PTSD? How Could I Have It? I Didn’t Fight Overseas in a War…

**Updated 7/11/2016

I didn’t know I had a problem. Let me do for you what friends and family did for me…

If you have followed my blog for very long, you recognize I am still learning to write. This post is by far the hardest I have ever written. Not due to sentence structure or paragraphs but because of actual content and its very personal nature.

I want to tell you as a guy many perceived to be tough, I had to act tough because that was what the world, well at least our culture in both EMS and law enforcement expected. I have never considered myself a tough-guy. I trained in the gym and in martial arts to be physically tough but emotionally I am no different than any other healthcare provider or police officer… I was trained for all kinds of stuff- except what I would face emotionally over my careers and over two decades in public service.Mental_prep2

Like many in public service, I worked more than one job to support my  family. I literally went 13 years without a vacation or any real time off of work. If I took time off from the PD it was to work EMS. If I took time off from EMS it was to travel and teach DT4EMS courses. I wanted/needed to be the best paramedic, police officer, martial artist , self-defense instructor ever. I wanted to earn the respect of my peers more than anything. So to be perceived the best, I took every class I could, got every instructor certification I could, and worked ALL I COULD!  Leading to all work and no play, no real way or time to decompress or relieve stress. The constant fear that if I wasn’t tough enough, strong enough, fast enough, smart enough to handle things emotionally or physically led to having a problem I refused to accept. Until now… Let me explain.

Early on in my careers as  both a police officer and paramedic,  I would do acts, that looking back now were actually acts of stupidity, not courage. There is a very fine line there. I learned how to tap dance back and forth across that line. The only reason I was labeled brave,courageous, tough or smart was because I got lucky and didn’t die or get seriously injured.

Here are some things looking back, I became acutely aware of:

  • I was a gym rat. Always working out because I had to be on top of my game against any dirt bag that tried me on the street. That was my motivation. Not physical appearance, but to be able to “win the fight” that I always perceived as inevitable.
  • Hated Crowds– I  didn’t want to go to a concert, sporting event, 4th of July Celebrations etc. being around people, specifically large crowds put me on edge.
  • Nightmares– My monsters were different. They were a critical failure of a piece of equipment in a life or death struggle. I would be shot and when I would attempt to return fire, the bullet would not fly through the air, instead it would fall out of the barrel of my gun and onto the ground. Or… if I stabbed someone in self-defense, my blade would bend on their body never penetrating their skin as they continued their attack.
  • Trouble falling/staying asleep- I attributed it to shift work as a medic and a cop. I needed not only things like Tylenol PM, but I would drink a lot to try and shut my brain off at night…just to fall asleep. Neither helped the nightmares… but I could at least fall asleep.
  • Hyper-vigilance –  I attributed it to being a cop. Never did I not look at everyone in a room, like a restaurant. My head was always on a swivel breaking down who was sitting where, is there a bulge in their shirt? Do they have  a knife clipped in their pocket? What is their body language saying?. Always looked for people who were trying to kill me or my family. It was so bad that when Lindsay and I were dating, she would get frustrated and tell me to “look at me” when we were having a conversation over dinner. I would tell her “I can see you”… I had a problem you see,  I just didn’t know it.
  • Chest Pain– Figured it was because I was getting older. Two different trips to the ED, thousands and thousands of dollars spent on tests. No cardiac problems were ever detected. A few months after the last bout my wife suggested I get seen for some sort of anxiety because my heart was fine. Of course I refused because there is no way, with all the stuff I do that I could have any form of anxiety…
  • Trouble Processing Information– I am not talking about new information but the stuff I had done for years. I would get angry, literally pissed off, if tasked with more than one thing at a time. Which is ironic because that was what I loved about EMS and law enforcement alike- I worked BEST under pressure… or at least I used to.
  • Loud Noises– That surprised me (door slam, yelling etc) would instantly infuriate me. My heart would pound seemingly out of my chest and I wanted to injure, literally, whoever made the noise.  This would go hand in hand with my sleeping issues. I had terrible trouble sleeping in hotels because every time a door to another room would shut, people walking/talking in the hallway my heart would pound.
  • QuickAnger Switch- I would get so angry at something someone who knew nothing about who I was or what we actually teach would type or say about DT4EMS in social media- my hands would sweat, my heart would pound and my voice would crack when I would speak. This directly tied in with sleeping troubles, loud noises and crowds!

When I started in EMS and later became a police officer, I had NONE of those things. They crept up and now as I look back became worse over time.

Sitting here typing this I recall two specific times where something happened, but I still didn’t know I had a problem. Neither of them were a particularly stressful call, just when I noticed I was “aware” something wasn’t right.

