Monday, October 21, 2013
Liisa: the story continues
Friday, October 18, 2013
Post op depression
April 17, 2013
Countless people suffer from post-surgical depression for months on end, so why aren't more people talking about it?
I have lost count of how many surgeries I've had in the wake of an accident that left me with internal injuries and scores of broken bones. I know the drill, how to prepare, and what to expect during recovery.
There are two fairly predictable but distressing things that I go through nearly every time. And even though I know about them, they catch me by surprise every time.
The first is that I usually experience a very intense spike in pain the evening of the second or third day post-surgery. It usually hits at the end of first day that I am starting to feel like the worst has passed. I have showered or dressed, begun the process of returning to some form of normalcy. There is no gradual build-up of pain. Instead, it feels like a tsunami of pain, utterly unexpected and devastating.
What makes the pain-spike devastating is that it is an expert liar. It tells me that something has gone terribly wrong, that my doctor has truly screwed it up, and it berates me for having given my consent. Above all, it tells me that I will never get out of pain. Every damn time, I fail to realize that this is that pain spike, believe the lies it tells me, and have a mini-meltdown.
The second thing that I can never seem to remember is that I am very susceptible to post-surgical depression. And like the invariable pain-spike, I never recognize it when I am dealing with it, and believe the lies it tells me.
Doctors have long been aware that many patients experience some form of post-surgical depression during the six months following an invasive procedure. But many physicians believe that being depressed after surgery is "understandable" and "unworthy of diagnosis or treatment." Since most people with post-surgical depression emerge from depression after about six months, many doctors considered post-surgical depression either benign or even helpful since it keeps people inactive.
As a result, most people do not know that post-operative depression is a common complication of surgery. If it were as benign as many surgeons have assumed it was, perhaps this would not be such a problem. But researchers have discovered thatdepressed patients are more likely to have other complications.They are less able to cooperate in their after-care particularly in rehabilitative therapy. And for people like me who have an existing history of depression and anxiety, the recovery from post-surgical depression is neither guaranteed nor as straight-forward as some surgeons expect.
No one knows exactly why there is such a strong link between surgery and depression. Some researchers have hypothesized that many people experience post-surgical depression because it forces them to confront their own mortality. A theory that matches my own experience is that the length of time spent under anesthesia seems to be related to the likelihood and severity of depression.
Last summer I had a series of surgeries, and in the days following each I was hit by the infamous pain wave. Fortunately, my husband identified them and helped me through them.
But we both missed the signs of one of the most serious post-surgical depressions I have ever had. What made it especially difficult and dangerous is that I never felt depressed or sad.
The only time that I had overt depression symptoms was in the weeks before my final surgery. My family worried for a couple of weeks because of how desperate I felt. My pain had been poorly controlled and I could not bear the thought of another recovery in agony. Once I found a way of controlling pain, the desperation faded, and we assumed any depression had gone with it.
Instead, what followed was a growing belief that I had finally come to accept the truth of my life specifically and the nature of human existence in general. To put it in cliched terms, I was confronting my own mortality. But for me, it wasn’t death that I grappled with. Instead, I began giving a lot of thought to the fact that aging bodies are more vulnerable and that combined with our culture’s ageism, getting older is the steady and irreversible dwindling of options.
I believed the lies of depression when it told me that what I was capable of four months after a series of major surgeries was where I would be two years later. I gave away my bicycle and told my husband to sell our camping equipment.
When my doctor told me that I would need at least one more major surgery in the next couple of years, I did not obsess about it. Instead, I became obsessed with what might happen to my husband. The idea of him going through what I had endured was intolerable to me.
Yet it was all I could think about. I began to research the life-threatening illnesses I thought he might face. In graphic details, I imagined him grim-faced and stoic after open-heart surgery or anxious about learning how to orgasm again after prostate removal. At night while he slept, I checked his naked body for suspicious moles or growths comparing anything I found to online pictures.
My husband seemed incredibly fragile to me. I began to worry about how long he would be able to keep working in his chosen field of information technology. I thought of how he would suffer if he was unable to find a job. The poverty we might face paled in comparison to the sadness I anticipated him going through.
I stopped even hoping for a future filled with joy and meaningful work. Life began to look like one long, painful, and sad slog into the grave. I wondered every day how I could just “opt out” without hurting my kids.
Fortunately, my family knows about post-surgical depression. And although it took them a long while to recognize it, they were able to intervene before I fell over the edge. I began a new medication almost exactly six months after my last surgery. It was like a light came on, and suddenly I saw just how bad it had been.
The thing that truly frightens me in retrospect was how normal I believed my thoughts were. Somehow I thought that everyone spent time anticipating the worst, that everyone thought about suicide every day. I did not recognize the symptoms.
What also concerns me is how few people know about this common and dangerous complication of surgery. It worries me that people suffer without understanding why and that their families are not alert to the signs of serious danger.
We need to bring to post-surgical depression the kind of awareness that we have brought to postpartum depression. People going into surgery need to know that it is a possibility, and they need to have a plan in place in the event that they begin experiencing symptoms. I think that this is especially true for people with mental health histories. They need to know that there are additional treatments available in times of crisis. We also need to talk about post-surgical depression more widely so that the family members and friends of post-surgical patients can keep an eye out as my family did. And people who serve as the support system for post-operative patients should know how they can help the person recover.
