The top 5 ways summer is out to get you

BY: RICHARD HASKELL

Hot fun in the summertime!

Those words are just as true today as they were when recorded by Sly and the Family Stone back in 1969. Summer is about having fun in warmer temperatures, especially after another brutal winter and a cool spring, we certainly deserve it. Just a few short months ago we were protecting ourselves from the -30 wind chill, right?.

SUMMER HEAT

But warmer temperatures can also be too much of a good thing if the thermometer climbs above a certain level. Our body deals with the heat in different ways, by increasing the rate and depth of blood circulation, by losing water through the skin and sweat glands as perspiration and when coupled with strenuous activity, causing us to pant when the blood is heated above 37 degrees (98.6.) Under conditions of high temperature (above 32 degrees) and high humidity, the body does everything it can to maintain its regular normal temperature.

Spending too much time outside on a hot day can affect the body in a number of different ways, some of them debilitating. Little wonder that the dangers associated with high seasonal temperatures are sometimes referred to as silent killers.

Here are a few of them that we have to watch out for as we enjoy this all-too-brief season:

1. Dehydration

photo credit: Cold drinks via photopin (license)
photo credit: Cold drinks via photopin (license)

When the body becomes overheated, the blood is circulated closer to the skin’s surface and excess heat drains off into the cooler atmosphere. You body is always trying to maintain an even body temperature. Sweating reduces body heat through a process known as evaporative cooling. When we perspire, our bodies are cooled through evaporation from the skin, but if there is high humidity, the sweat stays on our skin and we feel little relief from the heat.

Hence, sweating by itself does nothing to cool the body, unless the water is removed by evaporation. Dehydration occurs when more than two per cent of normal water volume is lost. Symptoms may include thirst, headache, general discomfort, loss of appetite and dry skin. Severe dehydration can lead to dizziness or fainting, decreased blood pressure and listlessness. Whether it means carrying a water bottle or making frequent stops at a public fountain, keeping hydrated on a hot day is a given.

2. Heat Cramps

Source: http://media.mnn.com/assets/images/2009/04/main_egg_0407.jpg
Source: http://media.mnn.com/assets/images/2009/04/main_egg_0407.jpg

Anyone who has ever done heavy physical labour on a hot day may well have experienced muscle sprains or spasms known as heat cramps. They may occur in the abdominal area or the legs and can be very painful. Anyone suffering from heat cramps should immediately stop the activity and rest, while drinking sips of water or a sports drink. Try to gently stretch the cramped muscle, holding it for about 20 seconds before massaging it. If the sufferer ceases to have any symptoms of heat cramps he or she may resume some activity, but should refrain from any strenuous exercise for at least 24 hours.

3. Heat Exhaustion

photo credit: IMG_20150705_143248 via photopin (license)
photo credit: IMG_20150705_143248 via photopin (license)

Heat exhaustion is closely tied in with dehydration – it results from the loss of large quantities of water and salt. When these are not replaced, blood circulation diminishes, affecting not only the heart, but also the lungs and the brain. When heat exhaustion occurs, high humidity may cause perspiration not to evaporate so the body doesn’t cool properly. Symptoms may include skin which is moist, cool, pale – or sometimes red – heavy sweating headache, nausea, vomiting, dizziness and general inertia. Body temperature is usually normal. Heat exhaustion is best treated when the person afflicted rests in a cool place and consumes small amounts of water every 15 minutes. Clothing should either loosened or removed altogether and cool wet cloths applied to different parts of the body. If left untreated, the condition could potentially lead to heat stroke.

4. Heat Stroke

photo credit: Suck It Heat Wave! via photopin (license)
photo credit: Suck It Heat Wave! via photopin (license)

Heat stroke occurs when a person’s temperature control system – which produces perspiration to cool the body – stops functioning. This creates an increase in body temperature so high that either brain damage or death can result if steps are not taken immediately. Symptoms may include hot, red and dry skin, a rapid but weak pulse shallow breathing, high body temperature, dilated pupils, dizziness and weakness, vomiting and mental confusion. If you suspect a person is affected by heat stroke, it is imperative he or she be moved to a cool place and be wrapped in wet sheets. Ice packs should be placed on the victim’s wrists and ankles, in the armpits and on the neck in order to cool large blood vessels. Call 9-1-1 if the treatment is not producing the desired results.

