depression suggestions?????

[KML]

My husband just had AVR and ascending aorta replacement (mechanical St. Jude/Dacron) three weeks ago. We have had several problems (which I know everyone does) such as med allergies, vomiting, dehydration, atrial fibrillation (back to the hospital AGAIN) and now he is feeling very depressed all of the time. He is also experiencing a LOT of shoulder pain. His appetite is DECREASING as time goes ( I mean compared to post-op appetite) by and he is growing more and more depressed. I understand that this was MAJOR surgery and he is going to feel depressed for many reasons but is there ANYTHING I can do to make it easier for him. I already try to have him do all that he physically CAN do to make him feel useful and I have taken off of work indefintely to care for him--so I am here 24/7 but he has NEVER been depressed before in his life so I dont know what to do........
Note: We are both 28--have been together since college and have never had a health problem. I made him go to the Dr for a migraine episode--they detected a heart murmur and shortness of breath--cardio referral--another cardio referral and 3 days later we were at Johns Hopkins and he was having open surgery. There was a total of 5 days in between his diagnosis and surgery. His valve opening was 6.5 cm and he was diagnosed with Marfans Syndrome at the same time. I have become a Marfans nerd and have learned that his condition should have been diagnosed at birth. He was born with Pectus Excavatum (that required surgery at three) and exhibits almost every characteristic of Marfans (tall, disproportionately long limbs, arched roof of mouth, long toes, mild scoliosis...........)
I have asked him if it would help for me to leave him alone but he is adamant that he does NOT want me to return to work and that it makes it better that I am there. Our surgeon told me that typically younger patients have a longer post-op recovery and that since this is his second sternotomy he is going to take longer to heal. I know I am rambling but I dont have anyone else that understands these procedures and what a toll they take on the patient so I needed to vent to people who I am positive understand. I found your site two days prior to his surgery (I am an insomniac when there is a problem) and it helped me PROFOUNDLY prepare for what was going to be done. In particular his awakening in ICU with the dreaded intubation tube--I asked that I be there when he awoke and he (as you all said) freaked out but I calmed him down by explaining to him where he was and that I was there with him and why he had tube in his throat. His CICU nurses were GREAT--they let me stay WAY longer than I was supposed to and they were not threatened when I asked lots of detailed questions..... and I slept in his cardiac chair in the step-down unit for all 6 nights he was there. Cannot say enough about how nice Johns Hopkins is
If anyone has any advice after reading my novel of a post....I would greatly appreciate it. Thank you for listening.

 

[Georgia]

Hi KML! Yuk - you guys really have had a bad month.

First - you need to massage his shoulder several times a day; if it doesn't help, get a friendly massage-person to come to the house to get that relaxed.

Second - get him out in the sunshine (if there is any in your neck of the woods - personally haven't seen it for a few days here).
Even wrapped in a blanket on the patio or deck or balcony will help.

Third - you need to get out of there occasionally. 24/7 is NOT healthy except when you're absolutely needed (like the first week to 10 days after surgery).

Fourth - when is he due to go to the doctor? Have you talked to his cardio or PCP? Depression is such a common after effect of this surgery. I was advised by the cardiac rehab people who visited in the hospital that if I felt depressed I needed to contact my primary care doc. Your husband must not jeopardize his recovery by not eating and exercising and breathing.

Has he been scheduled for cardiac rehab exercises? I started three weeks post op. It's really good for us both physically and psychologically.

Now, finally - you keep coming back here and unloading. We're all here for you and your husband. You can't believe the number of knowledgeable folks available on this forum. You kids aren't out there alone.

 

[JimL]

Welcome KML and husband! I had similar surgery almost a year and a half ago, St. Jude's in the aortic position, Dacron wrap, and I also had a mitral repair.

Some depression after surgery is normal, but it sounds like you want to talk to a doctor about your husband's level of depression. I felt that my whole life had been changed, and it certainly had, and it does take a while to comprehend the whole thing. There is a strong feeling of being alone, since few people you've relied on for support in the past understand what you've gone through. It was a couple of months after my surgery that I first found this website.

I went through an episode of depression and abandonment when I read up on the amiodarone my cardiologist had prescribed for me. He soon became my former cardiologist, especially because he didn't bother to inform my of its interaction with coumadin.

Please visit us often, and be sure to invite your husband in. He can read, he can share if he wants to, and he can be assured that we do understand. We've been over the mountain too.

