heart and depression.

[jerryc]

Just read that there is a study at present on depression in those suffering chronic heart failure. Apparently sufferers from CHF are more prone to depression than other heart sufferers. According to the study which is being carried out by the only Cardiologist in the world who has also a degree in psychiatry it is often undiagnosed and accounts in part to the higher death rate among CHF sufferers than those with other forms of heart disease.
My two encounters with depression were actually precipitated by cardiologists. I know my heart is very weak but to be told after three months in hospital "Your heart is in a bad way. It's never going to get better and will only get worse. You have a life span of at most five years. Oh and by the way you can go home tomorrow." I left hospital too weak to walk and naturally depressed.
The other occasion was quite recent. The cardiologist was less blunt, but totally clinical in his diagnosis. He did not take into consideration how I was receiving his information and when you are faced with the statement that the heart is very weak and it's about as good as it gets, you are prone to see the shades of the Grim Reaper just behind the doc.

But I'm lucky, I have a wife who was a cardiac nurse and attend an ongoing cardiac rehab unit. The girls there recognised my state of mind and worked hard together with my wife to get me back to being positive.

I've only pottered in the garden and am now just gathering motivation to start woodwork again.

So for those of you who may have chronic heart failure be aware of the possibility of depression and get it under control quickly, even if it means taking more tablets. It is, as you know a real bummer

Jerry

[wheelinround]

:2tsup::2tsup: good to see you here Jerry yes read an article from the UK where they have proven depression can bring it on and heart break loosing someone close etc.

I had 4 furnerals in as many months 3 which meant lost to my life. I am well back to doing woodwork again. Just watch this heat drink plenty of fluids.

The other is hardest to shake I know but getting there thanks to many off here.

Ray

[AUSSIE]

Hi Jerry
I am lucky I surpose I had a heart attack after having a stress test at the hospital.
After all the CCU and recovery ward stuff I was sent home days later.I cant remember much of it.
Then when I went to see the Doc,he was all upbeat and said,you should last to your 50 (I was 44 at the time) I was feeling crap as we all do after a heart attack,but that fired me up.he said 50? with fear in his eyes,then said 55 maybe.We left it at that.I am now 63 and getting along as good as I can.I don't think Doctors realize how much they upset us sometimes.
I know I am a lucky one.I felt like a waste of good food and the world was a b%63$d of a place but only for a few days.That doctor saved me without knowing it.If someone challenges me,I have this inbuilt thing that I have to do it better and keep at it till I do.
:2tsup:

[jerryc]

Sorry- Haven't been able to reply for a while.
While I agree with you Ray that depression can be a killer in itself and Aussie I know a positive attitude is necessary to fight any down situation such as your heart attack, I was specifically warning members who are suffering Chronic Heart Failure and not heart attacks. As you know, with heart attack it's the plumbing at fault and once it is fixed all is OK. With CHF it's the pump itself that's gone and it's permanent.

I had no intent to relate my medical history but at the risk of boring you I will, mainly to show that a positive attitude may not be enough to ward off depression.

I got left sided heart failure about four years ago. It came out of the blue and was possibly a virus. Cardiologist decided to put in a pacemaker defibrillator because I had heart arrhythmia, a not uncommon problem. Things went wrong and I contracted blood poisoning. Result was six months in hospital on antibiotics and a saline drip. At the end of that time my heart was a mess. New aortic valve, myrial valve banded and a hole which had developed between the ventricals was sewn up. I was so weak even my vocal chord muscles were not working. But I remained positive. My attitude was the surgeon had done his best and now it was up to me. No depression.

Last year I got intense stomach pains. Pumped full of morphine and diagnosed with CONSTIPATION. Sent home. Returned a few days later unable to breathe. Admitted to cardiac ward and put on oxygen. Lots of ECG's, lots of antibiotics. I was dry retching and not feeling that great. Sent home. A few days and my temperature was all over the place. My GP is very good and I had a stomach scan. She discovered what the hospital had not. The right side of my heart had now failed. She phoned the hospital and begged them to admit me to cardiology. Hospital thought different. I went to general medical ward, more ECG's , more antibiotics. Me? I was still dry retching and getting weaker.

That was when I was told "both sides of the heart are gone, it's never going to improve and will only get worse"After three months in hospital, I was sent home in a wheel chair too weak to walk. An electro cardiogram taken after I had left hospital showed my heart was in atrial flutter, that is it wasn't pumping at all. Only the pacemaker was keeping me alive. Wife was furious that no one had seen this on the ECG's. She spotted it on the first ECG she demanded to see.. I suppose then it was normal to feel a bit depressed.

