Traumatic Brain Injury & Whiplash … Not A Relevant History?
A little while back I posted a piece about the Epstein Barr Virus potentially being a beginning point regarding chronic health issues and progressive dysfunction that I have battled for almost three decades. A post throughout which I raised the more likely possibility that whiplash and traumatic brain injury (TBI) were the events that sparked progressive dysfunction, either in conjunction with illness or as illness and injuries entirely separate from one another.
In this piece I am going to highlight the importance of any person, with even minor whiplash or head trauma, being acknowledge in a medical context through detailing my own experiences of these forms of injuries and airing my basic thoughts on what is a very important subject that is being overlooked.
My primary experience with these forms of injuries came about through three significant car accidents from March 1990 to November 1996. The first was a rear end collision 1990, the second was a major head on collision during 1995 and the third was a car accident during 1996.
It is now 31 years since I had the first of those car accidents. —31 years in which I have been forced to endure together my medical history over the years, along with reading articles and personal accounts, these injuries have become far more significant than I had first given thought to.
Although, not significant enough that anyone with a medical degree would acknowledge or reasonably discuss these injuries, because the events and the traumas themselves have been viewed as all in the past since as early as 1997 … And deemed not relevant.
Not relevant? … I beg to differ!
1990 – Whiplash 1
Going back to the very beginning, the day of the first car accident, I was stationary at a set of traffic lights when my car was hit from behind without the other driver braking. The force of this impact of course was significant as the other driver was tavelling at 60km/h (approx. 37mph).
Not only was my car stationary as another car hit mine without braking at that speed, but I had also caught a glimpse of movement in my rear vision mirror once I had stopped at the traffic light and saw what was about to occur as the other car approached … Naturally bracing myself for the impact.
As if that in itself was not bad enough, I was also driving a pre-1970 Ford Cortina with no head rest (low back seats) that caused my neck to hyperextend in the extreme.
Putting that in simple terms!
+ other car 60km/h
+ me braced for impact
+ no head rest / low back seats
= Painful Whiplash Injury
Not only did I helplessly watch the impact in my rear vision mirror, but I also heard a loud crack from my neck as I was thrown back and forth in my seat.
Getting out of the car I felt quite stiff and sore through my neck and shoulders. Then as the day progressed I developed a headache along with other clearly defined post-concussion symptoms over a period of time. —(Symptoms that I only recognise now in hindsight through a great deal of research while seeking answers to valid questions that no one with a medical degree has so far been prepared to discuss with me or my extremely concerned family members.)
That headache that set in, for the record, heading toward 29 years, has never fully gone away while at the same time increasingly flaring with migraine. The pain and stiffness through my neck, shoulders and back persisting with occasional intense flares until those injuries were compounded by the next car accident during 1995.
1995 – Whiplash 2 + TBI
As far as this accident goes there is not much I can contribute from a first hand account regarding the impact itself as I still have no recollection of the impact at all. In fact I have no recollection of some time prior to the accident, with everything else during that day as snippets of memories prior to and brief moments of lucidity during the hours after I regained consciousness. (The amnesia in itself is telling enough of TBI.)
What I do know of the trauma involved is that it was enough to cause an orbital blowout fracture (think eye socket / cheek bone) on the right side of my face and cause discomfort also to the left side of my face. While I did have a head rest in this car accident one would have to assume there was a considerable strain placed on my neck once again as the retractable seat belt allowed for a reasonable amount of movement.
I think the images below of the front of my car and the accident scene paint a good picture of the impact.
Speed was a major factor in this accident, I know I was travelling at 60km/h along that road, the other car however, was seen by witnesses driving erratically and speeding. The other car was also airborne at the time of impact with my car.
The truth is, no one really knows by what and where I was hit in the head and face while being smashed around in my car at the moment of impact. Although, the impact itself must have been terrifying given that my brain simply will not allow me to recall what occurred in those moments, as much as I would prefer to remember so I can actually understand what took place.
What is known however, is that I was unconscious for a 90 minute period … That right there, alone! … That equates to a Moderate Traumatic Brain Injury!
And Yet … It apparently has never been worthy of investigation, not at the time of the accident other than basic nursing observations and simple x-rays of the facial fracture … Nor has it been deemed relevant anytime since the accident, even with episodes of blackouts / possible absence seizures, chronic headache / migraine and many other progressive symptoms throughout my body since the accident involving both cognitive and physical function.
1996 – Possible Whiplash 3
This particular accident would be somewhat different in regards to motion and force I would assume, given I was hanging in my passenger seat at the time of impact, the car up on its side, driver’s door to the ground.
As this accident occurred I was jolted awake in the passenger seat when Daniel, (then boyfriend, now husband), lost control of the car. At the time we left the dirt road, the car rolling onto the driver’s side door, we would have been going at around 70km/h.
So what speed that would have made the car ploughing through the dirt toward the trees that suddenly brought us to a standstill, while being shaken around? … I have no idea!
Still, the force of the accident was significant, the sudden standstill obvious. Only this time there had to have been force to my neck and back from various other angels as I hung in the seat. (Taking into account all other pre-existing injuries.)
I would also have to assume that hanging in my seat either made this a worse situation or maybe even a better situation, I don’t know … All I know is that it was one damn scary ride in the dark, in slow motion that felt like forever. The whole time not knowing when the car was going to stop or if we were going to keep rolling and flip the car completely.
