Tag Archives: TBI

Funny How a Melody Sounds Like a Memory…

I really don’t want this blog to turn into “1001 stories about how Kalypso’s fucked up in the head”, but I have to tell you all about something that happened over the weekend.

My sister, C, and her husband are currently stationed at Fort Hood.  Which is awesome, because they’re only two hours north of us and I can go see my monkeys any time I want.  So, I went up there on Saturday, spent the night and went to go to a concert with C, her husband B, and Monkey 1 and Monkey 2 (G and T, respectively), on Sunday.  Now, the kids at 6 and 7, but they had a blast.  It was a really good show, too, Man Made Machine, Halestorm, Staind and Godsmack.  And I was having a blast through the first two sets.

So, to give you a little bit of background, I’ve lived in Germany twice, from 2003-2007 and 2008-2011.  When I was there the first time, a LOT of shit went down.  I spent 2 years taking care of war-wounded soldiers coming out of Iraq and Afghanistan, I got married, I lost three babies, I got divorced.  I tried to kill myself a couple of times.  I got thrown in the mental ward for “observation”.  I know I’ve mentioned my official PTSD diagnosis before.  It was a rough couple of years.  I was also listening to a LOT of rock at the time.  C and B were stationed there too, we were always hanging out and C was always listening to Staind.

Fuck.  I’m still not telling this story right.  I’m sorry, guys, I suck at this.  I should mention, before I go any further, that music has saved my life.  When I was a teenager, I fell hard and heavy into love with Punk Rock.  It was proof to me that I wasn’t the only one who felt so out of place, felt so uncomfortable in my own damn skin.  It was proof to me that if I could just hold on, I would find the place where I fit in, where I wasn’t a freak or a loser.  I would find the place where I felt OK, felt like a real person, instead of feeling like I was trying to puppet a life that didn’t belong to me.

And I did, I turned 16, got my driver’s license and learned how to mosh.  I found a whole society of people who loved me, accepted me.  A whole society of people who welcomed me.  Who were just as fucked up as I was, struggling with a lot of the same shit.  And for the first time in 10 years, I was able to breath again.  I felt normal, whole, unbroken.  

So needless to say, I tend to form really, really strong emotional connections with music.  Songs can reduce me to tears, make me feel like superman, remind me that life is beautiful and precious.  And sometimes, they can kill me.

So, back to where we started.  I went to this show on Sunday night with C, B and the kids.  And when Staind came on, I was OK for about 3 minutes.  Then the lighting technician decided that a solid minute of strobe lights pointed RIGHT AT THE AUDIENCE was a good idea.  And I started to hyperventilate.  And all of the shit I used to feel every single day came flooding back in.  Worthless, broken, useless.  It didn’t help that it was HOT inside that arena.  And I started to panic.  Once it started, I felt like the room was getting smaller and smaller and so I ran.

I ran up the aisle, out the door, through the lobby and into the fresh air.  By the time C caught up with me I was crying and hyperventilating and shaking.  My nails left bruises on my palms from the firsts I didn’t know I was making.  I sat outside with my head between my knees, intending to stay there until I could breath again.

and that’s when the cops showed up.

Random Sheriff’s Deputy: Is she OK?  Ma’am, if something happened, we need to know.

C: No, nothing happened, she’s fine, she’s just having a panic attack.  She doesn’t do well with crowds or flashing lights.

Random Sheriff’s Deputy:  Are you sure nothing happened?

Me: (from between my knees)  No, I’m fine, I just needed to get out of there for a minute.  I’ll be OK, I promise.

Random Sheriff’s Deputy: Ma’am, are you sure?  You were really red and really crying when you came running past us.

Me: (peeking up from between my knees) No, really, I’m OK.  Well, I’ll be OK.  I just need a minute.

C: She’s got traumatic brain injury.

Me: (Looking at C, thinking “REALLY?”)

Random Sheriff’s Deputy:  Oh.  Are you prior service?*

Me: Yeah.

Random Sheriff’s Deputy: Oh, me too.  I totally know how it goes.  I don’t do well with crowds either, any more.  That’s why I’m up here in the lobby instead of down on the floor “working”** and watching the show.

Me & C:  Um.  OK.

Random Sheriff’s Deputy: Well, you ladies have a nice night.

Me & C: … (look at each other and shrug)

Me: Let’s smoke a cigarette and then go back in.

C: Sounds good, sissy.

It was a little surreal, to say the least.  But I calmed down and then we went back in.  Monkey 2 sat on my lap for the rest of the show and holding on to him kept me calm enough to enjoy the rest of the concert.

* For those of you who don’t know, “prior service” means “having formerly serviced in the armed forces.  It’s a slightly less nerdy way of asking of someone’s a veteran.

