Our Lives With Post Traumatic Stress Disorder and Traumatic Brain Injury

Archive for April, 2012

You Can Polish a Turd….

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An article published in the Los Angeles Times titled ‘Army encourages new way of looking at PTSD‘ discusses changing part of the diagnostic criteria for diagnosing military members with PTSD. This is because the general consensus is to develop PTSD one must have felt “fear, helplessness and horror”.

“There is considerable new evidence that certain aspects of the definition are not adequate for individuals working in the military and other first-responder occupations,” such as firefighting and police work, according to the policy, developed by the U.S. Army Medical Command.

It has been my experience that soldiers (term used all inclusively) are trained not to feel these, but rather to channel this feelings into anger and motivation. They are taught to rely on their training, which by the time they deploy (assuming they have in fact been properly trained) these actions and reactions have become nothing more than a muscle-memory reflex. They no longer have to think, they simply react and they know the rest of their element will do the same. They know their job because it has been drilled into them through their training as well as real world implementation.

In mass-casualty incidents with the 86th Combat Support Hospital, everyone knew their job and knew what was expected of them as well as what to expect of others. To watch it is to truly understand the meaning of ‘organized chaos’. It’s a dance really, with everyone knowing their choreography. Sometimes its unsteady and perhaps a little disjointed but you learn, adjust, and move on. This concept is also true for our civilian counterparts in emergency management.

The article goes on to suggest that clinicians consider all of their patients symptoms rather than a check list approach, which would ultimately denying a soldier has PTSD simply because they don’t reflect the symptom of ‘fear and helplessness’. Having other symptoms such as hyperarousal, anger, nightmares, and flashbacks should be suggestive of PTSD, even in the absence of a declaration of fear. Following this approach would allow these soldiers to receive much needed care and benefits. The author also cautions against throwing medications at the symptoms rather than treating the root of the problems.

However, as beneficial as this change may be, herein lies the crux. An opinion piece in ‘The New York Times’ entitled “Does the VA Get It?” makes some very valid points about the state of VA health care, especially in regards to mental health.

A new applicant for mental health services is supposed to receive an evaluation within two weeks, a standard the department says it meets more than 95 percent of the time. But the inspector general said that fewer than half of veterans received evaluations within 14 days. The rest waited an average of 50 days.

Did you catch that? I’m pretty sure that was the IG pointing out how the VA has been polishing the turd. If anyone wanted to fix the problem the first step would be to cut the bureaucracy. Less paperwork and hoops would mean fewer paper pushers which in turn means more money for health care professionals. More treatment personnel means more appointments and more treatment. It really is common sense…something that has been lacking in our military and government for entirely too long!

So, do we continue to polish and admire the shiny turd or do we start demanding the VA flush their current practices and actually fix the problems?

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PTSD FYI

Today was not a banner day for me. I feel the need to share a little ‘PTSD FYI’ with everyone. This is something my therapist shared with me… If you are taking an SSRI (Zoloft, Prozac, etc), unless it means life or death, AVOID STEROIDS AT ALL COSTS!

About a month ago, my family doctor put me on a short course of Prednisone to reduce the inflammation around the nerve in my back. It helped marginally while I was taking it, however it completely ERASED my Zoloft and Seroquel. I was a train wreck for two weeks with anxiety attacks, irritability and depression. My therapist said Prednisone is actually the worst drug to give a patient with PTSD.

Now…back to today. As mentioned in a previous post, I had a spinal steroid injection yesterday. I promise not to regale you with the gory details beyond saying I’ve seen better bedside manners in an inner-city DMV than from this doctor. Needless to say things didn’t go well. Anyway, I didn’t think the small amount of steroid that was injected (their version of sedation was a joke) would be enough to effect my SSRI….well, I was wrong!

I spent most of the day still sore from the injection which was bearable until my lunch date showed up unexpectedly. There I was, trying to relax and enjoy my afternoon when anxiety and panic arrived uninvited. There was nothing going on, no stimuli, no intrusive thoughts or flashbacks, there was simply fear and panic. Thankfully it was a short visit, but panic attacks always leave me extremely irritable for the rest of the day.

Long story short…if you have PTSD and take an SSRI, avoid steroids (especially prednisone)!


A Little Over-done

So the last two days have been a whirlwind of activities. Between teen’s prom and the dreaded weekly grocery shopping, I think I have seriously over-done it this weekend.

Friday, we had to get all the prom decorations out of the school because there would be no way to access them on Saturday. Most of the decorations ended up in the back of my van. Thankfully all those boxes were really light; however, leaning into the van to adjust them probably want the best idea for my back.

Saturday morning was a flurry of activity as we set up and decorated the banquet hall. It was fun work. There were a handful of rather entertaining teenagers and one teacher. We had everything done in two hours! I did pretty good for most of it. At one point, the DJ was doing a sound check and I had to leave the room. Apparently I am getting old because it was just too loud. I had to take another break when they started blowing up the balloons. I’m allergic to latex and just being around them (especially when they are being inflated) causes my throat to itch. I also made the mistake of carrying around a servers tray full of pitchers of water (not the brightest idea but better than carrying them by hand). I should have asked one of the teens but I highly doubt any of them has ever been a waitress and could handle a tray that full and heavy.

Later, I spent an hour or so trying to figure out how to style teen’s hair. She’s nearly as tall as me (I refuse to admit that last inch she’s grown this year lol), so I had her sit, which meant I had to hunch over at times to get her hair up. By the time we finished though, she looked STUNNING! My sweet baby is growing up way too fast. After she was all dressed and decked out, we went and took some pictures, decided to be silly and walk around the mall (more pictures lol) and finally arrived at the prom. Somehow I managed to stay awake long enough to pick her up at midnight and help with the rest of the tear down. By 130am we were home, I was hurting (my back) and thoroughly exhausted.

I woke up this morning to a screaming back and the usual numbness, neuralgia and sciatica. After some coffee and a proper dose of meds, hubby and I set out to do our grocery shopping while teen watched the littles (I have four children at home, teen -17, darling – 7, sweetheart – almost 6, and baby girl – 2 1/2…..ALL GIRLS!). I DREAD going to Sam’s after the church crowd has been released, thankfully it wasn’t as busy today, though I suspect the pain meds made me just groggy enough not to care about being there (Sam’s is normally one of my more persistent triggers for a panic attack). Then we hit Kroger’s and Aldi’s. Again, I made it thru with little more than a nasty case of nausea and indigestion from the experience…which is a hell of a lot better than how it normally goes.

All in all, even for all the pain I’m in right now, I would classify this as a good weekend. THANKFULLY the pain management clinic I’ve been referred to was able to move my appointment up to tomorrow instead of a week from tomorrow. I say ‘thankfully’, but honestly, I’m terrified! They will be giving me a steroid epidural block in my lower back. I get VERY paranoid about needles anywhere near my spine after getting meningitis after an epidural that caused a spinal headache and necessitated a blood patch. At least I know they will be giving me IV sedation, so I hopefully will be so loopy that I just won’t care what they’re doing to me! Time will tell. If I don’t post for a couple of days, you’ll know why!