After a period trying to start the heart with drugs, the cardiologist went to last resort and I went through cardioversion. My heart was zapped back into function with an electrical charge. Even then I was positive (no pun intended)

I felt nothing could shake me and yet as I said earlier, a chance remark by a cardiologist tipped me over into the beginnings of depression. I was lucky. My wife my wife when working was in charge of a cardiac catheter lab, I was attending a cardiac rehab course so there was another nurse and a cardiac physiotherapist who immediately recognised the signs and got to work on me.

My whole purpose is to draw to the attention of those of you who have chronic heart failure or who are in contact with someone who has, the ease with which any sufferer can get depression and be aware that some cardilogists and many GPs are unaware of the proven link. If you feel you need help -GET IT. Don't think of it as a weakness in yourself. It's not. I had immediate support and you may not have the same access to such help. Feeling down, then get the GP to do something about it.

Jerry

[acmegridley]

Had a heart attack ,some ten years ago now ,when I lived in Sydney,got top treatment from Royal North Shore hospital,one artery blocked couldn't stent it, so now on medication for the rest of my life.One feature of my rehab was mixing with other guys who had had the zipper job (straight down the chest) was they all were prone to cry for no reason at all ,at random times,doctors put it down to the temperature that the blood was at during bypass for some strange reason.:C

[rsser]

Thanks for the post Jerry.

Anyone with a chronic or complex condition can really do with a 'champion' on their side, who attends all the consults, asks the pointed questions, remembers the answers, and pushes for thorough care.

When you're weak, in pain, groggy etc. it's hard to advocate for yourself.

In my last encounter with the 'system' the best doc was an intern from Brazil. She explained exactly what damage was done to my wrist, drawing diagrams; she read my body language as I reacted to the treatment plan and responded immediately, and she attended to my non-medical needs.

When my Mum was taken to Box Hill ED after fainting recently, she also got excellent care that focussed on her and not just on the condition.

This kind of patient-centred care is now taught in many med programs.

But the big weakness I still observe is poor coordination between health care professionals and between shifts in hospitals.

[jerryc]

,One feature of my rehab was mixing with other guys who had had the zipper job (straight down the chest) was they all were prone to cry for no reason at all ,at random times,doctors put it down to the temperature that the blood was at during bypass for some strange reason.:C
Acme,
Those prone to burst into tears were probably woodworkers like myself coming to terms with a future of limited workshop time.

But to be serious, an increased risk of depression in heart failure patients has been recognized as a major factor in early death. I have no evidence to say this, except observing my own reactions, but very low blood pressure means less blood to the brain. When my BP crashes, so do I.

Rssr,

Your point about patient centred care is important. I got fed up with some of the student doctors approach to me. I waited until one day I had eleven students around my bed (I was considered an interesting "case) and then I retaliated.

The chosen leader, approached my bed, raised his voice and spoke so slowly. I beckoned him closer and then said clearly "I am neither senile not deaf. I expect to be treated with some dignity as an individual." It was my contribution to teaching patient centred care. I had other amusing clashes with doctors but being in a hospital bed for six months means you have to take steps to see the humour in a situation or you go under

Jerry

[rsser]

Excellent Jerry.

I do a little role play with the med students I teach; ask them to imagine they're now a GP and I'm coming into their rooms. I get up, drag my foot and slur my words.

And ask them what's their 1st thought? Loudest/quickest response is 'You're drunk.'

Well, they're 1st years so young and inexperienced. A bit more discussion elicits alt poss'ies by way of illness or disability. We then talk about how the 1st assumption might skew, indeed derail, the subsequent interaction.

Well the point of this is to reveal both the necessity and dangers of typification in social interaction, and the essentially social character of the practice of medicine.

[jerryc]

It's a funny old world. Here was I warning others about depression and virtually saying I was fireproof. I was brought up to believe in fighting one's own battles and not complaining was part of life. This morning however has dented that a bit.
I had a new pacemaker generator fitted two weeks ago and it has an update. Now if there is fluid on the lungs the alarm goes off. It went off this morning and I have to go to hospital for investigation this afternoon. BP went down badly and the one great fear I have is to be permanently bed ridden. I have been told by a cardiologist(not my own) that for me to be active with a heart that is only five to ten per cent efficient is unusual.
I know there are so many other forumites in far worse straits than I am but, for once, it doesn't seem to help much.

Jerry

[rsser]

No it doesn't Jerry.

