So I go to the VA for my CPT Group therapy and I see doc's not in there again. Feeling angry, I track down another doc I know and ask him what the hell is going on. I demanded to know what was going on with Doc Casagrande.
The doc I confronted looked at me, stunned. He had that 'oh, God, you don't know' look on his face. He told me that doc had passed away over two weeks ago. Yep, that's right over two weeks ago. The social worker in the room two weeks ago KNEW and didn't say anything, didn't address the subject or the grief we would feel. To the deepest core of my psyche, I felt violated - emotionally raped.
***UPDATE: They got the date of his passing wrong...It was AFTER my last group session. They never contacted me and no grief counseling was offered when I did find out.
I stood there stunned as I felt the floor fall out from under me. I asked about memorial services - already been held. Could I visit his grave? - Cremated. I asked about a few more things at the desk and then stumbled out to my car.
That's when the anger hit. The most furious and hell-bent anger I have ever felt. I was shaking. I thought, "THEY ROBBED ME OF MY RIGHT TO SAY GOODBYE, TO FIND CLOSURE". I got in the car and started driving home. All the while I was thinking:
Our veterans deserve top quality care. The dangerous actions (or, in my case, inaction) of the VA endanger the veterans they so strongly profess to care about. The VA proved to me today that radical change is needed. They need to be replaced with a system that is patient first, bureaucracy second. Enough is ENOUGH. This is to all of the politicians who want to sit around and squabble like spoiled brats. ENOUGH! You claim to have your constituencies' best interests at heart. Put your money where your mouth is. Your petty partisan politics have continually put funding for the VA programs at risk, making it impossible for them to make long-term plans for improvement. This, Congressmen and Senators, is YOUR dishonor. Prove to me that you are worth even a fraction of the sweat and love that Doc Casagrande gave to the veterans he served. Let his legacy be the standard to which we, as veterans, hold you accountable.
I arrived home and opened the door to get out of my car. As I closed the door to my car, I felt the anger blow away in the crisp spring wind. As quickly as the anger was there, it was gone. Blown away by my resolve to honor the man who had made such a huge impact in my life. Stay tuned for the memorial piece, being written now.
This past week has been a whirlwind as I worked to get everything ready for the fundraising campaign to go live. It has been an amazing experience and I have found myself looking at the world from a different perspective. I never realized how fulfilled I would feel as I pushed the envelope to advocate for veterans. I have felt energized and happy, better able to attend to my family, better able to attend to my own needs. I have felt so good this past week that I started to think something must be wrong. Being this happy was alien to me.
And then it hit me. And it hit me HARD. When I was telling my parents about my venture, they were 100% supportive but my mother asked me a very pointed question: "Max, you are overweight. If you are going to be the public face of this organization, you need to look the part." Something so simple. She thought I was going to get upset or feel hurt by her comments.
Nope. Not at all. As a matter of fact, she really made me think. If I am going to fight the stereotype and stigma associated with PTSD, I can't look like a 'sorry-ass dough-boy'. When I sat down and thought about it, I made another realization and it wasn't one I liked. I still hated the guy in the mirror. Despite all of the good I wanted to do, I was still striving to live vicariously through the successes of others.
For the first time, that realization didn't paralyze me. It didn't make me feel less than. It made me disgusted with myself - determined to DO something about it. It was time to Walk the Walk. I have been talking the talk for two years, shying away from holding myself accountable for my inability to take care of myself. I found it was easy to ignore my own deficiencies if I helped other veterans and their loved ones learn to live with PTSD. I can't delude myself anymore. If I am going to be taken seriously, I need to take care of myself and not look like a sloppy 'mess'.
So here's the skinny (pardon the term): I weigh 278.1 pounds. My 'fighting weight' in the army was 234. Today I started living by example. While I have done much to learn to cope with my PTSD, I wasn't able to overcome the feelings of inadequacy to take better care of myself. So no big promises. No grandiose plans. I am going to get in the best shape of my life and I'm going to show you all what grit and determination can do for a veteran with PTSD. Here's how I look now:
Yeah. Doesn't exactly scream "Support My Cause!"
