brain stem Archives - Jumbledbrain

Balance feeling unstable due to brain injury, it’s awkward

Michelle #jumbledbrain — Mon, 20 Feb 2017 17:04:23 +0000

Balance is a very complicated thing, but it starts with your inner ear. Effectively we are fitted with our own little spirit level called the vestibular system. If it becomes damaged it can make balance a lot more difficult. I mentioned before in Tinnitus, the loathsome bells of brain injury that I have suffered with tinnitus for many years. But since my brain injury it has got worse. But whilst a Doctor was trying to diagnose my condition all those years ago, I was asked to perform a simple test. I was told to close my eyes and walk forward. A nurse was stood behind me in case I fell. After just a few steps I heard voices saying “It’s OK I’ve got you.” Apparently I had been about to topple over, but I didn’t recognise it at all.

All the elements that go into balance.

What that test showed that I was using my sight to help my brain decide which way was is up. Once vision was taken away I was forced to listen to my inner spirit level, showing how inaccurate it was. But as long as I continued to walk around with my eyes open, I was able to cope.

But my brain injury changed that. There are so many reasons that might be the case as balance is a complicated recipe.

Vision – As your eyes give you a picture of what the world looks like, that information helps massively. Unfortunately as I have double vision now, this sense is not as reliable anymore.
Muscular strength – It takes a number of muscles able to produce a lot of force to keep us balanced. But as I have left sided weakness even that causes an imbalance within me.
Coordination – Being able to confidently place a foot on the floor as you take a step is something we learn early on in life. But my nerve damage means the communication between my limbs and my brain is off-kilter. Therefore I might expect my foot is about to touch the floor, but it’s not.
Brain-stem – As it controls movement it is also essential when taking those steps. I had a bleed which was next to my brain-stem and irritated it, affecting my control of movement.
Inner ear – Your in built spirit level. But we already know mine is broken.

When the world is spinning.

Together this means I can have spells of vertigo. Even if I’m sat down my brain can still be convinced the world in spinning. Some people find that if their head is spinning whilst in bed, putting a foot on the floor stops it. This is most likely because the information your foot sends back about the flat, still ground, helps convince your brain that is correct. Sadly this has never worked for me. I found this would be at it’s worst when my vision was particularly bad. Not a good combination, I can tell you.

But I have improved, maybe it’s because a little more strength is back. Or maybe it’s because my cognitive abilities have improved. You don’t realise all the calculations your brain does, and all the information it analyses in a fraction of a second. So just as my brain had learned to listen more to my eyes, than my spirit level, perhaps it is re-calibrating to the current inaccurate data.

Wish I had a tail.

Lots of animals such as monkeys, squirrels, cats and dogs have the advantage of as extra limb. The tail. And it helps them balance in the most challenging of situations. They swish it around to move their centre of gravity to counteract any imbalances. And don’t they just look majestic when they do this. Think of how a Leopard changing direction to chase their zig zagging prey, flashes its tail to the side to do a handbrake turn.

Instead I have arms. So often when I get up in the night of go to the toilet I look like I’m walking a tightrope. Except it’s not impressive when your walking on a carpeted landing.

I don’t use a walking aid anymore as I need to keep practising for the re-calibration process to be successful. But it would help the rest of the world know as it rushes by to give me a little more room.

Has your balance been affected? Is there anything in particular that has helped you?

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Surprising physical symptoms of my brain injury

Michelle #jumbledbrain — Mon, 22 Aug 2016 13:39:32 +0000

The initial bleed at the base of my brain, the hospital had seen but down played it. The blood pushed against and irritated my brain stem and spinal cord. These control the flow of messages between the brain and the rest of the body. This added to my physical symptoms.

Together the brain and spinal cord form the body’s central nervous system. The brain makes the commands for the body to function, and the spinal cord delivers those messages to the body and from the body to the brain.

Branching off the spinal cord is the peripheral nervous system. These nerves are the finer detail, like what capillaries are to arteries.

These systems work together to enable the brain to control the body’s many complex functions. These fall into 3 major categories:

Motor Functions – commands your body’s voluntary muscle movements e.g. walking.
Sensory Functions – allows sensation of touch, pressure, temperature and pain to be communicated and analysed.
Autonomic Functions – regulates digestion, urination, body temperature, heart rate, and dilation/contraction of blood vessels (blood pressure).

So although the bleed had stopped naturally, it still gave me a whole host of difficulties.

As I struggled to walk and had poor coordination, that fit into symptoms of Motor dysfunctions.

Then there was the fact that I constantly felt freezing (or as I kept complaining “Baltic!”)

No matter how warm it was or what I was wearing I felt cold. My friend and work colleague Kate, gave me a fleece lined onesie which I wore to bed as well as socks and slippers, and still I was frozen. In addition I had altered sensation down my left side. This means I still have constant tingling and my left struggles to identify sensations. So mostly it just registers pain, which I guess is a “just in case” to make me jump back as it might be harmful. Cold water feels like I’m being stabbed with a million knives. All these symptoms fall into sensory dysfunction.

The most frightening, and at the same time embarrassing, is autonomic dysfunction. Whilst I was in hospital my blood pressure was all over the place. Previously I had always had lower than average blood pressure, but the hospital staff had to constantly monitor me as it would be sky high and then abnormally low. This is dangerous, but luckily with their support it did level out over the coming days.

But my digestive system was struggling. I’m sure most people at some stage have endured the misery of constipation.

But after 6 days of being bed bound I still hadn’t been and was showing no sign of it being likely. After they had tried laxatives, which failed, they resorted to an enema. For want of a better word, this is where fluids are pumped into the lower bowel via a tube up the bum. I can’t remember how long I had it attached to me, but it felt like forever. I actually don’t remember much about it but it must have worked eventually. However for months I continued to have problems with my digestive system.

Something in my nervous system was still trying to get the right messages to the right places. Essentially my bowel needed to relearn what to do.

Alongside that though I now had an overactive bladder. I had “key in the door syndrome”. Suddenly as each time I got home, I found I had to run to the toilet (made me wish we had a downstairs loo in our house). It wasn’t necessarily a lot, but there was no stopping it. Or I would find minutes after being to the toilet, I would need to go again. This was caused by my bladder to not emptying properly. Again these basic functions of life were off kilter. It resulted in me feeling like I always needed to be near the loo. With the help from the gynaecology and physiotherapy departments I was able to retrain my body. However this took months.

Unfortunately none of this was explained before I was sent home after my accident. We probably didn’t ask the right questions and as I wasn’t self aware I wasn’t reporting the physical symptoms of my brain injury. But it would have helped if they had talked us through what we might expect. The doctors and nurses did a fantastic job at stabilising me and they work tirelessly for patients every day.

The NHS is amazing. But the constant pressure it’s under to save lives meant in my case once I was no longer “critical” they felt they needed to focus on others who were.

But not all symptoms are necessarily connected to your brain injury as I found out in Overlook other problems & wrongly blame brain injury.

Have you ever felt you should have been given more time or information on your symptoms? Should we except that staff haven't got the resources or time?

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