CPTSD and Surgery

  • 10 Replies
  • 680 Views
*

Contessa

  • Member
  • 796
    • View Profile
CPTSD and Surgery
« on: July 05, 2016, 03:52:39 AM »
Hi All,

I have just read a post by Kizzie (under Prevention, Advocacy and Awareness) regarding the need for medical professionals to be aware of the difference between PTSD and CPTSD when we are admitted to surgery.

It got me thinking of the last time I was in hospital for a day procedure, I did not come out of the unaesthetic well at all, and believe that I had an emotional flashback of sorts (still not sure what it was). That said, I had had a stressful couple of days beforehand, because this had never happened before, and I have not had any procedures since.

Just curious, has anybody else experienced any unpleasantness after or during surgery?

*

Sweetsixty

  • Member
  • 88
    • View Profile
Re: CPTSD and Surgery
« Reply #1 on: July 05, 2016, 09:30:22 AM »
Hi Contessa,

I've just replied to Kizzies post on this as I've  just had a total knee replacement just under 4 months ago which is the procedure she is having done.

I think any assault on our bodies will be an assault on our minds too. Even those who do not suffer CPTSD are often freaked out by anaesthesia and the like. The way I reasoned through it, and it's only my supposition, is that it's about control. 

My T once explained it to me this way, to help me understand in a simple way what is a lot more complex really:
1.  when we were children we had no control over what happened to us.
2. We came out of that childhood filled with shame, fear and guilt.
3 shame and guilt indicate that we had some control, as in if we are ashamed of something then it must have been our fault, we must have caused it.
4. The alternative is saying that we had no control and that's what healing CPTSD is about, meaning we had no control as we were too young.
5. Then of course as we get older we develop schemas that protect us, as in perfectionism etc.
6. Having surgery means relinquishing control to someone else again - scary!

It made sense to me and helped me through my surgery but it wasn't without issues. If you've seen my post on drugs and illness you will know how triggering it is for me. You may or may not have read my background story so I'm sorry if this is triggering for those reading. By the time I was being wheeled into the theatre I had dissociated and made the decision that if I died I wouldn't know about it, I even sent mental hugs to my family and told them I loved them! This would have been a flashback to the attempt to kill me by my ex.

After the op I had several issues with reactions to drugs which sent me again into an EF and I ended up refusing any drugs and doing my entire recovery from this major op on Paracetamol and ice!! Ouch.

But I did it and the outcome has been great!

But it's a really good topic to bring up as medics and operations often are linked to lack of control and the other thing my T told me was "only try to control the things you actually have control over". Which was great advice, I'm still practising  that one.

*

Contessa

  • Member
  • 796
    • View Profile
Re: CPTSD and Surgery
« Reply #2 on: July 05, 2016, 12:50:44 PM »
You know what Sweetsixy, I think you just gave me the reason why I suddenly and unexpectedly developed a fear of flying, haha.

Although my trauma was onset during adulthood, the steps you described resonate more with that than with the surgery. I haven't read your background, and no worry, it is no trigger for me at least.

The lack of control was a big thing for me, one year I went on no less than 20 flights with no problem. The next year I had no control during a domestic violent situation reminicent of that movie called "Single White Female". Later that same year the pilot of a flight makes a stupidly steep descent nosediving to the ground just before landing. Scared me to no end.

A few weeks later I'm on a flight when as soon as we take off I have a panic attack and for the next three hours think the plane is going to crash (somehow kept quiet but the poor guy on the seat next to me... sigh). Then I had to make the flight back home again :(

Thank you for that input Sweetsixty!! Actually that may apply to my surgery awakening too, but perhaps in a different way.


*

Sweetsixty

  • Member
  • 88
    • View Profile
Re: CPTSD and Surgery
« Reply #3 on: July 05, 2016, 04:12:53 PM »
Your welcome Contessa, I'll try to add in as and when I can. I'm not good at being open about this and as I have MS I'm often not well enough too.

It sounds as though you are right about the airplane incident, it would explain a lot eh? Maybe think about what part of the flight you can control, as in you and preparation etc.

When I went in for the op I had a copy of a letter from my doc with a suggested protocol for my before, during and after op drugs for pain relief,  as he knows how I react so badly to drugs (as in I'm classified as a fast metaboliser). I made copies of the letter and gave them to everyone I came in contact with and made sure there was one in my notes too. Unfortunately post op a nurse gave me too much of one drug and I reacted badly. I was fine of course, but it set me off again. So my only answer after that to gain control was to refuse everything.

A few weeks  later when I saw my T she asked me how it had gone, I replied terrible, they didn't help me and I ended up recovering on just paracetamol, blah, blah, blah. She smiled at me and said congratulations that was a resounding success. Your new knee is doing well, you kept control in a very difficult environment and you've learnt a lot from it about you and drugs. So often when we think we've failed we haven't.

But the op did seriously fire up my hyper vigilance symptoms and I'm still trying to get on top of that again.

So do whatever you can to feel in control and let go of what you can't! Our problem is we look back at childhood/abuse and assume we were in control when in fact we weren't.

*

Contessa

  • Member
  • 796
    • View Profile
Re: CPTSD and Surgery
« Reply #4 on: July 06, 2016, 01:34:26 AM »
Thank you for the advice Sweetsixty, yeah there is a lot that we can control besides the actual flying of the plane! Same goes for surgery. Usually i'm not fussed, and have never been worried at all, funny that these things happen. Before I did not understand how phobias worked in others but now I have a great appreciation - none of it is voluntary!

