Monthly Archives: July 2010

Post Traumatic Stress Disorder

PTSD is an anxiety disorder that can occur after a person has been through a traumatic event, or multiple events, where the person felt his/her life or other’s lives were in danger.  The hallmark symptoms include:

  • Repeated “reliving” of the event, which disturbs day-to-day activity
  • Avoidance of situations that remind you of the event
  • Feeling numb
  • Hyperarousal (feeling keyed up or on edge)

Sean had a long list of problems associated with PTSD, depression, and anxiety.  While he was in medical hold he was able to hide many of his problems from me as I was not seeing him on a daily basis.  We communicated mostly by phone and he would try to keep things positive and not worry me.  So the changes in him were quite a surprise when he came home.  The first couple weeks were wonderful as the family was in a type of
“honeymoon” phase.  But soon it was apparent that Sean was struggling with many demons. 

Sean does not feel safe.  He sits with his back to the wall so he can see everyone around him.  He scans parking lots and open areas.  He has terrible road rage.  Sean is highly impatient and inflexible.  He cannot tolerate noise, crowds, new people and places.  He is easily irritated and startled.  He is angry much of the time and subject to outbursts of anger for seemingly meaningless incidents.  Sean has trouble concentrating, has memory loss, cannot make decisions easily and questions his decisions repeatedly.  He has trouble sleeping, sleeps excessively, has night terrors and night sweats where he wakes punching and kicking, but does not remember the nightmare.  He has episodes where he stares and appears to be “checked out” where he is non responsive and is very confused when he comes back around.  He repeats conversations as if they never occurred.  He forgets events and conversations.  

It saddens and infuriates me to know that while he was at WRAMC and in medical hold he told his case workers at least three times (and this is documented by the case workers) that he was having PTSD symptoms, and ALL THREE TIMES he was DISMISSED and told there was NOTHING wrong with his mental health!  Here was a soldier asking for help, and it was refused because no one followed up with it.  According to the notes, the psychologists found him to be experiencing normal stress and agitation.  However, Sean says the sessions were relatively informational and were not indepth.  I wonder now how many of these symptoms he is still experiencing four years later might have been lessened with early intervention.

Something’s Not Right

I couldn’t tell you what it meant, or exactly what it was.  Sometimes the differences were so slight that I thought I was imagining things or overreacting.  But something wasn’t right.

I remember telling the doctors something is not right.  He’s just not right.  This is not the man I know. 

Dr. K, the psychiatrist told us that the myriad symptoms were a combination of PTSD, depression, and anxiety coupled with the adjustment to coming home following a period of severe illness and isolation in addition to the experiences in a war zone. 

I came home and Googled everything the doctors said.  Although I had heard about PTSD, I did not know anything about it.  And despite the verbal information presented by Dr. K, the VA did not provide us with any information.  I would have loved a handout, a factsheet, something!  But I did my own research and found the information I needed. 

It was a scary and confusing time for all of us.  I didn’t understand why Sean was behaving the way he was, the kids didn’t understand the changes in dad, and Sean himself didn’t know what was going on with his body (the abdominal pain and headaches persisted) and with his mind.  Imagine someone you love coming into the house and looking just the same as you remember, but acting completely out of character.  Looking back, we needed MUCH more support and training than we were given.  We did not have the resources available to adequately deal with the issues at home and help us all heal as a family.  Instead, we “made do” and “got by” by learning to either adapt our behavior to ease Sean’s discomfort, forcing him into unpleasant situations, or avoiding things altogether.  Our home was full of arguing, hurt feelings, and lonliness as we all tried to separate ourselves from the problems surrounding us. 

One of the first things I noticed was his agitation.  Sean was always upset about something.  The kids were loud, the dog wanted out, someone ate the last of the bread.  He was not just irritated, but would rant and rave about the smallest things.  Other times he would agree to do errands or pick up the kids, but when the time came to do so he would explode about the inconvenience and my expectations of him.  

Watching Sean struggle with chronic pain, excessive need for sleep, gave me great concern about his job as a lieutenant at the fire department.  On his days off he would sleep all day, eat some supper and sleep all night.    He was very run down and did not have energy for daily tasks he used to do.  When he failed his paramedic test (a job he had had for almost 15 years, and  class he was certified to teach) I knew the end of his career was coming.  He was not able to keep up or think quickly enough to do his job.

Entering the VA Zone

Now that Sean was home his medical care would fall under the Veterans Health Administration through the Department of Veterans Affairs.  Aberdeen has a Community Based Outpatient Clinic (CBOC) and there is a VA Hospital in Sioux Falls, SD 203 miles to the south. 

The transition from the Department of Defense (DOD) to the VA system is not exactly streamlined.  Sean had to make copies of all his military medical records to bring to the VA as the two organizations do not yet have electronic record sharing.  The doctors then had to review extensive records along with Sean’s accounts of the past 19 months in Iraq, Germany, and in medical hold.  Every encounter with a new provider meant starting at the beginning and going over the details. 

Sean was evaluated for persistent GI symptoms and mental health, specifically, Posttraumatic Stress Disorder (PTSD), depression, and anxiety.  He was assigned a psychiatrist at the CBOC along with a Social Worker for therapy. 

The CBOC did not have a doctor on staff, so Sean was evaluated by the Physician’s Assisstant and then referred to a physician at the VA hospital.  Thus began our regular travels to Sioux Falls for appointments.