5. Sun burn

photo credit: Bruceys Neck via photopin (license)
photo credit: Bruceys Neck via photopin (license)

Are you old enough to remember the days of, “I’m just going to lie out in the sun for a couple of hours and try to get a nice healthy tan?” The world has moved on since then, and most of us realize a tan is not healthy! Yes, the sun is life-giving and contributes to the production of vitamin D in the body, but over-exposure to ultraviolet rays over time have negative effects on the skin including sunburn, premature aging or an increased risk of skin cancer. After the winter, some people may wish to acquire the healthy glow a tan gives by starting out with a base tan using the facilities of an indoor tanning bed. But Dr. Anne Marie McNeill, a dermatologist with Newport Beach Dermatology and Plastic Surgery in California states on skincancer.org:

The problem is that ultraviolet (UV) tanning, whether from indoor tanning beds or from the sun, is harmful to the skin. Therefore, I don’t recommend tanning at all, during the summer or any other season. A tan is a sign of sun damage to your skin’s DNA. Skin cells respond to damage from UV rays by producing more of the pigment melanin to protect themselves from further injury.

Over-exposure to the sun results in a burn. Symptoms may include redness and pain, swelling of the skin blisters and in some cases, headaches and fever. It is best treated with ointments or in the case of broken blisters, dry sterile dressings. During the past twenty years, doctors have seen an alarming rate of increase in skin cancer of a type referred to as nonmylenoma – as much as 300 per cent and more than all other cancers combined . If detected early enough it can be treated successfully. If you must take some sun, do so for small intervals of time and always wear a lotion for protection.

Don’t let the heat get you

photo credit: 12/365: Beat red after spinning via photopin (license)
photo credit: 12/365: Beat red after spinning via photopin (license)

Enjoy the season! It’s a time for patios, cool drinks and taking life a little easier than at other times of the year – but never forget to take those precautions that come with the increase in warmer weather.

Dress for it! An all-black ensemble may be trendy, but leave it in the closet until September. Light-colored clothing reflects heat and sunlight, and helps your body maintain normal temperatures. Wear a hat to protect your face and head.

Even if you aren’t thirsty, be sure to drink plenty of liquids, and cut back on those iced lattes and cool pints of beer. Caffeine increases water loss through urination, and alcoholic drinks can also cause dehydration. Soft drinks and fruit juices usually contain high amounts of sugar, which means they aren’t absorbed as easily as water or a commercial sports drink.

It’s impossible to avoid the sun altogether during the summer, but don’t bask in it. Wear a protective sunscreen if you plan to be outside for any length of time-and go indoors to a cool environment if you feel any of the effect of too many ultraviolet rays.

But we’re not total downers – summer lasts only a few months, so make the most of it. Walk, hike, swim, bike, go for a leisurely stroll in a park or along the waterfront, or enjoy drinks (in moderation if they’re alcholholic!) on a patio. Because we all know how quickly -30 is going to come back..

Thoughts on reading and brain injury

BY: COIRE

I acquired my ABI following a surgery to remove a brain tumour ten months ago. The global neurological fallout from my brain injury has been extensive. As the one-year anniversary of my surgery approaches, I thought I would share my thoughts on literacy in response to Shireen Jeejeebhoy’s posts on the subject of trying to regain her love of reading.

Shireen’s posts got me thinking how inundated I am with the cacophony of letters which are part of words that have meaning in relationship to signs, food, location, businesses, pill bottles and cereal boxes. For me, these words populate my vision and are constantly demanding attention, yelling to be recognized and have meaning extrapolated from them.

Words are like the faces of friends I used to know but can no longer recognize. I seem to be unable to place them even though I’m continually on the verge of recognizing them, the meaning on the tip of my tongue, if I just look long enough, it will all come tumbling back to me.

photo credit: Gold Letters Kempton via photopin (license)
photo credit: Gold Letters Kempton via photopin (license)

Words – I think of all the hours we spent together growing up, the hours I spent practicing their loops and lines, the time I etched them in the black paint under the train tracks by the river high on marijuana and Allen Ginsberg, how in the empty space between letters they seemed to embrace the entirety of my young world, reckless and immortal, how joy and health was something I carried haphazardly in my pocket with a lighter, paper and some lint, its origin never questioned, its source endless. It seemed that words were an inherent part of the magic of existence.

