windy road on a foggy night…
How would you describe a concussion?
Sure, we all know it’s usually the result of a blow to the head. Concussions can occur during a car accident, during a sporting event, bumping your head while exiting a car, or even by falling out of a hammock on some quiet Saturday afternoon. Don’t laugh, that happened to me. With concussions come the possible swelling, the coup and contra coup, the confusion, the brain fog, the sensitivity to light, and even challenges with processing speed. Having suffered two concussions in my life – one serious and one moderate – I can vouch for the idea that these symptoms are real.
But now try sitting in the other chair. Describe the concussion not from the perspective of someone trying to help, but from the chair of the concussed. What’s going on? What do you feel? Are you able to describe what’s wrong, or even, what’s different? Why are repetitive sounds troublesome? Why are patterns tough to look at? Why do sudden movements throw you off? Beyond the frustration of your day to day activities becoming overwhelming, now try using your concussed brain to articulate what’s wrong with your brain. How do you explain your state of confusion from within that state of confusion? How do explain the “spacey” feeling from out in space? How can you explain that the world seems to be moving faster than you can think, when you’re having trouble keeping up in the first place?
It cannot be easy, at least it wasn’t for me.
Sadly, my Vision Therapy room has been loaded recently with patients who’ve suffered concussions. Baseball injuries, falls, car accidents, and even a harmless morning of wrestling with a child on the bed which ended with an untimely meeting with the head board. Accidents happen.
Vision Therapy sessions with patients suffering from a concussion can be challenging, but can also some of the most rewarding sessions. There’s no feeling quite the same as having a patient say they’re “thinking better” or that “the fog is lifting”. While VT alone cannot “fix” these challenges, we certainly can facilitate the process. But as part of that facilitation is communication. We have to ask questions and offer guidance. Whether you subscribe to the theories of Piaget, Socrates, or even Bates, the common link is communication. Which questions to ask, how to ask those questions, and to do with the response? Are there questions not to ask? And if my question doesn’t resonate with the patient, then what? In many ways, the need for positive communication is always present in the therapy room. But in my experience, the very nature of rehabilitative care with head injuries make that need broader, wider and deeper. We have to be on our game and know that the questions that worked five minutes ago may not work now. We have to go slow, keep it simple, remove the extra stimulus, and above all, allow the patient space to adapt.
As one of my patients who recently suffered a moderate concussion told me:
“The inside of my head is like driving a windy road on a foggy night. Sometimes, I just need you to slow down on the curves so we both can see what’s coming, and feel safe”.
What an incredible way to think of it!