Post Surgery Depression?

[mmglobal]

I just spoke to someone who had multi-level cervical ADR about a year ago. Her story is much like dshobbies... substantial relief from part of her problem, but some serious nerve issues were made much worse by the surgery. While she's still experiencing improvements at 1 year out, things could be better. Her life is better than it was before the surgery, but not nearly as good as she'd hoped for.

Much of the discussion was about post-surgery depression. Obviously, this will be worse in people with worse outcomes and less of a problem with better outcomes, but something she said really stuck with me and it's worthy of discussion....

Nobody warned me about depression after the surgery.

It seems obvious in retrospect, but her idea should be considered seriously. Anticipation of post-surgery depression, especially in cases with poor or mixed results, may allow for early treatment or avoidance of what might be considered a complication of the surgery???

Is there something we can do different or better to avoid or reduce serious depression after surgery?

Mark

[KL Aguilar]

I think this is something that does need to be investigated. So many of us in pain go through depression and yet it is rarely addressed pre-op, and even less post-op.

I feel very sorry for myself. I am in maneageable pain, but I am facing a multiple-level surgery that may leave me in more pain. I find that I have little energy to do anything. I have done virtually nothing to decorate my house for Christmas, not even the things I physically can do, like hang a wreath on the front door. There is already a nail on the door from previous years, the wreath is in a cabinet that I can reach, the wreath is not at all heavy, but somehow I just don't do it.

Mark's client is obviously going through even worse problems than I am, yet I still feel depressed. I have tried all the obvious things that people tell one to do, but it doesn't seem to help.

[Michelle]

I wonder if this doesn't come up because so many of us are chronic pain patients, and already on antidepressants at the time of surgery? Just a thought. But it seriously needs considered! I believe my father-in-law died due to depression after heart surgery (and I know there's been research about heart surgery-linked depression). He was too depressed to do his cardiac rehab therapy, the inactivity further weakened his heart, which made him more depressed until he simply gave up. Now, I know this is a totally different surgery, but it could raise the same issues. Too depressed to do therapy or exercises, thus continuing pain, thus depression... Not to mention being confined to the house/bedroom post-op adding to depression. Good topic!!

[Poncho]

I agree good topic Mark!

Post surgery depression is always something to be concerned about. Not just with the spiney population (though it seems more prevalent) - but surgery in general.

I've seen it clinically many of times in healthcare unfortunately and these are patients with good outcomes.

Even in my case, - I would say that I had some of this too. It is definitely a good idea to stay on the anti-depressants after surgery until the patient and patient's doctor feel they are ready to go off of them.

TTYL,
Poncho

[Bobb0]

Great topic especially considering the time of year. Christmas is hard for us as it seems to be a reminder of what the good times used to be like.
While neither Janet of me ever got professional help for depression it probably would have been (and still is) worthwhile.


bob

[dshobbies]

Happy Holidays to all!

No, I don't think I'm depressed, I do believe I'm disappointed and angry though. Despite too many medications, I have regained my interests in those things I didn't want to do for several years. I just have to do them at a slower pace. I can pick up and play with my grandchildren (did I tell you I have a new one, 5 months old now) for which I am beyond grateful.

The question is, how to you warn someone of possible complications when they're looking and hoping for 'the' miracle cure? Of course there are side effects, though I wasn't quite aware of this severe nerve damage and thought it would be fleeting at it's worst. However, despite these warnings, no one really thinks that they will succumb to anything other than an annoyance that will disappear with either a short amount of time or pt.

I had a 3 level adr and was warned that with 2 previous surgeries and scar tissue, my weight and 3 levels, my chances for a successful outcome were not as good as others who were 1 level and no other baggage... yet I was still too hopeful to be warned away. I was hoping for the miracle and I got it. My back pain is now muscular and with my pt should disappear entirely albeit a slow process since I'm still limited. Now I'm still hoping for another miracle in that the nerves that were severely irritated during my surgery will still regenerate, even though I'm 14 months post-op.

So back to the question, can you warn someone about post surgical depression? Sure, but I doubt it will sink in. Everyone enters this surgical arena hoping for that miracle. Telling someone it might not happen when they already know that... after their doctor has told them that he thinks they're a good candidate???

Side note: Mark, this is why a database is so important. When adr candidates can see in black and white, in percentages rating satisfaction rates, not the successes as doctors see them of which I'm one, they're decision is far more informed. OK, I've kicked this dead horse enough.

Dale

[mmglobal]

Great discussion! I'll have more to add in another thread. I'm still amazed that I discover more about my depression and my situation at 4+ years post-op.

I hope everyone has a wonderful holiday and an even better 2007!

Mark

PS... Dale, we'll talk about your dead horse soon.