Fatigue, depression, pain, puking – Mark Graham explains how life is still impacted by his concussion, over a year later.

This piece was published in February 2021.

A friend of mine wrote a wonderful piece on his life being “shattered by two punches” and his attempts to piece it back together again.

It made me cry.

Timothy Giles described his day-to-day struggles with concentration, anger management and fatigue, and acknowledged the pressures his recovery had put on his family. It was a remarkably good and honest insight into the impacts of concussion, and it gave me an inkling of what he had been going through in the years since his first concussion, back when we worked together 15 years ago. It resonated with me so much because I, too, am working to recover from a concussion.

As with Timothy, what I’ve found with my own concussion is that the struggles go well beyond the family interactions – though they’re certainly there – and beyond the dealings with the world, intermittent as they are. The ripples of that smack of my head into hard bitumen at speed carried on into my “self” – that person I saw in my mind’s eye. Now I was no longer that person who could do anything, achieve what I chose to pursue.

I was reduced to uselessness, fatigue, and depression. I slept through most of the first lockdown. 2020 was a terrible year for many, but I missed it almost completely.

Over a year ago, I was sideswiped by a ute while riding my Vespa. His lane stopped, mine kept going and he jumped into my lane where my Vespa happened to already be, carrying me and my 12-year-old daughter off to her gymnastics class.

I distinctly remember hitting the ground, firstly with my chest, which really hurt a lot, and then with my head. “That’s not good,” I thought to myself.

And it wasn’t.

The poor guy who hit me was mortified, probably at least as much at listening to my 20-minute profanity-laden tirade at him before the ambulance rescued me (and him), as at the fact he had nearly killed me and my daughter.

In many ways we were lucky. My daughter took a knock to the knee and, apart from being pretty freaked out by the accident and the sight of me lying in the middle of the road being told not to move, she was all right.

I was in pain but awake. And my toes moved. The swearing was also probably a good sign. I don’t recall being knocked out, but there are gaps in my memory, so I must have been.

After a series of tests in hospital I was diagnosed with three fractured ribs, concussion and whiplash.

My head, inside my helmet, had conducted its own short arc at speed as my chest hit the ground first, followed by my head whipping around behind it to bounce once… twice… onto the tarmac at high speed while managing to stay connected to my body via my neck.

Vertebrae are not designed for this. Fortunately, crash helmets and heads are, but they mitigate, rather than prevent, damage.

Assorted scans and X-rays showed there were no brain bleeds and apart from a massive headache, the odd bout of losing consciousness and puking, an extremely sore neck and an inability to cough, sneeze, laugh or generally move without the feeling of a knife being driven into my side, I was OK, I thought.

I wasn’t really that keen on sitting up in bed the next morning, but the staff looking after me insisted – I cannot remember why. But I do remember what happened next, or at least some of it.

I remember going dizzy, then it going black, and then I awoke from one of the most intensely pleasurable dreams I have ever had, to a view of the floor and assorted feet I was not prepared for. Then I puked again. Then I felt the blood from my forehead as they helped me back into bed. No one had caught me on my way down and so it was my forehead that broke my fall to the floor.

I hadn’t really considered the detrimental effect of a 1.5 metre pitch off the bed to faceplant on the concrete floor, but the ACC medical assessor cheerfully pointed it out for me. So there I was: a double concussion within 24 hours. And here I am, 15 months in and still messed up.

The ribs healed, as they do. It becomes less painful to fart and laugh, and eventually you even feel comfortable sneezing. The whiplash continues to cause pain and discomfort, even after a year, as do the effects of the concussion.

And while I share Timothy’s symptoms of irritability, concentration and fatigue (lots of sleeping!), the mental well-being effects of the brain injury continue to play a major role in my life.

Because you’re tired all the time, combined with feeling like you’re constantly jet-lagged or hungover (depending on the severity of the headache), doing anything is a major effort. Add in difficulty concentrating on things, a general brain fog and, for many sufferers, aversion to noise and light (not me, thank goodness – music is a solace), it’s hard to actually do anything productive.

Physical activity is fine – good, actually – and certainly beneficial for improving a general feeling of wellness. It doesn’t require thinking, too, and that’s a good thing. Walking the dog, hitting the gym, painting the house – improving physical condition after so much time spent doing nothing has been a rewarding path back to some semblance of energy and positivity.

But coming out of the difficulties of engaging in any kind of cognitive activity are the additional impacts and negative circles on both motivation and self-worth.

The less you feel you can do anything, the less you do. The less you do, the less you want to do. The less you do, the less you feel you can accomplish. The less you accomplish, the worse you feel. The worse you feel, the less you want to do anything.

When you’re left with time on your hands you also have time to ponder the failures of your life. If you have any inclination to anxiety and depression, this is going to make it worse, because you’re useless (figuratively and literally), something a recalcitrant 15-year-old delights in reminding me during periodic confrontations when I try to do some parenting.

For the first six months of my concussion recovery, I routinely forgot my wife’s request to put the washing on the line, much to her frustration (though her tolerance for my failings is remarkable). The kitchen would remain a mess and morning routines getting kids to school became a one-person responsibility (not me, since I was sleeping).

Trying to do any work is a major effort and everything takes longer. I started writing this a year ago.

Anxiety levels skyrocket, too, along with fears for my future. Since I shut down my business because I was unable to work (with associated guilt for unpaid suppliers and contractors), I was left with no purpose to fulfil. Nearing my 60s means my chances of finding a well-paid job are slim; unanswered emails or calls with friends are signs of rejection; unable to participate means being out of the loop; all of this only adds to feelings of worthlessness.

And while I’m grateful for ACC, there has been certainly been a degree of incompetence in their support.

Christmas, Covid-19 and internal restructuring meant I was largely left to my own devices to find treatments for the whiplash and concussion from January to July last year. I lost count at four case managers over the past year or so, and I was told by a supervisor at ACC that there was likely another four I wasn’t aware of because there was no interaction with them. I had no concussion clinic treatment from December 2019 to July 2020 after the funding for my case fell through cracks in the system.

Psychological counselling that had been requested in 2019 by my GP finally got approved in August 2020 after I sent an email expressing my dismay. It’s a good thing my suicidal thoughts remained just thoughts.

I also understand I’m not alone in experiencing these issues.

At the same time that all this is going on, there’s an awareness that others are much worse off than me. I have a friend who’s had to have back surgery while looking after her partner who was recently diagnosed with cancer, of parents dealing with their child’s cancer treatment, medical diagnoses that are permanent and debilitating, and I cannot help but feel that my own emotional toil is overblown and exaggerated – which, of course, adds to the feelings of worthlessness. How can I justify feeling sorry for myself when there are so many dealing with so much more?

Learning to accept the reality of my state of being and the validity of my sense of being has been a challenge, but I’m certainly grateful for the support of my wife and my friends, and those professionals who I’ve worked with in recent months. I know others who have or are suffering with concussion, and I know how tough it is for them because it’s such a hidden impairment.

At my last session, the psychologist I finally got to have counselling with told me that despite everything, I am still capable and have a lot more to offer. This message of value and hope was the greatest gift someone in my situation could have received. It still remains my go-to whenever obstacles seem insurmountable. Make sure you share it with anyone you know dealing with their own struggles.