Thinking Forward After A Traumatic Brain Injury

04/27/2026

Concussion care should never be approached as a one-size-fits-all. Sometimes symptoms are incorrectly tied to a diagnosis that is not brain injury related. Treatment for the symptoms may then not be beneficial.

I had no idea how much the injuries to my brain and neck after my concussion negatively affected my vision and balance (along with other things). Getting the right assessments and treatments significantly helped ease my symptoms (specifically neuro-glasses and chiropractic care).

I recently found a great post on LinkedIn by Sonia Vovan who is a Physiotherapist and Vestibular Therapist. I believe every person who suffers a concussion should have a vestibular consultation.

🧠 Sonia Vovan, Physiotherapist and Vestibular Therapist, Concussion Management and Vestibular Rehabilitation

A few patterns in concussion care that I wish we'd stop seeing.

After many years of clinical practice in vestibular rehabilitation and concussion management, and now as a PhD candidate researching s*x-specific differences in sensorimotor integration following concussion in working-aged adults, I continue to notice a persistent gap between what the evidence supports and what patients encounter in everyday care.

This outlines the specific patterns I see most often. What strikes me, collectively, is that closing these gaps doesn't require new science. It requires translating what we already know into consistent, individualized, multi-system care. It also requires recognizing that concussion recovery is shaped by factors we've historically underweighted in both research and practice, including s*x, hormonal status, the cervical spine, and the cognitive-motor demands of the environments people are returning to.

For clinicians, this means broadening assessment beyond symptom checklists and resting presentations. For researchers, it means continuing to build the evidence base around heterogeneity in recovery. For patients and those supporting them, it means feeling empowered to ask more specific questions about how their care plan reflects the complexity of their injury.

I'd welcome input from other clinicians, researchers, and those with lived experience. Which of these patterns resonates most with what you're seeing in practice?

https://www.linkedin.com/posts/soniavovan_concussion-vestibularrehabilitation-physiotherapy-activity-7452672561487998976-zXei?utm_medium=ios_app&rcm=ACoAAChz9rUB4CJ2jrGInBg6I3gwc-GSIRx4KZE&utm_source=social_share_send&utm_campaign=copy_link

04/08/2026

I felt the need to comment on this today. I’ll probably ramble. 😂 And it might sound funny or weird…

What if you woke up and you were no longer you is a powerful question. I think of obvious deficits or differences from my old self. Others might not notice, but they might after talking with me for a few minutes. I think of word finding, losing my train of thought, having a hard time following a conversation and needing things repeated, etc. Not a big deal, right? It is and it isn’t. It depends. It depends on the situation I’m in. I will tell you it is often embarrassing for me. I know what I am trying to say. I am listening to the person. I care. I know what I’m doing (You can have confidence in me, I promise! 😉).

There is almost always a question in the back of my mind: Was I like this before?

Am I that different than before my TBI?

Am I overthinking things? Of course I am…why wouldn’t I?! Now That I did before! 😂🙋🏻‍♀️

But, back to the question…am I really that different than before? Others who’ve known me for years before my TBI and now after my TBI tell me I’m a lot “different.” I’ve asked them to tell me what’s different. Telling me I’m “a lot different” makes me nervous. No one can really tell me or “put a finger on it.” Can you guess what happens next? You guessed it! I overthink! Sometimes I feel like a bad fraudulent check of my previous self! 😂 I think I said that right…feeling like a fraud. Does that make sense?

Imagine not knowing what is different about you now. Would you question how you’re perceived by others (like I said before)? I do. And it Sucks.

I want to feel like I “fit in,” that I’m perceived as “normal,” yet I want to still be me. Be whomever I was before the car accident (Whoever? Whomever? My little sister, Marley, the brainy sibling with a Masters in English, would know which to use…I don’t want to look it up right now 😂. My brain is tired.)? Who I still am? I forget who I was…or am.

Have I confused you yet? I confused myself 😂😉. Welcome to my world. Ha!

I want All of me to fit in, not just the pieces that fit into the “normal” puzzle (Boring…’The Office’ reference…PowerPoint is boring).

Just like everyone else, I want to feel like I fit in and belong. To be Accepted. Even better! We all want that. To be accepted.

