Practical Tips and Advice

To push or not to push?

My biggest question initially was how much I should push through my symptoms in order to encourage my brain to adapt and how much I should rest and try to avoid triggering them. Everyone recommends taking it easy for the first 24-48 hours – not hiding in a dark room but just not doing too much. But what about after that?

When I eventually saw a rehabilitation medicine consultant online, the first thing he said was that it’s very important to try to avoid bringing on your symptoms. In other words, it’s best to stop and take a break from any activity before you start to feel unwell. That way, he said, you will get more done in the day (since it’s quicker to recover from mental exertion if you haven’t already overdone it) and you’ll heal more quickly.

(Note that your symptoms and thresholds will vary, through the day, and over different days, and if you’re tired/stressed/menstruating/under the weather, your threshold will be lower, so take this into account. The Headway brain injury charity has a good guide to managing fatigue, much of which applies to keeping below your symptom threshold more generally.)

However, I’ve since found that some concussion specialists, such as Dr Heisig (in the video above) recommend gradually returning to normal activity from day 3 but in a ‘symptom-limited’ way – in other words, if you rate your symptoms on a scale of 0 (feeling fine) to 10 (feeling horrendous), allow yourself to do things that make your symptoms a couple of points worse, but not more than that, and if it take you more than an hour or two to recover, then you’ve overdone it.

I’ve additionally discovered that some concussion specialists, such as Michael Collins, identify  six different types of concussion, and give different advice depending on the type. For example, Canadian filmmaker Sarah Polley suffered from post-concussion symptoms for years after a fire extinguisher fell on her head (!). Eventually she saw Michael Collins and he instructed her to stop avoiding triggering her symptoms and instead to do all the things that bring them on – “run towards the danger“. She did this, initially finding it excruciatingly difficult, but after about two weeks realised she was able to cope with much more, and after six weeks felt basically to normal and has been fine every since.

This is similar to advice I received about damage to my vestibular system: I also sustained inner ear damage and when I eventually saw a specialist about it, was told that it’s important not to avoid bringing on those symptoms but in fact to challenge them, in order for the brain to learn to adapt to the damage.

So it’s a tricky one. In general, there seems to be a growing consensus among concussion specialists that the usual advice to just rest a lot, mentally and physically, is counterproductive. If you avoid doing certain things too much or for too long, you risk reducing your recovery due to ‘learned non-use’, i.e., your brain gets used to not dealing with those activities and further loses its ability to do so. Remember, your brain is resilient and can learn new ways to do things, if you give it the opportunities.

All concussion specialists emphasise the importance of being properly assessed by a specialist who can make you a tailored treatment programme.

Keep (or start) exercising

One American doctor who treats concussion patients says he wants to bang his head against the wall every time one of his patients says that a doctor told them to just go home and rest. It’s true that you mustn’t overdo it but, on the other hand, getting physical exercise is very important for brain recovery and general brain health, as long as you keep it below the threshold at which it will bring on or significantly exacerbate your symptoms. And don’t delay either. Recent studies find that you may be able to start doing aerobic exercise as soon as 24-48 hours after your concussion (check with your doctor, preferably a specialist), and the sooner you start, the more you speed up your recovery and reduce your chances of developing post-concussion syndrome. This is one of the things I wish I had known sooner!

You can also use exercise strategically to improve your healing and your ability to do specific tasks or activity. For example, one American concussion clinic has a method of treating post-concussion syndrome where they scan the brain to identify areas which are not functioning optimally then put you on a programme of “prepare, activate, rest”. This consists of short periods of physical exercise to ‘charge’ your brain, followed by targeted exercises to develop the abilities or faculties you’re struggling with, followed by rest to allow your brain to recover.

Although you can’t get that kind of brain imaging (functional neurocognitive imaging, a form of fMRI) on the NHS, I’ve wondered about following this basic format at home, i.e., doing some exercise which works your heart and lungs (for up to half an hour or as long as you can reasonably manage without over-exerting yourself), then doing some of the tasks which you find more challenging now – e.g., if you’ve got memory problems, then do some memory tests. Then making some time for proper rest and recuperation.

Don’t totally overdo it

I say this from personal experience. Two years after my concussion, I went on a well-organised trip abroad to play a bit of music with a friend. I expected the trip to be simple and easy. However, after thefts and travel delays and being pressured into things I really wasn’t well enough for, I had a major relapse. I didn’t lose any of the improvements I’d made in my memory and concentration but I did regress about 18 months in terms of my mental stamina and could barely do anything for even an hour without feeling intensely nauseous.

