I had thought that once my body had healed and I was back home, the battle for my life would be over. However, another struggle awaited that took me by complete surprise.
In NP school and clinical training, we are always taught that patients have to cope with their illnesses and how it is pretty normal for people to struggle psychologically when their lives are turned upside down. No amount of reading in a textbook could have prepared me for this. I thought that because I had a good outcome and survived with limited damage, I would be easily able to cope and accept what had happened. Logically, that sounds like a pretty sound prediction. I had no reason to be upset or depressed, I had beaten the odds after all. I would be ok, I could walk, and things were on track for me to return to work someday. But one thing I wished I had learned in school, is that psychological recovery is not a logical thing.
Before I had left rehab, my psychological cracks had started to show. I sobbed uncontrollably as a nurse drew my blood for the millionth time now it felt like unbearable pain and I was just so sick of it. One day I was cleared to finally walk around my room and then the next day because of issues with my blood levels of anticoagulation I had to be hooked up to an IV again and lost that small glimmer of freedom. I sobbed over and over again because now I was trapped to the bed again. My mom had mentioned it to my care team about my labile moods in hopes that they could help me. I only had a short visit with a psychiatrist who just mumbled about maybe exploring the option of starting antidepressants. I never saw him again and it was never brought up again. So I put on a brave face, pushed through rehab exercises in an effort to get home.
Once I got home however, the cracks began to get bigger. That first night home, I sat on my couch by myself as Matt works nights so he had gone to sleep earlier in the evening. I just stared around the apartment and just started crying again. I was completely overwhelmed with thoughts that I shouldn't be here and my own mortality. "I almost never saw this room again." Our cat Layla had been sleeping exclusively on my pillow during the time I was gone, something she never did the whole year we had her. Guilt ate away at me continuously about what I had put my loved ones through. I apologized constantly to everyone I saw. I apologized to Layla almost daily for being a horrible cat mom and traumatizing her.
I was a prisoner in many aspects. I was a prisoner to my emotions. They had completely taken control over my body and no amount of logic could rein them in. Whenever I was alone in the apartment those first few weeks I would just lay in bed and sob. Layla would give a little sad meow and jump up beside me trying to comfort me. One look at her and the tears would come harder. Not only was sadness now a constant in my life. So was anxiety. For weeks I refused to leave my apartment. I hated having people stare at me in my helmet and I would rather rot away in my apartment then endure looks of pity. Now I almost wished that I was back in the hospital. I hated being alone, something I had previously relished. Now when I was alone, I was haunted by my thoughts and out of control emotions. It felt like the ground was crumbling underneath me and I had nothing to hold onto. I learned to despise my helmet, a symbol of my imprisonment. It prevented me from doing anything independently, even in my home. I was not allowed to shower without a chaperone. At 26 years old the humiliation is indescribable.
My family did the best to keep me upbeat. They would try to get me to go out to places but I was essentially only forcing myself to leave for doctor appointments that I could not miss. I hated sitting in a car. The previous year I had been in a terrible car accident and had luckily walked away with just bruises. However, now all I could think about as I sat in a car was "well if someone hits us I'm going to die because my brain is just exposed." It was torture not only due to my anxiety, but now I would get headaches in the car. Why? Because without my skull there, my brain was quite literally bouncing around with every pothole. I did not want to accept that this was my reality, but here I was trapped in my version of hell.
And then, there was the looming reality that Matt and I were suppose to be planning a wedding. Thankfully, we had already secured a venue and date before any of this happened. We had sensibly decided to have a slightly longer engagement so we would not feel rushed to plan a wedding in a year. There was a bridal expo being put on at the venue we had chosen and we had wanted to go to it back in November when we put our deposit down. Now, Matt was going out of state for a few weeks for work training and I was stuck at home with my helmet. My mom and sister rallied around me and I agreed to try and go with them. As we sat in the parking lot I looked at all the people walking into the building and was consumed with anxiety. My sister decided to fulfill her maid of honor duties and went in herself to get information while my mom sat with me in the car. Eventually, my sister needed help so my mom went in, leaving me alone in the car. I watched a happy couple kiss in the parking lot, groups of people come and go smiling and laughing. I sat there crying, wishing I was like them. A day that was suppose to be fun and exciting filled with wedding planning now was filled with dread. Instead I was just depressed and thinking that maybe I won't even make it to next year and the wedding.
I had started to lose interest in food. It never tasted right, and now I was only eating to keep back the headaches I would get if I went a few hours without anything. Eating because you have to is a miserable experience. And despite eating, I continued to lose weight. My mom knew something was horribly wrong and that I needed help. She got me an appointment to talk to my neurologist. I sat there in her office with a list of feelings I had been experiencing. I sat in that office just sobbing for an hour. She started me immediately on an SSRI, but not surprised I was struggling so much not only because of how psychologically traumatic it was but also because of the physical trauma my brain had experienced. My whole brain chemistry was off. It only took 1 day on the medication for me to feel the effects. I could walk into stores with minimal anxiety and I had a tighter grip on my emotions.
While I had my doctor tell me that she was not surprised I was reacting this way and reassuring me that this is normal for people after surgery, the only question that ran through my mind was "if it is so normal then why don't you prepare and start people immediately on medications and make them see counselors." Having certified in primary care, a big part of my practice is PREVENTION. It is much easier to prevent a fire than to put it out.