PTSD for Medical and First Responders

[A_Tech]

Hi,

Well obviously this my situation.

I was hoping to find others here that might have a similar background to chat with, it can be so hard to talk about this stuff with non-med people (and I mean no disrespect, it's just often graffic or upsetting to others).

Im a 40 year old female that has spent the last 10years in the State Trauma Hospital as an Anaesthetic Technician. My PTSD was brought about after years of exposure to shocking traumas, deaths, and no support from management.

I would love to hear from anyone that has a similar story, or just wants to chat.

Cheers ✌️

[Croix]

Dear Bear53~

I'm glad Mark and I were able to strike a chord. I've found having others that understand and have the experience is a real treasure. Trying to explain things to someone who does not have the experience is hard - even if they are very supportive and want to understand.

Might I mention something about writing out your experiences? I've done that for some things and have found it a particular help to have my wife around - not looking over my shoulder, but available. She understands my condition and if I was to go down the path of triggering myself she'd be able to help. Leading me away, setting up my normal distractions and so on.

I think you mentioned you had a partner, is he able to help in this way?

I think Mark may be concerned about you getting into your psych quickly. I'd add to that that fortnightly visits seems to be the most helpful for me -at this stage. some people say greater frequency is an advantage - I don't know.

I did not find the process quick, please don't be impatient. If in doubt ask, your psych should be able to say if things are progressing as expected.

Please post again and say how you (and your partner I guess) are going

Croix

[The_Abyss]

Bear - I was so sorry to read about your struggle and admit it brought up one of my own incidents. I too thought I had dealt with my original situation, until a year later I when someone said "thank you" in relation to the incident. Such a simple act, but it plummeted me into an uncontrolled spiral. I couldn't understand the depth of my reaction when I had thought it was all put to bed. I suspect that some of it is tied up with what else was going on at the time (thresholding).

The incident didn't occur in isolation, and while the memory may, it's the added issues that have the greatest effect. The first incident may have occurred when the kids were sick, you were having a crappy day at work, you were tired, you were driving on a particular stretch of road that you always have issues with, etc etc. They all add up. When only one of the triad is present, it stays below threshold, but when you have a couple of others present at the same time, it pushes you over threshold and you react. In time, any of those initial factors can become associated with the feelings and create their own issues. The trick is to keep them all below threshold, and learn to deflate the easier ones. Hence the suggestion about you being over-tired - it may have been enough to push you over threshold and so by controlling that aspect, it can help to deescalate the others.

The reaction can come out of left field, leaving you completely paralysed. The feelings will pass, and I'm glad you got an appointment where you needed it. I found I needed fairly frequent appointments at the start, and were then able to lengthen the time between as it got easier to manage. I then kept "maintenance" appointments going for a while longer, more to deal with the accessory issues and thus keep it all below threshold. I had a couple of relapses, but they were quicker to deal with than the original situation. "Tightening up" so to speak.

Bear - and Mobi - I hope you both get the help you need. Sharing does help - sometimes it works best with those that were in the situation with you, but sometimes it helps just to share with total strangers. There is no judgement and you can be yourself (or your alter ego if that helps!).

Wishing you both good luck!

[MarkJT]

Bear - yes absolutely you are more susceptible to being triggered when you are tired. Night time is my red
zone for sure. I am generally really good during the day but if there is a time where i am going to go off my nut, it is at night. I even feel vulnerable at this time so have to concentrate on grounding myself but at the same time, this is very mentally draining so a double edged sword.

Great that you got into a psych and i agree with Croix, writing down the incident can work and work well but
make sure you have support there if needed as this is triggering massive.

You are in a marathon here, not a sprint so recovery takes a fairly long time so don't rush things. All in time.
The more work that you put into your base, the better it will be to allow you to move forward.

Mark.

[TrailRunner]

Hi Mark,

My workcover got approved! such an absolute relief.
Makes me think 'wow, this actually sucks, this is actually real, i'm actually feeling this way' weird place to be in.. I kept hoping i'd wake up one of these days soon and it will have all gone away like a bad cold or flu!

