Thursday, July 23, 2015

Vet infant PTSD from surgery without anesthetic and adult behavior

Baby PTSD. Other PTSD. Link to later political, religious leanings?
Conclusion:  No definitive way to find out?  Keep on table.
And everyone is damaged in some way, is that so?

The effects of baby surgery without anesthetic before 1986 or so:  Who as an adult is affected?  How?  Is there Baby PTSD. The New York Times highlighted an emerging concern in 1987, see http://www.nytimes.com/1987/12/17/opinion/l-why-infant-surgery-without-anesthesia-went-unchallenged-832387.html; and now the use of anesthetics in infants is again being challenged, as more damaging to brains than the trauma of helplessness amid pain, see 2012 article, http://www.webmd.com/parenting/baby/news/20120820/anesthesia-may-harm-childrens-brains  Narcotic, anesthetic negative result vs. trauma result.  How to weigh.

As for adults with PTSD including those who were subjected to medical trauma (or other trauma), are they less open to new experiences, changes of mind with new facts, feeling less safe with a variable environment. Is that reflected in their political and religious leanings, see The Psychology of Political Ideology, GoodTherapy.org.
  • How to test? Note this issue: "... for whatever reason, an individual's conception of their ideological position often differs from that predicted by a policy question." That is from Dr. James Rockey, economist, in a University of Leicester Dept. of Economics long-term study (136,000 subjects, 82 nations, 20 years), 2010, Political Leanings: Who is Left Wing and Who Just Thinks They Are, at http://www.sciencedaily.com/releases/2010/07/100714113110.htm

And as a tool for understanding political and religious behavior of adults, is it feasible to ask if such early infant trauma, where it resulted in PTSD, affects the degree to which an adult seeks safety, avoids change, feels threat, engages in sudden rages, goes to the barricades.

1.  First, vet facts underlying the premise that anesthetics were not used on babies until 1986 or so.  That seems clear.  Such no-painkiller surgery was apparently common. See FN 1.   Get more US data from professional sources, like http://ether.stanford.edu/library/pediatric_anesthesia/neo%20natal%20anesthesia/NEONATAL%20SURGERY.pdf; not just anecdotal, self-reporting or summary. Further resources are listed at Snopes.  

2.  Then vet the emerging anecdotal, and now an incipient, but scientifically supported, idea, about whether an infant stress disorder can have stemmed (if it exists), from that  a) surgery conducted on babies before 1986; if  b)  if that was done without anesthetic, as was common before 1986.

Appreciate the difficulty of testing the idea. How to determine or measure if there to be seen today a syndrome of fear-filled, anxious behavior patterns in some adults operated on as children without anesthetic, now as adults. Is there a baby PTSD, infant PTSD.
  • How to identify the triggering event. And why it persists in some medically traumatized persons and not others, as is probably the case. 
  • Look at the totality of the person. Where the syndrome is found, does that syndrome reflect in the adult's political and religious leanings as fear-generated, what will make me safe, how can I avoid change, how can I preserve me.  
    • Does the idea of behavior in beliefs defy analysis because of inaccessible records, flaws in self-reporting, unprovable neonate memory.
    • And if there is such a thing as baby PTSD, with memories erupting at odd times, what behaviors stemming from it, mind freezes, danger-danger.
    • Politics and religion as related to stress response. Is it also logical to think that the ideological and political and religious leanings of those people medically traumatized as babies would tend to safety, rejection of change because change is dangerous, status quo, fear of the unknown.
  • Research.  Some professional sources on the issue of pain in babes have been updated as recently as 2015, a good sign, see Perioperative Pain Management, http://emedicine.medscape.com/article/980222-overview
2.  Start here:

 2015
-1986
     29

Who is in that population. This is odd arithmetic, but with a purpose, and directed at people born before 1986. If you are one of those people, and if you underwent underwent surgery as a baby-toddler, you might not have been given any anesthetic. That is traumatic, stressful, and the issue is whether infant trauma can lead to PTSD: Post Traumatic Stress Disorder.
  • From the wings: Q. Can't babies just rebound? Operations without anesthetic sound impossible now.  A. Some do; and, agree, no anesthetic sounds barbaric.  Need more information, however, on the alternative harm of the anesthetic on the brain.  
3.  Symptoms:  PTSD in vulnerable persons we know from battle PTSD, disasters, abuse, can result in a complex of behaviors, See http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml 
  • fear or fright even when not in observable danger. This can also result from battle experience, of course; disasters; violence and abuse; see http://www.ptsd.va.gov;
See laundry list at http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Posttraumatic_Stress_Disorder_70.aspx

Ask if you dare if politics and religion for some relate to a stress response, a personal PTSD.

4.  Anecdotal meme sites abound already. This concept affects how many. Perhaps the broad recognition is only because if a diagnostic term gets used, someone will latch on to it.  Surely some professionals can figure out how to test the theory of infant PTSD in adult behavior.  Rage, depression, cutting off self from body, the disconnect?