So, my advice – stay aware of how you’re feeling. At times, you’re inevitably going to overdo it a bit if you get engrossed in something or get in a situation that’s difficult to extricate yourself from. However, don’t push yourself – or let yourself be pushed by others – too far beyond your limits. Sometimes this will just mean paying more attention moment-by-moment. Other times it might involve thinking through a situation and assessing in advance whether you’re at risk of pushing/being pushed too far. Social pressures can be intense and you might not have your usual presence of mind to resist them (see my Things to Watch Out For page too).

Stay off screens initially

It’s probably a good idea to minimise the time you spend looking at digital screens – smartphones, laptops, tablets, TVs – particularly in the first few days after your concussion. A 2021 study compared screen use in 125 people during the first two days after their concussion and found that those who were instructed to avoid using screens recovered twice as fast, on average, as those allowed to use screens. (Specifically, the people asked to avoid screens used screens for only about two hours over those two days and recovered within 3 and a half days, on average. In comparison, the people freely using screens used them for over ten hours over the two days and took 8 days to recover, on average. ‘Average’ here refers to the median value.)

More research needs to be done but it wouldn’t hurt to stay off screens as much as you can, to give yourself the best chance of recovery. There’s also mounting evidence that being on screens a lot is bad for your health in many ways, so it could be a good time to cut down on screen and smartphone use in general.

Keep doing the things you love, somehow

Having said that, it’s important not too shut yourself and your life down too much. Try to keep doing the things you love, even if you can’t do them as much as before, or have to do them in a different way. This will not only keep you motivated and mentally nourished but will also keep your brain stimulated. Some things might be more difficult to do than before so be creative with your (hopefully temporary) limitations and find new ways of doing old things.

For example, if you can’t read as easily or for as long (as I found initially), then see if listening to podcasts or audio books is easier. When you can, I think it’s also important to persist in trying to resume or maintain your abilities. I kept reading, albeit for much shorter periods than before, and it did involve constant re-reading as I’d forget most of what I’d read the day before. But it did get easier, and doing it regularly enabled me to get a sense of my recovery and progress.

Even if you don’t have any obvious physical disturbances due to your concussion, you might have subtle ones. I found that when I was playing taiko sometimes my left hand would not play what I was wanting it to. At first I attributed this to lack of practice (before my fall, I hadn’t been playing as much due to coronavirus restrictions, and after my fall I felt sick when I played taiko). However, I came to think some of it was due to my brain being glitchy. I kept playing, just a little every few days, and it did improve and after a year or so it seemed to be back to normal.

There’s also the issue of being able to do things but feeling wrecked afterwards. This is a delicate balancing act, I find. If you push too hard, you might get set back too much, as I have found. But there can be a value in pushing a little in order to do something that’s important to you, and being able to do things you love can sustain you in immeasurable ways. I’ve certainly found this with hillwalking: after six months I could go up a medium hill and although I felt pretty ropey, I felt stronger afterwards. Now I can go up a proper hill and feel mostly fine. This does require me picking a day when I’m feeling quite good and this is another factor to take into account – do the most difficult things on the days you feel the best.

It’s also really important for your recovery to keep your brain stimulated, especially with things you love. To some extent, the brain is “use it or lose it”. Crudely put, if you completely stop using certain faculties, your brain will eventually devote that part of its network to some other function. This applies to both mental and physical activities. For example, my vestibular physiotherapist told me that they had a record number of people coming to hospital due to falls in the winter of 2021-2022, which she attributed to the lockdowns. With people being less active than usual, their vestibular systems and brain were no longer functioning as well in maintaining poise and balance. Even some people who weren’t falling were having trouble when they tried to resume their previous activities. Then there was the widespread phenomenon of ‘brain fog’ due to insufficient mental and social stimulation during lockdowns. A cautionary tale…

Make time for proper relaxation and sleep

Physical and mental activity stimulate the brain so it’s probably best to not just sit around (unless it is genuinely all you can do at present). However, it is important to make some time each day to really really relax. Several therapists have pointed out to me that it’s when your body is in relaxation mode (when the parasympathetic nervous system is active, rather than the sympathetic nervous system) that it can do its healing and repair.