The time after my surgery is stark and still painfully clear how difficult it is being an illiterate adult. Since then, I have done a lot of work to get back to reading. And like many of us who are reading these blogs, there are moments of successes and triumph. But the triumph is dulled by the weight of loss, the scope too large to see at one time, like a panorama picture of loss.

photo credit: Free jumbled type texture for layers free creative commons via photopin (license)
photo credit: Free jumbled type texture for layers free creative commons via photopin (license)

Things that have helped me:  I try and remove all words and letters from my view when I don’t have the energy to work on them. I remove the newspaper from the table, when I sit there, lists on the desk. I don’t know if it’s like this for anyone else, but words in my field of view seem to taunt me to make sense of them, as though they are yelling for my attention and I am unable to block them out.

My family hands me the menu right side up to save me from flipping it around to try to make sense of it. Point to the exact place I need to sign on a form. I have been working on compensation strategies with the therapists that have helped hugely. Practicing scanning and flash cards, reading easy books to my young daughter. And also trying to enjoy young adult novels I already know or have read before or have listened to on tape. There is a great dyslexic font that has helped me on the computer which is free , easy to install and keeps all the letters from somersaulting as much.

photo credit: Stack of Books via photopin (license)
photo credit: Stack of Books via photopin (license)

I know everyone has different challenges and strengths and I only offer what has helped or is helping me in the off chance it will aid someone else as the literacy blog post helped me, as writing this is a obtainable goal helping me. As I read I focus on the enjoyment of it, reminding myself it’s a language, not unlike a foreign language and only comprehending 60 per cent or so is fine. This emphasis on enjoyment and not on comprehension helps me engage in an act that used to bring me enjoyment and now still does, most of the time.

11-year-old ABI survivor starts website to spread awareness

BY: MERI PERRA

Remember this great kid?

Andrew  Last month, 11-year-old Andrew shared his story of acquiring a brain injury as a result of a stroke for our #areyouaware campaign. If you read what Andrew wrote, you know that his story is beyond powerful – his stroke occurred just this past winter, and he is facing more brain surgery in the upcoming months. But none of this stopped Andrew from heading back to grade five as soon as he checked out of Holland Bloorview, finishing his school year, and then wanting to give back.

Andrew asked his parents if he could have a website for his 11th birthday. While Andrew says, he was “just joking around” his mom and dad took his request seriously, and with some parental guidance, Andrew recently launched www.iloveyourbrain.com.

“It’s for kids who have brain injuries, so they know there are other kids who have brain injuries,” Andrew said.

Andrew

 

Andrew wants to reach out to other pediatric stroke survivors in particular, since he says he has never met other kids who have acquired a brain injury as a result of a stroke. According to the Heart and Stroke Foundation, three to six kids per 100, 000 in the 28-days to 18-year-old age bracket will experience a stroke, which is a higher incidence rate than brain tumours.

“Not just only older people and adult can have strokes, but kids can have them too,” Andrew said.

The statement, ‘You don’t know how strong you are until it’s the only choice you have‘ is in the centre of the home page of www.iloveyourbrain.com, and strikes a chord with Andrew’s bravery during his recovery. Andrew says his mom, Nadine Vermeulen, found the quote on-line, and he also has a t-shirt with the statement on it.

“You need to be strong to survive things and fight things,” Andrew said.

Andrew and his family

Due to his recovery, Andrew’s summer activities are fairly limited right now, though the tough 11-year-old does have stuff going on. He is playing golf, and The Whitby Major Mosquito A baseball team, the Chiefs, are letting him practise with them this season. After a chance encounter with his mother, a former Colorado Rockies pitcher who lives in Andrew’s neighbourhood is going to toss the ball around with him, too.

Meanwhile, Andrew says his brain injury has – understandably – impacted his friends and family. He said before his stroke, his friends were pretty good at wearing bike helmets, but his brother was not.

“Well, he does now,” Andrew said.

To find out more about pediatric stroke and get support, contact the Canadian Pediatric Stroke Association. The Heart and Stroke Foundation has a resource guide for parents of pediatric stroke survivors. And be sure to check out Andrew’s website: www.iloveyourbrain.com

Untitled design-22
Andrew and his mom Nadine

Meri Perra is the communications and support coordinator at BIST.

Interconnected brain regions – an end to the GCS?

