Medical trauma

[Ruminate2much]

A few weeks ago I had an accident, and was taken by kind strangers to A&E. I usually avoid medical stuff like the plague (quite phobic) but was in shock, so didn't argue.
I had a lot of facial injuries and was covered in blood, so it was scary, but they, understandably, were more worried about internal injuries and said I needed a full body CT scan. I actually knew I didn't. I instinctively knew it, but I couldn't remember the few seconds of the accident, so they totally understandably insisted.
Anyway, meanwhile nobody was cleaning my face. I was in total shock, so didn't know who to ask. I was bleeding and desperately wanted the wounds cleaned and dressed. I didn't think I'd need stitches. But anyway, eventually, after the scan results a doctor came to look at my face and said I'd be referred to Maxillofacial for sutures. I was terrified then. I'm not hugely vain, but wanted to look like myself, and he made it sound so serious. I hated the thought of stitches on my face, so asked if they could just glue the wounds in A&E; but they were very reluctant and said it could lead to scarring; so I just thought I'd have to do what he said.
The thing is that he assessed the wounds before they'd been cleaned; and they looked a lot worse. A friend gave me a lift to the maxillofacial place miles away, as no room locally. The following morning, and I'd had the wounds dressed, but not properly cleaned, all night. I was scared to touch.
I was so upset at the idea of stitches in my face due to pre-existing mental health challenges. So was totally away with the fairies.
By then I was swollen and looked much worse.
Anyway, once in, I actually asked if I could have steri-strips instead, and he initially said yes. I explained that stitches would traumatise me for various reasons.
Well, somehow or other, I got talked into it. But actually, after the stitches were done, I realised the deep wounds weren't nearly as big as I thought. I honestly wouldn't have consented if I'd known. I'd have risked little scars. The stitches under my nose got badly infected. They weren't put in till 25 hours after the accident, and I think that's why. I now have a lot of stiff uncomfortable scar tissue, and have found the whole episode very upsetting
Some of the stitches were on my forehead, which is really weird, as most people just get steri-strips there, which I'd have far preferred. So I'm puzzled and upset. They said the little stitches they do would be less likely to cause scarring, but honestly the wound was so small that I don't think it needed that.
I'm so upset with myself for not being clearer. I worried about scars at the time; but now realise I'm much more worried about the feeling of violation.
I also had stitches inside my mouth, and it doesn't feel right, and I'm not sure it was needed at all. I'm actually almost feeling suicidal due to the episode. I'm so traumatised by it. It probably wouldn't traumatise most people, but I'm quite medically phobic, and so upset that I didn't completely refuse stitches. They said it'd be my best chance to avoid scars, and I guess I was a bit scared and gave in. The rest of my face healed beautifully very quickly, which confirms that I didn't need all that intervention. I just feel devastated by it all. I close my eyes and it's all I see. Does it sound like medical trauma? Is there any help available for it?

They don’t clean and dress the wounds until assessed, that’s normal.
They wouldn’t have done costly treatment unless they thought it necessary. Stitches are often the best solution, particularly on the face.
You were given medical advice, which you willingly took, you could have walked out at any point.

I know. That's why I'm traumatised, as I'm so cross with myself. I was in such shock I think. I don't blame anyone else. I just wish I'd explained myself more. Very hard when you're in such shock. I'm so upset about it.

Ive had stitches in my forehead and steri strips on my chin.

The chin has scarred - forehead has not.

I fully appreciate your anxiety but a qualified professional is more equipped to know how to treat your wounds then a someone who can't see them and isn't medically qualified.

Sounds bad they didn't clean them for so long though.

Can you ask for a GP appointment to discuss how your feeling? They'll have your note from the hospital too so can talk you through it.

I think you sound traumatised and as you have said yourself this isn't something everybody would feel traumatised by. Go to your GP explain exactly what you have said here, write it down if necessary and go from there.

@itsgettingweird and @Hellocatshome thank you. Yes, I feel I betrayed myself. I'm so into natural remedies usually. I guess stitches aren't all that unnatural. I almost wish I hadn't gone to A&E at all, and just dealt with it all myself at home. But I was taken, and too much shock to do otherwise

I would second (third?) seeing your GP; it sounds like you're spiralling and I don't know whether anything anyone says here will help.

For what it's worth though, I've had steri strips and stitches in the past; the latter have healed so much better. I have notable scars from the ones that they just stuck together. They're generally always going to do the cheaper and quicker option (steri strips) so the fact that they didn't means that they felt you needed stitches for the best chance of healing.

Thank you. That's interesting. I assumed stitches were more likely to scar.
Out of curiosity, if you'd been in my shoes, would you all have followed their advice and agreed to the stitches?

Yes, I think I do need help with this. I haven't been to my GP for many years, due to phobia, but I might have to. Thank you all for your advice

They've treated you like a "trauma patient", appropriately scanned you and referred you to a specialist they didn't have on site for your facial and mouth wounds. You are minimising your injuries to yourself by talking about steri strips, sutures will have been appropriate. They take longer and so wouldn't have been offered if not needed.

