Friday, November 9, 2012

Nephrology Appointment With PTSD

BIG FAT WARNING/DISCLAIMER: If you are a sexual abuse survivor with any type of dissociative disorder, and you are currently VULNERABLE, do not read this post. This is a trigger warning. While the topic is my kidney function, there is detail of very traumatic events. So PLEASE skip this if you are currently having trouble.

I am shocked, overwhelmed, and just...mortified.

Today I saw the nephrologist's nurse practitioner. She was a sweet older lady, very thorough, and definitely pleasantly old school. She was nowhere near a computer. She wrote notes in shorthand on a piece of unlined paper.

We went over the stupid "new patient" paperwork, which included "chief complaint". I had put acute renal failure and inability to void.

So there were lots of questions and lots of releases to sign, whilst going over my history -- including evidence of autonomic neuropathy. Which was cake (ha). I had stated that I need to refresher on how to with intermittent cathing (I'd already learned at age 18, but the last few times just kept coming back up with blood and nothing else. )

She asked about what technique I was using to initiate and continue a stream, and when I told her she turned pale. Not reaction I was expecting. I was old that this could be the cause of chronic UTI's and could lead to more trouble. She asked about frequency and I told her: once a day in the morning and twice if I'm lucky. She sat silently for awhile, and deduced that the acute kidney failure was a mix of excessive urine back flowing into the kidneys, chronic, severe dehydration, and very poor nutritional status. She then said she would need to do a pelvic exam. She said this casually, as if no big deal, as if this was something every 25 year old had at least once before, as if this shouldn't throw anybody into a tizzied panic.

My heart began to pound, and I told her I have severe PTSD from childhood sexual abuse.

She was kind enough, and she brought an LPN in with her to help with the anxiety process. It would have been a good move, in all honesty, if the only thing that we were dealing with was some PTSD that could be calmed with a hand to hold.

But what I neglected to tell them, is that I also have dissociative episodes. I prefer the term "dissociative fugue", but that is not my diagnosis. My diagnosis is Dissociative Identity Disorder (DID). Yes, that is the same thing as Multiple Personality Disorder.

But who would want to tell anybody that? Plus, I've NEVER had a pelvic. Ever. This was a completely unexpected treatment sprung on me.

She explained the purpose. She needed to see if the urethra had been damaged by my previous "method", but also wanted to see if there was some kind of blockage or obstruction.

In my head, I am frantically trying to calm myself, but the mind speak is nothing but globby gibberish that I couldn't untangle.

So feet in the stirrups, table angled, LPN holding my hand, my body rigid and locked. I was vaguely aware I was shaking. The nurse practitioner took a quick pulse (why?), told me to try to relax (heart rate over 150bpm).

And it begins. And I am aware of someone howling -- an eerie animalistic sound. And then nothing. I go completely blank. I disconnected from consciousness. But body memories were wracking me. A total time warp enveloped in sheer blackness and I am gone.

And then I'm half "here", everyone's voice sounding as if speaking in a tin can -- a quiet echo that is difficult to understand.

My face is wet. My diaphragm is spasming. My throat is completely raw. What did they do to me? Where am I? I don't remember any of these people, I don't remember how old I am, I am not "oriented".

I am propped up and I try with all my might to come "back". The nurse practitioner talks in low soothing tones: there is a lot wrong in that area. The urethra has been damaged, but nothing that is causing a blockage on the outside. However, there is adhesions and keloids from the abuse. Old things I cannot see, that no one has ever seen. Lots of obvious past trauma.

I start dry heaving and fall off the table. That shatters me back into consciousness.

The rest of the appointment is uneventful (thank God). I am given 8FR pediatric catheters since the 14FR adult catheters was causing way too much bleeding. I am started on Diflucan and nystatin (and if you have no clue why these would be prescribed I'm not telling you.)

I am scheduled next week for a repeat urodynamics test, and ultrasounds of my kidneys and bladder. Specimens are taken by straight cath since I cannot go on my own. I am given tons of wipes, surgi lube, an Rx for 8FR catheters, and told to come back next week for the procedures.

So how am I holding up?

I've been splitting all day. I feel totally violated. The retching won't stop. No amount of Klonopin is helping. I can't really talk out loud. My skin is on fire. Crying on and off.

But I just have to make it tonight. All I have to do is keep in touch with people who understand my situation. Next week one of the caseworkers I know is going with me for the procedures after this fiasco, so that is a major plus. Since this doc is in the next town over, typically caseworkers don't go. But this is a different case. And that helps me to be a little braver.

And I am exhausted and going to bed.



  1. sorry doesn't cut it - but I can't find words, I hope writing it down helped, it helps me

  2. Writing always helps. And the whole purpose of this blog is sharing my steps...including traumatic episodes like Friday. Because, you will see, I do NOT intend on staying knocked down. As each post rolls along, I am anticipating posting many, many victories as well. I know personal stories help people. And if what I am going through helps just ONE PERSON, then I have fulfilled my calling in starting this blog.