24 - Exercise and Yoga

Downward dog...good boy Bob 👏

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When I was in university I worked for years as a student in a research lab. I did a number of the cool sciencey things you see on TV shows. I mixed chemicals in test tubes, pipetted liquids from one small container to another, looked at teeny tiny things under a microscope and, yep, I wore safety goggles and that iconic lab coat.

One of the summers I worked in this research lab, another lab assistant and I became mysteriously ill at the same time. We both had extreme fatigue, difficulty concentrating plus head and body aches - much of the same symptoms I have today with PCS. But no, neither of us had a concussion. We wondered whether we were affected by something in the lab, but this didn’t really make sense as even though we worked in the same department, we worked in different labs, on different projects. I went to my doctor and had a battery of blood tests and assessments. The other lab assistant did the same. The results of all our respective tests came back healthy and unremarkable.

In talking between us, the other lab assistant and I discovered one thing in our medical history that we shared in common: mononucleosis. Both of us had previously had mono that lasted several weeks and longer. There is a blood test for mono, but the test will always be positive after you’ve had mono once, even if you no longer have the symptoms or illness. The prevailing theory from our doctors was this - somehow that year both of us redeveloped mono at the same time.

For those of you who are unaware, mono is sometimes referred to as the “kissing disease” because the virus is passed from person to person through saliva. It’s common enough for people to get the mono virus once they first start smacking lips and doing the tongue tango. However many may never develop symptoms while others may only develop just an average every day fever. Another subset of people, like the other lab assistant and I, can become ill for lengthy periods of time, missing school, work and all the fun activities.

I jokingly, but extensively, blamed my boyfriend at the time for giving me mono. So much so that one day he gave me mono as a gift - it was a plush toy mono virus, purple and fuzzy, about the size of a pie pumpkin. He said that if he was going to be blamed for giving me something, he wanted to for certain have given it to me. In later years Bob found this plush mono and made it his chew toy. Pictures of Bob on social media with the giant toy virus and the caption “Bob got mono” stirred quite the concern amongst people who were unfamiliar with the giant microbe toys (you could even say that photo of Bob and the concern went viral 😜).

Bob got mono 😉

With my past history of working in a research lab and owning plush toy microbes (I also had plush toy mad cow disease), you may picture me as the trope of a science nerd. Certainly, growing up I was never super athletic. I was always picked last in gym class. With the exception of ball hockey, I’ve never really liked team sports. In high school I joined cross country running mostly because I liked a guy on the team. I placed last in every single race except for that one joyous day I celebrated a third last place finish. As far as gyms go, I have tried them out in the past, but I continue to loathe my experience at these classic fitness centres - the rows of machines may move my body, but not my spirit.

Now, I want to make something perfectly clear. I do not judge people who participate in team sports or who enjoy hitting the gym. These things are great for many people. I have just never been classically athletic in this way, nor into popular team sports. But despite this, I can absolutely say that I have still always been very active.

From my childhood to adulthood I have always loved going for a bike ride. My route or destination never had to be anywhere fancy - I just loved the freedom of exploring on a bike. Throughout my life I have also always loved being outdoors. When I was young, I would run around my backyard, climb over fences and circle my house narrating some sort of story -mystery or action adventure - like I was in a movie. I still do silly things like this as an adult, but now it looks more like hide and go seek with my dog at the park or playing out similar stories on stage for improv.

At 16 years old I did however find my sport. I’ve always seen it as the sport for people who don’t do sports. I’m talking about rock climbing. To me, it’s the perfect combination of physical, technical and mental skill - a balance between indoor training and outdoor fun. It’s solving both physical and mental puzzles that make me feel strong inside and out. I love it.

One of my loves: rock climbing

During my university years I often took off the month of August to travel to British Columbia. A group of climbers and I headed for a town well known for its world-class climbing: Squamish. I always had a great time, though I haven’t been back to that specific climbing spot in years.

The last summer I went to Squamish was the year that lab assistant and I redeveloped mono. Even though I wasn’t fully recovered, I went on the trip to Squamish anyways. I knew I wouldn’t be able to climb or hike that much, so I settled on relaxing in the Rockies and I considered other activities I could enjoy with my limited energy and body aches. I had remembered some climber friends talking about a good yoga studio in town, so I checked it out.

