I have learned a lot about recovering from depression by studying methods for dealing with chronic pain. Now I have had a chance to turn this around. How can my skills in dealing with depression help me manage post-operative pain? Unfortunately, I have had more time than I had hoped to find out.
As planned, I had major surgery on July 5th for correcting problems caused by lumbar stenosis and degenerative disc disease. I’m closing out a month of recovery from the effects of the operation itself, and it has been a slow and painful process.
My surgeon said he had rarely seen so much scarring in a spine that had never before been operated on. I was warned to expect a painful period of recovery, and painful it has been. That’s hardly surprising. The surgery required an incision of about six inches and involved considerable knocking about of bone and muscle. Small bones called laminae were removed from three vertebrae, a damaged disc was cut from another and a fusion “cage” of titanium was installed to hold two out-of-line vertebrae in place.
The whole area of the incision has been healing beautifully, but there has been a lot of sharp, stabbing pain and deep aching as the back muscles slowly mend themselves. I had to remain flat on my back for the first five days after surgery as the most sensitive areas began to restore themselves. The original pain caused by pinched nerves is gone, but post-operative pain has been quite enough to deal with.
And that brings me to the helpfulness of depression management lessons in handling the pure, nasty physical pain of a healing back. Treating pain begins with the use of medication designed to stamp out the hurt, but, like many depression medications, they are strangely ineffective. A major ingredient is oxycodone, an opioid narcotic that can take the edge off the worst pain but also produces bad side effects. It can scramble your brain, freeze your bowels, parch your throat and disrupt your sleep, and, as we have all learned, turn you into an addict.
I have been finding that when the worst pain hits, unpredictably and suddenly, the best response is one I learned to use when sinking into depression. Instead of fighting it and trying to turn it off, I could talk myself into facing the intense hurt of the moment and achieve a kind of relaxation that began to make the pain much more bearable. I think that’s because part of the pain is the anxiety and tension that seize me as soon as I feel the first jolt. The stress and tightness of my body and mind seem to be a big part of physical pain. To achieve even a small degree of awareness, acceptance and a willingness to explore what the pain is all about restores a sense of self-mastery that is wonderfully calming.
A few complications have added to the slow pace of healing. The surgeon had spelled out in the consent form the most common problems associated with this operation in particular and with all lengthy operations under general anesthetic. I’ve had to deal with two of them: a slight tear in the sac that contains the spinal fluid, called the dura, and a blood clot that developed during the immobility and position of my legs during the operation and the flat-on-my-back posture I had to hold for five days following surgery.
The tear in the dura seems to have occurred as a result of a reflex nerve response and the generally scarred condition of my spine. A separate drain was installed to monitor the condition of fluid from the tear following the operation. There was no infection and none of the symptoms that are typical of this problem – primarily “pressure” headaches. The tear healed well and is not an ongoing problem.
The blood clot showed up through excessive swelling of the feet and lower legs. An ultrasound test revealed the location of the small clot under the right knee. To gradually dissolve the clot, I take blood thinners and get regular blood tests to ensure I’m maintaining the ideal balance of clotting and thinning factors. This treatment is going well, but the swelling takes a long time to go down and adds another level of discomfort I could just as easily do without.
Despite all this, I feel I have turned a corner this week in regaining physical strength and balance and have started cutting back on the pain relievers. I am still using a walker to get around, but need it only as a guide rather than a crutch that bears my weight. It’s amazing how quickly the dozens of little muscles involved in walking and keeping you upright lose their strength after a time of immobility. I’m now getting the wonderful feeling of being able to walk on my own again and gathering more strength every day.
The most difficult moments are those when the shadows of depression return. I feel down about the limits of my physical and mental abilities and recognize old tendencies to disparage myself. Fortunately, those are brief spells that I can readily handle.
Perhaps the most powerful part of healing is the incredible love and support of my family. My wife and sons and their great partners are always right there, helping in any way they can. Resilience and recovery need the ongoing support of such loving presence, I’m convinced. Sometimes, a bit of illness and hurt can bring home the great treasure of these relationships.
Recovering from illness presents many of us the biggest challenge we have ever faced. Having lost complete vision in one eye I went through a period where I was incredibly down. I became disillusioned and just could not seem to pull myself out of it. My turning point, Boxing Day 2014 I felt myself spiralling down. I didn’t like what I heard in my inner mind. I sat up in bed, said out loud ‘no more, I’m better than this’. I just knew that I hadn’t yet arrived at the point where there was no possibility of improvement. I have implemented massive change and have demonstrated it is possible to move from pain to recovery. I enjoy your blog posts.
Sounds like you have a very real, serious back issue — and I certainly hope that your surgery has made that much better. Hope you no longer have ANY pain or much, much less.
