A Sit Down – with Abby Asaad COVT
This post appears as part of a series called Sit Down – candid conversations with real people detailing their journeys and experiences with Vision Therapy.
A Sit Down – with Abby Asaad COVT
For the benefit of our readers, can detail your educational background and explain how you are involved in Developmental Optometry?
I grew up in Houston Texas, and after graduating high school, I got my BS degree in Health Science/Pre-Nursing from Abilene Christian University. My science/health degree led me to seek out a career in the medical field which is how I landed in the world of Vision Therapy.
How did you first discover Vision Therapy?
I became involved with Vision Therapy in 2010 when my life long Optometrist (Dr. Ann Voss) found out I was back in Houston, she asked me to come shadow in her therapy clinic, because she was looking to hire a new vision therapist… I was hooked!
September 8, 2011 was a significant date in your life. Can you explain?
I had just finished another day at work and was driving home when I was T-boned by a large SUV on my driver side door. My car rolled over 3 complete times, landing on its wheels, but facing the wrong direction. All my windows were broken, and I was covered in glass. Upon impact my head banged against the glass window to my left, several times as the car rolled. The doctor later explained I had incurred a “Coup-Contrecoup concussion”. This is basically where your brain slams back and forth against the inside of the skull. (Check out this link for a one-minute video to further explain)
Were you hospitalized?
I was immediately put in a neck brace, pulled out of my car through the driver side window, strapped down to a back board, put into an ambulance, and taken to the nearest hospital. I passed in and out of consciousness, so the details are a little blurry. Once in the ER, they ran a CT scan, and then I waited. After hours of waiting, and family being called, a doctor came in and explained to me that I had suffered a severe Coup-contra coup brain injury. He said, “Basically it’s a pretty bad concussion. So try to get a lot of sleep this weekend, and you may have some dizziness for about a week or so. You’ll be sore for a while from all the bodily bruising and whiplash, but otherwise you’re good to go home! Oh! And don’t drive while you’re on the pain meds.” Good to go? I could barely sit upright, think straight, or even make clear sentences come out, and I was supposed to just go home?!
After being released from the hospital that night, can you explain how you felt the next morning and in the days immediately following?
The next morning I LITERALLY felt as if I had been hit by a car…oh wait, I really had! Despite the bodily bruising and soreness the absolute worst part was the constant pounding headache. (Little did I know that this headache would become my closest companion for the next 4 months). Also, my head felt extremely heavy, as if someone had poured 10 pounds of sand into my head. My weak and whip-lashed neck could hardly support my now seemingly heavy head, and my parents took turns helping hold my head up so that I could eat and get to the restroom. Talk about feeling like an infant all over again. I spent the next 4 weeks sleeping around 16-20 hours a day. When I was awake I experienced lots of confusion and disorientation. My sentences were often incomplete, and I would lose my train of thought at the slightest interruption or distraction. Many friends and family stopped by to bring flowers and well wishes, but it would take every ounce of energy and concentration I could muster up, to track with what they were saying, and not fall asleep. Those first weeks were the toughest, because when my brain became overwhelmed it would immediately put me in sleep mode, and I would have to return to bed. Sleep became my escape from both exhaustion and exertion.
Another issue that lasted for months was the extreme dizziness. Every time I would move positions from sitting, to standing or even laying down I would become overwhelmed with dizziness that I would stumble and often times fall. However it wasn’t just when I changed positions, it also occurred if I walked too fast, walked up stairs, wore shoes other than flats, went too long without eating, switched from the outside heat of Texas to a cool air-conditioned room, went from a light space to a dark space, and the list goes on. The dizziness would completely overwhelm me and cause me to completely lose my train of thought.
I also lost my ability to make decisions. Whether it was between a turkey or ham sandwich or describing my pain to a doctor on a 1-10 pain scale, I couldn’t filter out, or narrow down, or reason through the options, and thus was left utterly confused and at a loss for words. (This was another reason, I later learned, I couldn’t live on my own).
How long was it before you were able to return to work?
I laugh at this question (now) because while I was at home recovering and sleeping, I became obsessed with the idea that I had to return to work as soon as possible. Looking back I just wanted my “normal” back, and that meant my job, my apartment, my friends and social life, everything. My parents had moved me back into their house, as the dizziness and lack of decision-making prevented me from being capable of living alone in my second story apartment. Five weeks after the accident I went back to work. I thought I was coming in for a full day, and would just pick up where I left off, but I was in for the shock of a lifetime! My brain was completely ill prepared for all the questions and most of all the amount of concentration it took just to engage with others, let alone remember how to do what I used to. One of my jobs as a therapist is the grade the testing that our patients go through before starting therapy. My inability to concentrate and hold onto continuous thoughts became most obvious to me when I finished grading a patients testing, only to find out from my manager (Robert) that I had incorrectly scored six out of the ten tests we give! I was shocked! I couldn’t believe I had made that many mistakes, especially after it had taken me an hour and a half to do it! (Previously I could grade four testing packets in one hour). Needless to say I was so exhausted and deflated that I went home after just three sad hours.
