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Depression/post-op blues - open for all

@Sommers16: Thank you for your informative note and kind words. I am truly sorry about your cat. 15 is a long time to have a companion and I understand how traumatic it must have been for you. I hope you will get another cat. (if you haven't already)

At 13 weeks post-op, I am not yet in STR. My pain is very intense now, perhaps because I am peri-menopausal and my hormones are crazy or perhaps it is the stress over the past 3 weeks pertaining to my cat.

I do not have a follow-up appointment with my surgeon, so I guess I should make one.

Of course you are right, I could not go on the way I was for the past year. My pain was chronic and debilitating. Now I am just frustrated at my slow progress. I have run out of patience. I want my life back..... I am only 52.
 
@Jaycey: I am sorry about your loss too. Yes, this pain is worse and I would go back to the pre-op pain if I could have my cat back. He was such a comfort for me, especially when I got home from the hospital. He never left my side. This loss is gut wrenching.

I am grieving for him and for me. I had to make the choice to end his suffering and it was the hardest decision I have ever had to make. It just seems like I have been crying forever. First over my illness, and now over him.
 
@Lee0521 I lost one of my Chihuahuas two days before my surgery. It was almost more than I could handle. Be strong. All of this will pass.
 
Remember that post op blues is a very real part of this recovery. Your body has been through major trauma. There is both physical and mental healing going on.

@Lee0521 do make a follow-up appointment with your OS or at least someone in their office. Your pain needs a bit more controlling. A slight tweak to your meds can make a big difference.
 
@belweav: Oh geez, that is so horrible! That would be enough to send anyone over the edge, especially pre-surgery. I am so sorry.
 
@Jaycey: thanks for the advice. I am not sure what else I can take, I have been through seven different medications since May 2015 and the only thing that really helped was celebrex, which I am taking a few times a week. I'm quite sure that my recent increase in pain is due to stress and hormones.
 
The emotions are very high following the operation.
I have been on antidepressants for the last 10 years and successfully tapered down to a tiny amount prior to surgery. But I've held at this dose for a good few months due to the operation and other life stresses.
I am very aware of anxiety and depression and know my body sufficiently well to know when suffering or about to. However the impact of post op blues is very different but very real.
I found myself crying in the hospital several times , when told off for not having my slippers on, when left on a bed pan which spilled on the bed. The last straw was when i was left in a toilet in the dispatch ward and had an accident because the toilet wasn't raised.
Do you notice a common thread ?
On leaving hospital I couldn't return home and had to spend 10 days in a hotel whilst my kitchen was rebuilt due to a malfunctioning dishwasher.
I received news that my job was at risk.
My daughter left for university four days ago and I've cried everyday .
Post op blues is very real and exaggerates the emotions you are feeling and yet it's not like the desperate feeling of anxiety and depression I have felt in the past.
 
@Reflex - so sorry you're feeling the blues. I do hope that now your hip has been fixed and you're free of that encumbrance, which would inevitably add to your daily distress, you are able to move freely and without pain. Depression can hit us all - it isn't selective - and I for one have to keep an eye on myself if I dip a bit too low. I have been told that some of the key factors in tackling it are to take daily exercise, walk in fresh air, eat nourishing food, do everything to ensure the best night's sleep and push oneself a bit socially. The last one can be the hardest if you feel you want to roll up like a hedgehog, but being with other people tends to throw our lives into the background and appreciate others more. Perhaps you should consult your GP if you feel things aren't improving as they might have other suggestions to offer? I do hope things look up for you soon.
 
@Reflex Gosh, no wonder you are anxious. You have been dealing with a lot more than just your surgery. I agree with Miss Muffet, try and get out in the fresh air daily and have healthy but small meals. Sometimes getting into a routine helps us feel a bit more in control.

Are you sleeping OK? If not, perhaps ask your GP for suggestions.
 
@Reflex Thinking of you. My own LTHR was 8+ months ago but the post-op blues were a real struggle. My surgery totally threw my career off track. Once I went back to work, the hours and physical strain were too hard on me and my "good" hip started getting very painful. Cortisone and PT has helped.
The theme that keeps recurring for me in my own recovery is my age and the fact that I'm a nurse. Your experiences while in hospital sound deplorable! No patient should be left on a bedpan so long it flows over. And no patient should be scolded for soiling a toilet, even if they were left there too long! My goodness. Such things should not happen. As for age, it seems there are many BoneSmartie women in our 50's, going thru or recently graduated through menopause. Wonder if the dropping levels of estrogen also play a part in our depression. It is tough enough for me to have gone through that, let alone the total hip replacement which walked in and derailed my career. Arrrgh! If I were a pirate I'd say somebody's been stealing me gold dubloons!
 