Georgia posted just before I finished. I second the importance of cardiac rehab. It is the best thing you can do after surgery to get back to normal. It is one of the best things you can do to prevent other problems.

 

[pegne]

Kml

Kml

Let me welcome you to this woderful, supportive site. You will find a load of VRrs who have been through the same things your husband has. We are a family here and it is a great sorce of information. I am really sorry your husband has had some post op problems. As for the depression I am pretty sure that this is very common. I have had 4 open heart surgeries for various valve replacements/repairs. After each surgery I went through some form of depression. After my 3rd and 4th I went through serious depression. You guys are so young. If there is one thing that makes you realize your own mortality it's a serious opperation. That can be a blow. I think your husband needs to visit this site so that he can see how good life can be after VR. I am 42 and I had my first surgery when I was 18 and my last was 4 years ago. I am doing very very well. I am living my life. I stay somewhat active and enjoy life. If you could get him lto look at the success stories here at VR, it may help. I hope you realize that this something that is out of your control. I know that is hard for you to hear because my husband had a hard time realizing that this was something he could not fix. Time will take care of this. Until then please visit us often. We will be here for you to vent as much as you feel the need to. Good Luck Peggy

 

[Nancy]

Hi KML-

Welcome to this great site. First let me say that your husband is one lucky dude to have had his heart problems discovered and dealt with fast and furiously. I'm sure it saved his life. He is also very lucky to have such a caring wife.

Depression is such a common thing after heart surgery that it should almost be dealt with routinely by doctors as an aspect of post surgical care. There are many, many, many posts about depression here. You could do a search on the subject and have your reading for the evening.

The most recent thinking on the subject suggests that it is physical and chemical in nature for these heart gals and guys, so it isn't something that will go away if you tough it out. The simple measures that Georgia has mentioned are good and work for a lot of people, but there are also many folks that need the help of antidepressants. There are a number of them on the market and they work beautifully.

If things don't turn around soon for your husband, please call his doctor and discuss this with him. If he suggests medication, it takes a couple of weeks to get to the therapeutic level, but it will make a world of difference to your husband and you as well.

There probably isn't much you can do differently to help your husband feel better emotionally, It sounds as if you are already working very hard at helping him and keeping a positive attitude.

The eating thing is something that sometimes happens after surgery. Things don't taste good for a while, and may have an off taste. I think we all have pretty much concluded that it is from the lingering effects of anesthesia and new medications. It should return in time. There was a post a while back that mentioned that it takes about 5000 calories per day for the body to heal from major trauma. You might want to tell your husband that.

Please tell you husband that there are many folks here that have traveled along the same path and after the healing progresses, life will indeed return to normal again.

We are all here for you, and there is usually someone here at almost any hour of the day and night. I think we have our share of night-owls.

I have helped my husband through 3 heart valve surgeries and 2 lung surgeries and a boatload of serious things. The spouse has a tough roll. So I really do understand your feelings.

Take care, and best wishes to your husband on having his heart fixed up.

 

[KML]

re: depression suggestions

re: depression suggestions

Thanks so much for your prompt replies It always helps to hear from ppl that KNOW! I have been massaging his shoulder and we use dry/heat therapy on his achy areas--also I MAKE him walk around our yard (2 acres but we walk a smaller area with our dog several times a day) and we sit on the deck when weather permits. I know that inactivity would definitely cause way MORE problems than depression--he has to do his cardiac rehab excercises (had pt in hosp and they came here twice) so he is defintely getting enough physical activity. His cardio and his coumadin clinic (his INR is still not right of course) are advising me that the less meds the better--in particular due to the potentiation that the amiodarone causes with the INR but I am told he has to be on amiodarone until the end of May due the several a fib episodes he has had........I have read that Toprol (his beta blocker) which he will have to be on forever due to the Marfans Syndrome (or some sort of bb) can also cause some depression but everyone is telling me that it may complicate the stabilization of his INR if they start switching meds all around NOW. Making things MUCH worse is the fact that he is a total needle-phobe (complete full-blown vasovagual response if he even sees a needle) so needless to say it has been a fun time at the coumadin clinic every week--he is not eligible for ptime finger prick yet b/c he needs to have an INR under 4.0
I think a lot of this is just so recently having surgery......he is really down about the Marfans part of it....he says he is sick of being poked and prodded (as you ALL are I am SURE!!!) and since the Marfans has some other things that have to be monitored he is just feeling all around crappy about it. At least he does talk to me about it--I would be really worried if he was just clammed up. One other note--the other reason I am reluctant to leave the house is b/c his BP is naturally slightly low (around 95/40) so a lot of times when he gets up he is a little dizzy and I am afraid he will fall and I would not be here--I know probably a remote, ridiculous chance but right now I am attempting to work out of the house occassionally out of his way but where I can hear things.
Thanks again for all of your kind words and helping me through this.

