Walking Progress Update 5 Months Post-Eye Surgery in a Life with Brain Injury

Published Categorised as Brain Health, Health, Brain Power, Personal

Almost three weeks ago, we came to the next phase in my return to independence: riding the bus alone. Eep! “A round trip,” my CNIB orientation and mobility trainer replied, “you don’t have to get off — all you have to do is sit and not throw up!” Um, OK.

My CNIB (Canadian National Institute for the Blind) trainer has been steadily increasing the difficulty of my walking training. When we began, he came to my home. Then he met me a few blocks away near a main intersection. Then a couple of times in August, he met me on the other side of the main intersection, letting me see him watching me cross, then hiding from view so I felt like I was crossing alone yet did have the safety net of him keeping an eye on me.

Gradually increasing independent walking builds up my confidence in myself that I can do this and won’t get run over — I hope!

I practiced crossing on my own in between training sessions as part of my homework and gained some confidence, but he met me on the home side of the main intersection a couple of times to increase my comfort level and keep my stress levels down. Sometimes includes backtracking.

But the day he assigned ride-bus-on-own homework, we met on the other side of the main intersection; then gradually further and further away and closer to my bus stop. At that point we began practicing an easy route to my appointment.

He’s trained me to ride a short direct distance on the subway, but after a disastrous attempt at using one of the busier stations, we’re plotting routes that involve minimal subway rides. At the busy station, I had pretty much frozen from a combination of slow processing from the brain injury, anxiety from PTSD, and visual overload; noise and movements of people and trains overwhelm my senses and cognitive processing capacity. He had to take my wrist and lead me on to the train. At some point, I’m sure I’ll get retrained to tolerate it all, but right now, we need to get me back to my appointments. So whatever it takes, however longer the ride!

Anyway, as he explained: break the route into steps: don’t see the entire trip as one but as a series of steps. You can walk to the bus, ride the bus, walk to the appointment. When I have to take the subway to my destination, break that down into steps too: walk to platform, walk along platform, get on train, get off train, take my time exiting, pausing as many times as I need to to let my brain catch up to all the visual and auditory processing and multiple small decisions that have to be made (like where to sit when a man with an enormous belly hogs the priority seats).

Ramryge angels at Gloucester Cathedral, England

Brain injury grief is

extraordinary grief

research proves

needs healing.

Meanwhile, in between training sessions, I have to practice walking to get used to turns and to increasing my speed sans getting dizzy, unbalancing, or pausing. My nausea is just about gone with walking. And with my Vision Mate, I have to practice crossing semi-busy, not major intersections.

When I practice, I have to expose my weaker side to traffic to get it used to all that movement; I have to consciously keep my head straight and look dead ahead (it increases my depth perception and so throws off my balance unless I practice); consciously keep both eyes open (my operated-on eye still wants to close when my brain decides it’s getting information overload); ensure I’m aware of people/bikes/cars/dogs/cats licking themselves as I cross streets and not swan off the curb lost in all that I have to keep track of as I balance with binocular vision; remember to muffle the noise of heavy traffic with earbuds so I don’t overload my brain with sensory input; don’t get freaked out by right-turning cars trying to beat me; stay calm as the light turns red before I reach the sidewalk because I’m slower than the light cycle (traffic services admitted that traffic flow is optimized for cars not pedestrians, no matter what the politicians spout to appear progressive and accessibility-friendly); and god knows what else I have to keep track of . . . Oh yeah, keep eyes focussed on a solid unmoving object while engaging peripheral vision so that I can stay balanced and walk sans pausing. This week, on quiet streets I know well, I have begun looking ahead way, way into the far distance as well as seeing the sidewalk under my feet all at once instead of just focusing on the nearest solid, unmoving object since the line of hydro poles or sheer distance I can see now no longer mesmerizes me into stillness or nausea if I keep moving. Still, my brain gets overloaded quickly, but it’s an improvement!

I’m better at gauging my pace plus my brain is getting used to the movement of me walking and me seeing other walkers. I still hesitate or slow down when people come at me as I have to consciously predict where they’re going to go so that I can navigate them — not easy when only now can I move off the line of my path to go around things or people — or when bikes and cars pass me by because my peripheral vision still can’t handle the visual and auditory information in real time.

Dizziness is no longer my constant companion! Yay!!

Riding the bus though — with its rattling and speed — well! The dizziness returned and nausea rose up again for the first few rides. I try to keep my eyes open, but when the bus fills up or the driver whips along, I close my eyes and play my music.

I’ve begun being able to play music while walking on quieter streets. I’m gradually pushing my brain to be able to listen to music, hear my environment, and see where I’m going while looking out for idiot cyclists and impatient drivers.

One unexpected aspect of learning how to ride the bus: I had to talk to my trainer with my eyes closed to cut down the nausea from visual overload. Weird. I rely on lip reading to understand, so it was a tad harder to follow him. Plus his voice seemed disconnected in space.

It’s been a bit of an experiment to see which seat my brain orders me to. The seat right behind the driver — because that location constricts my visual field — is the best one. Less visual information to process means a happier brain.

Since it’s becoming obvious it’s going to take me freaking forever to get anywhere, and I need earbuds to muffle the noise so that my brain doesn’t get overloaded from the auditory input and my PTSD doesn’t dial up my startle reflex, I had to buy a more comfortable pair than Apple’s. (Trying to find a set that lets me activate Siri, while being comfortable required the help of a senior manager and two tries at the store since I couldn’t read and research with my vision at its current state and Junior customer service reps are more into their fave brand.)

Unfortunately, the CNIB doesn’t provide tokens for TTC practice (my trainer has a special card that lets us both ride the system when I’m with him); I don’t qualify for a CNIB-sponsored pass; no brain-injury org that I know of supplies them; and being on CPP disability but not on ODSP, I receive no public transit benefits.

So that’s where I’m at! I need chocolate and a nap!!

My Duck logo walking on my books in pink and blue shading.



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