Unfortunately trying to fit in and be perceived as normal is Exhausting, especially after a TBI. I already have zero battery reserve, so my effort to fit in drains me after a few hours (sometimes a few hours more, a lot of times less). What’s left after that? Meh…not much. Cue in a cat nap? 😴 I like naps…

Maybe my next step is to truly accept who I am right now and not worry or dwell about who I was or could be. Or maybe not worrying so much about how I am perceived by others…especially when that drains me, too! 😂🧠 If I achieve the potentially unachievable (ha)…does that mean I’ll need to find a hobby to tire me out instead?! In my opinion, I’m hilarious. 😆

Now that I’ve rambled…Can you relate? 🤔💭

Brain Injury changes everything...

03/01/2026

🧠 March is Brain Injury Awareness Month, so it’s a good time to learn more about traumatic brain injury (TBI) and how it can affect someone. According to the Centers for Disease Control and Injury Prevention (CDC), 1.7 million Americans sustain a brain injury each year. A brain injury is a long-term or temporary disruption in brain function resulting from injury to the brain. A TBI occurs when there is a strong enough impact to the head to cause damage to the brain. Common causes of TBI include motorcycle accidents, sports injuries, falls or acts of violence. 🧠

Historically conceptualised as an injury event with finite recovery, TBI is now recognised as a chronic condition that can affect multiple domains of health and function, some of which might deteriorate over time. Many people who have had a TBI remain moderately to severely disabled at 5 years, are rehospitalised up to 10 years post-injury, and have a reduced lifespan relative to the general population. Understanding TBI as a chronic disease process can be highly informative for optimising care, which has traditionally focused on acute care. Chronic brain injury care models must be informed by a holistic understanding of long-term outcomes and the factors that can affect how care needs evolve over time.

Even 5.5 years later, my everyday life isn’t “easy” or “normal.” I am doing the best I can to adapt and take each day as it comes, and that’s okay. Stopping is not an option. I will continue to grow! Volunteering as a nurse practitioner allows me to continue pushing myself and doing what I love to do! 🩺🧠

Please share this post to help others learn more about what a TBI is and what can be done to live the best life possible!

02/28/2026

“You Look Fine" 🧠👀

This statement is Frustrating…

When invisible disability meets misunderstanding
Many of us with traumatic brain injury hear this constantly—even when we're far from fine. Just because our struggles aren't visible doesn't mean they aren't real.

02/21/2026

This! Exactly! 🧠 Check out Daniel Avesar, PhD’s podcast, Experiencing My Brain, for more great insights and personal experiences of TBI survivors.

From Experiencing My Brain: Episode 38. "But You're So Smart, Why Would You Have a Problem With That?" Part 2 with Dr. Maria Romanas, Jan 24, 2026

Introduction:

“The baby was born in May. I took my comprehensive early July, the written, and then the oral was August, okay? So that was just such a disorienting experience, okay?”

“This is the first time I had ever faced a situation like this, okay? Where they're asking me questions, and I couldn't hold on to the question. So I would start to answer it, you know, they would say like, you know, this is the problem, and then this and this and this and this, okay?”

“So I would start off, and I forgot everything else...
Right.
Okay.
Because you hadn't studied, or that was...
No, it was I hadn't studied.”

From Experiencing My Brain: Episode 38. "But You're So Smart, Why Would You Have a Problem With That?" Part 2 with Dr. Maria Romanas, Jan 24, 2026
https://podcasts.apple.com/us/podcast/experiencing-my-brain/id1596998070?i=1000746517685
This material may be protected by copyright.

Podcast Episode · Experiencing My Brain · January 25 · 1h 15m

02/01/2026

I can’t believe this was 4 years ago! HBOT treatments helped to improve (not resolve) some of my traumatic brain injury symptoms. I had a total of 40 HBOT treatments, waited one year (due to finances and life circumstances), then had an additional 40 treatments. I am So glad I had the additional treatments! I hope sometime soon HBOT treatments will be covered by health insurances to make treatments affordable. Those who have suffered a traumatic brain injury (think concussions), no matter how severe, deserve to have HBOT treatments included in their treatment plan.

I want to thank Swanson Hyperbarics Clinic in Fargo for their serves! ❤️🧠

A special thank you goes out to Melissa at Swanson for encouraging me to have 40 additional treatments! God bless you!

02/01/2026

6 years as a NP

02/01/2026

I became a family nurse practitioner 6 years ago on January 30th! I can’t believe it! I may not be doing what I thought I would be doing today as a nurse practitioner, but I’m still doing what I love. ❤️🩺🧠

12/20/2025

Interestingly enough, neurological fatigue can lead to physical fatigue! I think about when I’ve tried to push through a bunch of chores at home and then shift right away to exercising. I end up yawning throughout my workout. I can’t lift as heavy of weights. I have actually been close to falling asleep when lying on the floor to complete an exercise in a matter of seconds (on more than one occasion)!

