Monday, May 28, 2012

No matter where you go, there you are

Now and then someone asks how this project came about. What's the connection between riding (half of) Route 66 and recovering from TBI?

This project came from a pattern: after a hard aerobic workout, my thoughts were clearer. Voila! For a few days I could remember a thing or two! Of course these are just my observations. Post-TBI there have been daily examples of forgetting, remembering wrongly, or just spacing out. Even though memory is different than thinking, I've lost some trust in my own brain.

The alternative, if the medical establishment was right, was to sit there and wait for my brain to get better. Then to give up after 6 months...and do what? Stagnate, retreat, lose my job and financial well-being, my relationships with friends and family? My plans for the future?

I might have gone that route except long bike rides, endurance rides, helped whenever I did them. A hilly 100-mile ride typically bought me 2-3 days of clarity afterward. What's going on with the noggin? It might have something to do with blood flow. Dr. F. used the word perfusion, where the increased blood flow in your body transfers to your brain. Kind of makes sense.

You probably get by now that there are lots of minuses to having a brain injury. We could go on and on... One plus to having a brain injury NOW is, lots of people are doing lots of research. On TBI. On memory and cognition. What helps with recovery and what doesn't.

Someone at UCSF even developed a special MRI, one that sees subtle changes in the brain, like mine.

(Now if they could just return a phone call...)

With the vets coming back from Iraq and Afghanistan with brain injuries and the baby boomers getting older, we are taking a closer look at the brain. It's hopeful.

Here's another example, an abstract of a study that shows executive function does improve during exercise. Also, regardless of age subjects could perform difficult tasks faster during exercise. Just the increased blood flow to the middle cerebral artery does not explain the better-faster benefits. They did find a connection though, between blood flow to the prefrontal cortex area of the brain during exercise and increased brain function. The benefit increased with exercise intensity.

Hey, the prefrontal cortex is where short-term memory and attention live. It also happens to be the first part of my brain that bounced against my skull during the accident. If intense aerobic exercise clears my thinking and memory, if it makes me calmer and more able to focus, I believe that makes objective sense.

The folks at SBI have helped me understand that recovery from TBI is not a linear exercise, but a multi-pronged effort. There are emotional, social, and just functional hurtles to overcome. For me, it all starts with a baseline of brain function. There's a dependency relationship; without exercise it's not possible to get my brain to work on anything. It's overwhelmed and can't get to the other hurtles. So this is the one we tackle first. Every time it stalls, we jumpstart it again.

This project required cycling 22 out of 24 days. The Ruffy Tuffies hit the road every day except April 13 and 14; riding a bike was my job. Most days were 75-80 miles, with the longest day ~140 miles. As Danny points out, total April mileage was north of 2,000.

Recently an SBI board member asked how I felt. I'm clear, my thinking is SO clear right now. I still forget a little more than I should, but it is great to be able to think in a straight line. Since the trip ended on May 2 I've ridden only a double century and a century. No other exercise, and I'm still clear!

Of course, very tired too, feeling run down. At this exact moment, quite miserable with a flu type of bug.

And feeling lucky to be able to do any of this for myself, at all.


  1. Sweetheart, I'm rooting for you 1000%. Love, Mary

    1. Thanks Mary! Support from others helps me do for myself...

  2. Allow me once again to be flabbergasted and wildly impressed at how much you DO. :) I hope you feel better soon - though you're continuing to do, I think. Your body is busily doing right now, dealing with said bug!

  3. Thanks Rachel! Sending encouraging vibes for all your projects as well.

    You make an excellent point here too, in a subtle way. Most folks who stigmatize brain injury miss it completely. All survivors of brain injury have something to contribute. We are capable of many things. It's the constraints that need adjusting: time spent, number of tasks juggled, learning curve, and so on.