Ever since Patrick’s accident on 11/8/13, I have been experiencing PTSD (post-traumatic-stress-syndrome). For the most part, I try to observe my PTSD, as if it’s outside of me, to keep it in check. Like a good student, I see the escalation of fear at a speed of 0-60, and I say to myself, “huh. look at that.” On good days, I can do this. On bad days, I suffer knots in my stomach, a shortness of breathing, chest tightness, sheer panic, and racing thoughts.
It is well known that PTSD effects TBI survivors, but few people realize that caregivers very often suffer PTSD as well. When we say that we are forever changed by TBI, we don’t simply mean that the events have changed how we live our lives, but that our brains are forever changed by the severe emotional, psychological, and physiological trauma that a TBI can induce. Hell, they don’t call traumatic, for nothing.
Trauma is responsible for creating what many researchers of PTSD are now calling, the “fear-driven brain.” Trauma increases activity in the amygdala; the region of the brain that is linked to the fear-driven response. Those effected by TBI can have such hyper-activity in the amygdala, that they can exhibit fear/stress responses to pictures of others experiencing fear. Likewise the pre-frontal cortex, which regulates emotions like fear, is shown to have decreased function after faced with severe trauma. Perhaps most fascinating, is what occurs in the hippocampus when a person has PTSD. There is a marked reduction in flow to the hippocampus after trauma occurs. The hippocampus is responsible for regulating and differentiating our memories. So when a person has severe PTSD, their brains are unable to discriminate between past and present. This explains why a TBI victim with PTSD, cannot go to a worksite or ballpark if that is where they were injured. And that is why a caregiver cannot return to the hospital, (or sometimes any hospital) without experiencing the same emotions they did at the time of their loved ones accident. To our brains, it is all the same.
Sights, sounds and smells are powerful triggers. When I saw Patrick lying in the hospital bed on Thursday, I remember looking up at the monitor that showed his vitals. Everything looked good. My eyes moved from one number to another. And then? FLASH. I’m back at Del Ray Beach Hospital. His blood pressure is skyrocketing. His heart rate is up to 220 beats a minute. The machines are beeping with Tourettes syndrome. His pulse ox is dropping. They are having him “fly solo” to see if he can breathe unassisted. I’m watching the numbers go down from 98… to 95… to 93… to 90… to 88… .my heart racing, my hands sweating. Why isn’t anyone coming in here? He can’t breathe!!! 86….84….82…. the nurse finally comes in and puts him back on assisted breathing. His pulse ox climbs back up. “He couldn’t breathe!!!” I tell her. “No, he couldn’t.” She says. “If you took him off it now, he’d die within a few hours. That machine is the only thing keeping him alive.”
“You’re squeezing my hand,” Patrick says. I am back at Cooper Hospital. My heart is racing. My hands are clammy. I am digging my nails into his hand. For a moment in time, I’ve dissociated elsewhere. All because I looked up at the damn monitor.
Sometime later in the evening, I lean in to kiss Patrick, and the smell of iodine, dried blood, antibacterial wash, and a cocktail of whatever else they use in surgery, hits me hard in the face. FLASH. I am holding a plastic bag with a pair of jeans, shoes, socks, a wallet and underwear in it. It is sickly sweet smelling and everything is brown with 3 day blood. My hands run through the items looking for the wallet, and his ID. “I bought him these jeans,” I thought. “He looked so good in them.” I touch the red chucks and imagine him lacing them up, his fingers moving gracefully. His boxer briefs are magenta. I laugh at his eccentric, colorful taste. Then I see that they have blood on them. Then I see that my hands have blood on them. “How long have I been sitting here with my hands in his blood?” I wonder. I am suddenly comforted by the blood. I feel as if I’m touching something holy; something sacred. In my state of severe shock, I suddenly want to keep the clothes… and the blood.
Then, like being pulled out of dark water, I gasp internally, and I’m back again at Cooper. My lips pull off of Patrick’s; his smile so warm and endearing. “Mi Amore…” he says. I recognize my heart flying again. I try to calm down.
This is how it was during our short stay at the hospital. I gave him a sponge bath on Friday morning, and flashed back to the many days I bathed him in the hospital. It was the same pink basin, multi-purpose body shampoo, overly-thin, scratchy washcloths, and the rhythm of washing him in the silence. And that flash triggered another flash of changing him when he was in adult diapers; his wide, helpless eyes full of pain, connecting with mine as I told him it was OK. It happened again when I had to rotate him due to the mandatory bed-rest they had set in place. Over and over, flashes upon flashes, a domino effect revealing horrors and traumas I had worked hard to lock away.
Since we’ve been back home, it’s been better. But PTSD is always there, like a monster, lurking alongside you. The morning after we got home, I awoke to find Patrick’s face disfigured, and his left eye completely swollen shut. Though I showed him a strong face, I felt myself beginning to panic. I rummaged through my closet for a thermometer. I took his temp. It was normal. As my fingers pressed the buttons to call the doctor, I felt like I was moving in slow motion and couldn’t push them fast enough. I was flashing back to when he had developed an infection, was hospitalized and operated on to remove the plate that had been put in months prior. The swelling I was told was normal, but we’ve still been taking every precaution these past few days.
The more I write about it, the more I realize that PTSD has found a way to infiltrate most areas of my life. When Patrick is home alone for an hour or two, and doesn’t answer a text right away, it takes me all of 5 minutes to begin having racing, irrational thoughts that he has had a stroke, seizure, fallen, or even died. One morning I left the store and raced home, speeding, only to find him cleaning dishes, happy as a clam in mud. My PTSD is so far reaching that when my sister told me some months ago, how she was nearly in a car accident driving home, I pretty much flipped the f*$k out on her.
However, if I can try to find the good in it all, I will say this. When I met Patrick at 15 years old, he had at the time, (though I did not know what it was), a raging case of PTSD. His trigger was so sensitive, that anything could set him off. I have to this day, never seen a fear-driven brain as agitated and traumatized as his was in adolescence. Most kids who have PTSD will act out in school because everything is perceived by their brains to be a threat. Yet they are treated as young criminals; unwilling to follow rules, show respect, or act accordingly. So it was with Patrick. It was not until he was 22 that he was diagnosed with PTSD, and it was revealed that he had suffered abuse as a child. But by then, he had developed a substance abuse disorder, a list of maladapative behaviors a mile long, mental illness, diagnoses, and had learned only destructive ways to cope. Even knowing that, I had no idea what PTSD was or how to handle it when we reconnected at 30 years old, and fell back in love. Now, almost 3 years later, I feel my compassion and understanding for those struggling with emotional and mental illness has tripled. And I want to help spread awareness, so that our education system can help young people by recognizing PTSD early on, instead of punishing them for misbehaving. Patrick is now getting help and I’m in the process of doing the same. And I hope if you are experiencing PTSD from a trauma in your own life, that you will seek help though counseling, medication, alternative modalities, yoga/meditation, nuerofeedback, prayer, love, and friendship.
We can heal. The brain can rewire itself. PTSD does not have to be a burden to bear forever.