Is there something beyond "I don't understand"?

Is there something beyond “I don’t understand”? Can someone be so confused by a moment in life that it reaches a level of crimson intensity? What if there was no question available to help with this state? What if none of your friends believed you lived in such a state? Most importantly, what if there was no cure for this state? This is as close as I can get to describe what my Post Traumatic Stress Disorder (PTSD) is like. Life is supposed to be strange, messy, exciting, and intriguing adventure all wrapped up in a delicious chocolate chip cookie (I might have had a Percocet a few hours ago).  We get to create, design, produce, love, discover knowledge, and find answers, and most importantly, construct our own story every single minute of every single day, which is almost magical when you think about it. The unknown is why you are reading this on my website, have a smartphone, live in a country that has sent men to the moon, and have cured many horrible diseases just to name a few. Now, imagine losing this ability of understanding why you don’t understand during important moments in your story. Imagine being utterly confused but don’t know where or why you are confused. Finally, imagine being completely frightened of social constructs most learned early in life. Welcome to my PTSD.

For those of you that don’t know, most of my PTSD comes from a rock climbing accident I had in 2003. The short version is that I fell roughly 15 feet, hit the ground, rolled three times, then spent 3 days in the hospital so they could add 10 screws and a plate into my left arm plus 6 staples in my head. This doesn’t include the post trauma osteoarthritis, accelerated onset of rheumatoid arthritis, the degenerative disk disease, gout, depression, 8 surgeries, and countless pills since then. As my first physical therapist said, “I got lots of hurt”. However, I have never sat down to write about my PTSD until now, I’ve mainly focused on my physical pain.

The night I fell rock climbing I did not have any health insurance. I was working for a local greenhouse as a delivery driver supervisor and part-time as a ski instructor during the winter. I was the textbook definition of a ski bum. My checking account usually had about 2 months of rent in it at any given time but that was mainly because my apartment was only 450 square feet. My toys were cool and I had a place to sleep and watch t.v., what more does a single boy need.

It is now some 14 years later after my rock climbing accident and the only way I can explain my mental state that night is through a Return of the Jedi scene reference. Remember when R2D2 got shot and all his internal gadgets came out, that is exactly what my internal body and mind did in response to the fall. I went through every single conceivable emotion ranging from happy; smiling Alan to absolutely terrified and confused Alan in a matter of nanoseconds. To this day I can still remember my internal voice telling me that something didn’t feel right when I first came off the wall, my internal spirit telling me that I was still alive the nanosecond after I hit the ground, and the logical part of my brain trying to wiggle each finger and toe to determine my possibility of a spinal injury. If that was the Ying of my night, the Yang is I can also distinctly remember the mixture of pure adrenaline and being terrified to my soul that first moment after I stopped rolling, complete blanks in reality while trying to wiggle my fingers and toes, being petrified one second then back to reality at that same moment, and the illogical moment when I was too afraid to take a step over a rock that I had crossed a million times before when we were walking back to my car to go to the hospital (I’m proud to say that despite everything I still have never rode in an ambulance.).

I wanted to try and create the basis for my mental state before I describe my hospital stay for a reason. Since I didn’t have health insurance at the time, I now believe the care I received that night was also based on my R2D2 analogy. Instead of approaching me as one body and one mind, the strategy became more of a “put the gadget’s back into Alan” based on what hurt or looked the worse (I was in a CT for my spleen before my neck due to the huge amount of bruising. The fear was that I had ruptured my spleen). Instead of my care being based on such macro qualities like quality of life, micro budget decisions were being made. For example, should I have a brain MRI that night even though I showed little to no neurological symptoms (a couple of years later my psychiatrist, based on his testing, was willing to bet large sums of money that I had multiple brain bruises and significant swelling that night)? Let me be clear, I don’t believe this was the intent of the doctors, interns, nurses, and surgeons as individuals, they wanted to help create a foundation so I could have a high quality of life after the fall, this is just what happens in a healthcare system based around money. The trouble is that since PTSD is invisible, those micro budget types of care decisions make sense in the moment for someone with no health insurance but in the longer term (beyond 72 hours and more) probably helped build the foundation for my mental problems. Medical care, revolving around the moment and not tomorrow or the next day, was the start of my PTSD I believe.

My first PTSD incident after the accident. As I recall, about 3 weeks after I got home from the hospital I decided it was time to try and return to work. I had successfully walked to the gym, rode the stationary bike for 5 minutes, and walked back to my apartment without incident for a week at this point.  My surgeon reluctantly gave his consent under the condition that I would only work part time. For obvious reasons, a return to "Alan normalcy" would mean that I had started to put the accident behind me. Mentally I was considerably more excited to return to a manual labor job than my beat up body, my parents, my boss, my work's liability insurance, and other Boise drivers was. :)

My boss at the time, Jon, sent me out on deliveries with Kyla that day. There was no way he was going to let me carry the product but my extensive knowledge of Boise's streets made me an asset behind the wheel. Being back behind the wheel with Kyla was fun, exciting, and refreshing considering how I had spent the previous 3 weeks. For lunch, Kyla and I stopped at the Albertson's on Fairview and Cole. After picking up my chicken from the deli I started to walk towards the cash register. On the way there I dropped my chicken and that sent me back to the night I fell. I wasn't sure what I was supposed to do with the chicken on the floor, how it got there, why I dropped it, why was I scared, why was I suddenly insanely tired, and why did I go from a good to a bad day as quickly as it takes chicken to hit the floor. When Kyla asked me if I was ok I didn't know how to answer the question, but the weird part was I didn't understand why I didn't know how to answer her question. All I know was that it was time to go home and hide.

