Back to Normal-ish: Get Help for Post-Op Depression

Yesterday was my five-year re-birthday… Happy re-birthday to me!


Happy Re-Birthday to Me!

Five years ago yesterday I was laid out naked, unconscious, and helpless as a medical team sliced me open like a Thanksgiving turkey and performed an emergency quadruple bypass. Five years and I’m just now getting back to normal-ish, starting to not think about the operation, much.

Physically, I feel pretty good. I had my six-month visit with my cardiologist last Wednesday and he said I had “a good EKG.” The nuclear stress test I took a couple weeks ago showed my “heart muscle is strong.” My cholesterol is well below 200. HDL is good; LDL is, too. He said I was “doing great.” He told me this at my last appointment and the one before that. You’re doing great, keep doing what you’re doing.

That’s it--- great? I’m doing great? For some reason, I can’t accept great as an answer. It doesn’t stick; something in my head doesn’t want to believe them. Doctors were telling me I was doing great--- weight good, cholesterol low ---right up until they started telling me I was one flight of stairs away from a massive heart attack.

“I feel like I should be doing something… more,” I said, frustrated.

“Get out and enjoy life,” he told me and that was that.

Never once in the whole five, ten minutes my cardiologist spent with me did he ask how I was feeling mentally, psychologically, emotionally. I don’t think he even knows I’ve been seeing a psychologist since the operation. A recent poll found the majority of cardiologists ask fewer than half their patients about depression. Unfortunately, untreated post-op depression increases the risk for subsequent heart attacks and death.

Strength in numbers?
The CDC estimates there are 395,000 bypasses performed every year in this country and another 454,000 stent procedures. Estimates vary but somewhere between 40% and 75% of those people experience depression: short- or long-term. It’s a form of Post Traumatic Stress Syndrome really, similar to soldiers and assault victims.

I’m not surprised, then, that I can’t entirely let the experience go, that I feel “tentative” about the future, that I still get flashes, images of my heart that pop into my head. This mushy, red blob with squiggly tubes coming out one side and going into another. Any little pain or twitch in or around my chest makes me pause and wait for something to happen--- what, I don’t know.

I got an email, recently, from one of my readers named Charlotte who had a “minor” heart attack in 2006 that resulted in a couple of stents. The rest of her story is close to mine. After the procedure, she began to struggle with depression that she was only briefly told she “might” experience. She took the antidepressants they prescribed; a year went by until she felt like herself again--- almost, but not fully. She told me she felt unprepared for her feelings. She felt weak-willed, that depression was her fault somehow.

Free Advice
The American Heart Association posts the usual duh information on Facebook. Signs of a heart attack: shortness of breath, numbness down the arm, squeezing in your chest. Useful for some. Except, I had none of those symptoms five years ago. The Mayo Clinic offers generic diet and exercise tips. Nice, thanks, but it’s all BEFORE advice. There’s not much out there for AFTER.

My search led me to a book co-written by a surgeon and his Fox News anchor wife that promised an 8-step “cardiac comeback plan.” His story was similar to Charlotte and me: heart attack out of nowhere, depression “issues” during recovery. But that’s where the similarities end.

After surgery, he was afraid of eating doughnuts and having sex (not at the same time). Me? Not so much. His expert advice to get out of a funk: watch Rambo movies, sleep with a nightlight, and go shopping. Oh, and run a marathon! So, uh, yeah, thanks doc.

Help Yourself
Five years ago doctors stitched me together and sent me on my way with little more than a handful of meds and a cute red pillow shaped like a Valentine heart. Buh-bye.

Your going away gift from the cardiac ward

Your going-away gift

“I wonder,” Charlotte’s email concluded, “if more attention should be given to this rather common effect that heart patients are prone to. It seems as if no one wants to really spell it out to them for fear that the patient might become frightened. Being forewarned might be much better, the person would be able to cope, rather than be blindsided.”

I’m beginning to see that while we heart surgery “survivors” share a common cause for our post-op feelings, our roads to recovery are as varied as we are. Nobody’s going to ask us how we feel, including our doctors; we’re going to have to ask ourselves… and there’s absolutely no shame in looking for help.


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