x-post Post-Surgical Depression - can that happen to you?

from : http://www.obesityhelp.com/forums/rny/4116076/Post-Surgical- Depression-OK-that-why-I-feel-like-I-do-not/
(check the link for some responses)

I think I know what - beside pain is going on with me. -
I had a total of 5 surgeries in 2009.  And 4 of them from September- December.  No wonder I feel horrible.   I have a such hard recovering from PS (long surgery) and the following may explain why.  Knowing that how I feel may be a residual effect of surgery(ies)  and that - eventually  - one day I may feel better - gives me hope. 
On top of the almost 5 hrs anesthesia - I was on strong painkillers for over a month.  And I liked them.   Now - I am trying to get off them, and I am still in pain, bruised, still hurt, burning and itching all over.  So - beside my body - my mind has been affected.  Here - after PS - at goal - I was suppose to feel like a wonder woman (or I sure hoped for that), when in reality I feel hurt, weepy, tired, depressed, sick, ugly, and fat. And old.  With a smelly BM, gas, and body odor.  So - read the following I found at your own risk - and if you experience things like that - Like me know that probably you are not crazy and that eventually that too shall pass.  

Post-Surgical Depression

The incidence of post-surgical depression is much higher than most people realize, and it’s one area that I believe too often gets glossed over in the “risks and complications of surgery" pep talk given by most surgeons to their patients. It has amazed me in my career to find how many doctors do not warn their patients specifically about this phenomenon.

So let’s examine some of the major contributors to post-surgical depression, most of which are common to any type of surgery:

Effects of General Anesthesia

Did you know that traces of the chemicals used to “put you under" in general anesthesia can remain in your body tissues, affecting you both physically and emotionally, for up to a few weeks? These residual effects can include lethargy and depression, and even bouts of unexplained weepiness or despair. Incidence of these effects seems to increase in proportion to the age of the patient.

Pain Medications

Post surgical pain management usually requires at least a brief period of the patient being on prescription narcotic pain killers. As you may or may not know, most narcotic pain killers are in a class of drugs considered depressants. This does not necessarily mean that they will make you depressed. In layman’s terms, it just means that they tend to slow everything down, much like alcohol, but on a larger scale. Just as people have different emotional reactions to intoxication with alcohol, they also have differing reactions to being on pain meds. Sometimes, these reactions are similar to (and compounded by) those related to the residual effects of general anesthesia, as listed in the paragraph above.

Physical Restrictions Inherent to Recovery

Let’s face it: Almost nobody enjoys being stuck in bed, depending on others for help with basic tasks, being forced to abandon our usual routines and take time out for healing. Feelings of restlessness, boredom, helplessness, and even uselessness are quite common. In addition, the lack of physical activity usually means a short supply of endorphins, which is never a good thing, mood-wise.

Bruised and Battered

In a nutshell, when you look and feel terrible physically, you’re likely to feel terrible emotionally as well. Imagine lying in bed in pain, doped up on medication which makes you feel slightly nauseated… Then you get up and go to the mirror to sneak a peek, and the sight that greets you is a shell of your former self. Besides being creased with pillow marks, you are bruised and swollen, sporting visible stitches reminiscent of Dr. Frankenstein’s monster. It hardly sounds like a recipe for bliss, does it?

 

 

Oh, my dear .... I'm so sorry you're having a hard time of it.  Unfortunately you're right ... post-op depression is fairly common.

I did not have this happen to me after either the WLS or the PS -- but I have certainly experienced serious blues after other procedures. 

Things will look up.  Are you getting medical support?

Thanks Love. I do get help.  But - I did not expected to be so down. 
Beside this was a first time that narc pain pills did not make me sick - but actually they made me feel good, the recovery was much slower than I hoped for.  And being A-type personality - that was a downer by itself. 

I think my major mistake is to have so many different surgeries so close together.  My body didn't recover from one - and there was another, and another. 
But - at least now I know (hope) that this is normal - and it may take longer to get back to myself. 

 the recovery was much slower than I hoped for.  And being A-type personality - that was a downer by itself.  

I can absolutely relate to this.  It was a major downer to be able to less than desired, or expected.  And since I'm a perfectionist and control freak, it really filled me with dread and anxiety to see things that are my own responsibility go undone, or get done badly by others.

I don't know of any cure for this kind of personality, though!