This is the only promise I will make: I will do everything I can to look the part and earn the self-respect I so dearly desire. I WILL WALK THE WALK>>>No update pictures, no stories, no excuses. Just action. I will show you all what I am capable of and take a picture again on April 10th (A few days before the end of my fundraising campaign). All I ask is that you ask yourself. Do I just 'like' comments and say I support a cause or am I willing to walk the walk? Are you willing to spread the word? Are you willing to speak out against the stigmatization our combat veterans with PTSD face? Do you have the ability to donate to worthy causes but don't? What will you do to walk with me?
Yesterday, I posted my latest blog entry (you can see it here). I had been having a rough few days and I talked about it extensively. I talked about how the Phillip Phillips song, 'Gone, Gone, Gone' is what had gotten me through the moment and allowed me to find peace. As is the usual when I reference someone in my blog entry, I add them to my tweet in the hopes that they see it. Honestly, I didn't think, with how crazy P2's twitter feed is that anyone would even notice my post.
And then it happened. I started getting a lot of traffic from Twitter. People started retweeting my post, favoriting it and reaching out to me to comment on my blog. It was an amazing and overwhelming response. I never thought that so many would connect with my writing. It was an amazing feeling to know that I was able to reach so many and illustrate the human side of what it means to have combat PTSD.
With this in mind, I wanted to thank the fans or 'Philatics' who have demonstrated an amazing capacity for compassion for a stranger. Your passionate comments and support are a testament to the type of music that Phillip Phillips makes - it only draws to highest quality of individual.
Again, thank you all so much for your amazing display of support. I promise, no matter how bad it gets that 'like a drum, my heart won't stop beating'.
Yours in Health and Happiness,
WARNING: The following blog post is very graphic and will disturb some readers. If you have PTSD, this account could trigger you. Despite this, I had to get it out of my head and try to think through what happened.
The silence was deafening, but we all knew what was coming. I don't know if I held my breath for seconds or minutes. Time has ceased to have meaning when they fired on their own troops.
I startled awake and felt the familiar pain of bile burning the back of my throat. As was becoming the norm, I had woken up from the nightmare choking on my own vomit. I scrambled out of bed and ran to the bathroom. I vomited repeatedly into the sink. I dry-heaved for an hour, unable to clear the bile from the back of my throat. When the gag reflex receded, I continued to salivate and spit for another hour. I finally dared to look up and didn't recognize the person staring back at me. My face had a gaunt, almost skeletal quality to it that I hadn't seen before. My eyes were swollen and red, the blood vessels in my eyes inflamed.
"I thought things were getting better"
That's a common thought that runs through my mind every time I start to physically recover from my nightmares. It finally sank in yesterday that the nightmares seemed to be their worst after the deepest and darkest moments of my latest episode have receded far enough for me to see and recognize the insanity that others call 'hope'.
I was too exhausted to sleep after that moment. I somehow didn't let on at work that I had this horrible experience Friday night into Saturday. I was afraid to go to sleep last night and slept fitfully until something woke me up. I had only been in bed for an hour or so, but my heart was racing and I didn't know why. Determined to fight this feeling of complete helplessness, I ran for my iPad, plugged in my earbuds and turned on the Phillip Phillips. Something in one of his songs vibrated through me and I finally felt at peace.
"Gone, Gone, Gone"
I'd listened to this song many times before, but the lyrics never really registered until last night and I knew I had found an anthem that would put my mind at ease and always remind me that I wasn't going through this alone. I had the love of my wife, friend, family, and even strangers to keep my head above water - even when I didn't have the strength to keep myself afloat. So this one's for all of you - You Know Who You Are.
So, it appears that my therapist's advice really sank in. I woke up yesterday with a clear sense of purpose and a vision of where I wanted my life to go. I decided to conserve my energy at work (yeah, still a work in progress) and devote that conserved energy to my advocacy and my family. I started moving things forward and saw results. Here's what's happening right now:
As I said yesterday, it was an eventful day. I look forward to sharing all of this journey with you! Let's make a difference for each other and for the vets we still n
This past Monday, I met with my individual therapist and we talked about how I feel trapped by my current situation: I am not able to make a job change easily because my family depends on my income and health insurance. I can't get to the gym consistently because my work schedule is erratic and I come home from work emotionally spent. I don't have the time I would like to pursue my advocacy endeavors because of my work schedule making it nearly impossible to meet with my colleagues. It has made me feel more and more depressed and more and more demotivated.