The only other thing that would be almost a certainty, to my mind, is that this accident did contribute to my progressively worsening condition. Quite easily, due to the pre-existing injuries and further damage that would have been sustained as a result of my already weakened condition.
Changing Opinions on Whiplash & Brain Trauma
Back when I had my series of car accidents during the 1990s, whiplash, head trauma and brain injury were not taken as seriously as they are today. In fact the severity of the loss of consciousness I experienced was not even considered serious enough to really mention to myself or my family members in any context other than being called a head injury. Given no more importance other than an insignificant bump on the head that knocked me out for a brief period.
Thankfully a lot more information is now available regarding both TBI and whiplash, with the severity of even minor head traumas being given far greater importance than they once were.
That said, any understanding of the functioning of the brain is still extremely limited in contrast to the brain’s functioning itself … And, methods of assessing damage to the brain through injury, illness or a combination of the two is still vastly lacking as a result.
With so much more information available many scenarios have caught my attention regarding my own situation. One scenario in particular that I do believe rings true in my experience, is that significant whiplash can actually include TBI.
This form of TBI can easily occur as a result of the laws of motion and the way in which the brain is smashed against the skull during the movement of the whiplash itself. A scenario that also has the potential to cause a sheering to certain connections within the brain through the sudden jerking movement of whiplash. Each pre-existing trauma to the brain intensifying the next causing greater injury.
Some of these injuries having no lasting effects after healing and recovery, others have long term effects in various combinations and severity, affecting each injured person differently.
It is worth noting that all of these forms of injuries are still difficult to diagnose, even through imaging available today, much less able to be diagnose back in the 1990s. Some forms of these injuries, still cannot even be diagnosed until an autopsy can be performed after death. That is once the sufferer of those injuries has lived out their life with the dysfunction they have no choice but to accept and endure, knowing something is wrong, knowing what made it wrong, but are unable to get diagnosed or treatment for.
Thinking on whiplash involving TBI in relation to my first car accident, the concussion like symptoms I experienced on and subsequent to March 13th 1990, along with other symptoms of mild TBI that presented for a prolonged period of time after that particular car accident….
It leaves little doubt in my mind that the 1995 traumatic brain injury I sustained, was in fact my second TBI and not my first.
Taking all of that into account there is still the issue of the actual whiplash itself, aside from any TBI, with the impact it has upon the spine and therefore the central nervous system. An issue which is finally being viewed far more seriously, with patients like me starting to be believed more often instead of written off as malingers or compensation frauds, unfortunately too little too late in my case … Too little too late in the case of far too many people living with these injuries I would assume.
One major issue with whiplash is that it is most often only thought of or recognised in relation to car accident injuries by the majority of people, however whiplash has many causes including sporting injuries and even falls.
To add even further to my experiences of whiplash and TBI through multiple car accidents, is quite a number of significant falls since the car accidents as a result of issues surrounding balance, spatial perception and short term memory. The kinds of falls that could have potentially caused further whiplash injury through the jerking motion of the heaviness of the falls, along with the pre-existing injuries making way for further injury due to weakness.
Falls I have had since the accidents are all quite evident in my medical history. The majority of falls also witnessed by concerned family members throughout the years who can verify the severity of injury from those falls and the troubling dysfunction I live with that has caused the falls. One fall in particular recorded in emergency department records due to fracturing my elbow, another while pregnant.
One final noteworthy piece of information is the fact that repeated TBI is now being recognised as a pattern that can do significant harm to a person … Following on from the initial injuries and falls throughout the years was a further reasonable concussion I gave myself during 2015 when I accidentally smashed, and I do mean smashed!, my head into the soap dish in the shower. It was a blow to the head that distorted my vision and caused immense pain for quite a period of time to both my neck and head.
The latter forms of patterns now being the reason that so much emphasis is being placed on specific forms of injuries in a sporting context. This is the reason many of the new studies and information is focused on athletes, because sport and athletes are now such big business with so much at stake financially that these injuries are now being taken seriously.
The simple truth is that if I was a top ranking athlete I would have been scanned, diagnosed and rehabilitated to the nth degree.
Sadly however, as an average working class nobody reliant on Australia’s disintegrating public health system, my case of repeated TBI and whiplash is of no interest to anyone with a medical degree … Not a woe is me comment, just a simple Average Jane fact of life that any other average Joe or Jane would certainly relate to.
Final Thoughts on Part 1
All in all there is far more evidence available these days to suggest that the traumas I experienced in each car accident, each one compounding the next, along with a further pattern of injury, do in fact hold a very plausible explanation for my declining health from the day of that first car accident … Aside from, or in conjunction with illness. (More on the topic of illness to come.)
As a result of all my attempts to explore TBI and central nervous system damage through whiplash being shut down and dismissed consistently despite progressive dysfunction I have not even attempted to discuss this with any medical professional since early 2016, when I had my one and only MRI.
While I do currently have a fantastic GP I consult with during the worst of times, I have chosen to sideline this aspect of my medical history other than on a very basic level as a part of my history he needs to know … Besides, every attempt my current GP has made to assist me through referrals to specialists to explore a connection between my previously diagnosed Inflammatory Bowel Disease and other debilitating symptoms have been met with little assistance. (Only heightening my aversion to seeking medical assistance at all.)
Sadly, at this point all I can do is tell my story to add another voice to the conversation of how important it is to take even the slightest knock to the head seriously at the time of the injury.
Next post … Exploring the experience of cognitive and physical dysfunction in the light of TBI and whiplash.