When our son was born in 1982 and flown 750 miles away for life-saving surgery, we asked the medical professionals if the surgery and recovery would somehow affect him later on. “No,” we were told repeatedly, “he’s too young to remember. Besides newborns don’t feel pain.”
Even though the opposite has been proven true since our son’s surgery, the news hasn’t reached segments of the greater medical community. In fact, a mom whose newborn was in a major hospital’s neonatal intensive care (NICU) in December of 2009 was told the same thing we were. “She won’t remember. She’s too young.”
A recent national conference hosted by the Intensive Trauma Therapy Institute in Morgantown, West Virginia focused on the topic. One of the therapists from the institute, Linda Gantt, said the likelihood of PTSD developing after invasive medical procedures during childhood depends upon several contributing factors.
Factor #1: Timing
PTSD is less likely to occur if a medical procedure is scheduled and there’s adequate time to prepare the child beforehand. PTSD is much more likely to occur in emergency situations. Also, if the child’s preparation is age-appropriate, PTSD is less likely to occur.
Factor #2: Anesthesia
The kind of anesthetic used is a major factor. General, local or topical anesthetic should be selected based on the procedure and age of the patient. A patient’s inability to go under increases the likelihood of PTSD developing, as does “coming light” or “partial awakening” during the procedure.
Factor #3: Age of Patient
The younger the patient, the greater the risk of PTSD developing.
- The risk is greatest when kids are non-verbal, birth to age 3. Even when they become verbal, they are unable to access their non-verbal memories using words.
- Children who are verbal, but still in the concrete thinking stage (ages 4 – 10) are also at risk because their reasoning skills are very literal. They can’t yet think abstractly.
- Children from the ages of 12-18 are least likely to develop PTSD if their abstract thinking skills are in place.
Factor #4: Previous Trauma History
Children who have experienced previous significant trauma (sexual abuse, physical abuse, life-threatening situations) are more likely to develop PTSD after medical treatment.
The next post in this series will explore the general principle behind the occurrence of PTSD and how it can be successfully treated.
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Wow! Your son (and you) have been through a great deal. From what you described, your son is dealing with medical induced PTSD. The good news is that effective treatments are available. It’s a matter of finding a qualified therapist. Here’s the link to a post that can help you start your search for someone who can treat your son: http://differentdream.com/2016/10/find-trauma-therapist-kids/. I’ll be praying for you and your son. Jolene
Jolene. Quite by accident I came acriss your name and stumbled upon the link between medical procedures and PTSD . I feel so validated (finally)! My son has had a very tenuous and remarkable medical history (2 years hospitalized) + 18 more hospitalizations. Much of it emergent trauma where life threatening measures were made to sustain life (i.e. pain maintenance is thrown out the window and life saving is the priority. I recall a night where my son was septic and going south FAST: they were working to maintain a pulse: all night. Every time I tried to return to the PICU to be with him, they sent me away and would retirebe me once things settled down: became stable rather than critical. I returned every hour, only to be turned away- I recall 10-12 people working, needles (trying to get another IV line in to deliver more hydration – while other IVs /PICC lines were delivering precious broad spectrum antibiotics to fight the infection that had entered his blood stream). There was blood, I could see attempts to stab feet, groin, etc. (veins become impossibly small when dehydrated/sick). I was helpless and being sent outside the area. Finally, at dawn, I was allowed to go in. He was sound asleep and prognosis was uncertain (it had been a rough night, and with a child already compromised with serious chronic illness, a weak liver, etc. things weren’t looking positive). That is until my son awoke, and made the sign (sign language- he also has a trach and at the time could not speak due to an occluded airway) for PAIN. When the nurse saw this, she burst into tears (they had t thought he’d come through)- he came through and was able to let us know the pain he was in. My point: it was incredible trauma and pain that lasted hours: how much of it he was cognizant of, we can’t be sure, but there are no pain meds in a time of crisis like this. Following this hospitalization, his obsession with dogs (how he loved dogs: we’d have to stop people so he could pet the dog and let them lick his face)!- this turned to extraordinary fear: terrified of dogs: even coming close to him. This terrified fear has never diminished 🙁 there were other new developments following that specific hospitalization: couldn’t touch his feet, and to this day cutting toe nails is torture: I think it was all the pokes of trying to get an IV in his feet (never Did we witness any of these things prior to this very Trumatic hospitalization). Our go with the flow, fearless wonder (he had been hospitalized for a continuois 2 years prior to this- but the difference I believe it he was younger and children do not develop long term memory until age 2). This traumatic hospitalization aforementioned took place days after his 3rd birthday. Every hospitalization following this, there’d be some regression in certain areas: oral aversion/eatting, and fears/anxieties that hadn’t necessarily been there before. I have repeatedly brought up PTSD and been balked at. School specialists/therapists rolled their eyes and disagreed of such a rediculous claim, private therapists in the medical setting (OTs/ etc.) were unreceptive to the thought that the possibility of PTSD could be remotely possible, and some psychologists (school and private) have not been receptive. So little consideration is given to the child’s emotional development (even in medical circles: I’d like to see more emotional development and well being of the patient take a larger role in the treatment process: I believe it is critical to advancement and healing). Unfortunately, I have seen very little attention given to the effects of medical trauma with children who have long term/serious illness. Just now there is research/neuro science being conducted on chronic stress (neglect, abuse, divorce, poverty) and the tremendous impact it has on children (frontal lobe/ executive function: self regulatory functions not being efficiently developed)- the heightened fight or flight response mode (that is PTSD I would think) . Though I have yet to find the impact of chronic stress from medical trauna and/or illness (likely b/c it is much less common, however it is growing in numbers with the rise of medical advancements/ medical technologies). This all being said, I have received little reception in this claim: there is PTSD with children who have experience long term medical treatment/ complex and chronic illness, etc. I am so grateful to see it finally recognized and the connection being made (this will eventually help others to better treat children and address their needs as they effect everyday learning and life activities- but more importantly, recovery). Thank you!!
Lee, you are so welcome. Hopefully, the realization will get you a step closer to good treatment and healing. Jolene
I’ve suffered from a severe form of PTSD that has made most of my life a living hell, without ever knowing why. Now I think it might have been related to the several surgeries that I went through as a 2 months old. Thank you for sharing this.
Oh yeah, lots of other things can cause PTSD in kids, not just medical procedures. Physical, sexual, verbal and emotional abuse, of course, and natural disasters. Also adoption, divorce, the death of a close loved one, bullying, moving, and a host of other things. What adults see as normal change can be huge for a child.
Jolene
Living the fall out of complex ptsd, but not from the medical side of things. My son will walk in an operating room carrying curious george and an oxygen tank as if it is no big deal. . .