Your T is right. Glad you were able to come through surgery with not-so-negative consequences as they could have been. Love the moments when you can say to yourself "Yeah... I did good". Taking control of what you can control, preparing yourself and others as best we can, actively mitigates consequences. Generally, I never see 'failures' as failures, but it does make it more difficult living in a world where significant others do. Particularly in work situations.

Hope your hyper vigilance settles soon, we all need less of that.

*

Kizzie

  • Administrator
  • Member
  • 6980
    • View Profile
Re: CPTSD and Surgery
« Reply #5 on: July 28, 2016, 07:19:53 PM »
I'm late to this thread but just wanted to add in my recent experience with surgery.  I didn't have an EF per se while in hospital this time, but sure understand why I have had them in the past.  I  too had problems with my meds, either had too much or too little and mainly with one nurse in particular.  Most staff were good I have to say, but this one nurse was very passive aggressive and controlling and I had a hard time getting through to her and through her to the doctor. The implication was that I was being too demanding.  I ended up breaking down in front of my surgeon and finally got what I needed on Day 3.  I did so much better after that. 

I hate that lack of control and dependence on others, especially when those providing treatment and care are passive aggressive, PD, whatever.  Takes me right back to being at the mercy of my parents.  Fortunately I am far enough along in recovery now that I didn't have an EF, but it took a lot of energy I should have used on recovering. 

Same thing happened with a nurse gatekeeper when I was getting chemo in 2007. I had bad reactions to anti-anxiety meds and steroids which I reported to the clinic nurse but like the one this time she insinuated I was just being too sensitive and needed to just take what I was given. I had some really bad EFs as I recall.  Like this recent experience, I remember absolutely hating the fact that I could not get past the nurse at first.  I felt like I did when I was a child - powerless, my needs/want minimized and even some shaming going on.  It took talking to the surgeon to get my meds changed and once we did things were so much better.

At least adult me was able to get through to the doc then and now.  When we are vulnerable (as when we are in the hospital), our Inner Child is often dominant (or at least mine is), so we're vulnerable to staff who may wish to  silence/mistreat us. 

Sweet Sixty - so sorry you had to endure this surgery on just Paracetamol and ice - OUCH is right!  :hug:

*

Contessa

  • Member
  • 796
    • View Profile
Re: CPTSD and Surgery
« Reply #6 on: July 28, 2016, 11:26:58 PM »
Thanks for the update Kizzy, have been wondering how your surgery went.

Its curious that its not so much the trauma of surgery itself, its the effects of the supporting medication and people around that get us.

Sorry to hear that it was distressing. I suppose good thing is we do speak up about what we need, whereas others might not and will put up with the discomfort. Yay us!

*

Kizzie

  • Administrator
  • Member
  • 6980
    • View Profile
Re: CPTSD and Surgery
« Reply #7 on: July 29, 2016, 05:04:54 AM »
Yay us is right Contessa  :cheer: even though for both SS and I it didn't quite go as well as it should have.   :stars:    The point is we did both try and that means we are advocating for ourselves and by extension for other patients, not a bad thing in an environment that is so controlled by the professionals involved.

I think of all the energy that those of us with CPTSD expend because of the double load of present and past trauma - this is the kind of thing I'd really like to get across to professionals we have to deal with.  I managed to do so with my dentist this past spring. I told him about having CPTSD and how having dental work was very triggering because I had been shamed as a child. He and his staff were incredibly patient and kind, explained everything that they were doing, gave me lots of praise (felt like a kid but it was cute and frankly it felt good on some level), and genuinely seemed to want to do what they could to help me get through things without triggering my CPTSD.  That's the kind of thing I'm talking about - trauma sensitive treatment - not too much to ask for I don't think.  We're certainly worth it  ;D


*

Contessa

  • Member
  • 796
    • View Profile
Re: CPTSD and Surgery
« Reply #8 on: July 29, 2016, 10:08:45 AM »
It is most certainly a double load indeed and so exhausting trying to get that point across. Unfortunately more often than not requests do fall on deaf ears. Trauma sensitive treatment is a must.

*

Kizzie

  • Administrator
  • Member
  • 6980
    • View Profile
Re: CPTSD and Surgery
« Reply #9 on: July 31, 2016, 05:01:48 PM »
It is most certainly a double load indeed and so exhausting trying to get that point across. Unfortunately more often than not requests do fall on deaf ears. Trauma sensitive treatment is a must.

Agreed  :thumbup:   I was thinking this morning about what trauma sensitive treatment and services might look like and one of the main things that came to mind would be that professionals understand that dependency on others (such as being in hospital or having a dental procedure done) often results in an overwhelming sense of vulnerability for many of us with CPTSD. Just like my dentist and in fact my surgeon as well, explaining what would happen before, during and after, not minimizing or invalidating my feelings but acknowledging and working with me to bring them down; answering questions; responding to my needs/wants; being friendly, positive and personable rather than an authority figure....  all can help us to stay grounded, to feel better about handing over some control (because the staff have proven themselves to be caring, etc), and to feel we are people with rights rather than an object to be worked on (treated). 
« Last Edit: July 31, 2016, 05:06:29 PM by Kizzie »

*

Contessa

  • Member
  • 796
    • View Profile
Re: CPTSD and Surgery
« Reply #10 on: July 31, 2016, 10:43:02 PM »
That reminds me, about ten years ago in Australia, that general lack of a good bedside manner with doctors in particular became a topic of concern for the same reasons you put forward Kizzie. There was talk of medical students taking courses in people skills as compulsory units in their university degrees. Very important  particularly when visiting the GP!