The medical profession may not want to engage. The idea ranks 10 in the Horrific Scale. Who, then? Yet, there is a head start. This idea is part of assorted memes out there, including the informal (not by a medical person) http://differentdream.com/2011/03/can-you-imagine-infant-surgery-without-anesthesia/ and anecdotal blogs that so far appear to put too much in that diagnostic basket without controls, but may be tuning into something useful, see http://www.friendshipcircle.org/blog/2013/07/12/post-traumatic-stress-disorder-in-babies-and-toddlers-what-are-the-symptoms/; http://myincision.wordpress.com/category/infant-ptsd



5.  Physical effects of trauma:

Go further.  Is this so about Post Traumatic Stress Disorder in general:  Traumatic stress can affect brain volume in areas of the brain that usually regulate fear and anxiety, see PTSD study at http://www.sciencedaily.com/releases/2012/11/121105161355.htm/  A kind of deflate-gate.  Can the brain recover?  Of course, we think. Especially in little ones. Just pump it up again. Get on with it. The pre-conscious, pre-verbal one will literally not "know" the difference.



There are already some studies of medically induced torture-trauma on little ones, that appear to lead to later physical and psychological damage, see http://www.nytimes.com/1987/12/17/opinion/l-why-infant-surgery-without-anesthesia-went-unchallenged-832387.html/
Discussion:

6.  Combine the contexts for broader social analysis.

With the similarities among traumas, including the inability to counter the event, the helplessness, the agony, the horror, would be similar.  It should not be surprising, then, to find parallels to military PTSD in such children, together with heightened fear, anxiety. Explore further this aspect affecting later adult development, learning abilities, phobias, depression, fear and anxiety, all feared or actual.  ADHD:  This kind of stress may lead also to the child's body producing low levels of the hormones needed for attention, see The Harvard Mahoney Neuroscience Institute, newsletter 2011 article, The Long Life of Early Pain http://hms.harvard.edu/sites/default/files/HMS_OTB_Winter11_Vol17_No1.pdf/  Treatments can help the early pain survivor; but take the issue a step further.

8.  The hot button.  Vet politics, ideology and traumatic stress, recalled or not.

Political views, regimentation, conformity. Does fear of change, miasmic anxiety, affect our politics, religion, polarization, fear of loss of status in the traditional hierarchy, fear of the Other.  Michael Steele, will you look into roots here?  Is fear of others' autonomy indicative of nothing other than preference.

PTSD.  Traces of violence. Was there survival? With what compensating conditions.

9.  Back to brains: Trauma and brain size.

If the amygdala brain-part regulates fear and anxiety response (animals have been more studied on this than humans, see the Science Daily cite above); and that area is substantially smaller in Baby PTSD folks as well as other PTSD folks, a cause and effect is not necessarily so, but should be explored.  Did the smaller amygdala come before the abuse, or after. Interesting.  Do people with smaller amygdalae either get into bad situations easier, without the ability to get out (not so for infants, of course); or did the bad situation lead to a reaction leading to a smaller amygdala -- did it give up.

..................................................................................

FN 1

For evidence of the lack of anesthetic for babies before 1986 or so,  see for example this 1989 article acknowledging the issue of ongoing withholding of pain medication for neonates, the little babies.  See Pain Perception in the Neonate, from Canada's CFP-MFC, publication of the College of Family Physicians of Canada, at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2280358/ The article calls for change in procedures, now to recognize responses of the neonate to pain, and provide relief.

More recently, in 1991, an American Ph.D., (where are the MD's here?) wrote an article, Babies Don't Feel Pain, a Century of Denial in Medicine, in a circumcision symposium paper, see http://www.nocirc.org/symposia/second/chamberlain.html; but that smaller snip does not match the violation of, say, abdominal surgery without anesthesia. Where are the papers on that here?

Unthinkable idea.  See an example of the nonmedical memes out there, http://differentdream.com/2011/03/can-you-imagine-infant-surgery-without-anesthesia/
 and http://myincision.wordpress.com/category/anesthesia/

Are anecdotes just hype?  Find someone who had pyloric stenosis as an infant before 1986, was operated upon without anesthetic, see the scar, look at life patterns, ask the question.  Data begins with anecdotes.  Foster them, and analyze with science, reason.

The issue remains:  if most everyone experiences some trauma when very young, and most cope, why focus on medically induced trauma of infant PTSD.  How to identify them specifically for purposes of treatment. At least, start and see what evolves. Are there mindsets in adults who experience these traumas, or harbor reactive behaviors as personality adjuncts or patterns, and if there is no other explanation, why not ask about infant surgery.  Canada seems to do a better job than the US in addressing PTSD professionally, see http://bodyandhealth.canada.com/condition_info_details.asp?disease_id=194