**Yeah, he actually made finger quotes.

————————————–

You know, I don’t want to end this post like that.  I want to talk about why I’m OK with what happened.  When I was in Germany the first time and I was severely depressed and not handling things, I was also numb.  I’ve had a 15 year addiction to self mutilation (I’m a cutter) and I got really, really bad in Germany.  That’s the reason I was thrown into the psych ward.  But I loved cutting.  I still do, I miss it more than I can say.  I miss the sting, the blood, the pain.  And at that time in my life, I needed the pain.  Because at least I was feeling something.  It beat going through life on autopilot.  It was better than feeling fake.  Completely unaffected and unable to process anything.  Like it wasn’t happening to me.  Or I was watching from outside my own body.  The pain brought me back to center.

I haven’t cut in almost 6 years.  The last time I cut myself was the first time C ever found out about it.  And she told me “I can’t have my boys around that kind of shit.  You have to choose, cutting or your nephews.”  And I didn’t even have to think about it.  I still miss it, I do, but I know I’ll never cut again.  Those boys mean too much to me to risk losing them.

The reason that I’m OK with having a panic attack once or twice a year is that I’m at least FEELING.  It sucks when it’s happening, but I’ve got good friends and good family and an amazing husband who all know that my anxiety is usually situational.  They all know that as long as I can GTFO for a few minutes I’ll probably be OK.  And at least I don’t have to drive a knife into my leg to calm myself down anymore.


PTSD and other things.

I just read a very well written and awesome article called I Have PTSD… So What? and it has inspired me to talk about my own PTSD, that of my husband and that of my patients.

I’ll start with me.  My issues stem from spending two years working on an impatient ward at Landstuhl Regional Medical Center.  On average, I would work three or four 12 hours shifts each week (which actually translated to 13-14 hours each shift).  On the bad weeks, specifically when we would have MasCals (Mass Casualties) come in to the hospital, we would work 12-15 hours a day, 7 days a week.  Luckily, this only happened a few times:  When a chinook went downFallujah I and Fallujah 2.  I have a very specific form of PTSD called “Combat Caregiver Fatigue” or Compassion Fatigue. This particular form of PTSD affects healthcare workers who tend to war casualties.  It’s similar to regular old PTSD in a lot of ways.  I am hyper-vigilant.  I have problems with loud noises and crowds.  I have problems with with my sleep and with depression.  I have been medicated in the past, when it was at it’s worst.  I am no longer medicated.  Even when I was at my worst, living on Pop Tarts, diet coke and cigarettes, sleeping 2-3 hours each night (interrupted by nightmares about combat I had never been in) and drinking several pots of coffee each day just to make it through, I was still able to get up and go to work.  I was still able to provide the very best healthcare available to these war wounded men and women I saw each day. But eventually, I hit a wall and I had to transfer out of the inpatient ward and into a clinic. I couldn’t do it anymore, I couldn’t see another 17 year old missing both his legs. I couldn’t see another 20 year old with his whole life shattered.  I was prescribed sleeping pills for years.  I was on heavy antidepressants of for a long time.  I was even treated for bipolar disorder (which, BTW, I’m not, but sever mood swings are symptomatic of both PTSD and TBI, which I also have.).

Today, I’m no longer on any medications.  I still have a lot of issues with crowds and loud noises but have managed to keep my “freak outs” to a minimum.  I even went to a revolutionary war reenactment with my mom and managed to maintain my cool through the fake gunfire.  What’s funny is that I can go to a shooting range with no problems whatsoever.  I get really freaked out when people invade my personal space.  I still have the occasional nightmare, but now it’s more of a “several times a year” thing than an “every time I close my eyes” thing.  Bottom line, I’m a fully functional adult despite the fact that I have PTSD.

Now, let’s talk about Husband.  Husband has a raging case of combat inflicted PTSD.  He’s gotten much better in the last 5 years, but he still has flashbacks, has nightmares so bad he has no idea where he is when he wakes up, can’t handle crowds, can’t handle fire.  He’s had fire on TV trigger bad flashbacks.  Occasionally, the sounds of helicopters trigger flashbacks.  He’s got issues.  But, he goes to work every day.  He carry’s a gun (even though you’d never know it).  He’s armed, but not dangerous.  He holds a top secret clearance.  He’s currently a full time student (in addition to being a full time Soldier) and carry’s a 3.5 GPA.  He’s been in fistfights and had guns pulled on him (recently…ish) and has never once freaked out.  He’s even bucking for another deployment because too much time in garrison “gets boring”.  He’s a fully functional adult.  Hell, he functions a hell of a lot better than a lot of civilians I know with no excuses.