BY: SOPHIA VOUMVAKIS

Traumatic Brain Injury (TBI) can often lead to problems with a person’s cognitive control, affecting their attention, memory, thought, behaviour and emotion. Cognitive control is our ability to modify our behaviour and actions to adapt to the situation we are in. It provides the basis for planning, problem solving and adaptive behaviour (our ability to be self sufficient and independant, based on our age group).

person in MRI machine
photo credit: P4250960 via photopin (license)

Accumulating neuroscience evidence suggests that cognitive control functions are carried out within a network of highly interconnected brain regions. These networks allow for
communication across long distances within the brain and enable us to direct attention to important information in our internal and external environments, to plan and to problem solve. Three such networks have been identified: the salience network, the default-mode network (DMN) and the central-executive network (CEN).

Traumatic brain injury often leads to deficits in cognitive control. The salience network plays a vital role in controlling our emotions and our awareness to the physiological state of our body. Damage to the salience network produces deficits in awareness, such as difficulty with focusing and attention span.

The DMN allows for an internal focus of attention during self-reflective cognitive activity, and is responsible for our autobiographical memory (recalling events that happened to us, as well as facts about the time and place where the event occured), and social cognition (how people process social information). Damage to the DMN results in difficulties with remembering our personal histories, problems understanding time and space, and imagining the perspective of others.

The CEN supports an external focus of attention during goal directed, cognitively demanding tasks. Damage to this network results in impairment to flexibility of thought, working memory, and problem solving.

The different brain areas which comprise these networks communicate with each other via axons, the part of the cell which allows neurons to send electrical impulses to each other. Recent advances in neuroimaging techniques have shown that TBI results in damage to axons, and depending on where in the brain the damaged axons lie, damage to one of these networks, which, in turn, will result in specific deficits.

photo credit: Brain Animation via photopin (license)
photo credit: Brain Animation via photopin (license)
A New Approach to Diagnosing TBI

Since the mid-1970’s the severity of TBI has been diagnosed using The Glasgow Coma Scale (GCS). The GCS measures eye opening, verbal response, and motor response. The test is objective and correlates well with outcomes following severe TBI. It does not, however, predict the specific deficits that will develop in a brain injury survivor. In one recent study, researchers  propose moving away from using the GCS to indentifying the structural and functional integrity of each of the interconnected brain region. If damage is seen in a specific integrated brain region, then treatment can be better targeted and started earlier to deal with the specific deficits that will arise because of the location of the damage.

In a future post we will discuss new neuroscience research on interconnected brain regions and how this can be translated into effective interventions for TBI.

Since acquiring her traumatic brain injury in 2011, Sophia has educated herself about TBI. She is interested in making research accessible to other survivors.

How we went on a real family vacation after my son’s brain injury

BY: BARB KUSTEC

This is us last summer, when our family decided to drive to Canada’s East Coast provinces and take a real family vacation.

vacation
Our vacation began when headed out late one afternoon in our rented, and very comfortable, RV. Leaving late was our first mistake. Our plan was to get to the Maritimes fast (we wanted to get through Quebec before stopping for the night). That was our second mistake. Then we realized we had forgotten the sleeping pills and other brain injury-related medicine for my son at home. That was our third mistake – a big one.

We learned that to survive on our vacation, we must be better organized. We had to call ahead for hotels, and eat before hitting the road. We needed to get into the habit of allowing for extra time, for everything and anything that could come up. Getting up in the mornings takes longer for the person with the ABI, and changes in environment and routine are harder for them to deal with. Once we slowed down and got organized, the trip went much better.

vacation
As soon as we reached the East Coast, it was smooth sailing. The slower, calmer pace was perfect for our family. The landscape is beautiful, and our family relaxed and began to have a great time together.

We went whale watching, swimming, walked on the ocean floor, did Peggy’s Cove and visited Anne of Green Gables. We took lots of pictures, and it was amazing to see our son take everything in. It was wonderful to see all of us, my husband and two daugthers, relax.

I totally recommend vacation for families who are living with brain injury – especially ones where you’re trapped together in a comfortable RV. The bonding and closeness are moments that will last a lifetime. There were periods of chaos, do not get me wrong, but even those add to the story of us. (And, after the fact, they are funny to remember – like when my husband didn’t take the time to learn where the gas tank was, and had to figure it out when the RV was almost running on empty. After about an hour, the gas tank was found by a carload of young men who Googled it, and it turns out it was inside the driver’s door. My prayers were answered once again!)

vacation
Did the brain injury change our vacation? Absolutely. However, the rewards were greater than the challenges. Thank God we still have our son and brother. Who could ask for more than that?

Barb Kustec is the mother of three – Christopher, age 23; Cassandra, age 15 and Samantha, age 12. She is married to her husband, Danny. This is her second article for Brain Injury Blog TO.

