How Often Can One Relearn How to Walk?
Personal Perspective: The more a person with brain injury regresses, the harder.
Posted March 23, 2023 | Reviewed by Gary Drevitch
Relearning to walk is something you just do after brain injury. Re-relearning to walk after eye surgery shocks with its unexpected setback, but you rally quickly with the help of an orientation mobility trainer. Re-re-relearning to walk a third time because of the pandemic and a blast injury makes you sit down and cry.
I come from a family of walkers. I learnt to walk everywhere, even as a toddler. Then brain injury turned my walking into a stranger, as I described in my memoir Concussion Is Brain Injury: Treating the Neurons and Me:
“This now was about my mind instructing my legs to move, one after the other, in a slow walk, reminding me where I was going and in which direction to walk and to pull myself back from the curb where I’d listed to and walk in a straight line down the inside of the sidewalk. I began to list to the curb again, and my right leg shot pain into my right hip. And then my right leg was all pain, deep within, right to the bone. I gritted my jaw and told my leg to keep moving. I called out a rhythm: one, two, one, two. My leg screamed to stop. But I couldn’t. I had to get to the subway northbound. The thought of being on that train, wondering if I would get a seat, wondering if I would be able to endure the journey joined with the pain in my right leg and almost halted me….
"The train rattled up the line toward my stop. I steeled myself. The dizziness, so unlike that of low blood pressure I was familiar with much of my life, scared me. I didn’t have this kind of pain, this kind of fatigue even with the fibromyalgia. I lurched up and grabbed the pole nearest me. I walked toward the door while the train was screaming up the tunnel at a steady speed so I didn't have to fight to stay balanced against deceleration. I reached the doors. I commanded my left hand to hold the pole tightly. The train braked, pulling me down toward the floor. I tensed all my muscles. My dizzy head swam as the doors slid apart. Keeping an eye on the wall, I aimed my feet out and hoped not to trip on the small gap between train and platform.
"I leaned against the wall, and the fluids in my brain stopped their whirlpool.” (Chapter 2, What About Books)
I received no help in relearning to walk or using the subway, in regaining automaticity and balance. But with brain biofeedback and, over a decade later, enhancing my low gamma brainwaves, I regained my lost automaticity, I no longer listed to the curb nor worried about falling, although my balance hadn't returned to its former self.
Then I had eye surgery to stabilize my returning vision:
“Somehow the injury and my treatments were restoring sight to my blind eye. I’d had eye surgery to stabilize those changes and make the eyes work together again. The surgeon in his understated way had tried to warn me about the vision changes coming….
"My injured brain struggled to integrate [the] photonic surge of new information. I walked like a drunk, one foot stomping down hard to catch my balance, my opposite hand gripping the cane so as not to lurch right over. Dizziness spun my head; nausea rose up in answer. My auditory system didn’t like my vision reclaiming its space in my visual cortex, and the two began to duke it out. Just like in 2000 and 2001, evidence-based medicine had no answer for me. At least this time, it didn’t pretend to. Earbuds and a cane became my friends to dial down the world’s volume that the surgery had suddenly increased and to give me stability in this heaving visual world….like in 2001, I was back at the beginning, the recovery excruciatingly long, consuming, and arduous….
"[My new] orientation mobility trainer [began] training me the first week of June. I had no idea what to expect. Why did I need to learn how to orient myself on a sidewalk, cross a street, or walk toward people? This seemed bizarre to me, even though I was still in the midst of relearning many things that the brain injury had slayed. I soon learnt why.
"He guided me so that my brain could fire signals down neurons to move my feet. He kept me safe from cars and people while my head refused to turn and my brain could see so clearly yet not understand much.” (Chapter 27, Labyrinthine Recovery)
Over the years, block by block, neighborhood by neighborhood, building by building, I clawed back my ability to navigate the world, using my cane less and less. My progress was excruciatingly slow because I lacked social support to practice my walking lessons. But my trainer motivated, encouraged, and challenged me until I reached a good deal of my lost independence and stamina by 2020.
The pandemic shrank my world, robbing me of my hard-won stamina. Then a blast injury regressed my walking. My balance fled. Again, the cane became necessary in familiar areas. I had to relearn? A third time? Disbelief wrought despair.
How often can one return to baseline and relearn what one learnt as a toddler, relearnt after brain injury, and then after eye surgery? My pastor told me that when doubts assail, that’s when others hold you up. What happens when others aren’t around to encourage you? To accompany you as you once again practice what your orientation mobility trainer re-teaches you? How do you resist feeling the futility of it all — you relearn, you triumph, and you’re back to where you started?! Where do you find new reserves to re-re-relearn when previous years had drained them all? I don’t know. But re-re-relearning isn’t rare. It’s why health care for brain injury used to be indefinite and should be again.
Copyright ©2023 Shireen Anne Jeejeebhoy