Post-op Depression and Other Effects

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Peter Easton

Hi folks,

I am going on 5 weeks post-operation (next Tuesday is that anniversary) and things seem to be going pretty well. Haven't had much severe soreness and the fatigue has begun to fade. Walking is my prime source of exercise (and of getting out, since I still don't drive*). From a scant 100 yards of "shuffling" I'm up to about 2.5-3 miles of walking at a semi-leisurely pace (very leisurely uphill!) Often I can really feel my heart beating. Seems to sort of gently shake my whole rib cage, which tends to divert attention from whatever I am doing, but I guess that is par for the course.

I plan to phase back into work part-time week after next. Since part of my work can be done electronically, I've actually been performing some tasks over the last few weeks, spaced out by naps and light reading.

One effect I have noticed and haven't seen much discussed here on the threads (though it must be back there somewhere in our archives) is post-operative depression. I have had depression at a couple of times in the past, including one major episode about 15 years ago, so I am perhaps more susceptible than some to reoccurence. But I do get the impression that onset of some depression after major surgery like this isn't at all uncommon.

How have folks experienced it and dealt with it? Mine is worst in the morning, when it can be extremely hard to get going. I try a method that worked for me in earlier bouts. When I feel as though I just no longer have any faith (one of the symptoms), I ask myself "What would faith do?" (i.e., what would I do if I did feel my faith) and then I just make myself begin to do that -- and the depression seems to lift. Exercise definitely helps, and I am taking 100 mg/day of Zoloft, which was my medication when dealing with depression in earlier days.

(Chocolate also works for me on minor bouts, even it it doesn't quite fit with a cardiac diet. A friend brought over some wonderful chocolate mousse yesterday, so I must be in full-scale remission!)

Depression still suffers a bit of the old-time hush-hush treatment where people were embarassed to talk about it and own up to it, but happily we've come out of that mindset to a good extent in the last twenty years, I find. I think people realize better that it is a genuine medical condition, often linked to others. With me, onsets have always been linked to (though usually occur some time AFTER) periods of stress; so it stands to reason that major surgery could be a trigger.

So good cheer to any out there who may also be struggling with episodes of depression! Would love to hear about your experience and remedies, or any other related post-operative notes.

Peter

* My cardio actually says it's fine to drive after 4 weeks, but my wife say no (!). Probably a wise lady, though she ends up doing commute and kid carrying tasks about 24/7.
 
Post op depression

Post op depression

Hi Peter, All in all ,I think you are doing very well. I would suggest that when you return to work you do only half time for a while. That would leave you time for rehab.You have a nice program of walking on your own but I personally believe in a medically supervised rehab program.When you feel your heart "beating" it would be good to have it telemetry monitored by trained medical personnell. They could reassure you if everything is OK and even have you slowly step up the pace. Remember, exercise burns off those harmful stress hormones circulating in your blood from the trauma of surgery, the bypass pump,etc. which many believe contribute to the very common postop depression.Exercise produces endorphins which are great mood enhancers. The "runners high" is a genuine documented effect. Best wishes, Marty
 
Depression

Depression

Peter - After the all the build up to the operation, and preparing myself for possibly not surviving, when I did come through I found myself questioning whether I really did want to live after all! I was glad to have friends who could just accept that was where I was at without trying to make it any different. Talking about how I felt certainly helped.

I did a short drive to the shops on day 27 - this felt fine, but from what I read many people are still in too much discomfort. I would say - if in any doubt, don't.

Sounds as if you're doing really well. Keep up the good work.
 
Peter-

There was an enormous discussion on post-op depression, it might have been on the old forum, take a look there. That's a very common post-op complaint. I also read somewhere that the heart-lung machine can contribute to some of it, leaving me to think that it is at least in part physiological in origin.

Most who suffer from it, I think, do take antidepressents. It certainly has come out of the closet as a medical condition and is now freely discussed. I bet lots of people will respond to your post.
 
Hi Peter,
Depression? Oh yeah! Big time! I take 40 mg. of Prozac daily to fight it! I also see a counselor once a week. Without the Prozac my sunny disposition would cloud up like a rainy day! lol I am very open about all this.... everyone has problems once in a while and some of us just need a little boost to get over it!

As for chocolate...my heart surgeon's associate told me that chocolate is great for pain so I have not worried about eating it at all. ;>)

Are you taking anything for your depression?

Marty is right about only going back to work part-time for a while. Overdoing would certainly add to your depression.

Take care.
Zazzy
 
Well, well, another one of us. I believe your cardiologist might tell you that depression is quite common in heart patients. Don't know why, but there it is. I can't understand why they don't tell us about this BEFORE surgery, so we don't get up one day and are surprised and wonder wha hoppen. And since you have a possible predisposition to it, here it came again. Heart surgery isn't a picnic - it is a major stressful trauma, not only to our bodies, but to our emotions, as well. I take Paxil every day and have done so for some long time now and couldn't get by without it. So keep on taking your med and as in the past, one day it will lessen and then maybe go away. And if you have trouble with 'one day at a time' try 'one hour at a time'.

Think there are lots of folks out there who need, but don't take, antidepressants. There are lots of us who do, and for those of us who need it and take it, it is one of the things that keep us going. No longer anything to be embarrassed or ashamed of these days. Only ignorance kept it hidden for so long.

God bless, dear Peter, and keep the faith. You are such an inspiration.

Hensylee
 
Peter, I confess!

Peter, I confess!

