Could medical trauma be impacting your health?
I went into the hospital to have a diagnostic medical procedure.
I was 16 years old and I put on a brave face for the first surgery I would ever have. I had been having pain in my left hip on and off for years.
As a high school athlete, it was devastating when the pain started to prevent me from finishing team practices. After an x-ray and an MRI, the orthopedist believed that I had a mild case of hip dysplasia that led to me having bone grinding on bone.
To fix it, I would need a full hip reconstruction. The surgeon would slice my own cartilage in half to tack it back on, carve the bone spurs off the head of my femur, and reshape the inside of my pelvis.
But before that, my medical provider scheduled one last confirmation through a diagnostic procedure on my hip.
For this diagnostic procedure, I would be put under anesthesia while a needle would be inserted into the ball of my femur. The medical team would numb the head that was grinding, and add contrast to make the medical imaging more accurate.
Then, they would wake me up and confirm that numbing the bone did indeed stop the grinding pain the medical staff believed I had.
My Medical Trauma
I put on a gown and they inserted the IV. I got on the table and the anesthesiologist introduced herself to me through a thick south Asian accent.
Then, I remember the lead orthopedic surgeon turning to the anesthesiologist and saying:
“She is calm enough that I don’t think I will put her under anesthesia.”
I vaguely remember him saying something about how they keep adults awake for it and the procedure is less risky with no anesthesia.
Before I knew it, the anesthesiologist was holding my head. I can still feel her hands above my ears. Vividly, I hear her making a shushing noise and singing a lullaby in a language I didn’t understand. I whimpered in pain as the lead surgeon inserted a giant needle into my femur.
I only had seconds to prepare myself to be awake for this diagnostic procedure.
Then I remember the doctor moving my hip all sorts of directions and asking me if I felt any pain. I only nodded no because I could not speak.
Before I knew it, the medical team moved me to the intensive care unit (ICU). I recall the nurses asking why I was brought there since I didn’t have anesthesia and then I was wheeled back into the recovery room.
A member of the medical staff told my parents that I was calm enough that I didn’t need anesthesia. There was little regard for how I felt about the last-minute decision the doctor made. My parents agreed and thanked them.
I was stunned and angry. I was trying to be mature and calm, but I paid for it with no anesthesia. I felt tricked and traumatized.
Medical Trauma Repeated
About 8 months later, I had the full hip reconstructive surgery.
My hip reconstruction surgery went from 6 to 10 PM. I was awake for about an hour after the surgery to see my loved ones before falling asleep for the night.
However, when I woke up the following day, I would never be the same.
I woke up with mysterious chronic pain that was unrelated to the surgery.
Over the following months, my digestive and hormone symptoms worsened.
Within the next few years, I would be diagnosed with multiple autoimmune diseases.
Over a decade later, I recognize that it was incredibly traumatic to be told I would be put under anesthesia for a very painful procedure, and then have it sprung on me only moments before that I would be kept awake.
While my body was resilient to that first traumatic medical event, when they opened my hip back up again six months later, my body said enough.
In my 30s, I’ve finally been able to recognize that I went through a major medical trauma. Have you had a bad medical experience? Do you struggle with debilitating symptoms that no one can figure out? Could trauma be impacting your health?
In order to define medical trauma, we must first zoom out and look at trauma in general.
What Is Trauma?
In my own experience, the simplest definition of trauma that resonates the most with me is:
Trauma is when the body perceives a threat that is overwhelming.
Therefore, something traumatic for me may not be traumatic for you.
We must not define trauma by what is seen as acceptable or not in our culture.
It can be a single event or a course of events.
Trauma is about how our bodies perceive the threat. And when the body feels a threat, it no longer feels safe and it enters a state of hypervigilance.
A Non-Medical Example of Trauma
To give an example outside of the hospital setting, you can perceive a situation as being unsafe, even if you are still sheltered, fed, and clothed.
For instance, I had a teacher in elementary school who only knew how to manage her classroom by yelling. Her constant yelling made it really hard for me to learn in that situation.
I had constant stomach aches that year.
Even though I was physically safe, I perceived it as an unsafe situation because of how much she yelled.
Looking back, I wonder if there were stress hormones swirling through my stomach that caused the cramping and aches.
The following year, I no longer had stomach aches when I had a teacher who had much better classroom management techniques.
The frazzled teacher’s temper put my body into a state of hypervigilance. Her constant yelling was overwhelming for me.
The same goes for medical trauma.
Defining Medical Trauma
So as we transfer that definition of trauma to the medical setting, I would define it:
Medical Trauma is any health experience that the nervous system experiences as overwhelming.
Whether or not it’s in a hospital setting or during a natural disaster, it is a type of trauma.
I think it’s fair to broaden the definition to include witnessing a family member going through a terrible treatment experience.
At the same time, I don’t think that medical trauma has to lead to full PTSD or other mental illnesses in order to require attention.
It is the overwhelming of the nervous system that is traumatic.
In my case, my healthcare providers genuinely believed that not putting me under anesthesia was the best thing to do for me.
Most healthcare professionals would agree about the risks of anesthesia, and recommend minimizing its use in medical treatment when possible.
What made my situation a traumatic experience was that:
- Keeping me awake was sprung on me last minute
- I felt that even if I did speak up to say no, my request would not have been honored
- I had put pressure on myself to act mature in this situation, and if I had shown more of my fears, I might not have experienced that pain
That was a lot for my teenage self to carry and wade through. The poor medical experience took a dramatic toll on my body.
For these reasons, it’s important to include medical trauma as anything that’s overwhelming. Why? Because that sense of overwhelm is what can cause physiological responses.
Resist the Temptation to Minimize Medical Trauma
For over a decade, I minimized the effects of my own medical trauma. I thought to myself,
I didn’t have a heart attack or a car accident, nor am I dealing with a life-threatening illness.