Be aware of the diff tho btwn being down for a while as against clinical depression.

See the beyondblue website for more info.

Good luck. I'll be thinking of you.

[chambezio]

Jerry
Depression is sneaky and devious in the way it works (I am a 20 year sufferer) you can be going along just fine being able to handle this and that then out of the blue something similar to what you have been doing pulls the rug out from under you and you're down for the count. I had an incident this week which has left me stuggling.
I have no answers. The meds I am on are like a safety net but they sure aren't a cure in a bottle (I wish they were). Staying positive is more than a full time job and makes your body work overtime I'm sure, as I am tired all the time even after a night's sleep.
If I can give you some encouragement try your best to hang in there even for the sake of your family who are there to support you. What would your wife do with out you :D and who would kick the cat out a of a night.
Best of luck for your hospital visit and our thoughts are with you :2tsup:
Kind regards Rod

[jerryc]

Thanks for the support friends. It came just when I needed it.

Tests of the pacemaker this afternoon were inconclusive. All morning I had been down with low BP and my wife insisted I went to bed. BP OK when lying flat but dropped when I stood. Tomorrow I have cardiac rehab; Friday an appointment with the cardiologist; Monday rehab again and Tuesday blood tests. Wonder what I did before I retired?

Rod I'm just skirting the edge of depression and it is enough. You have my sympathy.

Rssr, I believe you have a redesigned wrist. Hope things improve for you.

Thanks again
Jerry

[rsser]

Thanks Jerry. Not as serious as yours but all the exercises I have to do just to maintain fitness with the various joint problems gets me down.

As someone said 'growing old is not for sissies' :(

[jerryc]

Stay with it Ern and try to see exercise as a step forward, not a present burden. Rushing this note through as I prepare to go off for rehab this morning so I know how easy it is to get fed up. I go twice a week and have come to the conclusion that it is not enough, I must exercise every day My road back from total wipe out which turned around in June (when I had the heart kick started again) has been a long one. I drive myself as I did when I was younger and a keen sportsman, that is to focus not on what you are going through now, but on the end result -- what you want at the end of it.
Funny thing in talking to you and to others is it makes me fight against feeling down. Group support from those who know your troubles is often the best support.

Jerry

[rsser]

Yes, I do stick with it Jerry; would be a basket case otherwise. What got me down was the realisation that the future would always be about working hard to stay the same, at best. It's not life threatening but does threaten the ability to do things that mean a lot, like woodwork and XC skiing.

I've been very lucky to stumble on a form of health care - physio - that puts me in control of recovery from the joint problems or a back incidents I've had.

Good luck with your accelerated rehab.

[Allan at Wallan]

I have not corresponded with you before JerryC but have been reading
your post with interest.

My heart attack (6 years ago) was nowhere as serious as yours but had
two stents inserted. Two years ago a prostate operation and last week
had the gall bladder removed in a complex operation.

I cannot advise you re any problems with depression as I have
fortunately maintained a positive outlook and been lucky.

Keep hanging in there and be assured many other woodies are
reading your threads with interest and wish you well.

Allan

[jerryc]

Thanks for the thought Allan. Looks like you've had your share of medical repair.
I'm not a depressive really. Fortunately I have excellent support, but occasionally I get frustrated at not being able to do what I could before the pump failed. Having been extremely active and fit before, it took time to adjust.

Jerry

[artme]

G'day Jerry.

That blck dog is a mongrel!!!

I have had clinical depresseion for so long I can't remember when I didn't have it.. I have been a little better over the last couple of years since the Bypasses and stents but still have really down days now and then.

The worst of being down for me is that my wife seems to think I can "snap out of it". After 23 years I thought she would know better! But :no::no::no:

[jerryc]

Artme,
As I said, I am lucky in that mine is not clinical depression. It is just that occasionally I find it hard to keep up the fight to improve my fitness and the ability to actually do things. I also believe for me it is a matter of extremely low blood pressure at times that seems to affect my thinking.
However I do know that clinical depression is just that-- clinical. Anyone who suffers from it is permanently trying to battle it, and being told to "snap out of it" or "pull yourself together" is far from helpful.
However your wife does what she can to help and, perhaps, when she says it , it is frustration at not being able to do more for you. Helpers often feel helpless to do more for you. As I've said earlier, my wife was a cardiac nurse for twenty years and was top of her profession, but I know the past year has put a great strain on her.
You have my full sympathy. The down days I have experienced are not as bad as your's but I'm very glad when they pass.

Jerry