Acquired Brain Injury Network Of Pennsylvania, Inc.

MADELAINE - posted 2008.07.06

Triathlons After Brain Injury

Brain Injury and triathlon are not two terms that one would normally expect to find in the same sentence, much less applied to the same person. In fact, if you were talking about me, you probably would not have paired my name and the word triathlon BEFORE my TBI much less afterward, when walking a straight line was a challenge. But then, one thing I have learned, life surprises us.

For those who might not know, the sport of triathlon requires an individual to consecutively perform a swim, a bike ride and a run. As such it is often called an endurance sport, though distances and difficulties of each of these tasks varies considerably. Some races consist of pool swims and short, flat bike and run courses, usually under 15 and 4 miles respectively. Other events are serious challenges, the most famous being Ironman Hawaii, a 2.5 mile swim, 112 mile bike ride and a 26 mile run. The sport of triathlon has grown considerably in recent years and events of all durations can be found during warm weather throughout the country.

My foray into triathlon came about 18 months after my accident. While I had run for years I was no athlete; my jogs, at best, might be described as a 'fast perambulation'.  Furthermore, at the time when I signed up for my first tri  I hadn't ridden a bike in 10 years and have never even had a swim lesson (though I had some rudimentary exposure to open water).  Ignorance was indeed bliss.

One might then reasonably ask, what ever compelled me to commit my TBI surviving self to such a task? Well, it was simple and serendipitous enough in its start.

My accident left me, in addition to my TBI, with damage to my left ankle, restricted motion in my neck, a loss of balance, and a tendency to get lost a few blocks from my house. However I still had a strong need to be active.  As soon as I was able I had tried to return to daily runs, but the damage to my ankle made it too painful. Wanting to do something, I dragged my old gearless ToysRUs bike up from the basement and took up what I called 'riding'.  If my running style is a mere imitation of that particular sport then  my riding skills were even more removed from being a TourDeFrance contender. I pedaled genteelly, looking more as if I were off to tea in the Cotswold's than one training for a race. For me however, the fine art of balancing on the bike was a significant victory so I didn't give much heed to appearance or speed.

After experiencing  a couple of months of this running & riding routine I stumbled across an ad for a triathlon. I was deeply in need of a goal at the time, feeling that my recovery had plateaued but that I was still far from being myself. Reasoning that I was doing 2 of the 3 sports already I figured, 'how hard can swimming be?' (I admit I ignored the correct answer to that).  My only concern was my limited ability to turn my head; so I sought permission from the race director to use a mask & snorkel (instead of freestyle). After permission was granted and I took a trial lap or two around the local pool I signed up.

Triathlon proved to be a major turning point in my recovery; physically, cognitively and emotionally. It provided me with a goal but it also gave (and continues to give) a lot more. A TBI survivor taking up triathlon is  not so far fetched as it might seem; the tri community is very embracing of challenged athletes. Indeed triathlon history is filled with stories of individuals who have a variety of disabilities, from loss of limbs, chronic illness (Jon Blais completed an Ironman with ALS), cancer and yes, paraplegics and even quadriplegics have participated (with assistance).  Because triathlon is, for the majority of us, more about finishing than about where you place, it is also more about your inner spirit than any innate abilities. Given that, a sprint triathlon is a very doable goal for many people - but please, be advised, no one should do a triathlon without medical approval.  

Triathlon however can do far more than simply provide a handy goal (and that is not to be dismissed lightly). While it has long been known that physical exercise is good for your health this is especially true for the brain injury survivor. Research studies have shown that consistent levels of aerobic activity support neuron/synapse development for the brain injured. In my own experience triathlon also helped with sensory management. By incorporating three very different sports with different muscles and skill sets, training became a form of sensory integration, strengthening my brains ability to process input data. My triathlon training also benefited my concentration abilities. Working on a given event I had to break actions down to their smallest level, developing techniques to address the various obstacles I encountered. Whether because of the physical nature of these activities or because I was less concerned about 'doing well' than simply 'doing' I found it easier to train my attention skills with this process.

