Monday, January 31, 2011

Life After Afghanistan - PTSD

I have been conflicted a bit about my blog ever since I returned home. Part of me thought that it should end right after I got home. After all, I was home and everything was okay, right? Not the case. Life after Afghanistan has challenges as well. I have written a few entries in the past few months. I seem to be gaining some inspiration to write again. Today I was reminded vividly of a very important condition - Post Traumatic Stress Disorder (PTSD).

In the Charleston Air Force Base Clinic today, I saw a patient who was at Bagram Air Field on 19 May 2010. It was the night we were attacked by the Taliban. It was a complex attack at 3 in the morning that sent the base into chaos. I remember it vividly and probably will for the rest of my life. My patient from today is a member of security forces, a military cop essentially. He was in the middle of the firefight that night! 8 months later he has issues consistent with PTSD. This is not surprising in the least. But, he can and will get better. I assured him of that. How can I be confident of this? Well, it is because I also have PTSD.

PTSD has one major requirement. The person must have been involved in something outside of the normal human experience. Examples are a disfiguring accident, a motor vehicle crash, and rape. These are not normal events, and they should not be wished upon anyone. Of course, war is definitely outside the normal human experience! It is messed up to say the least. That is why it leads to a large amount of PTSD cases. There are 2 condtions which have become the signature medical problems of Iraq and Afghanistan - Traumatic Brain Injury from explosions and also PTSD from the insanity of war. Without a doubt, PTSD has been present in all wars from the beginning of time. It was previously called "shell shocked" or "combat stress". To have the "thousand yard stare" was definitely taboo. Heck, General Patton did notbelieve in it which is why he slapped a hospitalized soldier right in the face! He lost a star for that. Good riddance. The bottom line is that in the 21st century we have a much better understanding of PTSD, thus we can recognize and treat it.

PTSD is characterized by a number of symptoms. Flashbacks to the traumatic event are common. These flashbacks become intrusive. The person has difficulty functioning in normal society. Poor sleep, anger, poor concentration, irritability, substance abuse, depressed mood, and low energy are all symptoms of PTSD. Many other physical things can happen as well such as back pain, muscle aches, and gastrointestinal distress. In general, these people are a mess! One of my PTSD patients here in Charleston was at home taking care of his young kids. His wife was gone. He began thinking about his war experience as he did constantly. He then got in the car and drove down the street. At a traffic light, he realized that he was supposed to be at home taking care of his young kids. He turned around and went home. The kids were okay. Nothing bad happened. Nevertheless, these incidents are scary for everyone involved. He essentially was in a completely different world for about 10 minutes.

In my first three months back from Afghanistan in 2010, I noticed a lot of the symptoms listed above in myself. My sleep was quite poor. It just seemed like I could not sleep through the night. The silence here was deafening to me after sleeping through explosions all the time in Afghanistan. I kept thinking about certain incidents over and over trying to make sense of them which I never could. One day I left the gym after a workout and began thinking about one of my patients in Afghanistan. I opened the hatch to my Saturn VUE. I got in the car and drove 3 miles down a busy road at 50 mph with the hatch wide open. I pulled over and closed the hatch. No big deal, right? Nope! I could no longer deny that I did in fact have PTSD. I needed help before things worsened.

To be continued...

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