How Sierra Got Her Power Back: Acute Injury Trauma and Mental Health

Acute injuries are sudden and brutal. When my accident happened, I lost my independence in an instant. It was a traumatic incident that resulted in a cascade of negative effects on not just my physical, but mental health.

The Emotional Journey From an Acute Traumatic Injury Through Recovery

It was a regular November morning. A snow storm had passed through the night before. I put on snow gear and was headed out into the city–cheerful and excited for the day, lost in thought.

Suddenly, I tumbled down a stairwell in the subway and landed sitting up with my right ankle broken in three places.

As I sat on the stairwell, buzzing New Yorkers walked over me, yelling to “move out of the way” and “just get up.” No one helped. I begged an MTA officer to call an ambulance. He rolled his eyes. It was not obvious how injured I was because I was bundled up and sitting on my foot.

The ambulance transferred me to a nearby ER. I sat in a hospital bed and was wheeled from room to room, without knowing where I was going or what was happening. No one would speak to me until the doctor arrived. They wouldn’t even make eye contact.

Nurses were touching my pelvis and spine to ensure the injury was confined to my ankle, but I was being treated as if I was unconscious. Finally, a doctor explained I had a trimalleolar fracture, and attempted to manually adjust my bones back into place–twice. I went from low whimpering to animalistic, uncontrolled screaming.

Despite being given a combination of narcotics and local anesthesia, I was in no way numb.

When I was transferred from the ER to the hospital for surgery, I was put on standby. My injury wasn’t critical from a safety/survival standpoint, and I was generally healthy, so I waited three days for surgery. Each day I was starved and delirious. My cousin and mother stood in as caregivers and advocates to get me into surgery.

The Emotional Impact of Feeling No Control

When it was time for surgery I was wheeled into the operating room by residents I had never met. “Do you speak English?” Asked a nurse. I replied “yes,” frightened that no one knew who I was or what I was doing there.

The surgeon introduced himself and went through the procedure instructions expediently. He then pulled a Sharpie out of his pocket, wrote his name on my injured leg and said: “you’re mine now.” I think he was trying to be comforting, but I was terrified. They whisked me to anesthesia and I was knocked out.

The surgery was successful. But as a result, I had no control over my body (from the physical impairment) or my mind (from heavy narcotics).

The hospital room was full of people monitoring me–touching my arms to get vitals, sponge baths, administering pain meds. I tried negotiating my circumstances where possible. For my dignity, I did not want to use bedpans. Instead, I worked to use a walker to go to the bathroom.

I wanted to leave the hospital so badly. I remember refusing meds during an acute pain attack in an effort to be discharged and the nurse said to me, “You are suffering. I promise you will leave the hospital soon, but stop suffering.”

The Challenge of Processing Intense Medical Experiences

Trauma comes in waves. I suddenly remember tender moments… like when my cousin and a nurse washed my hair in the sink since I wasn’t allowed to get wet. Or the way the surgeon knowingly looked into my eyes when I told him I need full range of motion in my foot. Or the resident who was comically too casual given the gravity of my situation. Or the smile on the faces of the hospital staff when I requested only chocolate ice cream for dinner… and the way my mom spoon-fed me said ice cream.

I also remember the week I spent waking from the same nightmare holding my ankle as I did after the fall–re-enacting my accident and jerking my leg in my cast.

Reclaiming Empowerment Through Getting Off Narcotics

I was given a full bottle of OxyContin and Tylenol for pain at home. After being on narcotics for more than a week in the hospital, returning to the familiar environment of my apartment, I started to notice the effects. I had weird in-between dreams where I couldn’t tell the difference between waking and sleeping life.

I was told that I should wean myself from the meds, but not given to instruction how.

My plan was to stop narcotics completely during the day, and take meds in the evening as needed. That first morning, after about six hours off of drugs, I started to feel my foot. It had previously been numb to any sensation.

