University of Vermont AAHS

Harmony: A Head Injury - The Aftermath As Seen from the Inside

By
Jan Dawson
AAHS President
 

[reproduced from Fall 2002 Caution:Horses]

 

The diagnosis was a mild concussion and I was released from the emergency room after about 7 hours observation.  My instructions were to rest and not ride for 24 hours but after that I was good to go. 

I left to give two lectures 48 hours later and cannot say that I felt 100% but after all the doctors said I could return to normal activity.  It was interesting on the airplane that every time I closed my eyes I was sure the plane was flying upside down. 

When I got home and began riding my well-trained horses were just awful.  They had been properly lunged while I was gone and nothing else was unusual but they rode like somebody elseís horses.  The only possible conclusion was that I was impaired.  As time went on I would take a test ride and the horses got better. 

Another side effect was what seemed to be a hidden impairment of cognitive skills.  Even though to the observer I appeared perfectly normal my usual routine would seem overwhelming.  The difficulty in completing my normal tasks would make me frantic.  This state of affairs went on for several months without my making the connection to the cause. 

The short-term memory effect became comical.  On one trip to Dallas I called my husband, Bob, three times to tell him I had arrived safely.  Short-term memory was non-existent for quite a while to the point that it was silly. 

It wasnít until I met someone else who had had a head injury that was telling a group about theirs that I began recognizing the symptoms.  He had experienced the same things that are so hard to notice at the time because one feels as if one is fine but simply unable to cope.  Once the cause was identified it was easy to just allow a bit more time to do things. 

I also took the films from the hospital to a neurologist who was better able to explain what I was going to be looking at in the way of complete recovery time.  The Doctor in the emergency room said probably 6 months.  The neurologist said it would be more like a year. 

As I continued to check out my horses there finally came a day when they began to go like they had before the accident.  At this point I felt that I must have been getting my coordination back.  I had not been riding them regularly; only checking periodically to see what was working so there is no way to say they had been schooled. 

Finally, they seemed to be their usual light, responsive selves.  At that point I felt that I had the physical part back together.  That happened at about seven months past the accident. 

It took at least that long for the cognitive skills to seem normal although there are still lingering side effects that are increasingly under control. 

So what is the point?  Had my friend Rusty Lowe of the American Medical Equestrian Association not sent me a document from a Head Injury Conference in Europe I probably would never have questioned what was told to me nor have been willing to believe that this bump on the head was more than a 24-hour inconvenience. 

Now it seems, many physicians who deal frequently with head injuries are saying that one should not return to whatever sport it is that you do till all of the symptoms are gone.  The difficulty is identifying the symptoms.  In my case I would not have recognized the symptoms had I not run into someone else who had had a head injury.  As far as the physical symptoms, had my horses been simple trail horses I am not sure that I would have recognized the impairment either. 

Some part, of course, is the fact that if the horse is not working correctly, one looks to the rider.  Horses usually do not fall apart in the space of a few days.  I was completely aware that I could not comprehend what was needed and was mechanically thinking my way through everything I needed to do with each horse.  One cannot do that fast enough to do it smoothly.  Everything seemed awkward and unbalanced. 

It is difficult to get someone with a head injury to do what he or she needs to do.  Proving that you are tough seems to be really important.  We Americans never want to be woosies.  Even if the person seems willing to cooperate at first it is still difficult to convince them of the importance of the long-term affects.  It is foolish to ride with impaired physical skill since one must assume impaired balance.  It is also hard on the horses.  It is foolish to push the cognitive when the mind and body refuse to comply willingly. 

Convincing someone, however, can be really, really hard.  From the inside one does not feel the problem.  The horses can tell you if you let them.  However, it is so easy to assume that the horse is making a mistake and correct what may have been a result of the riderís slowed responses. 

For me this has been an interesting experience but I am not sure that it has left me with much in the way of advice for others except this one thing:

After a head injury, the victim may truly not be aware of the extent of the physical or cognitive impairment.  Yet it is usually the victim who is making the judgment as to when to return to work or sport.  Now isnít that a scary thought!


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