 

[Ross]

I think I could almost write a book on post surgery depression. Heck, I'm the poster child for the front cover of it! The sad part is, there isn't a thing he can do to help himself. It just takes over and is the most miserable feeling anyone could experience. If he continues a downward spiral, talk to his Doctor, it sounds like he needs to be on antidepressants, at least until things (Chemically) get straightened around again.

I didn't like antidepressants at all, but if I hadn't taken them, I'm not entirely sure I'd be here to write about it today. The depression can get very bad, very quick.

As for the needles-Ask the people at the clinic to use "Butterfly" needles. They are small and do not pose the discomfort that the larger 21 gauge needles and vacuum do. I think that would help him tremendously. Yes, I hate needles with a passion myself!

 

[KML]

Thanks Ross! I will ask about the butterfly needles when we go back on Thursday.
Also Nancy--I see that you live in upstate NY--my husband and I work during the summer with a cancer camp for children there called "Camp Good Days and Special Times"
The camp is in Branchport right ON Lake Keuka!!! We love it there! We are hoping he is feeling up to it this year also! Puts everything in perspective when we go to camp

 

[sylviayasgur]

hi kml!
welcome! as you can see, this is a wonderful, supportive site full of kind folks who are more than willing to hold hands and help at any time. they were my saviour at the time of my husband's surgery ( and i still love coming back here to be with them).
joey was very frustrated at the beginning of his recovery because he expected his recovery to progress at a much faster pace. he had pain for a very long time (months) and was anxious to get back to golf, tennis, running and biking.
patience was the key. instead, i urged him to do a lot of walking. when the weather was nice, we'd go outside just like you do. i think the walking helped him bring his endorphins back to life. eventually, he started walking (slowly and for short periods of time) on the treadmill we have.
joey is also on amiodarone (went into afib 4 days after his surgery) and is in the process of weaning himself off it.
he, however, does not take coumadin. it did, on the other hand, affect his thyroid levels (he takes synthroid for an underactive thyroid).
just make sure your husband is being monitored with the amiodarone (baseline lung capacity test, regular blood tests, eye tests).
as everyone has said, depression is very normal after this surgery. hopefully there is some consolation in that.
i am also a needle-phobe. same vagal response (we forget to breathe when we get nervous) and eventually fainting.
ross is on the mark when he says you should ask for a butterfly_ it's less uncomfortable. it's what they use on babies and kids. i always ask.
in addition, i went to a phobia clinic and they taught me some tricks to get by. (not a cure, just a method of dealing).
while they are doing the blood test, think: a- is for alice, b- is for barbara, etc. using women's names, men's names, states, countries, fruit, vegetables. it's a mild distraction that takes your mind away from the blood test and needle.
again, works on a good day for me. i just try and remember to breathe!!

i'm so sorry you both have to go through this. i can relate. you just want to get through the surgery, then you want to recover and heal easily ( no surprises like the afib, etc). it sometimes just doesn't happen that way.

please tell your husband to try and be patient and rest, walk, breathe. i hope he feels better with each passing day in his recovery.
wishing you all the best, sylvia

 

[mike anthony]

Hi KML

Hi KML

As you have found out this site is unbelievable for support. I hope your husband reads the posts and when he gets ready will post himself. The only thing I will add concerns the Marfan's. I to had an ascending aorta aneurysm(6.5 cm), they operated in June of 2002 and just recently had my 2nd operation to replace my aortic valve. Back to the Marfan's...from birth I have had pectus excavatum, never had corrective surgery, so they first told me way back in May of 2002 when they found my aneurysm that I might have marfan's. I immediately started researching, since I had never heard of it before. I was lucky, after the test I was cleared of Marfan's. I won't go into great detail here since you know about all about Marfan's, but it's definitely something your husband will need to work through. I know my mind went in all different directions. Dealing with the surgery is hard enough and you will get through the surgery, believe everyone here...it gets better everyday. but I would consult with your doctor about dealing with the Marfan's.