Over the next three months Robert worked with me to create a schedule where I would come in for a week and only do one hour a day. Then the next week two hours a day, the next week three hours a day, and so on until I was back to a full 8am-5pm day. I wish I could say it was a nice and smooth transition but it was far from it! There were so many days where I would plan to come in for three hours but only make it two hours. Other days my headaches became so severe that I could be found at my desk, head in hands, crying in pain and frustration. There were several occasions that I was in such pain and the dizziness too severe that I would need a fellow employee to drive me home. The accident occurred in September, but it was January before I completed my first full week of work. Even then, it was another three months before I could maintain a full work week consistently, without any hiccups.
A common emotion among brain injury survivors is the frustration in finding “normal” again. Often times, patients will speak of anxiety as they begin to compare their own ‘pre and post’ head injury lives. Were there times when you struggled with this?
YES! Frustration doesn’t even capture how hard it was to wake up one day and feel trapped in a mind where the way you think and process is not only different but so much harder than the day before, and worse yet, knowing that the old way of doing things, was gone forever. For me, letting go of “how I was” was the hardest part, it took months. The “normal Abby” was active in her church, worked hard at work, loved to exercise, and loved to keep a busy social life! However, in the months following my accident, I wasn’t able to go to church, on account of the number of people, plus the high noise level, plus the ability to follow a sermon message were all above my ability, and completely overwhelming. Exercise was out of the question, because any quick movements, over-exertion or increased heart rate, sent my head spinning and always resulted in a headache and early bed time. I couldn’t work a full day of work, and seeing patients was utterly draining. My social life came to a complete stop, as I was trying to save all my energy into being able to last a full day at work. One day at work, we were having training on new vision therapy activities, I became so overwhelmed, then frustrated that I couldn’t keep up, that I worked myself up into a full-blown panic attack.
So, yes, I wanted my normal back! The thing is I was told many times over and over that my old “normal” wasn’t coming back, that I would be finding a new way of doing things. Though this was meant to help me move on, it was nearly a year before I realized that my “new normal” wasn’t a bad thing. I kept thinking that anything other than the way I used to do things was surely going to be awful, after all, that is what the first six months experience had taught me, that life was forever going to be hard and challenging, and I may never be independent again. Yet in time, I learned that perhaps I was being given a chance to make my “new normal” even better than my “old normal”. It was this thought that gave me hope and allowed me to open myself up to vision therapy.
Another major struggle for me was that I looked completely fine and normal. I had no scratches, no scars, no broken bones and no disfigurements! Yet, inside I felt (and was) all mixed up. So many people would treat me the way they always had. Though some may think this a good thing, as a brain injury I was so far from being ok. At work, certain people expected things from me that I couldn’t produce. I was perceived as being lazy, and “milking” my situation, or just trying to “get out of work”. On days when I was sent home (because my brain could take no more) I was met by judging looks from certain fellow employees, and I became the topic of office gossip. Though many people were kind, understanding and most of all patient, it was by the grace of God that my boss and my manager both believed in me, and were willing to help me, and give me the blessing of time. Time to heal, and time to find my new self, as I stumbled down the road to recovery.
Do you feel Vision Therapy aided in your recovery?
Absolutely! Even though I was (and still am) a vision therapist, I fought off doing vision therapy for quite some time. I didn’t want to let my fellow therapists in to see how much I was hurting and suffering and how far I was from being ok. In hindsight, this probably only aided in their perception of me being “lazy”. Yet, in time I finally came around and allowed myself to enroll in therapy. The therapist had become the patient! It was hard, and frustrating, and at times infuriating. Having been on the other side, I knew what the goal was, and worst yet what I thought I could do, but couldn’t. Yet with time, through vision therapy, my eyes were able to teach my brain how to visually sort out all the information coming in, into a way that once again made sense and order.
As a TBI survivor, you certainly bring a unique perspective to the Vision Therapy room and your patients. Do you find yourself feeling more empathetic towards fellow TBI survivors?