That summer in Squamish was the first time I’ve ever really been exposed to yoga. And it turns out I love yoga too. I don’t really remember what kind of yoga it was or what poses we did. But I do remember instantly connecting with the instructor. I remember the instructor using lots of imagery and metaphors to relate the poses to other aspects of life. I remember mantras and a more meditative approach. I know for some people this must sound very granola - very hippie dippy. To those people I say this WAS in BC, LOL. Joking aside, maybe those concepts seem flaky to you, but to me it was an introduction to using my creative mind to deal with my limitations; to see my mono symptoms differently.

The physical aspect of the yoga was one benefit, but the opening of my mind to the ideas of finding comfort in uncomfortable situations and accepting that sometimes the body works the way we want it to, and other times it doesn’t, was another.

When I returned from that trip to Squamish I tried to find another yoga class and instructor like that. I dropped in and out of classes here and there. I continued to rock climb and so yoga just sort of became an adjunct to that. It took years for me to find another instructor who helped me once again connect with the other benefits of yoga.

In the years leading up to my most recent brain injury I was the most active I’ve ever been. I followed a moderate rock climbing training plan in preparation for a climbing trip to South Africa. I was also getting outdoors on most weekends to go hiking, climbing, snowshoeing or even sometimes skating. I was swimming with a club led by an endearing archetype of the old-man-coach character who taught me it was possible to “transcend excellence.” I was walking and cycling for a lot of my commuting. Plus every day Bob was getting 1 to 2 hours of walking, dog park and even a little bit of owner-dog jogging (hey, I guess that high school cross country running paid off after all…for Bob at least).

Looking back, that was a lot of activity. Too much, even. I could likely have used more meditative, relaxing downtime. Maybe I was on a reckless path that was harshly halted by the brain injury. Needless to say since then, my life has been drastically different.

PCS recovery requires rest and slow gradual return to all activities. I had a hard time with this. Still do! There are so many activities to reintroduce and so many challenges. One year post-injury I still had times when just going for a slow walk around my neighbourhood triggered my symptoms. Both the stimulation of the outdoor environment and the effect of my heart pumping at a higher intensity than my brain could handle gave me headaches, dizziness, pressure in the head and blurred vision. I was afraid to ride my bike as head injuries are more common in cycling than in other activities. Swimming involved too much head movement plus the echos of the pool triggered issues with noise sensitivity.

In the beginning of this PCS, every time I would open the closet that has my climbing gear in it, Bob would get excited thinking we were going out to the forest for the day. But over time as my gear and I remained stagnant, Bob’s excitement dissipated. One and a half years after my injury I remember staring at that closet, crying, convinced I was never going to climb again. I came so close to getting rid of it all.

Luckily around that same time a friend of mine came over for dinner. We made a soup that needed 30 minutes on the stove to simmer. At that moment my friend turned to me and said “you want to do some yoga?” This friend was very aware of my brain situation. They were always quite good at accommodating me. They told me about this free 30-day online yoga program they had just started. Most of the yoga videos averaged 20 to 30 minutes and they were made to be done at home. People were encouraged to modify the poses as needed, to go at their own pace and to skip poses or sequences if they did not feel good. I tried the video with my friend that day. The yoga instructor was so entertaining - my friend and I laughed and I took the cues to only do what felt good. And in the end, it did feel good 😊

From that day, I was hooked. I tried to do the 30-day yoga program, but having done essentially no activity since my injury, this was far too much. Plus I discovered that some poses and movements were triggering my symptoms. I then discovered that this yoga instructor had many other types of free yoga videos online. I started with a series of short videos that explained and broke down each pose one at a time. These videos explored each pose slowly and highlighted alignment to prevent injury. This allowed me to re-learn the poses and build strength with a body and brain that felt like they had been in hibernation. I became active again all at home where I did not need to worry about other factors triggering pain and symptoms.

From there I worked my way up from 5 to 10-minute beginner yoga videos. I was surprised how hard these were for me. Was I not the person who just one week before my injury did a 10-hour hike in the mountains?? I was so deconditioned, more than I thought. Inevitably, I did at times strain some body parts and irritate an already irritable brain. I unfortunately discovered my limits by going over them. I had to take time off from my short yoga videos from time to time. But progress is never a smooth path upwards anyways.