When I explained all of this to my therapist, she understood how this could adversely affect me but brought up one point that stuck with me and made me think: It is your choice, whether you realize it or not, to stay in that job. It is also your choice to put all of your emotional energy into your work even though you don't get paid to be emotionally invested in it. She asked me, "What do you think would happen if you chose to save that emotional energy for the other things in your life?"
Why is it the simple things that always seem to be the hardest to change? Being emotionally invested in my work has been ingrained in my since childhood. I told my therapist that and she came back with, "No, that's your job. Advocacy is your work. Put your emotional energy into that and I bet you will feel better and have more energy to find a way to get to the gym and to be there for your family".
It's a foreign idea, but makes a weird kind of sense to me. She followed this up by explaining to me that I have the ability to choose what I devote my energy to. I can't control the fact that I am currently unable to change jobs because of my financial responsibilities. What I CAN control is who benefits from my energies the most - my job or my advocacy for veterans. I have felt trapped because couldn't see any way to take control of the situation and it was causing me to become extremely depressed and unable to see any positive outcomes.
So now comes the hard part. I have to change my behavior - a behavior that has been an integral part of my professional identity since I first started working. I have to learn how to redefine what my work is so that I can devote my emotional energy to my advocacy, my health, and my family. It is definitely not going to be easy but it will be worth the effort.
I was asked to address this issue by folks on the Facebook Page. It is a delicate subject and I wanted to take the time to really think about how I feel about the whole situation, so it took me a few days to write all of this down.
Over the past few years, there has been a very strong push to create an adjunct court system for veterans called the Veterans' Court. Supporters of the concept argue that veterans are not treated equitably by the court system and that the punishments/sentences meted out are much more severe than, in many cases, the crime dictates. They also argue that there are often mitigating circumstances that cause many of these veterans to break the law, PTSD being one of those circumstances. While I agree that veterans aren't currently being treated equitably by the court system, I think that the concept of a separate court system for veterans sets a dangerous and irresponsible precedent. Before punching your computer in anger, let me explain.
Being Singled Out for Stigmatization:
As anyone in the veteran community knows already, veterans with PTSD (and veterans in general) are often stigmatized by the public. It's called the 'Rambo Effect'. The ignorant believe that you and I, as law abiding citizens, are exponentially more likely to go crazy, cause mayhem, and commit mass murder. When you spell it out like that it sounds pretty stupid. If we created a separate court system to address veterans crimes, do you see this stereotype improving or getting worse? How does anyone think that being singled out as different and warranting special treatment helps? For generations, minorities have been getting the short end of the stick in the court system. Do you see any initiatives to create 'Black Court' or 'Latino Court' or 'Gay Court'? All of these minority groups (in this day and age, veterans are an extreme minority) accept, understand and value the court system we have and strive to affect long-term change by changing the system that already exists.
A Crime Is A Crime Is A Crime:
If a veteran with PTSD turns to illicit drugs to numb himself or gets in a heated argument with someone and commits assault and battery, how is this different from anyone else with PTSD doing the same thing? While I understand that, as veterans with PTSD, what we experienced is truly horrible, a bad decision is a bad decision. Don't get me wrong, I am not condemning their actions. I understand how easy it can be to head down that road. The first time I was on prescription pain meds after the PTSD, I almost got hooked. If I would have gone down that road and gotten in trouble for abusing prescription medication or worse, who do I have to blame for that? Me. No one else. Just me. I don't think it's a good idea to create a system that would unintentionally encourage a lack of accountability. I have heard veterans say, "It wasn't me, it's the PTSD", completely deflecting blame for undesirable behavior off on their disorder. Creating this system would encourage this.
So, If Not Veterans' Courts, Then WHAT?
From my experience with vets who have gone through the court system, it seems that veterans get held to a higher standard of conduct than the average citizen. It the curse of honor and duty. Do we not hold ourselves to a higher standard than civilians? If a civilian and a veteran pulled a punk move and hit their respective wives, which one would you be angrier with? Which one would YOU hold to a higher standard? I know I would hold the veteran to a higher standard, fair or not. So, what is the solution?
