Starting Strength: Post Brain Surgery and huge muscle loss later

[mcspud]

Hi Rip,
had brought SS:BBT and gave it and GOMAD a good turn. Worked amazingly. After 3 months my stats were something like this:

Height: 6'1
Age: 23
Weight: 83kg - 100kg
Squat: 65kg - 140kg (3x5)
Deadlift: 80kg - 180kg (3x5)
Bench: 70kg - 105kg (3x5)
Power Clean: 50kg - 105kg (5x3) (maybe 2 messy ones out of the 15)
Press: 45kg - 75kg (3x5)

The gains were still continuing, I'd been doing 2.5kg increases per lift for approximately a month and they werent slowing down, as long as I ate and slept, which I learnt from 2 humbling experiences under that bar. Also, being bigger and stronger seriously changed my life, making things like doing the dishes, taking out rubbish, walking up stairs much much easier. Sounds ridiculous I know but hey. Then shit happened:

Got drunk at uni, jumped on a skateboard (first time ever to :P), tried to race downhill, and smashed my head. End result (I dont have my medical documents here but here goes):
Accident date: 16th April 2011 10:00pm
Fractured right side of my skull from temporal to base
Fractured right temporal bone in 3 places.
Ruptured middle ear
Did something to my mouth were the temporal bone attaches to it? (this may be slightly off)
Had a 2 plate brain craniotomy (term may be slightly incorrect)
Had a 5cm hematoma on the extradural tissue in the rear right region of the brain
Had an internal subdural hematoma on the rear right (location name?) and left-parietal lobe of the brain.
Had a small arachnoid hematoma left parietal lobe.
Many multiple petechial haemorrages in the left parietal region (estimated at around 20).
Broken clavicle (xray 3 days ago show it is medially broken in 8 places, that there are 5/6 pissed off bone fractures floating around, and the biggest 2 are displaced by 10mm - this is essentially another surgery)

The above is what happened, some of the terms may be slightly off/mispelt, but they essentially cut two parts of the right side of my skull off and saved my life. I was at hospital approx. 10 minutes after eating shit on the road, and was in a "natural" coma by the time I hit ED. Was also brain dead after they gave me a scan I've forgotten the name of (glauco... or something). Had an amazing neurosurgeon who operated on me approx 30 minutes after the accident and saved my life, although it was predicated that I would most likely die, and that if I woke up I'd be somewhat mentally damaged.

For what its worth I'm fine. All cognitive functions work, I have full memory except that night, etc. Question I have:

When can I start training again and;
Recommended clavicular surgery?

thanks in advance rip!

[Mark Rippetoe]

Fuck if I know. Have you somehow gotten the impression that I am a faith healer?

[mcspud]

Well, of course I do, but lets try to be more specific:

I did a search before I posted that and on a thread from 2007? you said that Lon had started training again approximately 3 weeks after brain surgery. I was left in an induced coma for a week, and I was mistakenly discharged from hospital 2 days after I was brought out of it. I left hospital at 80.5kg. I know every case is different buuuuut -

All my cognitive abilities work
I have no memory loss, besides that night
I can speak/read/write/do the rest
I have no CNS impairment at all.
I still seem to be me, according to various people

Given the fact I'm not (obviously) mentally broken, and that its been a month since the injury, and that, even though I probably fall into several risk categories, does your experience tell you that even though I fucked myself up good, I need to go in some time or another, overly careful neuro people aside? Or is 3 week squatting post coma a little too ballsy. I'm actually genuinely looking for an answer on this, as I feel that the neurosurgery recovery people are telling me to tread wayyyyy too carefully (they have said a minimum of 3 months).
For what its worth, the actual procedures were hematologic evacuations of the blood clots.

The clavicle break is what concerns me more. Its pretty badly messed up, and I'm going to go and have it fixed with plates/screws. I read on another searched thread that this type of operation causes a problem with presses. The orthopedic surgeon recommended that I have the plate removed after 3 to 6 months without me telling him any of my future plans, besides the fact I like sport (boxing specifically). This surgery will likely happen in about 2 weeks after my neurological assessment post brain-CT scan.