The max fax team will have done the best sutures available.

I would definitely have followed their advice!

I'd guess this isn't as such about stitches and scarring, but about the feeling of being out of control and, as you say, violated. Plus the trauma of the actual incident ... possibly by focussing on the aftermath you avoid thinking about that.
Do you have access to counselling via work? You might find a 'quick debrief' helpful to talk over what happened without going in depth into anything.
Otherwise GP could perhaps refer for some sessions of, for example, CBT

Thank you. Yes, I will admit I think, looking back, that it was all overkill. I feel guilty about having used NHS resources when I feel my injuries weren't that serious. They did look very serious at first.
I also feel guilty because I told them I couldn't remember the accident when they asked me what happened. It's true I have no recollection of the actual fall (from my bike) but I think they possibly misunderstood (my fault) and thought I meant I'd forgotten the entire episode. I wonder if my wording caused the overreaction?

Thank you. Alas no access to counselling with work. I'm very prone to rumination, and just going round in circles. I'm very upset with myself for not having handled the situation better at the time. Not having asked more questions etc

@Ruminate2much Yes, I absolutely would have followed their advice. I actually have been in the reverse situation - in one injury, I had a choice between steri strips and stitches and I went for the strips as I didn't want to take up too much of their time. I wish I'd advocated for myself and had the stitches instead.

That's interesting. I wasn't really given a choice. They seemed very keen to do stitches. I think my priorities have changed. At the time I was worried, as my face was such a mess. I now realise I'm much more concerned with autonomy and not being too tampered with than about scars. The wounds were small (deep but small) and wouldn't have left big scars. I heal quite well naturally too.
So ironic that you had the reverse experience. I guess I know in future. If I could go back in time I'd handle it differently; but I was so unprepared at the time

I’m medical. They look small because they’ve been stitched up by an expert - maxfax are the best at minimising scars and making you look like ‘you’. Honestly, you’ve had the best treatment. You do need to accept that they knew what they were doing and gave you the best option. Hope your recovery goes well, best of luck.

I think the other thing is that I've never had an accident like that before, and had very little experience of the NHS, so I was blind-sided by it all.
Anyway, thank you. Just talking on here has made me feel a bit better. I do know I need help with it, as it's been about six weeks now

@Ruminate2much I was only given a choice because it was borderline (and it was about 3am!)

Thank you. That's very kind. Funnily enough, one of the reasons I've been so upset is that the referral to max fax almost made it feel like cosmetic surgery or something! I'm such a natural woman, and would never have cosmetic surgery (no judgement of anyone who does) and so having stuff done to my face was very foreign. Very upsetting. But actually, deep down I know stitches are just a means of pulling the skin back together and letting nature take its course. Thank you. Your post helped

Ah! I wonder if the reason they were so worried in my case is that there were so many lacerations. Maybe if it had just been one they'd have dealt with it in A&E with steri-strips

My accident was on a Sunday, which is why I had to wait till the following day for the stitches. I do think the delay was too long to be honest. But nobody's fault

You had a traumatic accident - it does not sound like the NHS staff did anything wrong.

Although you don’t believe that you were given the best form of treatment- you have had reassurance from others on here that they took the most appropriate form of action for your type of wound so that must be reassuring?

How are your scars looking today?

Stitches are a very very old and traditional way of healing wounds, older than steristrips, if that is something that matters to you. You’re healing well now and you’re allowed to be cared for medically - it doesn’t mean you’ve lost “natural points”. I’m sure the people who were looking after you are used to seeing past blood etc to understand what is best for the wounds you had. It sounds frankly awful, and I agree with others that you’re remembering lots about the hospital and not so much about the actual incident - see if you can think this through too and not dismiss it. You’ve been through a lot. Your medical phobia is the issue here, not how you were treated - that all sounds very sensible. I’m so sorry it was all so hard for you - it would be great if you could live your life without needing medical help. But be angry at the accident not the medics. You’ve done nothing wrong.

Thank you. Yes, I have no criticism of the NHS staff. Apart from not cleaning the wounds in A&E. But otherwise, none. My criticism is of myself.
On the outside, my scars are healing really well. Unfortunately under my nose there's a lot of hard uncomfortable scar tissue that I can feel rather than see. Also my mouth feels very strange. But I guess it's still early days for the scar tissue to settle.
My only other worry is that I think something might be working its way out of my forehead! They extracted about 15 pieces of stone and shell etc from it. But I think something might have been missed! I guess time will tell

Thank you. That's all very helpful. Yes, weirdly the accident itself doesn't traumatise me. I can't remember it. I remember the lead up, but not the fall. I think I blacked out for a few seconds. Maybe my trauma is displaced. Thank you for saying I didn't lose natural points. I honestly feel like I betrayed myself. But I'm probably being silly

If you'd dealt with the wounds yourself you could have ended up badly scarred. Stitching is the best option to limit scars.
The wounds will feel strange and uncomfortable at the moment, but give them a few months to settle down.