EDUCATION. Plain and simple. All of these lawyers espousing the creation of the veterans' court could be spending all of that time and effort educating other lawyers (especially public defenders about the issues facing veterans - especially PTSD). If the argument is made that a veteran has a service connected diagnosis of PTSD or related behavioral disorder is not fit to stand trial but should be sentenced to court mandated medical treatment, how many veterans' lives would be irrevocably changed for the better? Veterans are notoriously bad about not keeping to their treatment regimens. I should know.
What I am saying is that veterans with behavioral disorders should be afforded the opportunity to get treatment first, before they are thrown in jail. Jail is a really bad place for someone with untreated combat PTSD, for obvious reasons. That being said, if a veteran IS afforded the opportunity to get medical treatment, is deemed fit and released from care, any further violations of the law should be treated like anyone else.
Now we just need subject matter experts to stand up and educate. We need those same experts to testify at trials. The argument shouldn't be about the severity of the punishment meted out, it should be about whether these veterans are competent to stand trial in the first place. God knows, before I started getting treatment for my PTSD, I sure as hell wasn't.
As I do my best to avoid landmines on this subject, I need to put this disclaimer out there first and foremost:
I am not a doctor. I can only share my experiences with medication for PTSD, dos and do nots. Never stop taking your meds without informing your doctor of that decision first. If you are concerned about what the medications could do to you physiologically, express those concerns with your doc and see what you can do together to mitigate those effects.
OK, now that we have that out of the way, let me take you on a little trip back to 2004 when I first got home. As soon as I got into the VA system, I was put on meds. I was put on trazodone for sleep (the nightmares were nightly for months after I initially got home), Citalopram HBr for mood, and Gabapentin for jitters. I took them religiously for two years. I honestly think that the compassion of my teachers and staying on my cocktail were the only reasons I made it through college.
In March 2006, I met my wife, I made the classic mistake that all properly medicated people make at some point in their treatment. I felt so good, I went off my meds. I stayed off them until December 2007, I think. There may have been little spurts where I took them, but it wasn't consistent. I had graduated from college in May 2007 and the stress of having to find a good paying job was killing me. I found a job at a local bank and without my meds, I went belly up and out the door in six months. I went back to the VA and they put me on my meds again in December 2007. In May 2008, my wife graduated from Massage Therapy school. Somewhere along the way I had stopped taking my meds again. Part of the problem is that my PTSD was really out of control and I was having issues with loss of my sense of the passing of time. My wife would ask if I had taken my pills and I would tell her I had because I really thought I had. My head was a mess.
In June 2008, we moved down to Georgia and things got really bad really fast. I had not access to a VA hospital that I trusted and, therefore, had no meds. We had moved down because there were supposedly a lot of jobs to be had down there. Unfortunately the economy was in full recession mode and there were no jobs to be found. I worked temp work here and there but my wife couldn't practice massage therapy because the state of Georgia never, in six months we were there, sent her a licence. Our finances were at a straining point, my PTSD in full episode (all I did was play Call of Duty 4, 12-16 hours per day). In December 2008, I took a contracting job in the Middle East out of pure desperation. We moved my wife back home to be near family and I went over to Qatar. I lasted about a month without my wife before I had to bring her over. The separation was too much. Keep in mind, I am still off my meds. Shortly after my wife got over there, we moved to Manama, Bahrain. And that's where my PTSD got dangerously bad. Without going into details, I was the worst I had ever been. I was drowning. Out of desperation, my wife put her foot down and we went home in September 2009.
I knew I was screwing everything up and I was determined to get myself straight. I went back to the VA and got put on meds. I started attending group sessions. I got a job at a local grocery store and still work there. I haven't gone off my meds since. It's the only period since I have been home that I have enjoyed a true sense of stability. Over time, the docs augmented my cocktail with Lorazepam (for anxiety), and Wellbutrin (additional mood med). The reason the changes were made was because I was noticing changes in my behavior that I didn't like. The previous meds didn't seem to be working the same as they had been. So the doc evaluated me and changed it up. Brain chemistry changes over time, so there will the potential need to 'tweak' the cocktail.
So what are the lessons to take away from my mistakes?
