IT HAPPENED TO ME: I Had a Medical Emergency Abroad and Developed PTSD

Who gets PTSD from a kidney stone obstruction?

Jun 18, 2014 at 2:00pm | Leave a comment

In early 2009, during a semester studying abroad in southern India, I woke up in the most excruciating pain of my life (labor was a close second). There was a stabbing sensation in my back, and I was retching uncontrollably like I had the flu. Writhing on the floor, I texted 911 to one of my roommates, and managed to crawl over to the bathroom, feeling like I was going to puke and piss my pants simultaneously.
 
I lowered myself onto the toilet, clutching my back in agony -– and nothing. No pee. Suddenly I realized that I hadn't peed for the past three days. It had puzzled me at the time, but I was traveling with a group of students and everyone was irregular. Pee could be irregular too, right? Was that a thing? (Spoiler: It's not.) 
 
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The view on the way to the hospital, dusty and loud.

 
My roommate dragged me down the steps of our housing complex and hailed an auto rickshaw, which took us to a hospital across town. I hobbled inside and for the next hour or so I vaulted between the waiting room and a small squat toilet in the back of the hospital, trying to squeeze out some pee and failing, trying not to vomit on myself and failing some more.
 
Where I was in India, everything is inefficient as hell and takes forever. Nobody waits in line when running errands or buying groceries. There's no system. You just shove until you get to the front of the line, and you grab what you can before someone else does. This was particularly difficult in the midst of a medical emergency.
 
Before I could be seen by anyone, I had to shove (and be shoved) through a mob of people, only to fill out a stack of paperwork that asked questions like, "What is your mother's maiden name?" and "What does your father do for a living?"
 
Eventually, the nurses took me back to triage and had me lie down on a gurney. I was still writhing in pain and openly retching, but everyone seemed strangely unfazed by it.
 
“Can I just get a shot of something?” I kept whimpering, probably sounding like a junkie but too agonized to care. The nurses smiled, ignored me, and kept asking me bizarre, totally unrelated questions. Are you a student? What are you studying? Where do you live?
 
Finally, they decided they were going to catheterize me. I probably had a kidney stone, they told me, and I would have to try to pass it on my own. They gave me a water bottle and told me to drink. "Great," I say, "except I keep throwing up everything, and by the way, can you give me some painkillers or put me under or something?" No? Awesome. The nurses inserted the catheter, and nothing came out. They tried again –- still nothing. The stone was blocking the way. I would have to have it removed with a scope. 
 
The hospital building and everything inside it looked like a relic from the 1930s -- the IV drips were glass, instead of plastic. There were puddles of water on the floor. There was no soap in any of the bathrooms -- and I tried to pee in a lot of different bathrooms. 
 
None of the nurses wore gloves, and before every test I had –- an MRI, an ultrasound –- I had to pay up front, in cash. I asked one of the doctors for pain medication, and she closed her eyes, put her hands on my forehead, and prayed over me. Another one told me I just needed tea. All of these things combined to make me feel generally unsafe. None of it felt real. I was just wandering through a nightmare –- horribly pained, confused, and mostly alone. 
 
Other things, I think, contributed to the trauma. Nobody from the study abroad program bothered to call me or check up on me in the hospital -– not even the “student liaison” whose job it was specifically to help students adjust to the culture shock.
 
When I finally did pee –- 18 hours into my hospital stay and one minor surgical procedure later -– the inside of the toilet bowl was doused in blood (the stone, along with the surgical scope, had torn up my urethra). They prescribed me medicines that had unfamiliar names, ones I knew nothing about and that I couldn't successfully Google.
 
Because the meds had been manufactured outside of the States and were obviously not FDA-approved, the doctor (who I called days later) couldn't tell me anything about them. Did they interfere with my regular medications? The malaria pills I was taking? Nobody at the hospital could tell me. I had painfully little information. Worst of all, because of bad cell reception, neither my fiancé or my parents knew I'd had surgery.  
 
I was utterly alone. 
 