I resolved that, since most of my symptoms were apparently due to cognitive fatigue, I would get seriously into meditation as a way of calming my mind and teaching my brain to work more efficiently, so I could make better use of my more limited mental resources. However, I didn’t factor in the frustration caused by my poor concentration and in the end I didn’t persist with meditation much. I think going to a meditation group would have been helpful as, in the past, I’ve found there’s a certain power in being part of a still and calm group meditation. I did, however, intuitively learn how to let my brain slip into a slower, slightly sleepy, state from time to time, and found this was a good way to revive it when it was flagging. What I probably should have done – and do – more of was listen to guided meditations and relaxation exercises. There’s a good selection here by Malcolm Huxter (scroll down the page to find his): guided meditations. They’re effective and pragmatic and he has a lovely reassuring voice.

Slow breathing is also a good way to quickly relax your brain and body and doing it regularly has multiple health benefits (you can find out more on my friend’s website about slow breathing, where you can buy audio tracks for guided slow breathing).

Sleep is vital too, especially for “memory repair” (as my consultant advised me). There are millions of websites offering advice on getting better sleep so I won’t labour the point here. However, during the five years of insomnia I had in my twenties, the best advice I was given was to get up at about the same time every day, regardless of when you got to sleep. This is to do with training your circadian rhythms and keeping regular circadian rhythms and sleep patterns is vital for good health. Having meals at similar times each day too is also good for this reason – the more you can keep a reliable rhythm each day, the easier it is for your body to function optimally. (If you’re interested in this kind of thing, read ‘Chasing the Sun’ by Linda Geddes.)

Concussion specialists often talk about ‘sleep hygiene’ which sounds quite unappealing but appears to mean having good sleep discipline – keeping a regular rhythm when going to bed and getting up but also not having naps during the day. If you can’t manage without a wee daytime snooze, try to keep them to under half an hour and don’t nap in the evening.

Get out in the sun and a natural environment

I’m convinced that getting plenty sunshine (though not necessarily heat, though I’d have to say that, living in northern Scotland) is critical for good physical and mental health and healing. So much so that I wrote a book about the sun, completing my first draft just before I fell on my head (it describes a sailing trip to northern Norway and the midnight sun). There is an increasing body of research on this so make sure to get outside each day, especially in the mornings. This is a good article if you’re interested: Biological Effects of Sunlight (Holick, 2016)

Sunlight goes into our brains – via the retina and optic nerve – and also goes deeper than you would think into our skins and tissues, producing not just vitamin D but endorphins, amongst other things. Indeed, it’s some of the red and near-infra wavelengths found in sunlight which are harnessed in photobiomodulation technologies for healing the body and brain. Even on cloudy winter days, it’s actually far brighter outside than indoors under lighting, so get outside as much as you can.

Being in a natural environment – even a city park – is also restful and restorative for your senses and brain. Most of us know this intuitively but researchers at Heriot Watt University in Edinburgh (down the road from where I grew up) have now documented it by measuring the brain waves of folk walking around different parts of the fair city. (You can read the original study or a New York Times article about it.)

As Dr Gavin Francis says in his excellent book ‘Recovery: The Lost Art of Convalescence‘, ‘We need to take care over the environment in which we’re attempting to heal, celebrating the importance of nature and the natural world and recognising the part it can play in hastening recovery.’

There’s an interesting talk about this, which includes research specifically with the brain-injured, on Headway’s youtube channel: Natures’s benefit after brain injury

Vices

Sex: I haven’t researched this much (see this Headway page for more info) but I did find that the concussion affected my sex drive for a while. I’m not sure if it was due to the concussion directly affecting my hormones or the fact that the concussion (and inner ear damage) made me feel sick a lot, which isn’t particularly conducive to bouncing about in bed. It’s a disconcerting enough experience at an individual level but can be a difficult thing to go through in a relationship too. Thankfully, my libido came back and the nausea abated. I’m still limited by my poor mental stamina – when I get too overloaded, I just don’t feel like doing anything – but this still leaves plenty time for fun 😉

I found it helped to try to see it as a practical problem rather than an existential issue and therefore as something that can be adapted to. For example, if you notice any patterns or rhythms in how you feel, such as times of the day or month when you’re more or less up for it, then work around those. You and your partner may have to adjust your expectations and habits but this is not necessarily a bad thing. After all, variety is the spice of life.

Booze: I’ve never really taken to drugs but pre-injury I did enjoy wine and the occasional dram or several. All the websites about concussion that I’ve looked at tell you that you shouldn’t drink alcohol at all until you’ve completely recovered.

