Since June I've been in rehab for post concussion syndrome with a great functional neurologist in Oakville. As I've been working through the very comprehensive, and at times intense, program I've been thinking about how these challenges relate to those that our members experience.
If you've overcome a barrier, I'd love for you to share it in the comments - I know so many of you have!
If you're pressed for time, scroll to the bottom for strategies for successful change.
As a quick side note, many people are unaware of the possible consequences of concussions, let alone how to manage them. A part of this problem is our fragmented health care system. Despite having a history of multiple concussions I found it nearly impossible to find a neurologist who was even willing to say that my symptoms were concussion-related, let alone who had a strategy to manage them. When I finally met with this (not-OHIP-covered) functional neurologist, it was so relieving to hear him confirm my symptoms rather than imply that I was crazy. From daily headaches and neck pain, light and sound sensitivity, memory impairment, processing delays, vision problems that led to constant dizziness and nausea, to balance and coordination issues, leaky gut, and an eventual tremor in one side of my body, my symptoms are proving to be resolvable. If you or someone you know is struggling with PCS, keep pushing for help! If you're in the GTA, Dr Jay is an excellent resource.
Struggle 1: food!
I think all of us have battled with food in one way or another. I hear often from members "I know what to do, it's just a matter of actually doing it." Creating habits that push us towards our goals is difficult, but if we can push through the first couple weeks we can really surprise ourselves with how capable we are of change.
I have been a vegetarian for about 12 years and a vegan for almost as long, so when I was told that I couldn't eat grains, legumes, beans or soy, and that I had to get animal fat into my diet my initial reaction was a hard hell no. However, a complexity of post concussion syndrome is that inflammation in the brain triggers inflammation in the gut and vice-versa. Over time I developed a variety of intestinal problems that are summarized by the term "leaky gut".
According to Harvard Health Publishing, leaky gut can be described as "An unhealthy gut lining [that] may have large cracks or holes, allowing partially digested food, toxins, and bugs to penetrate the tissues beneath it. This may trigger inflammation and changes in the gut flora (normal bacteria) that could lead to problems within the digestive tract and beyond." So with that in mind, it became important for my rehab program to minimize inflammation by eliminating foods that were too difficult for my body to properly digest.
With regards to the animal fat, the brain uses DHA (a type of fat we get from animals) to heal & repair itself. While ALA (fat from plants) can technically be converted to DHA, that rarely actually happens inside the body (0.5 to 9 percent of ALA is thought to be converted to DHA in the body). While vegetarians, vegans and health-conscious meat eaters all tend to live approximately the same amount of time, for an injured brain it's important that DHA be present in the diet. I had already been taking high DHA fish oil supplements, but that simply was not enough for my body.
So there I was, torn between my morals and my desire to not only be symptom free, but to minimize my chances of developing Alzheimer's, MS or Parkinson's disease (all of which are thought to be risks for those who have suffered multiple and/or severe concussions). I am an evidence-based practitioner, and so naturally an evidence-based patient. But this one was tough.
After many tears and a good sleep, I told my husband I would try fish. He lovingly bought fish, cooked it for me, and sat with me while I choked down my first non-plant based food in over a decade. I think I cried the first 3 times I ate fish (I know...right now those of you who eat meat are scoffing, and those of you who don't are reading this in horror), but it got easier as time went on because every time I had a negative thought, I countered it with a logical one.
"I can't eat this" ---> "I want to be symptom free and feel like myself again. I want to be symptom free more than I don't want to eat _____",
"I feel so guilty" --> "Managing my health is a necessity, not a luxury, and so there is nothing to feel guilty about."
"This is too hard" --> "Living with constant pain and tremors is harder. The consequences of not managing this now will be harder still. Eating this food is easier than the alternative."
The first two weeks of this new diet - the autoimmune protocol - were the worst! I was exhausted and sleeping frequently, I was mentally fatigued from coaching myself through eating fish, and I was HUNGRY. The autoimmune protocol doesn't require you to be hungry all the time, but since I am not willing to be more than pescatarian and my usual foods were off limits, I certainly was. Thankfully some test results that showed I do not have an egg allergy came back, and the diet became more manageable with their addition.
About three weeks into the new way of eating, I felt some of my energy come back. I didn't have to pump myself up to eat fish, and I didn't feel deprived anymore. In fact, it felt liberating to have such a basic, repetitive diet (what?!). Anyone who knows me will be shocked to read that sentence, but it's true! Once I stopped battling myself and accepted that these habits are simply what I have to do to achieve my end goal, life became so much easier. This isn't to say that I was not crushed to learn that I have 2 out of 2 genetic markers for non-celiac gluten sensitivity, and therefore should never eat a Beechwood donut again; but, there's a bigger picture here. My health is more important than a donut.
So what's your battle? How often do you argue with yourself over whether or not to have a treat, lose the battle, eat the treat, then beat yourself up a little more for the indulgence? Not only is this a toxic way to treat yourself, it's exhausting! The fatigue of constantly fighting ourselves is often why we want to quit. Think about it: if another person was yelling the horrible things at you that you're yelling at yourself, would you stick around? Of course not.
Here are some strategies for shutting down those exhausting mental battles:
1. Remind yourself of the bigger picture. Ask yourself if your action is about to sabotage your ultimate goal. If it is, remind yourself of how important the end goal is to you. Remind yourself that you are choosing to forego said action. No battle here, just choices. And hey, if you decide to indulge yourself that's fine - just don't beat yourself up about it later. The constant negative self-talk is a goal-squasher. Accept your choice and move forward as planned.
2. Enlist support. I definitely got tired of coaxing myself into these habits in the beginning, and when that happened someone was there to push me along. Find a buddy, whether it be a friend from the gym, a partner, or family member, who will help remind you why you're working towards your goal when you are too tired to remind yourself. In return, you can be that person for them.
3. Create strategies to get you through the first 2-3 weeks of a new habit (plan and prepare). The first couple weeks are rough, but we are capable of much more than we think! Enlist your support system, plan ahead to make the new habits as easy to complete as possible, and if things don't go perfectly for you one day don't throw in the towel. Keep going. It will get easier, but goals are incredibly difficult to achieve without planning and preparation done in advance.
4. Ensure your actions are originating from a place of self-love and care, not punishment. If we keep viewing healthy habits as punishments for the unhealthy ones, the negative self-talk will never stop and we likely won't stick with our plan. Exercise because you appreciate all that your body can do now and will do later. Eat well because you want to feel healthy and live a long, healthy life. Healthy habits are not punishments. I repeat: healthy habits are not punishments. Until we stop viewing them as such, we likely will not achieve our health and fitness goals.
I hope this gives you strength and strategy for overcoming your own battles. Keep working hard, enlist support where needed, and don't quit when things don't go exactly as planned.
It's tough work - especially in the beginning - but, you're worth it.