I just thought I’d share with the group the history of my back pain with depression/bipolar. Since I was about 15 years old, I had back pain, and had to put a board under my mattress in order to sleep without waking up during the night with bad back pain. Starting when I was bout 50 years old I kept an ongoing mood chart. It also had a line in the graph that showed back pain — up and down it went. And my moods also went up and down, of course. I am a very rapid cycler. I was trying to find any correlation with depression, but could not find any. When I was in my mid-50s, I started a medication which completely cleared up the back pain. I THINK it was Seroquel, but not certain. In the mean time, I have had different psyco-meds (LOL) and my back pain has not returned. I’m 73 now. Presently I take Lexapro and Lamictal.
Depression, anxiety and PTSD, my diagnosis, plague me often. Growing up in an abusive family, having an abusive marriage and worst of all seeing two daughters killed in a car accident, my depression took an abrupt and debilitating nose-dive. Then there was divorce. I know others live through such things with sorrow but don’t grieve and isolate as I do. I don’t like to share it with anyone. I did go to therapy after the deaths of my girls and did EMDR and therapy. I believe it helped a lot, for a while. Can’t afford it any longer. I live alone and one grown child lives not far from me. I miss my life, my family, some sense comfort. I am afraid some days the end will come yet I worry for my grandchildren and kids. I hold on for all of them. I tried suicide before and my children were so angry with me. Therapists, books, spiritual searching, hospital psych wards, and people telling me I can change easily. I don’t seek or desire people feeling sorry for me. I like being alone…….sometimes. Depression, Anxiety…….GO! Leave me alone! let me feel comfort.
This is great. I have a condition that I know is temporary. But it has caused chronic pain. Even though I know it is not permanent, I get quite depressed about it. Thank you for writing this. I too have struggled with depression, ACA issues, and anxiety.
This is great. I have a chronic condition that causes me a lot of pain – and no doctor has been able to do anything about it. I will take your advice and try to relax, to accept it, and see if that makes things better. Hope your 2014 is going great so far!
Does anyone have any advice on how to recognise recovery (or signs of) in depression? I understand that its not quick but it would help me to learn more about any patterns recovery takes or if its totally different for everyone. I’ve tried researching his but can’t find much. Any advice would be greatly appreciated.
Hey great article. I’ve always found the best “cure” (for want of a better word) with mental health has always been empowerment. Learning about methods and techniques yourself starts to build in that base level of confidence and empowerment. Things then start to spiral upwards, as you learn more and apply more you feel better about yourself which drives you to learn more etc!
hi, there was a time when i started living with depression all the time. i did not eat well, sleep well. stopped laughing. but then i started reading books. i was so involved in my novels that i finally recovered, now books are my best friends. sharing a link how to deal with depression …click at my name..
We all need to have support groups that can help us recover from pain in a significant way. I personally believe that the presence of peers can help hasten the recovery period.
Isn’t it interesting how life gives you new subject matter just when you thought you had covered all you could about depression from your own experiences? My pastor counseled me about depression way back in 1975. Since he had no history of depression himself, he assured me it was a spiritual problem rooted in the fact that I did not love and appreciate my father. Umhmm. Around 2005, thirty years later, he had open heart surgery and found himself deep in depression afterwards. His attitudes about the nature and causes of depression changed profoundly! I believe that those of us who tend to have depression will tend to see it age right along with us, and express itself perhaps slightly differently with each challenge, each stage of life.
My dad had a similar back surgery to yours, but his was after having previous back surgeries, so I have a little bit of a glimpse of what your recovery is looking like and you have my sympathy and positive healing thoughts for a gradual but effective recovery. Please don’t rush it or you might find yourself going back under the knife to have it all done again.
Look forward to reading your articles and newsletter again soon 🙂
Keep moving, nice and steady.
Every best to you.
Dear John: Praying for you and always grateful for sharing your story as it continues to help me.
“Acceptance and a willingness to explore what the pain is all about restores a sense of self-mastery that is wonderfully calming.” I am implementing this strategy when I start sinking into the abyss of depression.
Hope your recovery continues to go well. I’m just starting down the journey of back pain (after 27 years of working as a nurse, I guess it caught up to me). The depression had been fairly well under control…off all meds…until this. Meeting with the MD in a couple of days to discuss what to do next. Really scared that the answer will be having to learn to live with some degree of chronic pain…and I don’t know how I’ll be able to cope with that and depression. Thanks as always, for sharing your story. It give me hope.
John, It sounds like you’ve been through quite an ordeal. Wishing you a quick recovery….just take care of yourself and we will be here when you get back.
Hard to tell from the article….when was this written?
Could you please tell me?
Thanks,
Lori
Hi, Lori –
I wrote this post in early August about one month following my back operation. Since then I have recovered almost completely, though I’m still getting a lot of help from physical therapy to rebuild muscles and range of motion.
Thanks for commenting.
John