When I first saw a consultant, he told me I should avoid alcohol for the first year or two. I evidently looked very alarmed as he quickly reassured me that I didn’t need to become teetotal, just to be very careful and not drink often or a lot. Actually, I had been far more alarmed about the fact that it might take years to recover (at this point, I had assumed I would be fine in few months). He said alcohol would affect my brain much more and I’ve found this to be true. When I have occasionally had a drink, I get drunk faster and suffer more afterwards. I’ve actually had very little desire to drink since the concussion given that I’ve felt groggy and out of it enough as it is. To my surprise, the more I recover, the less inclined I am, since my growing clarity feels too precious to sacrifice. So at least this injury has been good for my liver.

I’ve since found this more nuanced article by an American concussion specialist which says that there isn’t a clear-cut medical answer as to whether the occasional drink will harm your concussion recovery but, given that it’s bad for your health in several ways (such as affecting your sleep and your gut health) which will directly affect your recovery, then it’s best to avoid it until you’re better. (Being drunk obviously makes you more likely to fall and bang your head again which can severely impact your recovery.)He also notes that “Even 1-2 drinks per day can increase how fast your brain atrophies (shrinks)” – try thinking about that when you’re feeling tempted.

Drugs: In terms of drugs like cannabis, or even cigarettes, one 2020 study showed that cannabis, cigarettes and alcohol didn’t seem to make much difference to concussion recovery in the very short term. It’s possible that cannabis in some ways might help slightly. However, it’s well known that cigarettes (and alcohol) are bad for your health in ways which will almost certainly negatively affect your recovery and brain health in the longer term, and there’s currently just not enough research on the long-term effects of cannabis use on brain injury, so you should probably avoid them, and, if you do use them, take it easy. This video has a good, balanced discussion of these issues: Do alcohol, cigarettes and cannabis mess up your concussion recovery?

In terms of legal drugs, the consultant told me that for the first year or so I should take only half doses of medicines such as paracetamol and ibuprofen because they’ll affect my brain more. In terms of medication for post-concussion syndrome itself, he said there was nothing, other than medications for associated problems like depression. Apparently it’s common to feel depressed with a head injury because it is a difficult thing to go through – and I did feel pretty dark initially – but they generally don’t want to medicate for that unless the depression is out of proportion to the situation. This suits me since, if medicines are affecting the brain more than usual, it seems wise to minimise them. I was prescribed anti-emetics for my nausea, just for the periods when it was particularly bad, but they made me feel very spaced out so I stopped that. Also, I think that it’s important for me to notice the nausea since it’s a sign that I’ve started to overdo it and I need to take a break – and should have taken a break sooner.

Rock’n’roll: For months I felt sick when I played my drums (taiko, big Japanese drums) so my music career was out the window. I can play again now without nausea but doing late night gigs with my band in loud crowded venues is still a long way off. I also used to teach taiko and after about a year my memory had improved enough to allow me to do this again. However, I did have to make some practical changes such as teaching in the daytime as I’m too tired in the evenings. So if you are struggling to keep up with things, see if you can find practical ways around it. There are often logistical changes you can make which can offset some of the effects of your symptoms and accommodate your new rhythms and needs.

Time

I saw the rehabilitation medicine consultant for the second time online about a year after my injury and merrily told him that I was maybe almost halfway better and thus in another year or so might be fully recovered, to which he airily replied that the first year was critical and I probably wouldn’t recover much more now, so I should get used to where I’m at and take any further recovery as a bonus. I was devastated, told all my friends and anyone else who would listen, and in return heard multiple stories of people with various conditions and injuries (including head injuries) who had also been told by NHS medics that they wouldn’t recover more after 6 months/a year, yet who had nonetheless gone on to recover much more or even recover completely. I’ve since discovered that this supposed one year deadline is a common – and damaging – misconception.

I absolutely don’t want to be given false hope and unrealistic expectations but, on the other hand, it’s always nice if someone isn’t dismissive of your prospects. As several health practitioners, including my GP, have reminded me, his is only one opinion (albeit based on statistical evidence) and, as the consultant himself said, every person is different and they cannot predict my individual trajectory. There’s also strong evidence that being

It’s true that the first year is very important, and the more you can do to help yourself recover in the days/weeks/months immediately following your concussion, the better. For some, the challenge will be to stay motivated and stimulated. For others though, it might be difficult to adequately stop and slow down. It’s easy to feel guilty about not doing as much, especially if sometimes you’re feeling not too bad, and especially if you’ve got people or work to take care of. If you’re finding this, try reading ‘Recovery: The Lost Art of Convalescence’ by Edinburgh GP Gavin Francis. It’s an easy read and a thoughtful and nourishing one. You need time to heal, you need space to heal, and if it’s not offered to you readily, then you need to take it.