Now, I can say that meds are not for everyone. Some people will do better with natural alternatives. Some won't benefit from either. No two veterans are alike in their emotional needs. Regardless of what decision you decide to make, I ask that you consider how your potential change in emotional stability and change in demeanor could adversely affect the ones you love. It's not fair to put our loved ones through the emotional meat grinder because we are too proud to admit we actually need our meds/natural alternatives to stay stable.
So, there you have it. That's my lowdown on PTSD and Medication. I encourage you to educate your loved ones on the meds you are taking, including side effects. Having extra eyes looking for disturbing changes in emotional and physical health will help you stay healthier too.
It's amazing how being laid up for a week can adversely affect your outlook. Even though I am feeling physically better, I am feeling progressively more depressed and that concerns me greatly. People who are ill for prolonged periods are prone to mild depression. When you add PTSD into the equation, thinks spiral down a whole lot faster and a whole lot farther.
What's frustrating as hell is that I KNOW this and I can't seem to snap out of it. I am doing everything I can to stay focused on doing things that are productive and fulfilling for me and it seems to be helping a little bit. While I know I focused a lot on the things I am dissatisfied with over the past few days, I haven't come up with any good plans to address those issues. I am going to read over everything I wrote in my last blog with my wife and see what we can come up with. Sometimes I get my thoughts out on here and forget that I haven't shared them with my wife.
All I know is that my wife's love and support mean everything to me and help me regain proper perspective when I get in these funks. Maybe, if I remembered to share with her all that I blogged about she would be better equipped to deal with me.
Yep, still in a funk. At least I can see the light at the end of the tunnel. My ear is finally healing better and as soon as I am allowed to go back to work, I think that the majority of my depression will lift. If it doesn't lift, on to plan B. When I figure out what plan B is, I'll let you know.
Introspection...Ally or Enemy? It's a question I have been asking myself a lot over the past few days. It seems that every time I have too much time on my hands to sit and think, I get evaluate everything that's going on in my life. I look at my home life, my work life, being a husband, being a dad. I examine every facet of my life, ad nauseum. In some cases, in excruciatingly fine detail.
I have to wonder how healthy this is for a person like me to do. I seem to get less and less out of it the longer I look. While, I know that there is a lot that makes me very happy in my life, there is also a lot that has left a very bitter taste in my mouth. I wonder if I will ever be able to realize my full potential, and sitting on my duff recuperating from a physical health issue doesn't lend itself to feeling positive about what the future holds.
What I have begun to realize is that I desperately need more out of my professional life - and soon. I think about all of the things I could be doing with my time to advocate for changes in behavioral health care, to educate people about PTSD, to work to reduce the stigma associated with PTSD. It makes me sick to my stomach that I am spending my time in customer service in a grocery store. It's depressing and demotivating. I am an accomplished speaker, an even better writer. Yet, here I sit, wondering how I got myself stuck where I am. I constantly think about hunting for work in Veteran Advocacy. I look online all of the time. I think about the good I could be doing and I feel trapped by the need to make a living to support my family, unable to get out from under the thumb of crap wages and a shitty economy.
Yep, that's introspection for you. It allows me to make important realizations - realizations about things I need to change in my life. Yet, when I am in a position where I don't get to choose when the introspection ends, I get caught in the quagmire of depression and catastrophic thinking. I am on pain meds, so I can't drive anywhere, I can't work. I am stuck here at home with one of two options: sleep or think too much.
So I sit here and think. And contemplate the edges of a sword that never get dull from overuse.
This is the danger of isolation for veterans with PTSD. It suffocates our will, douses the flame of hope. Too much introspection is not a good thing. It's like painting yourself into a corner, with no one around to notice you have until the last stroke has already been painted.
Boy was that a depressing trip. I think I need to make sure that I get to CPT group tomorrow, despite my inability to drive myself. I need something to shake the cobwebs loose, something to turn my sight outward. I need to focus on getting a hold on the depression as it sinks its claws ever deeper into my psyche. I need to focus on my wife and my daughter, how much they need me to be here for them. I'll find a way, I always do. I think I just needed to get those poisonous thoughts out of my head. To rattle those insidious doubts from their nesting places in my mind.
I know I can make it until tomorrow, and that's all that truly matters when the going gets rough.
As I continue my life with PTSD, I will share my challenges and discoveries on this blog.