Beyond One Hour: Why We Drive Instead of Fly When You Love Someone With a Brain Injury

Beyond One Hour: Why We Drive Instead of Fly When You Love Someone With a Brain Injury

People ask me all the time: why don't you just fly?

We live in Southern California. Our son just graduated from ASU in Arizona. It's less than an hour in the air. On paper, flying makes total sense.

But nobody is living on paper.

Here's the thing about that one-hour flight: it is never one hour. Not for us. Not for any family living with brain injury. And I want to walk you through what that hour actually costs — not because I'm trying to talk you out of flying, but because if you love someone with a TBI, dementia, Parkinsonism, or any neurological condition, you deserve to understand what you're actually deciding between.

This is the long version of what I cover in this week's video. The video is the gut-punch. This is the science underneath it.

Watch first, then read

The trip starts days before

This is the part nobody tells you when you're new to caregiving. A travel day is never the travel day. It starts 48 to 72 hours earlier.

Routines have to happen. Eggs. Coffee. Bathroom. Even when we're running early. Even when we're running late. Routines are how Rob's brain orients itself — and a disrupted morning means we're already behind before we leave the driveway.

We have a book. I write his schedule in it every morning. Appointments, chores, activities, everything. Rob follows the book. It means he doesn't have to ask me the same questions over and over, and I don't have to answer them. That list keeps both of us sane.

Why does this matter for travel? Because the second we step outside of those routines, the cost of every small interaction goes up. A 2017 review in Concussion on cognitive fatigue in mild TBI found that fatigue after brain injury results from the increased work the brain has to do to process information after trauma-induced damage. Translation: even simple things cost more energy than they used to. A travel day stacks every "simple thing" the brain has to process on top of each other. By hour three, the tank is empty.

That's before we've even gotten to the airport.

The drive to the airport — the first destabilization point

If we were flying, this is where the unraveling would start.

Unfamiliar parking. Visual chaos. Signs, directions, strangers everywhere. His brain is already scanning, already looking — because Rob's brain never stopped being a soldier. It's always running threat assessment. That's not a metaphor. That's neurology.

Research on combat veterans with TBI has documented this directly. A review in Frontiers in Neurology examining the mechanisms behind PTSD symptoms in TBI patients describes PTSD as a chronic defensive state manifested by hypervigilance and increased sympathetic drive and parasympathetic withdrawal. In plain English: the nervous system is stuck in fight-or-flight, and the brakes don't work the way they should.

Damage to specific white matter tracts from impact-related TBI appears to disrupt the very pathways that regulate this response. So for a veteran like Rob, with multiple impact TBIs in his history, the experience of walking through an unfamiliar parking lot isn't just stressful — it's biologically loud. His autonomic nervous system is shouting before he's even reached the terminal.

The airport — a threat factory

I call airports threat factories. It's not a joke.

Look at what an airport actually asks a brain to do, all at once:

• Process announcements over speakers while filtering background hum
• Track people walking in front, behind, and beside him
• Answer questions from strangers — quickly — at counters and security
• Manage belongings he keeps dropping or losing track of
• Take his shoes off, take his belt off, separate his electronics, put it all back together while the line moves
• Tolerate smells, sounds, fluorescent lights, crowded spaces, and unpredictable touch

Every single one of those things is a documented trigger for sensory and cognitive overload in brain injury survivors. A 2018 study in the Journal of Head Trauma Rehabilitation on veterans with TBI found that sensory sensitivities — to light, to noise — are strongly linked to autonomic nervous system hyperarousal. The same nervous system that's already stuck in hypervigilance from the combat history is now being asked to filter out an environment specifically designed to demand attention.

Underneath all of it is the hypervigilance. His brain is scanning every face, every bag, every exit. Not because he wants to. Because that's what his brain does now.

By the time we'd get to the gate, he'd already be done.

And we haven't even left yet.

The plane

More line. Six-foot-four in narrow aisles. Overhead bins opening and closing. People stopping in front of him to put bags away. Too many people. Too tight a space. Can't move. Can't escape. Strangers brushing against him.

Less than an hour in the air. But the damage is already done before wheels up.

I'm not going to dwell on this part because the video shows it better than I can write it. But the clinical reality is this: a person in sustained autonomic hyperarousal doesn't get to "calm down" just because the cabin door closes. The cortisol is already up. The sympathetic system is already running. According to Frontiers in Medicine research on combat veterans with PTSD and mTBI, the vagal brake — the system that's supposed to bring the body back down from stress — is measurably impaired in this population. Coming down from threat mode takes longer, costs more, and sometimes doesn't fully happen at all until he's back home in his own bed.

The other side

Landing. The chime. The herd of people standing up at once. Luggage carousel. Rental car counter. A new environment. New signs. New strangers.

And now we need him to function at a graduation.