I cannot begin to describe how differently I view my patients, post-accident. I have changed from being sympathetic, to empathetic. I can now see in a patient’s eye when they are truly trying their utmost hardest, yet failing to reach their goal. I make it my personal mission, to meet a patient on their level. I find myself giving encouragement and building self-esteem in the downtrodden. I both laugh and cry with patients and parents as they fight their obstacles and look for light at the end of the tunnel. And when I work with my brain injured patients, we are able to connect as I share my own story. The way they open up to me, knowing that someone having been through a similar situation is here for them, for the long haul, changes them, it gives hope – one of the greatest gifts on earth.
In early 2013, I wrote a blog post entitled “una bella vita” detailing your story from my perspective as your co-worker and manager. At that time, it was important to you that I use an alias as you were not ready to be identified, which was quite understandable. A year and a half later, you have not only shared your story here but have done so openly, honestly and with much bravery. What has changed from then to now?
In 2013 I was still in my “adjustment phase”, as I have come to call it. Though I was doing so much better physically and mentally, I was still struggling with the emotional part of it all. As you’ve read from my other questions, there were many things that made me feel vulnerable and weak, and I wasn’t sure I was ready for the rest of the vision therapy world to know.
Feeling this way however has helped me to be more aware of the different emotions I see in my patients in the therapy room. Nobody likes to feel or appear weak and vulnerable, it’s simply uncomfortable. Yet, having been there myself, I have found more ways than I thought possible to help patients feel safe, and secure, and help them find moments of success. Having moments where you feel that you can actually do it, you realize there is hope, and hope is a powerful tool that every therapist ought to carry.
I believe that hope (and a serious dose of patience) is what changed from 2013 to now. Before, there was so much doubt that I would be okay, that I would find my way again, that I would be able to function in society. Once my brain healed, I still worried that I would relapse, or hit my head on something and end up worse than before. But with time, I have come to learn that I can not live in fear. I have been given a rare platform that can be used to help others, and rather than hide away in shame and fear, I can openly share with others, knowing that I can bless them by walking alongside them as one who understands from the inside.
As someone who has been through a serious head injury, and worked very hard to put their life back together, is there any advice you’d offer others who may find themselves in a similar situation?
The best advice I can give is this; Give yourself grace. Grace to mess up, grace to fail, grace to learn and re-learn, and grace to start each day with hope and more grace.
The main rule about a TBI is that there are no rules! This is both a relief and a thorn in my side. But each day is going to be different and will present its own challenges, yet, each day is also an opportunity to grow and be one step closer to regaining your life back, a life that can and will be great, if you keep going and don’t give up.
Moving forward, you completed your Vision Therapist Certification (COVT) last year in Orlando, FL. What was the process of certifying like?
The process was a great learning experience that taught me a lot and grew my knowledge and skill base as a therapist. Through writing the essays and studying for the test it both showed me what I knew and what I had to learn. The great thing about Vision Therapy is that there is always something new to learn, and skills that can be improved upon. I’m really glad I went through with it, and though it was a lot of work, it was well worth the effort!
In many ways, completing your COVT seemed like your announcement to the world that you were back; that you had made it through. Is this a fair statement?
In a way it did! Few know this, but I had planned to get my COVT the year before the wreck, and for obvious reasons that didn’t work out. So to come back from such an event as a TBI and come back to my field with the determination to finish what I had started was a big moment for me!
Lastly, your life has had some interesting developments this year. Please share!
This year has been such an exciting year! Not only did I receive my certification in October, but our office has grown tremendously and I have been able to help train three new therapists!
Finally, the best for last…the amazing man in my life proposed in August and seven months later, we married on March 22, 2014!!
Some Closing Thoughts: A very big thanks to my friend Abby for sharing her story so bravely and openly. Abby and I started working together in the fall of 2010 and got to know each other pretty well over the next year before her accident. Having a front row seat to her struggles following her accident, Abby has taught me so much about the important things in life, the incredible strength of the human spirit, and most of all about the power in lifting others up when they need it. From a Vision Therapy perspective, Abby is the one and only person I’ve known both before and after their TBI, and the lessons from helping in her recovery and witnessing her triumphs will be present in my heart forever. Although I’ve moved away and we are both busy with our own lives, something tells me that we will stay friends for a very long time because of that experience. The world of Vision Therapy is definitely much better and stronger with Abby on our team. In a word, she is simply, incredible. Please join me in wishing Abby and her new husband, Erhart, the absolute best! 🙂
Added Bonus: Abby recently appeared in an educational video produced by the VisionHelp group entitled The Impact of Concussion on Vision. I’ve included it below. Enjoy!