This was the 10-hour hike. People were like "is Bob going to make it?" and I was like "if he doesn't, than no way I will either!" Bob was a champ and had more energy than me #ProudDogMom

The yoga instructor continued to be so engaging in the videos. Even though I wasn’t physically in the same room, I felt that same connection I did with the yoga instructor in Squamish. This online instructor offered their twist on some of the same granola imagery and mantras, for participants to take or leave. The instructor is funny and I often laugh out loud. Plus their dog joins in too, which is bonus points for Bob, whom I’ve now trained to downward dog on command on my yoga mat.

One full year after my friend had introduced me to this online yoga, I went from being able to do just five minutes of yoga to doing a whole one-hour at home yoga practice. Last year I had progressed enough to complete the 30-day yoga program. On day 30, I cried. A new 30-day yoga program is released every year in January. This January I signed up again to receive an email every day with that day’s yoga video. At the beginning of the month, I had a significant (and unrelated) setback. I was having issues with dizziness and moving my head. However, I continued to participate - I modified a lot and skipped a number of sequences. At times, I spent more time breathing and meditating than moving.

I may not have been able to commit to all the poses, but that didn’t matter. I committed to showing up on the mat with intention - I committed to myself. That is the true yoga. And I benefitted just the same.

Just a few days ago was the last day of this year’s 30-day yoga journey. For a second year in a row I have completed 30 days of yoga. And for the second year in a row, I cried.

I am super stoked at this progress. I have such gratitude for that online yoga team who have made an activity I love completely accessible to me. The yoga and supportive language offered through these videos helped reopen a door I thought was closed. This past summer I swam a few times. I rode my bike a few times too. Recently I started running one block at a time with Bob. And yes, I started climbing indoors again too 🙌.

Returning to physical activity is probably the best and most tangible example I have of the need for patience and persistence during the inconsistencies of PCS recovery. I have come a long way, but still have a long way to go. There are definitely still yoga poses, even simple ones, that I can’t do or can’t overdo without hurting my brain. Moderate amounts of somewhat intense activity, like dancing, lifting and carrying boxes or gardening can still make me dizzy and affect my concentration. And even though I started climbing again, I need to stick to easy stuff on a well taught rope so I don’t sustain a fall. It’s slow going and I can’t consistently do all the activities I’ve reintroduced. But both literally and figuratively, I have gotten back up on my feet again.

I share this story here not in an effort to promote any one type of activity for people recovering from PCS. This is not for me to recommend.

Indeed, with any activity in rehabilitation from any injury, we need to be careful of the risks. I discovered through trial and error what worked for me, but I wouldn’t recommend this process for everyone. Certain exercise movements, even in yoga, risk causing a fall and hitting the head again. There are specialized instructors and programs for physical activity and yoga post brain injury that would better support this. I just didn’t personally have access to these services.

Yoga may have been my personal gateway into reintroducing physical activity, but I share my yoga and activity journey here to promote the patience, perseverance and support it takes to become active again. The success I have had may be less related to any specific activity, but more related to how the activities were offered and what they meant to me.

The online yoga gave me easy access to this activity in a safe environment. I was able to mostly just listen to the cues from the instructor without having to look at the screen. Because I could do this at home, I could slow down, pause or stop the videos whenever I needed to. Heck, sometimes I just laid on my mat and was simply comforted by the sound of the instructor's voice.

I had support from other people too. The friend who introduced me to the online yoga also continues to be my yoga buddy today. I also find the online yoga instructor very empowering. They often remind those watching that with over 4 million subscribers to these videos, we are never truly practicing alone. I felt supported by this virtual sense of community.

Finally, yoga was something I loved and valued before my injury. I was therefore more invested in the time and effort it took; I was more willing to be patient.

If I’ve had success with yoga and my other activities, it’s likely because they move more than my body - they also move my heart and my mind.

Sometimes the body and brain works the way I want them to and other times, they don’t. I have come to accept that I may never be as active as I once was. There are activities I may never do. But just like when I had the mysterious redevelopment of mono, I can find some comfort in the discomfort of PCS. The door is open for me to discover what I can do and what I can enjoy.

After all, exercise shouldn’t be about doing as many activities as intensely as possible. It should be about enjoying physical activity. And physical activity should feel good.

Best in brain and body health for all,

- Krystal

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