Can the brain repair itself?

BY: SOPHIA VOUMVAKIS

When I suffered my traumatic brain injury (TBI) in 2011, I believed that the cells in my brain which had been damaged were irreparable. But recent research suggests that the brain can repair itself, and that what was once damaged may be able to heal.

Before we explore the scientific evidence, we need to have a rudimentary understanding of how the brain works. Very simply, the brain is made up of two main groups of cells, neurons and glial. When these cells work together, the electrical activity they create enables us to move, think, emote, feel, remember – essentially, to live.

"Human neural stem cells (shown in red), originally reprogrammed from adult skin cells, differentiate efficiently into brain cells (shown in green), after being cultured with star-shaped cells called astrocytes." Photo credit:  Chen Lab, Penn State University via Pen State News
Human neural stem cells (red), originally reprogrammed from adult skin cells, functioning efficiently with  brain cells (green). Photo credit: Chen Lab, Penn State University via Pen State News

However when one of these cells gets damaged or dies, the result is damaged wiring and connections. If the damaged nerve is a motor neuron, then motor functioning is impaired. If the myelin cell is damaged, diseases such as Multiple Sclerosis (MS) develop.

Speaking at a TED Conference in July 2013, Dr. Siddharthan Chandran, director of the Centre for Clinical Brain Sciences, describes a case of a patient with MS whose brain scan showed myelin damage. Subsequent scans showed some repair in the area of the brain which had originally displayed damage. This repair had occurred with no medical intervention, which led Dr. Chandran to conclude that “the brain can repair itself, just not well enough.”

Dr. Chandran believes this discovery will lead to a new direction in finding therapies to treat brain disorders. Human stem cells, which can can self-renew to create new bone or liver cells, show great promise in this endeavour. Scientists hope that one day stem cells can be used to create new motor nerve or myelin cells.

In 2006, Japanese scientist Dr. Shinya Yamanaka discovered that just four ingredients can convert any adult cell into a master stem cell. This means that scientists can create a stem cell from any of us, and then make that cell relevant to our disease or injury, such as a motor neuron or a myelin cell. Yamanaka won a Nobel Prize for his work in 2012.

A recent clinical trial by Dr. Chandran, in collaboration with other scientists,  illustrates this point. Researchers took stem cells from the bone marrow of patients with MS, grew myelin cells in the lab, and then injected them back into the patients’ veins. To measure whether the intervention was successful, the scientists examined the optic nerve. The size of the optic nerve was measured before the injection of the lab grown myelin cells, three and six months post injection (patients with MS usually have vision problems). Results showed the optic nerve had stopped shrinking, which Dr. Chandran believes is the result of the injected myelin cells, which promoted the brain’s own stem cells to do their job of laying down more myelin.

TEDGlobal 2013 in Edinburgh, Scotland. June 12-15, 2013. Photo: James Duncan Davidson
TEDGlobal 2013 in Edinburgh, Scotland. June 12-15, 2013. Photo: James Duncan Davidson

In addition, scientists can now use human cells to find ways to promote and activate the stem cells, which are already in our brain, to repair damage. Dr. Chandran believes this technique could replace animal testing in the future.

Although Dr. Chandran discussed these new advances in the treatment of brain disorders such as MS and Parkinson’s, these scientific advances may have applicability to the brain injury as well. To quote Dr. Chandran, “the day we can repair the damaged brain is sooner than we think.”

Since her TBI in 2011, Sophia has educated herself about TBI. She is interested in making research into TBI accessible to other survivors.

What my personal experience with concussion has taught me

BY: KAROLINA URBAN

Summer is here and with it comes the inevitable concern for safety and injury prevention. From organized sports such as soccer and rugby, to recreational activities such as wakeboarding, tubing, biking or your friendly match of volleyball, there is always a risk of a concussion.

Concussions are not limited to a direct hit to the head. They can also be the result of a large biomechanical force, known as a acceleration-deceleration injury, which causes the brain to move within the skull.

The rate of concussions occur in 754 per 100 000 for boys and 440 per 100 000 for girls. Nearly one-third of these injuries are the result of falls, while skating and hockey account for the greatest number of sports related concussions in Canada.

photo credit: UPEI Panthers at Saint Mary's Huskies (Nov 27 2010, Halifax NS) via photopin (license)
photo credit: UPEI Panthers at Saint Mary’s Huskies (Nov 27 2010, Halifax NS) via photopin (license)

The difficulty with assessing or recognizing a concussion is the wide range of symptoms that vary as a result of the heterogeneity of injury. These symptoms can range from being physical in nature (i.e. headaches or dizziness), to cognitive (i.e. difficulty concentrating), to behavioral (i.e. depression, anxiety) or sleep-related (i.e. difficulty falling asleep or sleeping too much.)