It wasn’t until I listened to a presentation from a fellow pastor who talked about how lower case t traumas still cause physiological effects.
It was a lightbulb moment for me that the body can treat capital T traumas and lowercase t traumas in the same way. I had a flashback to that diagnostic procedure. I compared my experience to worst-case scenarios.
However, it doesn’t have to be a life-changing event to be a traumatic experience. Overall, my hip reconstruction was considered a success.
At my two-year follow-up, the surgeon complimented me that I had the best hip mobility of any of his patients.
But if my hip was okay, why was my immune system seemingly out of control?
RELATED: Why does medical gaslighting happen?
What May Be Happening in the Body
Even if you don’t have overt medical PTSD or mental health issues, your body can still be triggered into fight or flight mode by a medical trauma.
This is the part of the sympathetic nervous system that is supposed to help you stay safe from predators.
We are still learning so much about how the nervous system impacts the immune system and vice versa.
The stunned feeling I felt after the diagnostic procedure was probably a cascade of hormones known as the freeze response.
While I did not end up with a textbook case of PTSD, my immune system continued to go haywire over the next 5 years. I would receive medical diagnoses (and misdiagnoses) for almost 10 autoimmune diseases.
With the help of the best of conventional medicine and functional medicine, I was able to reverse 6 autoimmune diseases.
What Medical Trauma Did in My Body
But the effects of medical trauma were still permeating my health. I still had Chronic Fatigue Syndrome and Chronic Joint Pain. Fibromyalgia came and went unpredictably.
As a busy mom, I was rushed and frantic a lot. I had no reason to be racing around the house to get everyone out the door each morning. But something kept my nervous system revved up on hyperspeed until I would crash into my desk later in the day.
Can you relate?
Finally, in 2019, I suspected I had Mast Cell Activation Syndrome and some bloodwork confirmed my suspicions. (Although the medical testing is still rather elusive since this only got a diagnostic code in 2016.)
I learned that trauma was one of the root causes of mast cell activation where the limbic system and nervous system don’t calm down between threats.
In my late twenties, I struggled with infertility. A naturopath helped me identify that I needed a hormone called pregnenolone to get pregnant.
When I looked into it further, I discovered that if you have elevated levels of cortisol, (one of the main stress hormones,) it could steal your pregnenolone.
Pregnenolone is a precursor to the other hormones your body needs to get pregnant.
I was blessed that I got pregnant after one month of a small dose of pregnenolone.
I didn’t think I was stressed out, but my body was covertly operating from a place of fight or flight.
And it was using up resources that kept me infertile. It was another confirmation that my body was stuck in a state of stress.
What to Do About Medical Trauma
If you suspect you have medical trauma, the best first step you can do is to simply acknowledge it.
Have you ever had an unpleasant medical experience that was overwhelming?
It could be as severe as an unexpected c-section, but also what some may deem routine medical care. Your medical trauma could simply be a practitioner gaslighting you or doubting your symptoms.
But the biggest takeaway I hope you glean from this is to find a clinician who can help you. The titles and training you want to look for are “trauma-informed” whether you find someone in psychiatry or psychotherapy.
While we don’t have hard data on treatments for medical trauma in particular, I think we can transfer the best practices for other types of trauma over to medical trauma.
One meta-analysis study on PTSD found that trauma-informed Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR) were the most effective.
By the age of 30, I had done 4 years combined of CBT (but not trauma-informed). My primary focus was figuring out why I was struggling to implement the lifestyle recommendations of my functional medicine doctors. I grieved a lot of food loss.
Looking back, I wonder if the psychological impact of medical trauma was causing me to binge and stress eat. I knew that I was using food to self-soothe.
Navigating food cravings has been the toughest discipline in my life. But I knew I had to find discipline with food if I would ever find wellness and regain my health.
After I discerned that I had Mast Cell Activation Syndrome and needed to address the physiological aspects of my own trauma, I sought out modalities that could access deeper parts of my brain. I felt like I had hit the max therapeutic benefit of talk therapies like CBT.
This past year, the most helpful therapy has been Eye Movement Desensitization and Reprocessing (EMDR).
EMDR is where you repeatedly rehearse a traumatic situation under the care of a licensed clinician. There are different tools to keep you grounded. Some use screen imaging where you look back and forth while others use vibrating hand holds.
I was fortunate to find a retired army medic turned social worker who also had experience with medical trauma.
I also wanted a practitioner who knew how to walk me through somatic experiences so that I could find calm after walking through these traumatic memories.
After unearthing the traumatic memory 4-7 times in about half an hour, my therapist walks me through body scans and happy place meditations to get my nervous system into the parasympathetic rest and digest state of calm.
After about 5 sessions of EMDR, I noticed a massive downshifting of my nervous system. I no longer automatically revved into a state of fight or flight every morning.
And when I do catch myself getting frantic, I’m able to use a 30-second stress mastery technique to calm down.
Where to Get Started
Whether or not you are ready to work with a professional, there are some books and courses that can help you start to examine your medical trauma.
My favorite book by a trauma-informed therapist is called Try Softer by Aundi Kolber.
I also found the Try Softer workbook very helpful as I sorted through the concepts.
You may also be interested in taking a course to learn more.
I love everything put out by Aimee Apigian, MD. Her 7-day Trauma Disease Connection Course may be a good fit for you as well.
My hope is that if you’ve been through a traumatic medical experience, you can take steps toward acknowledging that it was too much at that moment. And in turn, I hope that you seek out the best next steps for you.
It’s not easy to share about medical trauma, but I hope that it might help you identify your own traumas and address them.
Do you suspect you’ve had medical trauma? Would you be brave enough to share your experience below? I’d love to hear from you.
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