Lynn Beisner is the pseudonym for a mother, a writer, and a feminist living somewhere East of the Mississippi. She is a regular contributor to Role/Reboot. You can find her on Facebook
Monday, October 14, 2013
Road to recovery
Money matters!
Saturday, September 28, 2013
Back to the land of the living
Monday, September 23, 2013
Alone
Sunday, September 22, 2013
Something special
Bardo
Tuesday, August 13, 2013
Monday, August 12, 2013
Really?
These days, I have been walking around (and sitting down) as if divided in two. One part of me is feeling at peace, comforted by the presence of my guest. The other half is in panic and sadness, calming down for a moment and then letting it rip again. Nothing much I have been able to do about it, except realise that it is an absolutely subjective matter, entirely dependant on my point of view.
The topic is, as before, the fact that I don't like my system breaking down. I don't like anyone's systems breaking down, for that matter! Dammit!
The obvious reaction to my worry would be: Hello, DUH! as our American friends so quaintly put it. Duh, indeed. What a surprise, people do get old. I feel like the proverbial little chicken, running around in circles and screaming: The sky is falling! The sky is falling down! while the rest of the population potters happily about, remaining oblivious to the impending disaster. Young people, old people, not bothered at all by the reality of life that we all must become old and frail and suffer.
In my desperation, I sent a mental note to God yesterday night, which said: Please, God, help me, send me some courage! I really need it!
And what do you think happened this morning?
Suddenly I experienced a shift in consciousness. It happened mid-stride, just as I was going to the cafeteria to get something to eat. It was as if a switch would have turned in another position. And suddenly I felt, what I had known before of a conscious level: EVERYTHING IS ALL RIGHT. No matter the state of health, no matter the pain, no matter the discomfort, it is all right. The state of mind can be, and is, at peace and not touched by the physical discomfort.
Also, the panicky feeling of having done everything wrong in my life and now failing to put it right: the impulse to run somewhere, do something useful, while I still can, to escape! that I had felt the entire weekend, subsided as well. It is simply not here any more, and I saw the futility of this thinking. As if from the side...
Now this is very interesting to see where it will go. I have had my share of illuminations which have lasted for longer or shorter periods, but the situation has never been serious before. And here, now, it IS serious, after a fashion. On how I learn to manage now, depends the quality of my living for the rest of my life. If I give in to panic and desperation because of the awful instability of the biological system, I will have some crappy years to look forward to.
On the other hand, if, with God's help, I should be able to develop a different frame of mind, and a more philosophical outlook, then it won't be so bad. It may even be quite good. The change has to rise from the very roots of my being, and the roots are where the change has to begin.
At this moment it feels as if it happened. I'm not sure if it's really so or if my mind just got so tired of this panicking that it has simply switched off, leaving *me* alone. It remains to be seen!
Sunday, August 11, 2013
Visiting
Saturday, August 10, 2013
Cake
Company
Thursday, August 8, 2013
For a while
Wednesday, August 7, 2013
I wonder
Suddenly, or not so suddenly I see my fellow travellers in a different manner. Well, as of late I have been bothered, beyond reason, by the strange notions that people have, by their beliefs and convictions. It seems that, based an Estonian facebook group, the Museum of Nostalgy, a half of the people yearn for the Soviet times and think that everything is so much worse today, and Estonia has been sold into slavery in the EU. Another half, to my great dismay, holds Nazi paraphenalia (and not only that!) dear to their hearts. They too, think that everything is going down the drain and life these days sucks. They both hate and would do away with the following (short list): Africans (an average Estonian insists on his right to call them *negros*), gay people (*homos*, everyone in Estonia hates them). There are many more but I just won't bother.
Then, I have internet acquaintances among both the Conservatives and the Liberals. The Occupy movement. Muslims. Buddhists. I have to say, I don't particularly like any of their beliefs which they freely and aggressive share. For a while I let go of the most militant contacts and now ... I know some of these people for such a long time, I LIKE them although I might not care for their beliefs.
The same stands true of everyday life. I have known the people here for a sufficient period now to know what I don't like about them. Be it their habit of one-upmanship, be it their negativity, egocentrism ... but still, I like most of what I see.
It has been going in this direction for some time and here we are. Today in the morning I saw the truth of it: everyone is just trying to console himself: be it by idealising the past, our native land, our new country (myself), by different beliefs. Everyone is in the big illusion, trying to keep up his own illusion, an to somehow DEAL. I wanted to say, deal with with reality, but ... that IS the reality!
Everything's an illusion, except maybe for the trees and stars and such. They are here, no matter what our opinion of them is.
My conundrum at this point is not liking the course of life. I don't like seeing my body break down and knowing that from here, it can only get worse. As Richard would say: pieces of me will fall off! Nobody likes that!
My pillar of strength, Tilly, was near panic the other day when she realised that she may not get her driving licence this time. 86 years old and the car, for her, is freedom. The freedom to stay in her own home, with her dog and occasional friends. At that moment I realised that as long as it isn't about us, we may be logical and brave. But in the face of decay everyone falters. Death isn't the point, the immense frailty of this biological machine is.
And that's the reality. We must move on, in order to make room for other people to come.
What then is the point of it all? Catch the brief moment of beauty, maybe make a difference, LOVE people ... oh this is the main hurt. That all those sparks of light must fade. That such individuals as ... I'm not saying who, must fade away.
Well, what follows, where are the ways to deal with it, shall remain for our next session.



