@JennyHipcakes
Thanks for your post.
At what point did you start reducing your meds?
I am so concerned about the effects of codeine that want to stop taking them and just continue with paracetemol.
I know they say they are not addictive but I'm more concerned with withdrawal from not taking them the longer I stay on them. I've had some really bad withdrawal experiences on antideppressants 22 months ago . So much so that I reduce at 10 % taper every few weeks. I'm down to a tiny amount. I can't face withdrawal from codeine as well.
Did you go back to nursing? How do you feel 9 months after your operation?
 
@Reflex When you start forgetting doses of your medication that's the sign you can taper off your meds. I would not try this now as you are still early out from surgery. Typically it's the midday dose that goes first. You will not become addicted as you are taking the medication for pain control. Here's an article from our Library on this: Myth busting: on getting addicted to pain meds
 
I think I need some input. Sorry but this will be really long. My health insurance nurse/coach encouraged me to seek counseling. I already do take antidepressants on an ongoing basis. If you've read my pre-surgery entries, in 1968 I had halothane anesthesia which caused me to lose half of my liver, get halothane hepatitis and spend years regenerating my liver. I avoided GA since. For my LTHR last week my OS strongly pushed me to take GA because the surgery approach he preferred would be a very small incision requiring paralytic agents. I studied anesthetic, analgesic and paralytic agents for weeks and watched many online sessions on pharmacology as well as 20 THR and 30 GA/intubation videos. I learned that it should be safe for me to have GA IF only Propofol was used for both induction and maintenance. I spoke to to my colonoscopy anesthesiologist as well as the OS's hospital anesthesiology department. My colonoscopy A advised me not to go GA but tell OS I wanted spinal. Hospital A's said they would do Propofol A if I could pass extended liver tests which I did. I have had Propofol many times as sedative even for BTKR and no problems.

So last Tuesday in pre-op I met with my A and explained my whole medical history and he agreed to only use Propofol to induce and maintain. He seemed very nice. Got in the ER and was relaxed but had some trouble finding comfortable spot to lie down on table due to large bowl in center. Suddenly a nasal cannula was placed on my nose from behind. The air pressure so high that my senses were overwhelmed and I couldn't hear anything. I started trying to find my A to find out why I had a cannula, did he confuse me with someone else because I was having GA not a sedative but he was nowhere to be seen. I sat stunned and scared. Then someone started untying and removing my gown from the back. My crazy thought was that they didn't take your gown off until you were unconscious so they must think I was and we're going to start surgery. I whirled my head around and made eye contact with a nurse. I thought ok they know I'm still conscious but where is my A? I remember nothing after that for several hours. Not PACU, going to my room or even talking with my husband in my room.

What I remember is nurses giving me crackers and liquids which triggered nausea for which they have me IV treatment. But I then had hiccups and indigestion for a day and a half straight. I never slept that night because I hiccuped all night. At 4:00 am my night nurse asked what A I had received and I told her only Propofol. She checked my records and said that I was also given Versed which could be why I was so sick.

I feel that the A really disrespected my wishes and violated my trust and our agreement by giving me Versed after we had agreed on only Propofol to induce and maintain. I thought from what I had read that Propofol was strong enough itself to provide the anesthesia and amnesia needed. And by adding the Versed he took a chance with my health and my liver because Versed is metabolized in the liver. And he caused me to be sick for a day and a half. And his unprofessional and impersonal behavior in the OR caused me to be terrified prior to my surgery.

Here's where I need your thoughts. My follow up with my surgeon is tomorrow and I'm not sure how strong or emotional I should be. Am I over-reacting? Do I need counseling as the nurse/coach said? Is this my issue rather than the A 's because professionally he felt Versed was needed so therefore I should accept it and move on? I have to get my other hip done next year and, after all these years and surgeries with my OS, I think I'm going to find a new OS and hospital.

Thanks for your thoughts on this.


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BusterBeans said:
I'm not sure how strong or emotional I should be.
Click to expand...
I would be very strong and get all this out on the table. You were not given the treatment that was agreed and that "scare" just before your procedure started was totally unnecessary!

I guess the big question is why did the anaesthetist commit to something that did not happen. When you were in a very vulnerable state - trust was broken. I think for your own peace of mind all this needs to be talked about.