In a few hours. In a banquet hall. With a thousand people he doesn't know, music he didn't choose, lighting he can't control, and questions he'll need to answer about a son he's deeply proud of but can't always find the right words for in real time.

This is what nobody sees when they say it's only an hour.

So we drive.

And by "we," I mean me. He doesn't drive anymore.

The car is familiar. I am familiar. The road is familiar.

Is it a five-hour drive across the desert? Yes. Do his legs cramp? Yes. Is it perfect? No. But the overwhelm gets brought down to a reasonable level. Not eliminated. Reasonable. That is the goal.

We don't have to worry about packing too much. Overhead bin limits. Liquid restrictions. We bring the touch points of home: his blanket, his pillow, full-sized shampoo, snacks he actually eats, the dog's leash. The variables I can control, I do control. The ones I can't, I plan around.

A five-hour drive that costs us nothing on the other end is cheaper, in every way that actually matters, than a one-hour flight that costs us three days of recovery.

So the next time someone tells you to just fly, it's only an hour — show them this. Because for families like ours, the trip starts days before, and the recovery lasts days after, and the hour in the air is the smallest, easiest part of the whole equation.

What I'd tell another caregiver

If you're newer to this than I am, here is what I wish someone had told me:

1. You are not being dramatic. You are not over-accommodating. Hypervigilance and autonomic dysregulation after TBI are measurable, documented, and biologically real — not preferences to be talked out of.
2. The cost of an event extends far past the event itself. Plan for three days of recovery for every "big" travel day. If you don't plan for it, you'll pay for it in worse symptoms, faster.
3. Control the controllables. You can't control TSA. You can control the drive, the snacks, the route, the stops, the playlist, the temperature, the lighting in the hotel room, and what time you arrive. Stack as many of those in your favor as possible.
4. The book is sacred. Whatever your version is — a notebook, a whiteboard, a calendar app — the external memory system that lets your person not have to ask the same question fifteen times is the most important tool in your house. Bring it on the trip.
5. When someone tells you to "just fly," they are not wrong about flying. They are wrong about your situation. That's not on them. Their nervous system isn't doing what your person's nervous system is doing. Don't argue. Just decide what's right for your family and go.

Get the rest of these as they come

I write about this every week in our newsletter, From the Nest. It's free. Rob writes a section in his own words. I write the translation. We cite the science. We don't sugarcoat any of it.

Subscribe here — Wednesday mornings, straight from a caregiver who's living it.

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Robbins Nest Alliance is a 501(c)(3) nonprofit (EIN 39-2763662). We educate caregivers and families navigating brain injury, dementia, Parkinson's, CTE, PTSD, and FND. Every dollar funds free, peer-reviewed education for families like ours.

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Related reading on Robbins Nest Alliance

• Brain Injury 101: Start Here
• CTE Symptoms, Warning Signs & Causes
• Caregiver & Veteran Nonprofit Overview
• The Nesting Journal
• Coming soon: When the Words Won't Come — a companion piece on aphasia and communication breakdowns in unfamiliar environments

Caregiver tools we actually use on travel days

Curated on our Amazon storefront:

• Calming the Nervous System list — sensory tools, weighted items, noise-reducing headphones
• Caregiving Tools list — the practical items that make trips survivable
• Safety and Sanity list — what goes in our travel bag every single time

As an Amazon Associate, RNA earns from qualifying purchases. Affiliate revenue supports our free educational mission.

Peer-reviewed sources cited in this article

1. Wylie, G. R., & Flashman, L. A. (2017). Understanding the interplay between mild traumatic brain injury and cognitive fatigue: models and treatments. Concussion. PubMed: 30202591
2. Tan, G., Dao, T. K., Farmer, L., Sutherland, R. J., & Gevirtz, R. (2014). A possible mechanism for PTSD symptoms in patients with traumatic brain injury: central autonomic network disruption. Frontiers in Neuroengineering. PMC: 3867662
3. Callahan, M. L., Binder, L. M., O'Neil, M. E., et al. (2018). Sleep Disturbances in Traumatic Brain Injury: Associations With Sensory Sensitivity. Journal of Head Trauma Rehabilitation. PubMed: 29991430
4. Lamb, D. G., Porges, E. C., Lewis, G. F., & Williamson, J. B. (2017). Non-invasive Vagal Nerve Stimulation Effects on Hyperarousal and Autonomic State in Patients with Posttraumatic Stress Disorder and History of Mild Traumatic Brain Injury. Frontiers in Medicine. PMC: 5534856

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Heather Kendrella-Robbins is the founder of Robbins Nest Alliance, a 501(c)(3) nonprofit, and the full-time caregiver for her husband Rob, a Special Forces veteran living with Parkinsonism, aphasia, FND, and probable CTE. This article is educational and is not medical advice. If you are navigating a neurological diagnosis, please work with your medical team.