80  per cent of adults recover from a concussion within two weeks. For children, the recovery process tends to be slower, but despite the longer recovery period, it has been shown that most of the pediatric population does not continue to have long-term difficulties. However, around 14 per cent of the children who sustain a concussion continue to have symptoms beyond three months after injury. As a parent, guardian, coach or friend it is critical to recognize the impact of concussions, know how to prevent them and how to promote recovery.

Throughout my hockey career I always had this willingness to do whatever it took to win. In the face of injury I would shrug off the pain and continue to compete. In my second year of hockey at the University of Toronto I sustained a concussion in the last season game. From what I recall, the puck came out of a scrum in the neutral zone and the next thing I can remember is sitting on the bench feeling ‘out of it.’ My line-mate asked whether I was okay and I simply responded, “Oh yeah, lets go.”

Image via Facebook
Rowan Stringer; Image via Facebook

Luckily there were only few minutes left in the game as I continued to play. That evening I began to feel worse, more anxious, dizzy and fatigued. But as I had always done, I continued on until the next evening, I went to class, wrote an exam (which I did horribly on) and continued onto practice. As we began to do skating drills, I began to feel nauseous and dizzy and finally agreed to get an official diagnosis. Although I took this step, I quickly got cleared to play again as game one of playoffs was eight days later.

It was quite evident I was no were near ready to return to play. I missed the puck several times, my reaction times were slower, my head was hurting and I was dizzy every time I turned. To be honest I probably hurt my team more than helped. I was, however, extremely lucky to have not sustained another hit to my head. This is called ‘second impact syndrome’ where you undergo another hit to the head when you haven’t given your brain time to recover from the first injury. Impact to the brain during this vulnerable period may result in devastating consequences, such as with the recent death of high school rugby player Rowan Stringer.

If you or someone you know has sustained a concussion, there are return-to-life and play guidelines to help. The Ontario Neurotrauma Foundation has produced pediatric concussion guidelines and has information on persistent concussion symptoms. Parachute has return-to-play guidelines which are also a valuable guide for concerned parents and athletes.

These guidelines are the most up to date and based on research. However, I would like to impart some of the things I have learned throughout my career and the few concussions I have had:

  1. Remove yourself from the activity you are doing. I know this is hard but you are probably putting yourself at risk for a longer or more complicated injury. If you want to get back out there as quickly as possible and avoid more serious injuries, it is critical to stop what you are doing. 
  2. Give yourself time to rest – some of the symptoms of concussion can develop up to 24-36 hours after the injury occurred. So jumping right back into a high risk activity can put you at more risk.
  3. If something doesn’t feel good, stop. If you hurt a muscle and felt the pain when you began running you would stop, so don’t treat your brain any differently. I think this is particularly important when you are trying to get back to your life and sport. Monitoring how your brain feels when you are beginning to re-integrate yourself into all your activities is key.
  4. Be patient – For me this was the most difficult one. Some days you begin to feel better and think that you have recovered and then the next you feel worse again. This can be extremely frustrating, especially if you want to get back to school or back to what you love doing. As long as you are aware that it’s not going to be a straight forward recovery, then maybe you can lower that frustration.
  5. Rest, but don’t sleep all day. Previously it was thought that it was important to completely isolate yourself, stay in a dark room until you felt better and your symptoms were gone. However more recent research has shown that full rest can have a negative effect on brain health and recovery. After the suggested 24-hour rest period, begin to get back into what you are doing, slowly. Go for a walk or try cooking dinner, but whatever it is, make sure you’re moving in small steps.
  6. Define your priorities. One common symptom for  people is fatigue and difficulty to concentrate. If you overwhelm yourself you could hinder your recovery.
  7. This so-called ‘invisible injury’ is nothing to hide, nothing to be ashamed of and it is okay to not feel comfortable doing something that everyone else is. All that matters is taking care of your brain and you need to do whatever it takes to take the appropriate steps.

 Karolina Urban is a former University of Toronto and Canadian Women’s Hockey League player. Currently she is a PhD student at the Concussion Centre in Holland Bloorview Kids Rehab Hospital.