symptoms Archives - Jumbledbrain

Dehydration must be avoided by brain injury survivors

Michelle #jumbledbrain — Wed, 28 Aug 2019 18:07:07 +0000

We are in the height of summer here in the UK, even reaching temperatures of 33 Celsius or 91 Fahrenheit. Parts of the country (including London and the South East of England) were issued with the highest level of weather warning. We were told that you must not spend prolonged periods outside between the hours of 11 am – 3 pm. These are always the hottest part of the day. Now those of you who live in more tropical climes are probably laughing your heads off right now. As you have the temperatures regularly, you must think it’s preposterous that here in Britain we have to be told by the government not to sit out in the midday sun. Well, we do. The saying “Only mad dogs and Englishmen sit in the midday sun”, holds true for when we are home as well as when we are abroad on holiday. Because we feel we don’t we enough have great weather usually, we do go a bit mad when the sun comes out to play.

Dehydration is a serious risk

I think we have just about got our heads round the idea of sunblock to avoid skin cancer. But there is an even more basic risk that even the shade can’t save us from: Dehydration.

Did you know that by the time you feel thirsty that you are already dehydrated? Thirst is the alarm button the brain hits when hydration levels have already become too low. The brain itself is made up of about 72% water and there is some research which suggests that our brains may temporary shrink when dehydrated! Scary, right?

Dehydration makes the brain more vulnerable to brain injury

When we have the right levels of water in the brain it helps transport chemicals and elements to where they are needed. But this there is a notably negative effect on the brain ventricles and brain cavities when we are dehydrated. This in turn slows down the movement of cerebrospinal fluid, which is vital for the brain and spinal cord to function. This can mean that a person is more likely to suffer a concussion (a “mild” brain injury) which is especially bad news for those of us who have already suffered a brain injury.

But even if you don’t give yourself another brain injury , dehydration can still cause real cognitive issues. One study suggests that the effects can make it as dangerous to drive as if you were drunk. Thus it is why dehydration must be avoided by brain injury survivors.

Conditions that can result in dehydration

Hot weather isn’t the only circumstance that we need to look out for dehydration. There are a number of medical conditions which can leave you dehydrated as a side issue to some of the other nasty effects that they give us. These include:

Vomiting and/or diarrhea
Serious skin burns
Conditions such as diabetes

Symptoms of mild to moderate dehydration:

Increased tiredness
Dry mouth
Increased thirst
More concentrated and darker coloured urine
Less urine output than usual
Headache
Dizziness
Dry skin
Few tears

It’s crucial that when you experience these symptoms that you drink water to address it. Clearly a number of there symptoms we can suffer from already as a consequence of a brain injury, so getting into the habit of ensuring you drink regularly is important.

Symptoms of severe dehydration:

Ability to walk and general mobility is clearly affected by lightheadedness
No urine, or if there is some it is a dark yellow or amber indicating that it’s very concentrated
Lower blood pressure which can cause dizziness or fainting when standing from a seated position
Fever
Decreased skin elasticity – pitch the skin on the back of your hand, and the time that it takes for the skin to return to its normal position is markedly increased
Lethargy and confusion
Shock
Seizure
Coma

Don’t ignore the signs like I did!

I’m writing this because although I did as the government told me and I stayed out of the sun, I clearly became dehydrated. I was busy doing some work, and although I recognised I was thirsty, I kept thinking “I’ll just finish this bit…..” I don’t know how long that went on for, but then the headache started. This didn’t feel like the usual tension headache in the forehead, this was my entire scalp. And then I decided to clean the kitchen, instead of sort myself out. This might have been signs that my cognition had declined to the point where I couldn’t prioritise things properly. But as I bent down, the pain in my head intensified and was unbearable. Finally I took the warning seriously and went to lay down and mad an effort to replenish my fluids.

In addition it’s a good idea to make sure you have a good level of electrolytes by using the powder sachets that you dissolve in water, or drinks which already have electrolytes added. This will speed up your recovery and hopefully avoid an emergency situation.

Do you often allow yourself to become dehydrated? Do you feel the effects of it any any worse since your brain injury?

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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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