Ive been back at work in a non-clinical role with a little bit of supernumery clinical work in ED for the last month.
First couple weeks were hard just being in the building, then it was hard hearing machine noises associated with sick patients, then it was hard because i felt totally helpless and hopeless when the dept was busy and I couldnt do anything but shake and sweat in the office, some days their were flashbacks and its weird having them in public like that, makes me feel so vulnerable. But now the worst part is the managers comments. So now I dont want to go to work because i'm scared of hearing more unhelpful comments from them, and i'm scared that i can't take any more comments, and i'm scared about what i'll do if i hear one too many of these comments.

I have a couple days left til I'm on holidays for a month and I dont know if i should even go in for these last days
I'm going trekking in nepal.. I'm anxious and scared about this too.. so many what ifs.. Has anyone else been on a holiday in the midst of all this? I"m hoping getting away from this place will help put me in a greater headspace. but i'm scared that i'll fall apart and my bf, gp & psychologist are half a world away!
I am travelling in a group of people, and a couple of them know about my ptsd, to some degree.

Any tips on travelling with ptsd?
I'm not on any meds for my anxiety, and my depression scores were improving (although remain severe) so we didn't start them meds either. hoping i dont regret that.
Any other non medication tips you have?

[MarkJT]

Trailrunner, awesome that your WorkCover was ticked off - major hurdle to cross so you can now put that behind you.

In regards to unhelpful comments from your managers, it is difficult yes, but tell yourself that what they think and say, try and not let it hurt you. You know what you are capable of at work and what you have achieved in the past. Yes you are taking some time away from your normal duties but that is okay, you are injured and you need to let that injury heal (recover). Once this is done, you could well get back to pre injury duties. It is impossible to say whether you will ever get back to those duties as you need to recover first. I have mates that have got back to their duties so it can be done.

Travelling with PTSD is anxiety provoking, no doubt but it can be done. Trekking in Nepal can be so calming because there is no noise other than nature. You have such an unbelievable look at the stars every night and the landscape is astonishing.

What trek are you doing?

The Nepalese are such beautiful people and the air is as crisp as you will ever experience. Mindfulness is the key - there are so many ways you can practice this in Nepal.

A word of warning about Kathmandu though, do not expect it to be a decent city. It is run down, incredibly poor, smelly, crowdy and dirty. It is an experience that is for sure.

I did the Annapurna circuit a couple of years back.

I just wish i had of known about mindfulness then as i would have taken so much more of this wonderful country in!

Drink plenty of water that has been sanitised or buy bottled water, buy up on nuts in Kathmandu as they are good for energy, mix with the locals in the small villages you stop by, don't be put off my the Nepalese and their sanitary standards, tell the guides that you have PTSD as they would have dealt with people getting anxiety at altitude, if you are going above 4,000 mts, be aware that the air thins greatly at that level so breathing is harder - it is a bit freaky but you can get used to it and just have a great time!

Mark.

[The_Abyss]

Hi Trailrunner

I have done a lot of trekking (and hope to do Nepal next year). I have found that after a couple of days of adjustment, the worlds I trek in are so different from those that trigger me, that I no longer worry about it. You can't help but 'live in the moment' while trekking - you are so busy getting up the next mountain or taking in the view or absorbing the beauty, that your anxieties melt away.

Having said that, I did become overwhelmed at the end of a day trekking Kokoda - I was so exhausted, and doubted my ability to go on. I sat there and sobbed until I was sick. At the end of it all, my guide pulled me up, dusted me off, patted me on the back, and moved on. It was what I needed at that moment, and afterwards felt so much better! Finishing that trek was made all the sweeter!

It is human to falter. It's what we do with it that makes the difference.

Go enjoy your trek......I look forward to hearing the details!

[bear53]

Hi Trailrunner, great that youve posted your concerns about travelling. ( was going to post today anyway, see my second half)

My experience with travelling in the last few years was that my anxiety is way worse before the trip with the 'what ifs' too, especially when it comes to packing. Once I am there there is very little anxiety, so hope this works for you too. Also there are very few,

triggers for me overseas, so being away from home can work that way. As an example , ambulances were once a major trigger for me, esp. early on, but on hols. they didnt trigger me.

Nepal is such a beautiful spiritual place, beautiful people, and the views are unique. If you do happen to forget any trekking gear, you can easily buy it in Kathmandu, at bargain prices too. Namche also has a reasonable range, just not so many shops. "Trip advisor" may be useful for you for travel advice on shopping etc.