In addition to the cognitive and physical benefits I also gained a lot of emotional strengths. Despite my enthusiasm for signing up I was very intimidated by the prospect of the actual race; fear of the water (I will tell you that I did give the water rescue dogs some excitement on race day) , worry about falling off my bike (I had a lot of practice with this - ALWAYS wear a helmet!), embarrassment to ask for help (a biggie for me) and especially an overwhelming desire (many times) to say 'I can't do this' and go eat  an ice cream sundae instead.

Not surprisingly these realizations about how my mind could sabotage itself carried over into all aspects of my life. I came to recognize how easily we can be held back by fears (real and imagined), how worrisome future predictions just waste energy and sap our inner strength, how pride can both help and hinder and mostly how the way to get from point A to point B, no matter where they are, is one stroke, one pedal, one step at a time. I also found a lot to inspire me; taped to the handlebars of my bike are a series of photos, pictures of the women in my life who's strength I admire; my mom and daughter, friends who have overcome (and not) cancer, and people who have just been there for me. Self, I came to realize, was not so much the person who crossed the finish line, but rather the person who first thought, 'let me try'.  

Triathlon has other benefits as well, particularly in changing the image of TBI, both of ourselves and from others. To participate in triathlon allows the TBI survivor to identify with something that is outside of their injury; it gives a person a new 'label', one that focuses on achievement and not loss. The training process and the race event are wonderful times to recover socialization skills, giving TBI survivors a chance to share the thrill of victory with others. The feeling, as one heads towards the finish line accompanied by a cheering crowd, is amazing. My fellow athletes were equally supportive, offering encouragement throughout the race. Even those athletes who require partners to complete the race come to feel the accomplishment and joy of that moment; there is no one there who does not recognize the effort it takes to simply participate.

TBI survivors, no matter how far they have come, tend to struggle a great deal with their identity and a huge sense of loss. Re-integrating into the world is important. That first triathlon was a huge mountain for me, but I finished (with probably the longest time in the history of sprint triathlon).  Afterwards was the first time since my accident that I had felt whole again. In one of my favorite races they call out your name as you finish. Every time they do that, no matter how often I hear it, I break into a grin. I may be the slowest person there but even more I know that when I cross that finish line, no matter how I got there, I am a winner; I can call myself a triathlete. 

As a side note I want to say that I do not race as a challenged athlete as I feel that my physical capacity puts me into the standard 'age group' category. I also act as a mentor to a number of women 'triathlon newbies'. While these women are not handicapped many experience the same self-doubts that TBI survivors do. To encourage them I let them know that I am a very ordinary person with no special skills or talents, indeed my training efforts are often comedic. None of this is to downplay brain injury however. I fully recognize and acknowledge how very difficult it is for TBI survivors  to perform many everyday activities, much less triathlon. Nor does everyone with a TBI need to do a triathlon to prove anything to anyone; triathlon is simply one tool, one that worked well for me. The real goal for any activity is always about self empowerment and that is the message I try to leave with any one who attempts triathlon; ' Qui audet adipiscitur', she who dares, wins.

Alas, as another side note, this season, unfortunately, residual problems from my accident have, for the first time, interfered with my ability to train and race. I will hopefully soon have access to the resources to enable me to get back on track. I continue to stay active and to mentor and will let you know if I do race, I try to do a fund raiser in August.  

If there is anyone who has further interest in triathlon and the challenged athlete let me know and I will see what can be done to assist you.  

I urge everyone; caregivers, TBI survivors, family, providers to watch the following videos:

http://youtube.com/watch?v=uadKAxUKZII&feature=related (part 1)
http://youtube.com/watch?v=w9DK2FFE9HE (part 2)

This is an incredible story, not meant to make anyone feel that they have to do what this father has done, but just a wonderful story; http://youtube.com/watch?v=oyiApzjIuzw&feature=related. Additional stories of determination and inspiration: http://youtube.com/watch?v=oLdi0hMkinM&feature=related and http://youtube.com/watch?v=yn816YARuyI&feature=related.