Let’s talk about my patients.  When I was in Germany the first time, I spent two years working inpatient.  99% of our patients were war wounded casualties that we would receive within 24-48 hours of their injuries.  Needless to say, within 48 hours of being shot or blown up, you’re a little fucked up in the head.  And well you should be.  I saw the full spectrum: from absolutely no problems to lapsing into flashbacks so often that he couldn’t carry on a sentence.  Unfortunately, the inpatient turnover was 3-7 days, so these men and women were usually still in the more extreme phases when they left us to go back stateside.  When we went back to Germany, I worked in the LRMC TBI clinic.  More specifically, I ran the Vision Therapy program for the TBI Rehab Center.  Basically, I would to long term rehab with Traumatic Brain Injury patients to improve their visual function.  You want to talk about some PTSD?  Look at TBI patients.  PTSD and TBI often accompany each other and their symptoms are very similar.  Ignoring the physical deficits associated with TBI, that is, and focussing on the mental status changes and mood changes associated with TBI.  They’re virtually identical to PTSD patients.  But you know what?  Every single patient that I did long term rehab with? They might have been a hot mess, but they were trying.  They were doing everything in their power to return to that point where they could function.  They were amazingly strong and dedicated.  And most of them had some form of PTSD.  So what? Did that make them unpredictable?  Sometimes. Did it make them dangerous?  No.  Did it makes them any less deserving of the very finest healthcare we could provide for them? HELL NO.  If anything, it makes them more so.

A lot of people look at PTSD with the same shameful glances that depression and anxiety have gotten over the years. Like it makes you weak.  Like it makes you less of a person.  And that’s horseshit.  If anything, I think it makes you stronger. It takes a hell of a man (or woman) to be able to admit that they need help.  I think that if any of us went through what these soldiers go through we would be lucky to only have PTSD and not a full psychological breakdown.  I think that we should be more worried by the man who doesn’t get PTSD from watching an IED kill his teammates, his friends, his family, than the one who does.

I had a friend say recently that PTSD stood for Pretty Typical Sign of Decency.  And I’ll agree with that.

**Updated 9 Feb 2012: edited for my shitty grammar.


NB4 Haters…

Let’s talk about Botox!  I’ve been getting Botox injections in my forehead, neck and shoulders for about a year.  It’s a medical treatment, not cosmetic.  It’s part of the treatment regimen for my migraines.

I’ve had migraines since I was a kid, like 7 or 8.  So basically for 20 years.  Every treatment they’ve ever tried doesn’t really work or works really great for about a month and then stops working.  Every prophylactic they’ve tried me on hasn’t worked.  Oh, and not to mention, I’m allergic to triptans, the major migraine medication class.  So Imitrex, Zomig, Maxalt, all those, I can’t take them.  I go into anaphylaxis.  Which may sound fun, but having your throat swell shut is a real bummer.  I’ve done stress journaling, food tracking, sleep studies, everything imaginable to try to figure out my triggers.  And we can’t.  I’ve had MRIs and CT scans and there’s nothing physically wrong with my brain to cause them.  Best as we (my neurologist and I) can figure is that they’re post traumatic migraines stemming from the 15 or so concussions I’ve had in my life (4 of which were before the age of 10).  Most likely, I’ll have them for the rest of my life.  At their worst, I would get 3 or 4 migraines a week.  It was rendering my life unlivable.  They were affecting my ability to work, my ability to function.  And then I started working in TBI (traumatic brain injury).  When I started working with a bunch of neurologists, they started taking care of me.  I finally got the often asked for, never before received, all important referral to neurology.  In case you didn’t know, the Military Healthcare System is … Special.  Basically, you have to go to primary care for everything and be referred out to specialty clinics as needed.  And primary care hates to give out referrals, because if you start being seen by a different clinic, you’re not creating RVU (relative value units) for primary care anymore and they need those RVUs to justify their continued employment.

Once I got the referral to neurology, things finally started getting better.  They started with an occipital nerve block on each side and immediately started Botox every 90 days.  I’ve been getting Botox for a little over a year now.  And holy shit, has it made a difference in my life.  I still get migraines but the intensity and frequency of them has decreased significantly.  I might get a bad migraine once or twice a month now.  And after years of getting them 3 or 4 times a week, I can handle that.

The reason I brought this all up is because I’ve had some haters lately.  And in general, I love me some haters.  If I have people hating on me, that means I’m doing something right.  Because it’s all sprung from jealousy.  But I tend to mention my Botox appointments whenever I have them and everyone freaks the fuck out.  “You’re so young! Why would you do that! How vain are you?!?”  And I calmly explain that my Botox is medical and not cosmetic. I don’t give a fuck about wrinkles.  And they again launch into a diatribe, this time about my medical care.  “You shouldn’t be getting Botox for migraines, you should be taking x drug instead or change your diet or blah blah blah blah.”  You know, just in case this was an impulsive decision on my neurologist’s behalf.  I had one person in particular tell me that I should “Just smoke weed, it’ll take care of your migraines.”  Well, there’s two fundamental flaws with that plan: I hate weed and I get drug tested at work.

But what really irritates me is the implication that I don’t know the best treatment for myself.  The implication that despite the fact that I have been in the medical field for 10 years, worked in/with neurology for 2 and dealt with these migraines and all the associated treatments for 20 years, somehow they know better than I do.  Like a fucking barista can give me medical advice.  Or a software engineer suddenly knows more about TBI symptomatology that I do.

Look, I appreciate that you care and you honestly think that you’re helping me, but back the fuck up off me, I got this.