Unfortunately we never made it to base camp as the earthquake in 2015 happened while we were there. Certainly some stressful times then( thats another story), but travelling as a group meant we could be there for each other for support. Its great that others on the trek know about your ptsd, that way hopefully they can be there for you if you are having a hard time. Whether you tell your guide or not is up to you, but if you are struggling it would be good to tell him, that way he wont be 'second guessing' what the problem is and be more supportive of you. A good tour guide would encourage you to keep communications open,ours did.

Now part 2: so after my last post I worked yesterday, lot of driving, some pretty bad weather. ( scary enough for anyone)Sometimes 1 of my biggest fears is coming across another accident, was feeling this way yesterday all day. Today i learnt that 3 hrs after i was on a country rd, there was a double fatality there. Shook me up . today, luckily i was in the office, but still found it hard to concentrate. Cant see my psych till mid May. so not sure where to go fron here. Just want to get to easter break.Work not aware of my issues, early on, my psych advised against work cover claim mainly as she said it would be more stressful, less confidential ,and it may easier on me if i dont claim. I can also get where you're coming from trailrunner when you say people comment about you, I think would feel the same way if others at work knew. Though we all know it shoudnt be that way.

[A_Tech]

Hi Goldenlight,

Reading your post was far too familiar to me. It's me to a tee. Can I ask how long have you been a nurse? And in what area?

I was an anaesthetic technician for 10 years in theatres at a major trauma hospital. I specialised in Emergency, Cardiothoracic and was on call for the Cardiothoracic transplant team (a full load!)

I also have a history of anxiety, which strangely enough is what makes us SO good at our job! The anxiety aspect keeps us on our toes, so we're vigil, we ready and raring to go when needed. But it's our downfall in the biggest sense because we never have that chance to actually unwind and relax (even at home) like everyone else. I never sleep properly, I don't think I ever have.

It makes us perfectionists, also good for the job but not for our health. I too have struggled all my life with an eating disorder. I think that maybe my obsession with my own shortcomings is why I got into health. Looking after others is something people like us do SO well.

I started out feeling like you do. I was ok at work, but when I was off the thought of going back was overwhelming. I started to take sick days, then weeks. Eventually I had to admit that I was struggling.

All the advice in the world won't help unless your ready though. I knew something was wrong for quite a while but didn't want to admit it. By the time I did, it was too far gone to just have a short time off. I wish so, so much that I had acted sooner. I haven't worked in almost 3 years now, and it's destroyed any self esteem I had. But I know others that were back within the year. It really all comes down to how soon your willing to recognise it and act on it.

If you have supportive GP then you'll be ok. If not then that's the first thing to do. It makes all the difference in the world. Your GP can sort out any meds if needed, psychs, therapists etc. definitely the first port of call.

I hope I've helped at least with something. Please let me know how things are going. Your a nurse for a reason, because your a special type of person. I believe that our past experiences are what makes us stand out from the rest of the herd.

Take care,

Donna x

[TrailRunner]

What's the deal with anniversaries?

I know it's not happening again.

In the past couple weeks I've been pretty well. Standing up for myself, eating, exercising, socialising.

knowing it was coming up didn't seem to change my days. Now I'm here in the middle of the days of last years events, I just want to cry, curl up on the couch and disappear again. Wtf

any advice or similar experiences?

[A_Tech]

Hi TrailRunner,

I know EXACTLY what your saying when it comes to anniversaries!

I'm the same. I have no idea what it is that triggers these things when like you said, days before everything is pretty good. Yes we're aware that the anniversary is coming but you feel ok. Then suddenly it hits like a tone of bricks.

The last two years for me I was doing pretty good right up until an anniversary and then I crashed. I ended up in hospital both times. It's a huge setback for recovery too. Especially with a hospital admission, doctors get touchy about it!

One of the psych registrars said to me at last admission that all of our memories, especially when connected with trauma/emotion etc are basically stored in our sub conscious mind. So even though we're doing well on the outside, until all the traumatic events are truely dealt with, we will have episodes when our sub conscious brings it back to the surface. I'm guessing that anniversaries are such episodes.

I don't know if that helps at all, but I felt like it made sense for me.

Just know your not alone, but if you feel out of control please make sure you let someone know.

Take care xx