Hi! My name is Tiffany. I  am twenty-two years old. I was injured in August 2005.

I was going to the Community College of Philadelphia and I attended a job fair there. I noticed a Girl Scout table and I was interested as I used to be one. I went though the whole application process and I was very overjoyed once I found out that I was hired for the job.

The job was located in Gilbertsville, Pennsylvania. I had to stay up there while I was working. I was thrilled about that but the only thing that I didn't like was I had to miss a lot of church activities.

The day my car accident happened, we were driving down Route 76 going towards the camp. The driver fell asleep and we impacted a utility pole.

I sustained a traumatic brain injury as a result of the car accident.

There were things in the back of the car which I didn't know about when entering the vehicle.  When the impact happened,  the objects all came forward and hit my head. I was knocked instantly into a coma that lasted about seven to nine days.

I had eaten previous to the car accident. When we hit the utility pole,  I regurgitated everything that I had eaten and lay in it so my oxygen was cut off - I was not breathing at all. When the rescue squad came to the car,  they got the other two people out and left me still lying there for an unknowm amount of time. They had to come back for me and then they took me to Lehigh Valley Hospital.

I stayed at Lehigh Valley Hospital for awhile - I  am unsure of the exact amount of time.  Next, I was being transported to another hospital. The ambulance ran out of oxygen for me so they had to stop at another hospital so they could get some more oxygen. After that I was transported to MossRehab Hospital on Tabor Road.

I stayed at MossRehab for a little over a month and have been out of there for two years now.

Ever since I was a patient at Moss I  have been involved a lot with them. They are just so good with brain injured patients. Their care is fantastic.

I am in the process of making myself better. Each year gets better and better.

It has been two years now and I am so glad to still be here.  

I have learned that a traumatic brain injury dosen't mean that your life has to stop, but that you learn things differently than other people.

With us it just may take us a little longer,  but we will get it eventually.

I hope others read my story and realize that they can get better such as I did. 

John survived a traumatic brain injury on July 10, 1993, when he was 22 years old.

At that time, John owned a full-time  lawn and landscaping business and was also a college student at Shippensburg University. He was looking forward to a career in environmental science and felt life was great. He felt he had everything going for him.

Unfortunately, he got into a car with college friends, and the driver was drunk. The car crashed into a pole, and the pole penetrated three feet into John's side of the car. While the driver had only a few stiches and bumps, John had a 1% chance of survival.

John was taken to Hershey Medical Center and then Good Shepherd Rehabilitation Hospital. He spent three months in a coma, then learned to talk, walk, eat and dress himself again.

As part of his rehabilitation, John took classes at a community college, and then returned to Shippensburg to finish his degree. He has worked ever since at jobs with increasing responsibility.

As John says:

"Now that my life has changed, my goals have also changed. I want to share my personal story with audiences who believe they are invincible.

"During my presentation, I show a videotape which depicts my struggles through the numerous stages of rehabilitation. My goal is to use my experience to illuminate the danger of drinking and driving, and other dangerous actions. I teach audiences to take two steps back and think before taking an action that could ruin lives.

"My presentations are approximately 40 minutes in length. My goal is to make a lasting impression on the audience and hopefully prevent similar tragedies from occurring."

John's website is located at www.johndibiagio.com.

PAT - Telford, PA - posted 2006.09.01

These three poems are printed with Pat's permission. Please email Pat at Email ABIN-PA for reprint permission if you would like to use them.

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THE LONG ROUGH ROAD - 10/07/1990

It's a long rough road back to recovery
Following head trauma.
Things once seemed as second nature
Now must be analyzed, studied and practiced.

Loss of balance, dexterity, memory and
Practical thinking are chores to overcome.
Long after the broken bones have healed
And the scars have begun to fade,
The reality of brain damage is apparent.

Physical therapy helps to retrain the body to
Move in a normal fashion despite the mental disability.
I wait, wonder, and try to do as I did before.
I see my life as it was and feel how it is now.

I grieve over what's been lost and what could've been,
But rejoice over what I've gained and
Where it may lead me.

