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Resources

Part 1

Part 2

Post Traumatic Stress Disorder After Sexual Assault

By- Kayla McGehee

Part 1

the Patient Experience

What were you experiencing that made you seek medical attention?

1

When the patient is asked this question they respond by explaining that they were sexually assaulted within the last year and later diagnosed with Post Traumatic Stress Disorder(PTSD)

The patient then continues by telling them that they have been experiencing extreme suicidal ideation and had made a plan to end their life

How long was it before you went to see the doctor?

The patient truthfully tells you they have been struggling with the thought of suicide for a week now and made a plan but instead of following through on the plan they chose to come seek help.

2

Do you know what you did to “catch” the sickness?

I was sexually assaulted and after the assault was diagnosed with PTSD

3

Were the signs and symptoms gradual over time or did they come on abruptly?

The symptoms of suicidal ideation started abruptly. However the symptoms of flashbacks and nightmares have happened daily since the event causing the PTSD.

4

Have symptoms stayed relatively consistent or have they gotten better/worse?

Until last week they have stayed the same. However recently they have gotten extremely worse everyday.

5

Once they diagnosed you and started treatment, how did you feel? Did you get better right away? Did you feel worse? How long did it take?

6

After the diagnosis I was advised to seek counciling with a therapist who specializes in PTSD and Survivors of Sexual Assault and Abuse. As time passed I continued to get nightmares and flashbacks of the event, however with counciling it slowly got better. Along with counciling I was put on antianxiety and sleep medications to help with the physical symptoms of the PTSD.

What did the doctor tell you about your prognosis? Is there a cure or are they going to experiment or just try to treat the symptoms?

7

The prognosis is good with counciling, medication, and the use of healthy coping skills. PTSD is something that I will struggle with for as long as I live. A PTSD diagnosis is not good however it opens doors to lead to healing, finding healthy coping mechanisms, and a way to understand why I feel the way I do.

How is this affecting your life? (Mentally, physically, emotionally, etc.) Your family life?

8

Being diagnosed with PTSD changed my life, in good and bad ways. After being diagnosed I realized that my reactions to things such as being touched and immediately ready to punch whoever it was was a trauma response. I have learned that a lot of my mental health diagnosis are due to having undiagnosed and untreated PTSD for so long. Having PTSD has lead to severe anxiety, depression, insomnia, night terrors, night sweats, flash backs, panic attacts, constantly being in fight or flight mode, and extreme hypervigilance. PTSD is something I would not wish upon anyone as PTSD isn't black and white, it is complex and leads to many other issues, mentally, and can

even lead to physical issues because the body

takes mental pain and turns it into physical pain.

Part 2

The clinician thought process

Who is your patient? (age, gender, race, etc.)

Patient is a 20 yo caucasian Female

1

How did the patient present?

The patient was in distress upon admittance, she presented with extreme tremoring throughout her body, with evidence of hyperventalation for an extended period of time. The patient also presented with lacerations to her upper thighs that were partially healed.

2

What were initial signs and symptoms when you encountered the patient?

Upon the first interaction the patient had signs of hyperventalation with a low O2 on the pulse oxometer. The patient had signs of partially healed self inflicted lacerations. Upon talking with the patient she disclosed she was here for suicidal ideation and self harm due to the flashbacks and night terrors from a sexual assault.

3

What did your exam look like?

The exam started with an introduction and asking the patient why she was in the Emergancy Room today. Once establishing trust and the reason for her visit I asked for consent to do a physical exam. I took her vitals her O2 was 89%, her blood preasure was 124/72. After getting her vitals I asked if I could see her legs to ensure the lacerations were healing properly and there were no signs of infection. I then just talked to the patient asking about the Suicidal Ideation and how long it has been going on as well as if she had a plan to harm herself.

4

What is on your DDx list? WHY?

On the patients Diagnosis list it has she was diagnosed with PTSD less than a year ago after being sexually assaulted. She has also been dignosed with anxiety, depression, insomnia, and a panic disorder.

With her PTSD she developed extreme anxiety, insomnia due to night terrors of the event, panic disorder causing panic attacks randomly and with flashbacks of the traumatic event. She developed depression as she was told by many people around her it was her fault for the assault leading to self blame and major depression

5

What other tests or studies did you order to help you diagnose the condition, differentiate it from other illnesses on your DDX list? What were the results?

The patients other diagnosis came after the event that lead to her PTSD therefore it is reasonable to see the PTSD was the root cause to her developing the other conditions she has been diagnosed with.

6

What is the patient’s prognosis? Is there a cure or just control of symptoms or are you attempting to just slow the progress of the disease?

The patient has a good prognosis, PTSD is not a curable disease but can be controlled with therapy, medications, and having support of others who have been in a similar situation.

7

What is your treatment plan/options?

Seeing as the patient came in instead of harming herself as she wanted to, the treatment plan is to get her resources as well as making an appointment with a therapist and finding a support group. We will keep the patient overnight to ensure she is kept safe and if all goes well when we reevaluate in the morning shift change we will make sure she is set with resources before discharge.

8

What is the time frame of your treatment?

The patient came to the Emergancy Room and therefore I am a short term care provider however I will ensure she has an appointment with a long term provider prior to her discharge.

9

Part 3

Resources

National Sexual Assault Hotline

1-800-656-4673

1

https://www.rainn.org/resources

2

https://www.nsvrc.org

3

https://sakitta.org/survivors/

4

https://www.dcjs.virginia.gov/victims-services/programs/sexual-assault-awareness-month-resources

5

https://namimass.org/sexualtrauma/

6

https://www.cdc.gov/violenceprevention/sexualviolence/resources.html

7

https://victimconnect.org/learn/types-of-crime/sexual-assault/

8

https://www.joyfulheartfoundation.org/learn/sexual-assault-and-rape/resources/hotlines-and-more-information

9

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