Wednesday, January 27, 2010

PTSD

I have some very personal experience with Post Traumatic Stress Disorder (PTSD) that, even after successful treatment, sometimes impacts my life. Typically, PTSD develops after an individual survives a traumatizing experience and only afterward has a reaction to that event. Those who are raped and combat soldiers are most often thought of as people at risk for PTSD, but it is also widely recognized as a possible consequence of emotional, physical, or sexual abuse, neglect, violent crime, natural disaster, and the events of 9-11. Symptoms of the condition vary widely, but are generally depression, inappropriate fear response to specific situations, flashbacks, body memories, and nightmares. That was my experience of PTSD, at any rate.

MY PTSD was not a result of any of the circumstances I listed above. Instead, mine evolved about five years after I stopped having reconstructive surgery, and was a direct result of how I handled (or in this case didn't handle) what happened to me. (The entry "What My Classmates Never Knew" describes my medical history.) The PTSD exploded onto the scene when an interviewer asked me a simple question, "How did all that hospitalization effect who you are now?" My stomach fell into my shoes and a floodgate opened with memories pouring forth day and night.

Any little thing – word or even a specific texture of plastic – could trigger a swamping of my mind with events of the past. Body memories are a kind of flashback with which I became very familiar. It goes beyond remembering to actually experiencing the physical sensations associated with the memory. Some completely lose touch with their current reality and the remembrance is all they know, but I didn't have that experience. Instead, I recall making my hands into fists and focusing very hard on just breathing because somebody happened to mention needles. I avoided one specific plastic food storage container because of the shape of the rim evoking memories of oxygen masks held over my face. There was one January day where my roommate held me for a very long time because I couldn't stop the memories from coming one after another.

With therapy, I learned to control the memories and work through what I had experienced as a child. Ironically, an emergency appendectomy aided in my healing in ways I still do not fully understand. I guess it has something to do with going through a medical situation that was 100% necessary for survival and coming out the other side without experiencing the kind of trauma I did as a child. Whatever the case, one year after it all came pouring out I was getting better.

To be clear, better does not mean gone. I do not know anybody who has dealt with PTSD who does not from time to time have a disproportionate fear response to something or the occasional nightmare. Current life events can sometimes drag up old issues and things get "interesting" for a time. At the moment, that is the case for me. One of my eyes is misbehaving and, though it has no useful vision, it still lives in my head and can develop problems. Of course – and this happens to me a great deal of the time – the doctor has no idea what might be actually causing the symptoms, so I have been making rounds of experts, including a totally weird but incredibly brilliant ear, nose and throat specialist, to determine if my facial structure anomalies explain current symptoms. Fortunately his quirks were an intriguing distraction whereas the ophthalmic plastic surgeon was fear-invoking. At the best of times, this species of doctor makes me want to scream and this one found it necessary to start discussing how a "cap" on the eye not giving me trouble could be beneficial.

Now surgery looms on the horizon, filling me with instinctive fear. Some days I think my emotions are irrational and perhaps I should be declared the literal kind of insane. Other moments find me proud because I have managed to not have a single nightmare. Part of the problem is that I have no idea how freaked out a "normal" person would be about current circumstances. Am I just the usual amount of scared or something beyond that?

I know my childhood medical experiences and the resulting PTSD will be a part of me throughout my life. My appendectomy helped me realize I can manage a difficult situation without it resulting in trauma. Perhaps this surgery will be the time and place where I realize that the part missing from me being "better" is me declaring it to be so.

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