Neurofatigue is a serious consequence of sustaining a traumatic brain injury. Brain breaks are necessary!

12/15/2025

TBI Life: Holiday Strategies

Navigating the season without overwhelming your brain

My brain most Definitely hates me during the holidays, so I wanted to share some good tips!

Why holidays are hard

Sensory Overload

Festive lighting, loud music, and constant stimulation can exhaust your brain faster than you realize.

Routine Disruption

Changes to your regular schedule make it harder for your brain to predict and regulate energy.

Social Pressure

Expectations to attend everything and appear "normal" add invisible emotional weight.

Strategy #1: Protect Your Energy During the Holiday Season

As the winter holiday season approaches, choose one event or activity that matters most to you. Let the rest be optional. Your energy is limited—spend it wisely across all celebrations and traditions.

Ask Yourself

What gathering or tradition, regardless of its origin, would genuinely bring you joy? That's your priority.

Give Yourself Permission

It's okay to skip events that drain you. Your presence isn't required everywhere, especially during a busy holiday season.

Preserve Your Reserves

Energy you save today is energy you'll have tomorrow. Pace yourself intentionally through all festive occasions.

Strategy #2: Build in Recovery Time

Schedule downtime before you need it. A quiet room, a short walk, dim lights…Recovery isn't optional. It's a strategy.

01–Plan Ahead

Block out rest periods on your calendar like appointments. Treat them as non-negotiable.

02–Create Safe Spaces

Identify quiet rooms or outdoor spots where you can retreat when you need to reset.

03–Use Timers

Set gentle reminders to take breaks before fatigue sets in. Prevention beats recovery.

Strategy #3: Manage Sensory Load

Lower the lighting. Sit on the edge of the group. Keep earplugs or noise-cancelling headphones nearby. You don't have to absorb everything.

Control Lighting

Request dimmer switches or bring your own lamp. Soft, warm light is easier on your brain than harsh overhead fluorescents.

Reduce Noise

Noise-cancelling headphones or discreet earplugs can filter overwhelming sound without isolating you completely.

Position Strategically

Sit at the edge of groups or near exits. Give yourself physical and mental space to breathe.

Strategy #4: Communicate Boundaries

You don't owe anyone a long explanation. Try: "I'm taking a quick break so I can stay regulated."

“I need to step outside for a few minutes to recharge."

"I'm managing my energy carefully today, so I'll need to leave early."

"I'm taking a quiet moment—I’ll be back when I'm ready."

Short, clear statements work best. You're not being rude—you’re being responsible for your wellbeing.

Strategy #5: No Apologies Necessary

Taking care of your brain isn't being difficult. It's being strategic, self-aware, and resilient.

You're Not Broken

Your brain has different needs. Honoring them shows strength, not weakness.

You're Being Strategic

Every accommodation you make is a tool for sustainable participation and long-term health.

You're Modeling Self-Care

By protecting your needs, you give others permission to do the same.

The holidays aren't a test of endurance

Show up in ways that feel sustainable, meaningful, and safe for your brain. You're not alone—this season, we're pacing ourselves together.

Share this post with someone who needs these reminders. Tag a caregiver, friend, or fellow TBI survivor who's navigating the winter holidays and celebrations too!

11/01/2025

🧠 Those of us with brain injuries are always looking for ways to improve! Center for Rural Health has many great and informative YouTube presentations available that focus on traumatic brain injuries. Go check out their YouTube channel then comment, like, and share (my page, too)! 🧠

North Dakota Brain Injury Network (NDBIN) Webinar Wednesday - July 23, 2025.

Mike Studer PT, DPT, MHS, NCS, CEEAA, CWT, CSST, CSRP, CBFP, FAPTA, is the author of the bestseller, The Brain That Chooses Itself. In this webinar he will cover the physiology and practical applications to maximize short-term alertness, long-term attention, and consolidation of learning (neuroplasticity) both in recovery, and life – with consideration for brain injury.

North Dakota Brain Injury Network (NDBIN) Webinar Wednesday - July 23, 2025.Mike Studer PT, DPT, MHS, NCS, CEEAA, CWT, CSST, CSRP, CBFP, FAPTA, is the author...