Over the next few weeks I quickly discovered that people running red lights would also send me back to that same mental state as the dropped chicken and falling off a cliff. The one benefit of falling off a cliff is that it's incredibly easy to convince bosses, coworkers, parents, and doctors that you need to go home due to pain. What I wasn't sharing at the time was the fact that some of the time the pain was mental and not necessarily physical based pain. It didn't matter if it was 6am or 6pm, if I entered this state I would go home as quickly as I could, shut the blinds to my apartment, turn on the tv, and just cry. I had no idea at the time what was wrong with me, which meant I had no idea how to ask for help. Not only that, was I even allowed to ask for help with emotional issues since I was a male, after all, healthcare had not inquired about my mental state at this point. Once again I was having gadgets pop out, like R2D2, but this time I was trying to put them back in by myself.

It was during these months that I started reading and studying Buddhism. One of the first things I learned was that I needed to let these "episodes" run its course, that I would only make things worse if I tried some tough guy technique for preventing the tears. I was struggling in those moments and needed to let my body and mind finish with the struggle before I could began to try again. Meditation, and especially meditative breathing, was a great technique for helping me to stay in the moment. For example, 5 minutes of breathing and meditating exercises at work would usually buy me an extra hour or 2 before I needed to go home due to my mental pain. Sometimes small victories are not so small.

After 2 years of trying to balance delivery driving plus being a ski instructor with my physical therapy and PTSD I decided it was time for a change. My manual labor career had to stop, it was time to move inside and use my brain. After much deliberation, I concluded it was time to go back to school for a second degree in Accounting (I already had a degree in Political Science at this point from Boise State University). In addition to Accounting, I was also considering law school at the time, which would have required me to move, but the fact I needed neck surgery and liked my surgeon convinced me that all the signs pointed to staying at Boise State.

As I write this I’m realizing I don’t recall any PTSD episodes while at school. It took me 3.5 years to earn the Accounting degree during which I had 4 surgeries in 2 states too. Maybe it was the change of scenery, the distraction of 4 more surgeries, and the new adventure in life that prevented an attack. I’m not sure right now and frankly, I am kind of confused as to why that would be. Any thoughts from you the reader?

Let’s jump ahead now to September 2016. Long story short, a collection of misunderstandings, immaturity, rudeness, and antagonizing behavior by myself along with actions of others finally exploded after several years. My behavior and actions ended up hurting a couple of people that I had tremendous respect, admiration, and love for. Like most adults, I have lost close friends before. However, in previous situations I had purposely walked away for my own good. I knew exactly what I was doing. This situation was different, much like the night I fell or the dropping of the chicken, I still don’t fully understand everything that happened during that month and will probably never will.

As I start to come out of this latest, and longest, PTSD episode of my life, I’m just now realizing how many gadgets I’d lost control of. September 2016 will go down as the start of a 9-month rock-climbing fall that hopefully I have finally hit the ground.

The absolute low point of the PTSD flare was this past February. My Aunt Dianne died on my mom’s birthday, Aunt Dianne was my mom’s older sister. In addition to my family’s loss, I was accused of some horrible things on Twitter. After working with a therapist, I now realize I probably should not have been allowed to drive during this time. I knew I was angry and depressed during this part of my life, what I didn’t realize was how far into my PTSD I was. There is a distinct possibility that I was not entirely there for several months after my Aunts death.

Over the years, I’ve tried to make it a point to ask, “I do not understand?” or “what did I do wrong?” to those I’ve felt most comfortable with in the hopes of fighting the R2D2 feeling. In my heart I knew that this wasn’t the right question to ask but I wanted any honest conversation to begin in the hopes that my brain would find the answer it is searching for and stop randomly throwing gadgets out for no particular reason. Answers to human centered problems don’t come without open and active communication after all. However, the usual response was these people assuming I was being sarcastic or mean on purpose, these questions would hurt them. In turn, I would get upset and mean for them judging my true intentions for asking. In my head, this was a level of vulnerability that scared me which was now being thrown back into my face. I now realize it was hard for these friends to comprehend how can I go to work at a job that requires me to make multimillion dollar decisions yet not understand a simple social situations that most probably learned in middle school. 98% of the time I’m a high functioning chronic patient, the trouble is the 2% has caused too much destruction and confusion, which overshadows the 98%. My PTSD has created a situation where I feel comfortable and safe alone but confused, fearful, and uncomfortable when I feel love. I’m working on this now, please be patient with me.

According to my healthcare team, my PTSD/Depression plus chronic pain could potentially create more destructive and potentially dangerous situations in the future for me if I don’t learn from these past many months. Social situations, ranging from friendship to love, will always be a tad more difficult for me than others because of the overall haze I live in thanks to my physical and mental issues. Every mind, including mine, is capable of amazing things but we all have our individual limits. These past 9 plus months have brought me to my limits both as a person and PTSD patient. What I need to work on and remember is that callousness and evil do not need to be present to make a mistake; I’m not a bad person even though my brain still loves to tell me regularly that I am right now. I’m a chronic patient whose brain sometimes thinks 2 + 2 = a bag of cookies and doesn’t understand when people challenge my answer but I still get out of bed and try to work, ski, laugh, write, awkwardly wants to find love, has the potential to be a great friend to anyone that wants me in their life, doesn’t give a shit about many social norms which gets me into trouble, hikes, and takes photographs. Someday this will lead me to finding out why I don’t understand why I don’t understand…I hope! 

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Time vs Pain Scale