*** 
 
I started having panic attacks months afterward, when I was back in the States and working a nanny job between semesters. Sitting in a noisy restaurant, or riding in a car where the music was too loud or repetitive, my heart would start pounding seemingly out of nowhere. That's odd, I would think. Trying to ignore it, my stomach would turn. I would try to breathe and my lungs would catch in my chest. I couldn't take a full breath. 
 
Any time I was traveling, or in a situation I couldn’t immediately get out of (like dinner with friends, or riding in a car), I’d come down with these weird flu symptoms like chills and aches. Sometimes even a low-grade fever. And if I went to dinner anyway, or rode in a car against my better judgment, I’d start falling down a rabbit hole of pure panic. Hyperventilating. Uncontrollable crying. Immediate diarrhea. Shaking. And crying some more. What was wrong with me?


 
Slowly -- very slowly -- I noticed a pattern to my triggers. Sudden, loud noise? Panic attack. If I had to pee and couldn’t immediately get to a bathroom? Panic attack. I had a constant urge to escape, and if I couldn't, I would need to run to the bathroom and hyperventilate/cry for the next 15 minutes. After a while, there wasn’t much that didn’t trigger a panic attack. And once I had a panic attack, I was literally immobile. It was hard to go outside at all.
 
Soon, most of my time was either sleeping or watching TV under my electric blanket. Nothing triggered me there. For days at a time, I would watch TV shows where there was virtually no conflict and no loud surprises. Nothing that scared me. Nothing that hurt me. No reminders of India. Or the hospital. Or anything medical. Or anything unexpected. 
 
I watched a lot of "House Hunters."
 
Inundated with shame, it was six months before I went to the psychiatrist. Surely it couldn’t have been that bad, I kept thinking to myself. People get kidney stones every day, and they get over it. I hadn't been assaulted. I hadn't been raped. So what was the big deal?   
 
But when I’d think about taking a return flight back to India, I would break out in a cold sweat. I would put my head in my hands and take deep breaths to keep from feeling like I was falling. I would run to the bathroom and have instant, IBS-style diarrhea. Hell no, I’d think. If going home makes me a pussy, so be it. I’m not going back. I got out. I’m out. 
 
I’m okay. 
 
*** 
Shame was a major part of my recovery, and it was probably the reason I waited so long to start therapy. You're fine, I kept telling myself. Get over it. But I couldn't. My brain wanted desperately to just “get over it,” but the minute I had to pee my heart would start pounding.
 
The panic attacks, the crying jags, and the IBS flareups were still coming at a steady clip, more and more frequently as the months went by. But according to my shame-brain, it was all under control, and not even pooping my pants at Red Lobster could convince me otherwise. I'm not going to the doctor, I thought. Going to the doctor was akin to admitting I had a problem. So I just drank wine to curb the relentless panic. A lot of wine. 
 
One night, on a drive through the city, my then-fiancé pulled into a local gas station and watched, horrified, as I started hyperventilating, unable to stop. The reason? I had to suddenly pee, and we had been stalled in traffic for a few minutes. He drove me back home and I made an appointment with the student health center for the following morning. I had a PTSD diagnosis from the counselor the very next day. Apparently I was a textbook case: hypervigilance, avoidance, nightmares, flashbacks. Together, the counselor and I spent the next six months unpacking what had happened and why I just couldn't seem to move past it. 
 
There was no moment of clarity, no revelation that made me not have PTSD anymore. I went to therapy for months. I tried a lot of different antidepressants, eventually settling on one that made me feel like I could breathe again. Very gradually, I stopped needing to drink so much wine. I could ride in a car without wanting to throw myself out of it. I could hear a doorbell and not want to crawl in bed and hide for the rest of the day. Slowly, I started saying “I had PTSD,” instead of using the present tense. 
 
As I type this, I can think and talk about what happened in India without feeling pure, helpless terror. I no longer have PTSD. But although I've moved past the original trauma, what happened in India definitely incited an underlying panic disorder that I still need medication to treat. I take Zoloft. I go to therapy occasionally and I bust out my rosary when things get especially rough.
 
It's something I still have to manage –- the sporadic bouts of panic, the racing, obsessive thoughts -– but I do manage it. I'm functional. Best of all, I can pee without a problem now.