Now my foot was waking up. I felt gurgling, tingling, pinching. Going from no sensation to sensation is intense. Coupled with generalized fear, I was terrified of the possibility of pain. I screamed to my mom to bring the narcotics and she ran to me.

My mom was all too familiar with my screams of pain from the hospital. She said to me “what do you feel?” That skillful question took me out of the black and white “pain” or “no pain” and into the exploration of sensation.

I ultimately determined that I was feeling sensation, and while the sensation was not pleasant, it didn’t warrant a pain-killer. I managed to get off narcotics within two days.

Had my mom not slowed down my reaction to the sensation, I’m not sure I could have done what I did. That was my first moment of reclaiming discernment and choice in my recovery.

Re-Establishing Boundaries to Help Restore Mental Health

In the hospital, there was no part of my body that felt like mine. In my apartment, I had to fight to retrieve every piece of physical independence while being realistic about my own abilities.

Not being allowed to shower alone (shower stalls are too slippery), left me literally naked in front of friends I had never exposed myself to. I broke down over small things like not being able to get my foot into my boot or being unable to get ahold of my doctor.

People I was not intimate with were seeing my physical and emotional vulnerability in a way that left me raw.

However, as I softened into my new reality, I realized that despite the loss of control (and sometimes dignity), I did have choices. I had the choice to embrace the love and the care that all the individuals who came into my home gave me. With that choice came a power; a feeling of love and of non-reciprocated care.

Over time, the physical empowerment came back as well. I was able to shower alone, prepare food on my own, and go back to a normal life over the course of months.

Tracking Recovery Progress to  Reclaim Independence

A big part of regaining independence after this acute traumatic injury was my ability to assess where I actually was and to test my own limits. Tracking my progress each day was important.

It was a big deal to carry tea with a steady hand from the kitchen to my living room. Previously my hobble was too precarious to have hot liquids in my hand. The ability to walk up and down stairs without a crutch was progress. The day I was able to shower standing up was a highlight.

Celebrating small miracles was important, and kept me on track. I saw tangible differences in my resilience, in my mood, my outlook, and my priorities. The last thing to come back was learning to trust my own body again.

Self-Massage to Regain Feeling and Return to the Body

The story of my accident is my own, but anyone who has suffered a life-altering injury can relate to the trauma of sudden change and the bravery it takes to advocate for yourself. It is exhausting, empowering, and life-changing.

It is easy to disassociate while pushing through the pain of simple things, like walking. It took me time to even consider trusting my body again–I was terrified to feel.

I started the process of feeling again by using the Roll Model® Method therapy balls after a couple of months of healing. I moved very slowly and listened to what my body needed.

Below is a gentle massage for the ankle I practiced. Note that the scar was well healed and I was cleared by a physician and a physical therapist first.  

The gentle pressure from the therapy balls helps to desensitize the ankle to stimuli, which is vital after a traumatic event since the nervous system is on high alert in the injured area. However, it’s important to note that the pace (and the depth) of pressing into the therapy balls is entirely your choice.

You get to modulate your self-massage, which can help you reclaim a sense of autonomy and control over your physical self.

Gentle Ankle Massage with Therapy Ball

Props: Yoga Tune Up® Therapy balls, classic set

Sitting on the ground, bend your right knee.

1. Place one therapy ball to the outside of the ankle, and move the right knee down toward the ground, pinning the ball between the outside of the ankle and the ground.

• Plow the ball from the outside of the ankle to your Achilles’ tendon, letting the therapy ball tug at the skin gently.
• The pressure is to your tolerance.

2. Keep the ball compressed and point and flex your foot at the ankle joint.

• Move slowly, and do not force this movement. It is not about moving to your end range, but rather gentle, tolerable mobilization.

3. Maintain the position and pressure, and use one hand to spin the ball into the tissue.

Repeat steps 1-3, placing the ball to the inside of the ankle

Related Article: Beyond Pain Management: Disrupting The Pathways of Pain

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