Where will it lead me, this road I've landed on?
Life's future is interminable,
But I am prepared to travel
The long rough road ahead.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

SURVIVING - 03/18/1998

It's 9 years past and
I'm doing quite well.
I'm thankful to be a wife, a mom,
And alive to tell.

A mother of two, at age 34,
Facing infancy again, right down to the core;
Wearing diapers, learning to walk, talk, and swallow.
Being taught, just how to put on shoes, and to follow.

Life hasn't been easy
With this brain injury of mine.
It's caused those who love me
To walk fine line.

After coma, my husband had a tough time coping.
Instead of support, he faced denials ongoing.
Of 4 main therapies recommended for me,
Only 1 could be chosen that insurance would see.

Months in the hospital,
Months of Rehab. to follow,
Years of striving,
To make a better tomorrow.

Who can know what the future
Holds to instill.
No one plans for a tragedy,
Or how to pay the bill.

It's 9 years post and
I'm doing quite well.
I'm ever so thankful to be a wife, a mom
And alive to tell.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

LOOKING BEYOND DIVERSITY INTO TOLERANCE - 08/11/2005, revised 09/13/2005

By listening, having patience, empathy, and respect,
We can bring the truth about what we believe to others.

Accept people as they are right where they are at,
Rather than forcing them to meet our expectations of them.

Tolerance is not just putting up with the people you don't like,
Pretending that the differences of your most important issues,
Really make no difference at all.

It is standing up for what we believe in,
Without force or with any misrepresentation.

Air issues before they turn into resentments,
Promoting calmness to short-circuit misunderstanding.
The simple courtesy of reason is often the most troublesome to convey.

Watch our reactions in times of frustration,
Take the initiative to make a commitment to set an example of honesty.

It's not our job to make everything go right in the world,
But to "speak the truth in love",
And hope to persuade.
Honor and integrity for all.

I graduated from Northeast Catholic High for Boys and then had two years of college at Settlement Music School. After spending some time in law enforcement,  I realized my calling was in music. I auditioned for Sky Dancer, a band in South Dakota. We opened for a lot of big groups, two of them being Blue Oyster Cult and Santana. 

After 12 years of playing music on the road, our family moved back to Philadelphia, where my wife had our second child. He was born with a heart defect. He had his surgery at CHOP but we lost Danny at the age of one. Our third child was Katie who came along not far after Danny. 

While playing music around the city and down in Wildwood, NJ, I got a job in an oil refinery in the city. I gave up music for the benefit of my family, but with all that, ended up getting shot in the head in 1991. I ended up in a coma for 15 days, then at MossRehab for 11 months.

After a year at home trying to get better and maybe be able to walk again, I began to figure out what I wanted to do with my life. I started an Alumni Association for patients and former patients at MossRehab. I began receiving services from Jewish Employments and Vocational Services (JEVS). 

Now, I volunteer my days at MossRehab of Elkins Park, mostly for the Therapeutic Recreation Department. I have been volunteering with MossRehab for 10 years so far, with 9 years in Therapeutic Recreation. I give back what they did for me as a patient. I love the people I work for and they care about me too, and everyone that works there all the way from the supervisor in the volunteer's office to the supervisor in Therapeutic Recreation. 

In 1999, I became a member of the Brain Injury Association of Pennsylvania and did some volunteer work for them. In 2000, I was appointed by the Governor to serve on the Community Living Advisory Council (CLAC) in Harrisburg. I am a good advocate for brain injury, with MossRehab having one of the best brain injury rehab floors in the tri-county area. 

In 2003, I was elected to the board of the Brain Injury Association of Pennsylvania and am still serving there. 

Since 1998, I have also been volunteering with the Philadelphia Narcotics Unit's program "Head Up", almost 10 years. We go into the school system, teaching kids and parents about drug use, and teaching the parents what to look for in a child on drugs so they can get their child help.

I get around in a wheelchair because my walking has not come back to me yet, but you can not stop living due to that.

You must never give up. Your mind and body must fight to recover as much as possible.