and this can lead to difficult interactions. Moreover, complications in diagnosis means some may not realize they have this milder form of brain injury.

This book will enlighten brain injury survivors and affected families and allow professionals an insight into their patients' experiences. As concerns grow over the risks which contact sports pose, this book shows how even mild brain injuries can wreak havoc with careers, relationships and one's sense of self, but that a happy life can still be found.

2014: Perspective

Chapter 1

Brain injury

The incident and immediate aftermath

Life had followed a fairly standard course: schooling, career, marry high school sweetheart, leave home to travel the world and seek my fortune. There are always variations on this theme, and changes to the best-laid plans.

Much of my schooling involved sports, as many childhoods do in New Zealand. My football career started at eleven years old, when I was granted permission to play in my brother’s team. We lived in a small, rural town, and I was the only girl in the league, so they had to create new rules to accommodate me. Right from those early days I cherished the feeling of being a part of a team, of shared endeavour towards a common goal.

Over the next two decades or so, I would play in a dozen different teams, in New Zealand and London. A highlight was playing in the reserve team for a well-known premier league club. No, women weren’t paid. In a year in which the club advertised £30million deals for male players, females had to pay a monthly stipend for the right to wear that same jersey.

My initial plans to study geology at university were swayed by a single pamphlet advertising a new course ‘Bachelor of Viticulture and Oenology.’ What 17-year-old would choose rocks over grape growing and winemaking? I mean, think of the free booze!

The resulting career proved varied. While I did grow grapes and make wine, I also sold, advised and wrote about wine. It can take time to train up the sense of taste and smell to competition level, but over many years of applied effort, I found myself in a role which combined teaching people about wine and helping with international judging events.

In everyone’s life, they reach a point when it is either time to settle down where you grew up or travel. My husband, Ash, and I chose the United Kingdom as the first place to visit on our round the world trip. The tour ended quickly when we found ourselves with friends, jobs and enjoying a city lifestyle.

Emigrating half way round the world means you need to meet new people and my first step was to join a local football team, City United. At the first training session I met many new friends. Some bonds were destined to wither while others grew. Hopefully some of those friendships will last for a life time. But you never can tell at first, and few friends are willing to travel the road of trauma and injury with you.

So there I was, in London, playing football, working with wine, still looking for that fortune.

Clinic notes: Pre-incident

Employment: Patient worked full time in a management role which included national and international travel.

Exercise: Cycling 40 miles per week plus weekly football training and matches.

Social: Engagements usually twice a week.

Prior incidents:

• Two diagnosed concussions, one each in 1998 and 2001.
• Both concussions also resulted from impact to the face and nose.
• Patient experienced no complications beyond 24 hours on either occasion.

Sunday the 9th of March: The day of the incident

It was a cracking Sunday afternoon, a perfect day for football. City United faced tough opposition. As a centre-back I was frequently under pressure. It was odd that my injury came when there was no pressure at all. I’d already headed the ball clear when the opposition striker leapt at me in a recklessly late tackle. The full force of her airborne body was behind her shoulder as it slammed into the bridge of my nose.

I remember dropping to the ground, my hands clutching at a nose which already felt three sizes too big. My inner commentary kicked in: OK, that was a bad one. Even so, I couldn’t quite believe the amount of blood which poured through my hands into an expansive puddle on the ground. I have a strong memory of admiring the way the rich red contrasted beautifully with the vivid spring grass.

There was so much blood that my teammates had to wash it into the pitch while I was led, shakily, away. But at the time there was no dizziness, confusion nor unconsciousness.

Monday: Eighteen hours after the incident

‘What the hell?’

Exactly what everyone wants their boss to say first thing in the morning. So I grinned back at Alder and added the obligatory, ‘Yeah, you should see the other guy.’

My nose felt gigantic and ached despite the ibuprofen taken liberally at breakfast. The swelling had increased overnight. Bright blue and purple bruises surrounded my eyes and nose in a pantomime villain mask. There was only one way to conceal pain and injury this obvious: with laughter.

As the tale underwent numerous retellings over coffee, the striker became larger and my thwarting of her ambitions ever more courageous. The pain increased so the laughter needed to as well. By lunch time, all jokes regarding the resemblance to a panda had been fully explored.

Football mates were also checking in to see how things were going so I obliged:

‘My nose is HUGE!! Check out the photo :-)’

‘Woof. Hope the other person came off worse!’

‘You look cool! Hope u feel ok.’

‘Dear god, no offence that looks horrible.’

That last reply must have hit home as my mask slipped a little before humour sprang back:

‘None taken, it is horrible! Ach, well. I’ve given up on concealer at this point.’

That evening was a regular dinner date with friends. We did what people do: enjoy good food, great wine and excellent company. Do I regret the wine given what came next? I used to; especially given I don’t remember much of the meal at all. But eventually… well, we can only hold on to so much guilt and still get out of bed in the morning.

Tuesday, the day my world changed: Thirty-six hours after the incident

Pain, nausea, dizziness, confusion. WTF? Why is the bed spinning? What the hell is happening? I had flashes of lucid moments which prompted action in fits and starts. Ash left me in bed with a suspected hangover. While he left for work, I moaned something about feeling awful and dropped back to sleep.

An hour or so later the screen of my phone swerved alarmingly under my gaze. I managed to text the office with an apology for my absence before falling back into a horrible dizzy interlude. Sometime later, consciousness re-emerged to say, ‘this isn’t right, something is horribly wrong’ before again waving a white flag and succumbing to nausea.

Eventually I managed to check my symptoms on the NHS website. The screen flashed an alarming red: Call an ambulance, seek emergency help.

Tsh phsaw, and yet… Anxiety spurred me into action. I couldn’t think straight. Something was wrong, the internet says to get help urgently. But I didn’t want to cause a fuss. So I caught a bus.

Part of me was relieved by the weary receptionist’s automatic ‘and what seems to be the problem?’ People are grumpy and put out by others calling for their attention; all is well with the world.

Another part of me wanted to scream: I can barely stand. I need to grasp the furniture and walls to stay upright. My face is black and blue below eyes swollen with blood. In what world is this a normal Tuesday morning?

I guess I must have explained the collision on Sunday and my symptoms to her. I don’t really remember. I recall flashes of the visit, slumped gratefully into a plastic chair while minutes slipped away, unfelt and untracked in this new nauseous reality.

There was an x-ray and a harried nurse who explained that there was no obvious break in my nose. But there might be microscopic fractures that couldn’t be picked up. Beyond that I just had concussion which needed rest.

‘So, what do I do about work?’

‘I can’t sign you off.’

I waited, expecting more. She typed away on her screen for a ...

Table of contents

• Cover
• Half Title
• Series Page
• Title Page
• Copyright Page
• Dedication
• Epigraph
• Table of Contents
• Acknowledgements
• List of abbreviations
• Prologue
• Part 1: 2014: Perspective
• Part 2: 2015: Priorities
• Part 3: 2016: Planning
• Part 4: 2017 and 2018: Pacing
• Epilogue: Me, but different
• Reference
• Glossary
• Index