Having said that, there is no time limit to recovery. Jill Bolte-Taylor, a Harvard neuroscientist, points out that she continued to improve in her abilities for years after a massive stroke. And I myself have found that I’ve continued to improve fairly steadily, albeit slowly, over the two years since my injury. And my experience with new treatments has shown me that my healing can be speeded up quite dramatically with a bit of help.

It’s also important to remember that healing and recovery really is a journey. I don’t feel like the same person since my injury, in a subtle yet profound way which I can’t really explain, and as a result life has been challenging to navigate. Yet once I accepted that life and myself are different, and that it’s okay to be disorientated for a while, I’ve found that it’s an interesting journey, even if it’s one I wouldn’t have chosen voluntarily.

It’s also important to keep in mind that when you do start to notice positive changes, they feel so good! Make time to notice and appreciate these and to really enjoy every little gain in ability, every slight alleviation of pressure or pain. You won’t go through this again (hopefully) so make it count.

Acceptance

It’s critical to accept what’s happened to you and not to waste your energy agonising over it. You need to focus your limited resources on healing and on trying to enjoy the process, or at least find some interest in it. I could have beat myself up endlessly over my carelessness in not fixing the weight imbalance in my bag which meant that, when I slipped, I fell too fast to catch myself. But there’s a real power in being able to thoroughly accept what’s happened. Acceptance is different from resignation (to my mind), in that resignation is passive while acceptance is active. In a way, it’s something you’re continually renewing and, as such, is dynamic and changing.

So you need to accept your predicament. However, consider carefully what you accept in everything that follows. For example, I wouldn’t necessarily fully accept any depressing prognoses you get from medics. As I described above, one consultant told me that after a year I was very unlikely to ever fully recover. In response to that, another specialist pointed out that the brain never stops learning and adapting. Other therapists, and my GP, reminded me sternly that the consultant’s view referred to general statistics rather than my individual case and that there was no point in assuming the worst. Assuming the worst can definitely delay or scupper your recovery. All medics admit the power of the placebo effect yet there’s a nocebo effect too (and this has been documented with concussion recovery) where negative expectations become self-fulfilling. After all, our thoughts are not disembodied ethereal things. They involve chemicals, electricity and biological tissue, and are not separate from our bodies.

As one concussion specialist points out, feeling fearful and anxious, about your health or anything else, can itself give you concussion-like symptoms. He talks about adopting ‘a growth mindset‘ where, if you do have setbacks, you view them as opportunities for further recovery rather than getting depressed. Good advice!

That’s absolutely not to say that you should ignore medical advice and assessments. I would not have wanted to be lied to or given false hope. I accept that I may never fully recover but I also know that I may well recover completely, or at least a good deal more, and that this is just going to take more time. It might also require more treatment, because, although you won’t hear about them on the NHS, there are new treatments for brain injury being developed all the time.

I strongly believe that, even if you are (temporarily or permanently) changed by your concussion, that there can be strength and value in that. There’s a strength in simplicity, even if it’s not what you would have wished. And there’s great strength in acceptance. On an internet ramble one day, I came across a quote by an Orthodox Christian woman who said that, because of her religious views, she didn’t see suffering as “a problem to be solved.” This blew my mind as it took away the nagging feeling of need – that I needed to fix myself soon, that I needed urgently to stop suffering. I’ve felt more relaxed and less frustrated since then which can only be helping my recovery.

The ultimate thing of course would be to not just accept but affirm, to be glad for what you’ve gone through. Sometimes I feel I’m getting closer to this, and not just because I’m improving…

Find out about others with injuries

I have, perhaps perversely, found it morale-boosting to read about other people with head injuries and brain problems as it reminds me how much worse it could have been, and makes me feel slightly more chipper about the fact that I ‘only’ have post-concussion syndrome. It also reminds me of the range of human experience, and how this includes injury and ill-health. (Obviously this requires you having enough concentration to read. There are audio versions of some of the books I mention, or you could get people to read to you if you’re able to take it in.)