I don't know if the above clarifies anything... hope so

[RobCor]

OP, for various legal and common sense reasons, Rip cannot tell you when to start training. He's neither a neurosurgeon nor a neurologist. Moreover, aside from a partial listing of your injuries, he has no real idea of what state your injuries are in. Obviously you managed to screw yourself up really well, and I'm glad that you lived in spite of Darwin's attempt to take you, but this question would probably be best answered by that dude that took your skull apart, lest it explode all over the platform when you try to deadlift. That would annoy the custodial staff at your gym.

Also, why were you doing deadlifts 3x5?

[tbennett]

I work in a brain injury rehab hospital (neuropsychologist), and while I'm glad to hear about your recovery, let me urge you to be cautious - your injury was not a minor one, and brains heal much more slowly than other things like bones and muscles. In fact, one of the most treacherous side effects of certain kinds of brain injuries is something called anosognosia - essentially, the inability of your brain to recognize that something is wrong (not the same thing or the same cause, but imagine an Alzheimer's patient who tells you their memory is "just fine" - they're not in denial and not lying, they just can't appreciate that things are wrong). Not saying you have it, but if you did, you wouldn't know - and anosognosic patients usually have terrible recoveries since they ignore everything their treatment team tells them. This is to be avoided, obviously.

Having said that, rehab for most brain injuries involves PT, and while I know that gets bagged on here (and deservedly so in any number of cases), if you are required to do physical rehab and are interested in lifting, you would be a PT/OT's dream - most patients refuse to do anything, simply assuming they'll be back to normal in a week or three. Fact is, it may take years, and it may be 100% recovery or it may not, but hard, consistent work in rehab is what gets you the most gains, and the fastest gains - now where have we heard that before? :-) At the same time, we have seen on occasion where young, fit guys try to bite off too much too soon (in fact, most of them were football players and wanted to get back to the weights), and then have significant failures and adverse consequences.

Overall, you are *very* early in the recovery process, so take it easy and *listen to your docs.* Yes, they very likely don't know SS, but they do know about recovery from such injuries, and they want to make sure you can breathe, walk, talk, etc., before you start trying to squat bodyweight, let alone anything with a bar on your back.

[hatmanii]

Fuck if I know. Have you somehow gotten the impression that I am a faith healer?

Quote of the day.

[franklie]

Mcspud,

You need to have a talk with your neurosurgeon if you haven't already. It may not be a good idea to have increased inner-cranial pressure from lifting heavy loads for the first year.

Some general guidelines:

While you have made a remarkable recovery since the accident, it typically takes a year for the brain to heal. The neurons and other parts have to reconnect and the bits that have died have to have their functions assumed by other neurons.

During this time, you are at a higher risk for seizures and by the end of the year if you stay seizure free your probability of having a seizure is no greater then the general population.

Alcohol and recreational drugs are a no-no during this time not only because they generally lead to increased stupidity in how you act but for some unexplained reason lead to an increased probability of seizures.

You may end up with personality changes down the road, be aware of that. It is a possible long-term consequence of the damages you sustained.

At 17 I sustained a brain injury similar to yours except that I was also paralyzed and like you I had a miraculous recovery. I was a good boy during that year of recovery and followed the advice of the doctor.

In that same time frame, one of my friends when he was skating took a header in an empty pool. He didn't listen to the neurosurgeon, and went back to toking joints and partying like it was 1999 and he developed seizures. He had to take seizure medication and it made him sound like he was slow-witted. It sucked for him when he wanted to meet girls.

[Mark Rippetoe]

Lon's surgery was NOTHING like your situation. Be very careful, please.

[big eddie]

@mcspud, I'm guessing you are Australian. That is pretty much the best attempt at "she'll be right" ever.

[mcspud]

Thanks for the replies guys, greatly appreciated.

RobCor - 1x5

tbennett - Your final few sentences about young guys who seem to come out relatively unscathed is probably the only thing I've read/heard that has stopped me. As a competitive athlete it sucks hard when you don't do what you normally would because of whatever, especially when your body is telling you that you can.

franklie: I'm actually intimidated by the personality change possibility. Especially since my brain wasn't as elastic as yours at 17. As a curiosity did anyone say that you experienced personality changes (considering that you were relatively young?)

rip: Thanks for the forum, your books, and comments