Please let us know how it goes.
 
In the beginning my OS just didn't get it. He said it was normal practice to have a nasal cannula or face mask placed on your face and anesthesia injected into your IV. I kept trying to explain that I never saw or heard my anesthesiologist in the OR. Never had the courtesy of being told a cannula was being placed on me with oxygen at full force or anesthesia was being being injected into my IV. Felt like I was ambushed/assaulted from behind and couldn't get my breath or think straight. That this was not normal practice in any of the 6 other times I had received Propofol. That this is traumatizing for women who have been assaulted. He said he hadn't seen/noticed any of this. By the time he finished scrubbing/suiting, I was unconscious and intubated on the table and he positioned me for scrubbing and wraps.

He said he wasn't aware of any agreement I had with the anesthesiologist that I was only to receive Propofol to induce and maintain anesthesia. He said it was his understanding that just about everyone receives Versed but that Propofol provides sufficient amnesia itself. He wondered if I had been given Versed to calm me prior to surgery but I said I had been meditating in pre-op and was extremely calm with a low BP. I said if the A felt I needed additional amnesia medication and given by medical background and our agreement, he should have spoken to me because I have previous experience with another amnesia drug that would have been safe for me if only he had asked.

My OS said there are 60 A's who serve at the hospital and he never knows who is on and who even served during my surgery. He wishes he was in control of his entire surgical team but can only control 3 of its members. He said he was concerned that any of his patients would receive that treatment and feel as I did. Since it was late Friday afternoon, he would call the hospital's A department and consulting A arm. He would have them determine who the A was and arrange for the A and hospital A management to call me next week to discuss what had happened because he wants this resolved. I told him I was grateful for his concern and involvement because I worried that this experience would end our surgeon-patient relationship. He scheduled an appointment for 6 weeks from now.

Phew! I feel so much better! I didn't think my OS would want to get in the middle of this. That doctors would stick together. I feel so much relief. I think I'll be able to finally get better sleep tonight. Thank you for encouraging me to see this through!


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@BusterBeans So glad you were able to talk to your OS and get this addressed! Well done! It took courage to raise this concern. And I am sure others will benefit from your resolution as well.
 
@BusterBeans - really really sorry you had to go through this. But I agree with Jaycey - you did absolutely the right thing following up your concerns. They shouldn't be ignored. Hope you had a good sleep and are feeling a bit brighter today :console2:
 
@BusterBeans, good on you for telling all to your OS, and persevering until he "got it". And it's very good that the hospital A department will call you next week to discuss it. We can hope this won't happen to anyone else in future because you are speaking up now. So sorry for your trauma! May you recover well.
 
Everyone: The hospital's anesthesiology department did call me today at my OS's request to discuss my negative experience in the OR. The A on the phone couldn't understand my frustration and anger at being give versed. He acknowledged that my A had promised that I would only receive Propofol but that he gave me versed anyway and that I had told my A that I had vomited on versed before. The A said that everyone receives versed. I replied that I didn't need versed -- I was relaxed not anxious so I didn't need a sedative; I was having Propofol as the anesthetic so I didn't need it for that; and Propofol would prevent the coding of new memories via my pre-frontal lobes so I didn't versed for amnesia. The A said sometimes adding versed to the mix makes drugs work better together and allows A's to use less drugs, but I said that they then had to add versed to the mix of drug so that didn't make sense. He did say my A was wrong to inject anesthesia and hook the nasal cannula from behind without warning and never speak to me or appear.

Bottom line: the A offered that if I agree to come back to their hospital in the future, he will be my A and he will honor my requests for only Propofol to induce and maintain general anesthesia and I will not receive versed. And if I choose to go elsewhere, he advised me when in pre-op to ask the A to list every drug he intends to use with me and state that versed will not to be used under any reason. Last week I did request a copy of my official anesthesiology record and the name if my A from the hospital for my records and I added versed to my medical records as an allergy. So I guess the issue for me can finally close and I can move on. Thank you to those who gave me courage with this.


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Glad you did this, @BusterBeans! Too bad that the A couldn't validate your frustration. Apparently, he doesn't have very good interpersonal skills, which I think may be common with anesthesiologists. They have chosen a specialty in which their patients are unconscious most of the time! I do like his offers if you do return to that hospital, and idea of what to do if you go elsewhere. Hope he learned something from this. I know I have gleaned valuable info from your negative experience.
 
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