Travel advices for individuals who have had a brain injury (TBI, concussion, stroke, etc.)

The holiday season is here, which always brings fun, family, festivities and… traveling. Traveling can be a fun and exciting adventure, but for individuals who have sustained a concussion or other form of acquired brain injury (ABI), travel can be a very stressful and symptomatic endeavor. Individuals who have experienced an ABI are typically very sensitive to sensory stimuli and can quickly become overwhelmed by the added hustle and bustle of a typical travel experience, especially if traveling by plane. Airports are notorious for being busy, loud, and full of movement/visual motion, and all of these factors combine to form a recipe for exacerbated symptoms. Common symptoms that arise from these environments for individuals with ABI include dizziness, nausea, headache, cognitive fatigue, confusion, reduced memory, “mental fog,” poor motor planning, poor spatial awareness, a sensation that visual space is moving or waving, and an overall sense of being overwhelmed. Though there is no way to completely avoid these overwhelming stimuli and resulting symptoms while traveling, there are ways to plan for travel that can make your trip as smooth as possible. Please consider some of the tips below as you prepare for travel during the holiday season:

  1. Prepare and pack things early and organized for reduced stress
  2. Pack in the least cluttered room in your home, and consider packing on a plain white sheet (on the floor or on the bed, etc.) to reduce extra visual stress
  3. Mark your bag with a unique identifier to reduce stress and confusion when trying to keep track of your luggage at the airport
  4. Place essential items (ID, ticket, etc.) that need to be accessible in a single bag or specific place in your bag/purse to avoid the stress of searching for them at the airport
  5. Pack ear plugs in an accessible location to reduce noise
  6. Keep peppermint or ginger chews on hand to help reduce symptoms of nausea
  7. Consider purchasing Airplane ear plugs. They are designed to help with changes in pressure when flying and may reduce disruption of the vestibular system when changing elevation (this can trigger nausea and dizziness).
  8. Consider purchasing a heavy pillow or a weighted blanket to place on your lap to aid with grounding yourself and reduce any “floaty” sensations
  9. Create a list of steps to take once you arrive at the airport for reference in case you become overwhelmed or cognitively fatigued
  10. Allow extra time to avoid feeling rushed or overwhelmed
  11. Consider using airport disability services to reduce cognitive demand and stress
  12. Find a quieter coffee shop or restaurant to wait for your flight as opposed to sitting in the terminal where it is loud and busy
  13. Sit with feet flat on the floor and back against a chair/wall to ground yourself
  14. May remove shoes for better grounding with your feet as you sit/wait
  15. If dizzy or nauseous, try pinching your pointer finger and thumb together to ground yourself
  16. Rest (vision, mind, memory, etc.) between necessary activities like checking in for your flight, going through security, and boarding the plane. Find a quieter/less busy space to close your eyes, sit, and breathe. Though you may not feel symptomatic at the time, resting frequently will help prevent compounding stress and symptoms that can cause prolonged recovery time after your trip.
  17. Avoid small/detailed tasks such as reading, knitting, searching your phone, or other detailed tasks that might cause you to ignore your peripheral vision
  18. Either board the plane early (if possible) or wait to board until the crowd entering the plane is as small as possible
  19. Avoid putting a bag in the overhead compartment if possible, this will reduce additional vestibular movement and stress before and after your flight
  20. Consider wearing a baseball cap, sun glasses, or an eye mask while flying to reduce awareness of the small enclosure of the plane and other visual distractors (lights turning on and off, people getting up and down, flight attendants moving down the aisles, etc.)
  21. Wait to get off the plane until the majority of people have exited to reduce extra crowding and stimulus around you
  22. Wait to retrieve your bag at baggage claim until the majority of the crowd has already gotten their bag (use this time to rest and recuperate).
  23. Have a ride pre-arranged for you if possible to avoid use of shuttles, buses, or trains
  24. REST when you arrive at your destination – you may need to let family know you need a few moments to regroup cognitively before entering into busy family festivities
  25. Do not feel bad if you need to take time for yourself (breaks from other visitors/family) to rest and recover every so-often. Even if you are not feeling overwhelmed, taking breaks will prevent compounding of symptoms and a longer recovery period upon your return

These tips are designed to help make traveling with ABI as smooth and symptom-free as possible, but each person is unique and it may take time to find the tips and tricks that work best for you. If you have tips or tricks of your own that you have found helpful while you travel, please share in the comments as these will likely help others as well!
Our team at OCVT wishes you a happy holiday season and safe travels!
Aubrey Breithaupt, OD

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