My ongoing depression coincides with periods of anxiety and this is the way it has been since my surgery. I try to analyze this and seem always to come up with a reasoning that relates back to several factors: (1) I have always maintained what I believe was a healthy physical regiment of exercise....primarily running and basketball. I could run for miles and could keep up with those a lot younger than me. (2) I never spent a day in a hospital prior to my surgery and not understanding the severity of my "newly-discovered" condition was and continues to be overbearing for me. It continues to impact my everyday thoughts of where I am in my life and "what will come next." (3) My energy level has steadily declined since my surgery and I am only now realizing that I cannot do what I used to be able to do. (4) My valve noise and thumping drives me up a wall. Symptoms similar to TIAs are regular for me and again, a feeling of helplessness and not being in control of myself. (5) I believe my life has been shortened and I have difficulty in accepting this.

I don't like these feelings one bit, for sure, and acceptance has been difficult for me. I have always been a "survivor" and now I wonder "how I will survive."
 
Peter, I don't know your age but I recall that my ex went through something very severe at mid-life - examining where he was and where was he going and what he had missed, and how was he going to make it through 'today'. He was prone to depression, as well (he spent a week in bed one time without getting up for anything or anyone). I truly do believe that there is something that happens to men, right along with us women, at a certain age when our hormones flip out of sync. You probably should consult someone who can walk you through this, and help you get past whatever is going on. You must avoid stress wherever you can - it is a big causative, as you know. Anger is, too. At the hospital, they kept telling us to avoid stress and anger. We all try to do that but it's nigh to impossible, isn't it. God bless
 
Thanks Bob, Hensylee and others --

It's good to share these things -- and to take events and symptoms one day at a time, I guess.

Hensylee, I did in fact have that kind of mid-life depression about 15 years ago when I was in my mid-40s. That's why I suspect that I'm susceptible to this reoccurence. Stress always was a major factor in my own experience of depression and I suspect that the natural stress of the heart surgery is the trigger this time around as well. I did a number of years in counseling, which helped a good deal. In fact, I had never felt so well in my life as I did after I got free of that major depressive episode and got a handle on what depression was and which factors seemed to trigger it in me. I know that I had suffered from minor bouts, at least, of the same thing throughout my life but had thought up to that point that these sieges were just an unavoidable part of the universe. When I discovered that I didn't have to feel recurrently that bad it was a real eye-opener and blessing. That also gives me a lot more confidence in these reoccurences. I sort of know where they are coming from and that they can be overcome.

Bob, I know a bit about what you're dealing with and really appreciate your courage in facing it. I really hope a new equilibrium will open up for you. For what it's worth -- though my circumstances are different -- when I had my major depression time fifteen years back, I was convinced that my health was permanently impaired and that I would never be the same again. Turns out I was wrong, thankfully. For one thing, that diagnosis on my part was itself a symptom of my depression; for another, I underestimated the regenerative powers of flesh and blood, which seem able to take many unexpected paths toward renewal.

Let's keep each other posted.

Peter
 
I have been battling depression for the past couple of years. Weekly therapy has helped. I didn't like taking drugs, but they helped me get through the worst six months of my life last year.

I found my most recent surgery more difficult than my first because of the added stresses and problems associated with the depression. However, I have been fortunate enough to get it together for a few months prior to the operation and got through it pretty well.

After my surgery, I found the depression creeping up occasionally. I found that relying on certain tools to try to change some of those negative thought patterns helped a great deal.

We need to be respectful that our bodies require time to heal. I found I hit a wall around one month and again at about two months post-op. For me, it's the setting of unrealistic expectations that pulls me down. I feel great for a while and then have one of those days where you are just wiped out and can't do much; then I get upset about it.

I often try to remind myself that even now, 14 weeks or so after my operation, I will have those days. After my last surgery, it was six to eight months before I felt completely symptom free - and I was young and otherwise healthy.

Here are suggestions that worked for me. Hope they help:

-Don't let the rat race fold you back into it. We must try to pace ourselves. Some day I feel superhuman and on others - subhuman.
-Expect that you will continue to have low-energy days here and there and try to remember that tomorrow you will probably feel better. The depression doesn't have to stay. We can accept it and hope for better tomorrow.
-Keep up your daily exercise. It is a depression fighter.
-I eat chocolate and I don't give a crap what anyone says. As long as I eat a giant stack of veggies and fruit everyday, a little chocolate isn't going to kill me.
-I am still trying to learn that other people's expectations of me are far less than what I expect of myself. I'm trying to lighten up and let people help me.

By doing these things, I find that my bad days are far more tolerable. I would say I've had maybe 5 days since surgery where I was in a depressive state. That's not bad all things considered.

Peter, I appreciate you bringing this topic back to the forefront, since it is already obvious that many of us suffer from or are confused by these feelings of depression. It is not something we should keep hidden or be embarrassed about. Particularly when considering the state of the world at the moment.

Keep well.
Kev
 
Most of us hate change and the late developments in our country have increased psychiatrists' visits by 50%. We ALL need help from time to time and talking it out is usually the best med around, except for clinical depression (when you can find NO relief anywhere) and that's when you need a professional, be it a counselor, psychologist or psychiatrist (who is a full MD). Hate to see folks have to go to psychiatrist because it usually ends up being VERY drug related (used to be married to one, so I know this) and many drugs confuse the issue and mask the problems causing further problems. If you can find a close personal friend to help you find your way, I think that's the best counselor around. I have one and two of my friends have me and we talk one another down when we need it. You guys don't like to talk about yourself much, but you are doing it here and so maybe we are your counselors!! So keep on relating. God bless
 

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