Raises hand:
http://www.obesityhelp.com/forums/plasticsurgery/4085956/An- essay-upon-being-mortal-and-forgoing-PS-VERY-LONG-AND/page,1 /action,replies/topic_id,4085956/

I am now on anti-depressants and anti-anxiety meds, seeing a therapist twice a week and a psychiatrist to monitor my meds.  I am now laid off and cannot interview for a job, and I'm trying to get disability to cover some of my missing income.  I don't know how to make the anxiety stop, the brain fog to clear, the aphasia to go go away -- and I'm also afraid that losing touch with my fast-moving profession is not a good idea.  I've had offers of jobs, and other job interviews that I've had to delay -- I'm not fully functional.  My mornings are very difficult in particular.

I know I'll get better -- I have to.  But this is taking a lot out of me, and it is taking SO long to get better.  And it's scaring the crap out of my husband.

Thanks Diana. I wish i saw that earlier.  I am glad you posted it.  It was scary when I thought I was going crazy.  I think there is not enough info about the post op emotional issues.  But - I was getting panicky before the PS.  I was getting a mild hyperventilation - panic attacks so I started taking the anti-anxiety meds 3 weeks before my surgery.   

The post op depression and recovery is hard. People do not realize this - even when things go smoothly and there are no complications. Throw in some nice complications such as infection, seromas and additional surgeries to fix the complications, and the patient morale goes in the toilet!  Been there/done that.  It's important to ask for help and get help, both physically from your support system and emotionally from professionals, friends, clergy and all of the above.  As I stated in another post, I've been recovering from one procedure or another for the better part of the past 22 months - and that's a long time to mentally deal with all this crap.  You do begin to like the relaxation the pain meds bring, and the comfort of others helping, but you battle in your mind that I can do this or that. The amount of anesthesia is hard to get over and the fact that you are not feeling put together is overwhelming.  The most important thing is to get that help that is needed and have open communication with your doctor.  There are things with my last plastics that will need to be revised, but I need a break and quite frankly so does my doctor.  He has done an incredible job of getting me through some tough times with complications and infections - keeping me focused and encouraged, but neither of us is ready to do it again right now.  Sometimes it's a good thing to take a break for a few months.  The summer of my LBL and alll the complications, I read 35 books, watched all the seasons of CSI and ER that were on DVD, plus countless other movies.  I worked on quilts, read my Bible and made phone calls to lost family and friends, to keep my sanity. All of that helped tremendously, but nothing feels as good as being BETTER and NORMAL again.  I long for the day once again that I am not dependant on others for help.

I also think that when it comes to plastics, we have an idea that this is just a minor procedure and do not allow the amount of time really needed to heal.  We expect to be back on our feet in no time, resuming our old duties and we would never have the same expectations following a c-section or appendectomy or hernia repair.  We would baby ourselves more, and we would ask for more help.  We wouldn't feel guilty about the need to take a nap, or rest with our feet up.  I think that we feel that we are doing something selfish and we shouldn't feel that way at all.  We need to treat our plastic/reconstructive surgeries like any other major surgery and not try and rush the recovery or have unrealistic expectations of the process.  I've been very guilty of that, and this last round tried to really clear the calendar and pressure, but still ended up not being very patient. 

Thanks for the reminder that we need to be aware of the post surgical/recovery depression or blues and know that we have to fight that with medical/emotional treatment as well.

Jennie,
Thanks for sharing.  As you said, many of us getting ready for the PS think of it as a minor surgery when in fact it is a major surgery with a lot of time under and - in some cases - much longer recovery than any other procedure we had before.  

 I had a relatively easy time with my PS and not a lot of pain but I did get very emotional for a couple weeks after. This was a first for me. Never happened with other surgeries. It was short but still had an impact. My PS said its not that uncommon. It did pass but   I was concerned because I had not expected it. I had not been aware it happens to a lot of people. Just knowing it could happen would have helped me. I will be prepared next time.

Susie,
I know what you mean being prepared for the emotional ups and downs. I did not expected that and for a while I though that I was going crazy.  (That is still a possibility - may I add) 
I have increased my antidepressants, got off my pain pills and benadryl (I took that for itching) and I make sure I take my vitamins and try to move more - even if that is walking in a store. 
I start to feel the difference.  Small - but even a little helps.  Also - i talked to my friends and a therapist - so I hope that was the worse I experienced and now - I am on a way to a recover (physical and mental).  
Thanks for sharing.