One is where I was working as a police officer and had a report of shots fired. I arrived and the man allegedly firing the shots was refusing to come outside. I was directed to provide lethal cover for the officers attempting to make contact. Mind you this is something I have done hundreds of times as a police officer. Having someone at gun point was something I was not only well trained for, but had experience at! I was using my patrol car for cover and had my patrol rifle pointed in the direction of the residence. All of a sudden I heard a distinct tapping, a rattling type sound. Unaware where it was coming from I began to look around. I was shocked to realize it was coming from me. The magazine of the rifle was tapping the hood of the patrol car because I was shaking. I immediately told myself “What is your problem? Are you a pu _ _y?”  I had no idea I had a problem. I found all kinds of excuses as to why I acted that way… that night.2015-08-08 19.26.50

I left the PD to free up time because DT4EMS was growing. I went back to full-time EMS. Still having sleeping issues, I became acutely aware that when the tones would go off, my heart would about pound out of my chest. I look back now and realize for years early in me EMS career I loved it when the tons went off. Now it seemed like it scared me…I was becoming afraid to have the tones go off, and it wasn’t just the noise.

So let me get to my point. Here I was a medic with 20 years of experience on the street. I ran hundreds of codes… I specifically recall a code I ran (one of my last shifts as a full-time medic) and while this should have been a run of the mill elderly code I can still feel what I felt that day… having a problem processing the information. I was standing there arguing with myself saying…”WTF? Why can’t I think what comes next? You have done this hundreds of times you dumbass!”  How could a guy who studies as much as I do, taught ACLS and PALS as much as I did not be able to process a simple effin code?! So instead of me even being able to find a cheat sheet in my EMS Field Guide, I was busy arguing with myself, calling myself names in my head…while trying to work a simple code. I figured it must be some form of adult onset ADD that I have that is just rearing it’s head…or something. Again had no idea I had a problem.

So here is where it really started coming to light. I would be teaching DT4EMS’ EVE somewhere around the country. I would tell my story of a violent encounter, how my ambulance was car-jacked and be fine. But during the presentation where I  would start telling stories providers told me, to my face, about their encounters and I would start to cry. In front of a room full of people, I would cry. It worsened to where I would start to cry even at a TV commercial. I figured it must be low testosterone because nothing else could explain it. You see, I had a problem and didn’t know it.

So last year I was away teaching. The host was driving me to my speaking engagement. We had quite a bit of time to talk thanks to traffic. He started mentioning things that he had experienced. All the while I was recognizing they were the same things I had experienced. He then stated he sought help and was a totally different person. That it helped him once he got past the stigma that EMS can be human and are not immune to suffering, contrary to popular belief within our culture.

I then tell him how I experienced many of the same things. He said “I know” and then he told me to get help. I started really looking back over my past. All of this really started after my ambulance was car-jacked. Over the years it became progressively worse. I told my wife maybe she was right and she asked around at her medical office who they would recommend. She set the appointment 🙂

I went to the doctor a short time later. While telling him my symptoms, I tried to puff up and act tough. The next thing you know I started to cry… Well, so much for the tough guy routine.

I started treatment and within a week, my chest pain, that had been almost daily, was gone. Within another week or so, while still aware of my surroundings I didn’t look at everyone as though they wanted to kill me. Loud noises in hotels still wake me up, but I can turn over and go right back to sleep. I have taught without crying and can actually process information again. It has been about 6 months now. I am finally “me” again. I sleep well, I love more and I am not afraid.

I am not asking you to label anything.I am simply stating that if you have experienced some, any or all of the things I described above, please see someone. A professional, particularly one familiar with EMS/Fire or ED setting.  I am trying to do for you what others did for me. Get treatment and like me,  who got back to being ME, you can get back to being YOU.

If you still need convincing you have people that care about you, will stand up for you, right beside you and your health mental OR physical for you my EMS, Fire and PD family… I have broad shoulders and a chin that has been tested. I got your back as much now as I did for years before I shared this, my personal story of struggle and triumph.

 

**Update 6/27/2016

Hard to believe it has been nearly two full years since I originally decided to share the intimate story with you. In doing so, I found it was not only easier for me to talk about my own demons, but recognize similar ones in peers, family and friends. I have been chest pain free (for the most part) for nearly two years. I still don’t desire to be in crowds, but I am not overwhelmed with tension when I am. I have become aware of something over the past several months, I never really noted, specifically, before… What made me good in emergency situations back then, is the very thing to anger me today; two or more decisions at once. 

Those working in any field where handling emergencies of others, are what they live for, the ability to process large amounts of rapidly evolving information is crucial, and often life-dependent. I was one who loved the fact I not only handled those situations seemingly well, but I actually enjoyed them. Well, that was certainly then, and this is now. I have to make a conscious effort to not become angered when taxed with more decision at once. For example, I may be typing a post for DT4EMS related topic on social media using my phone, when my phone vibrates, or worse, rings in my hand due to an incoming call, I’m hit with instant anger. How is it something so simple, so trivial can make me mad enough where with jaws clenched, I want to throw the phone? Especially since I used to make my living, enjoying finding calm within chaos?

Now that I am aware if this, I am much quicker to pull off of one object of my attention, pause to deal with the second, in the capacity required. Doing so keeps me from becoming frustrated.

 

PTSD stages fam2