I have a long-standing interest in psychology and studied it at university, so that probably helps. However, reading anything by the late neurologist Oliver Sacks might cheer you up. Not only will he describe awful conditions that you can be glad you don’t have to suffer, but he has a way of casting these in a sympathetic and intriguing light, and opening you to the possibilities that brain problems can bring – possibilities of greater understanding and insight into the human condition and of the human potential for change and adaptation. ‘The Man Who Mistook His Wife For a Hat’ is a good one to start with as it’s comprised of short chapters, each with a different topic.

I also read ‘Do No Harm’ by neurosurgeon Henry Marsh (who’s now dying of cancer and has a book about that called, ‘And Finally’). He’s brutally honest about the wreckage that brain injury and sometimes brain surgery can cause and, again, his reflections on human life and consciousness (and the slow destruction of the NHS) are refreshing and liberating.

Jill Bolte Taylor’s ‘My Stroke of Insight‘ is not only dramatic, as she describes having a massive left hemisphere stroke and losing her language, but also immensely inspiring as she describes her eight year recovery. Her experiences have hugely changed her outlook on life and how the brain works and are extremely interesting.

I haven’t read it yet, but there’s a book by an American doctor who suffered a whiplash brain injury, which sounds good – Brainlash: Maximising Your Recovery From Mild Brain Injury

Headway, the British brain injury charity, has an online forum where you can talk to others with brain injuries: Headway forum

Talking to people about your concussion/recovery can be excellent too. Not only might they give you good ideas or inspiration, but they may also tell you about their own health issues, which helps you to realise that perfect health is not as widespread as it might seem. I know in the past that I have tended to assume that everyone I encounter is fully well unless I specifically know otherwise. However, one of the most humbling things about this experience, is how many people have opened up and told me about their own health problems in response to me mentioning mine. It’s brought me closer to some people, and has also helped me realise that I have a wider network of support around me than I thought. Most importantly, it’s put my own problems into perspective. We can’t forever avoid injury and illness so, when we inevitably encounter them, why not accept them with grace?

Practical Aids

When I was first looking up post-concussion syndrome in the months immediately following my injury, I found various support websites for post-concussion syndrome sufferers. They suggested things like carrying around a “concussion kit” with ear plugs and eye masks for those times you’re out in public and finding things too much, and can’t easily get away somewhere quiet in time. My first thought was, “oh those poor people, well that’s not relevant to me.” A few months later I was in Highland Industrial Supplies enquiring about ear defenders.

So here are some things you might find useful, even if you only have concussion symptoms for a short while.

Ear plugs/ear defenders – ear plugs will probably give you more sonic protection, especially if you shell out for really good ones, and they’re nice and  discreet. On the other hand, sometimes you want people to know you’ve blocked your ears, in which case ear defenders are good and highly visible. I personally prefer them since I have waxy ears that are easily blocked if I repeatedly poke foam or plastic into them. I got industrial ear defenders, the kind you’d get if you were using a chainsaw (which I also do, so they’re doubly useful).

Sunglasses and hats – useful if you’re sensitive to some kinds or certain levels of light. I’m fine outside in natural light but struggle with bright indoor lighting or any lighting with a flicker (which makes me feel dangerously spaced out). I’ve always found overhead fluorescent lighting unpleasant and now it’s sometimes unbearable so if I have to go to a supermarket or big store, I wear sunglasses and it seems to increase the length of time I can cope. Baseball caps or other hats with brims can also help shield and shade you.

Eye mask – if you need to just stop and shut out the world periodically, then carry an eye mask as well as ear plugs. You can get these in the travel sections of chemists or if you know anyone taking a long-haul flight, get them to steal the one they get on their flight for you. Having said that, they tend to be poorer quality these days (thankfully I still have a nice fabric Virgin Atlantic one from back in the day) so you might want to buy one or make one from a strip of comfortable fabric. For the strap around the back, any thickish elastic will be fine. I find straps from old bras are great as they’re often made of a durable comfortable material and they can be adjusted to fit.

Emergency financial assistance (for limited purposes) – British charity Headway have an emergency fund to which you or your family can apply for a one-off grant of £1000 in the immediate aftermath of a head injury. This is for limited purposes only, such as emergency accommodation or clothing, travel costs to attend outpatient appointments or travel costs for family to visit you if you’re in hospital. Unfortunately it can’t be used for the costs of daily living or any private treatment. Still, better than a kick in the head…