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Tothill Asked September 2020

Post surgery depression? Mum had a Knee replacement.

Mum is 86. She is in remarkable shape physically and was dealing with minor short term memory loss, which she was aware of and compensated for (lists, calendars etc). Mum has lived alone since step dad died 2 years ago.


PreOp


Mum takes no medication, is physically active, socially active, 100% independent except for minor computer issues. I should note that Mum is an identical twin.


Post OP


Mum has stopped most the post op pain meds (2.5 weeks post op) but depression has set in. Physically she is doing well, she is getting around, even up and down the stairs. Mum had a short depression shortly after Covid shut down most her life and all her activities. But she was able to snap out of it.


I am worried about her now. To top things off a very old friend/former family member, has just died. She was 90 and Mum had known her for 60+ years.


I am very familiar with depression, but was wondering if anyone else has heard of post op depression?


Adding to the story, her sister stayed with her for the first week post op. Auntie is of course also 86 and in great physical shape, but she appears to be slipping mentally. I think that scared Mum.


I am taking Mum shopping in a bit, then going to take her out for lunch and a drive. It is a beautiful day here today and I think getting outside will help. Mum is rarely in her house, she spends a great deal of time in the garden or walking her dog.

Tothill Sep 2020
I took Mum out for dinner at a pub with a beautiful ocean view. I chose the community and she chose the restaurant. It was a nice meal and Mum decided to pay, although I had invited her.

Afterwards we went shopping and it really perked up her spirits. Bring house bound since the surgery except for doctor's visits was part of what was dragging her down.

My grandson, her great grandson is staying with me a few days later this week. A visit with him will perk her up too.
AlvaDeer Sep 2020
GREAT news!
AlvaDeer Sep 2020
Yes, post op depression is extremely common. It is a visit to "reality" with how quickly life can change. Some elders become almost afraid to move, realizing what one incident can cause. This is a very very VERY short time post op. Definitely give courage in "You are doing really well". Allow her to voice concerns, and just feeling low, and reassure her that it is normal. There are entire BOOKS written about the depressions suffered by people with major open heart bypass surgeries, and so common is it that doctors warn patients it almost certainly WILL happen. So just encourage a step at a time, day by day.
Tothill Sep 2020
Thank you Alva,

I knew about the link between heart disease and depression and was wondering if there is a similar one for surgery.

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Hedgie Sep 2020
I was a very active 70 year old when had to have orthopedic surgery which lasted about an hour +/- , over night in the hospital and then home. PT started about 6 weeks later and was very effective. I still had brain fog and depression from the anesthesia for about 3 months. It has now been a year since surgery and I know that my brain is not functioning as well as it did before the surgery but depression is mostly gone. In my mind, here is definitely a connection between anesthesia and post surgery depression and brain issues.
Tothill Sep 2020
Hedgie,

Thank you for your personal experience. Mum's PT started before she left the hospital. She has daily exercises to do as well as regular PT visits.

Knowing that the depression could last as long as 3 months, will give Mum an end date, it should be over by Christmas.
Dosmo13 Oct 2020
I'm 80 yrs. old. Had both knees replaced and spinal surgery in the last decade. (3 separate surgeries) No major pre-existing medical conditions except for borderline type 2 diabetes. Had some depression after both knee surgeries, but had good physical recoveries. The last knee surgery was h*ll, mentally. I was quite confused afterward, angry, delusional (imagined people saying things they did not) for weeks and then depression set in. Think I came close to losing even my closest friends!
Finally, I regained normal thinking, but the depression took longer to fade.
When I needed spinal surgery, also a long procedure requiring general anesthesia, I had a lengthy discussion with the surgeon beforehand. I described to him my state of mind after the prior knee surgery. He Immediately attributed my symptoms to anesthesia. Said he understood the phenomenon and had seen it before. He promised he would not allow use of the same anesthesia I had had before.
I'm so glad I talked to him pre-surgery. The procedure went well. (I was 78 yrs. old at the time )My recovery was relatively quick and my mind cleared rapidly after the surgery. I'm just relating my experiences hoping it will be helpful. Suggest you talk to the anesthesiologist WELL before surgery. (No 2 minute introduction then "see you in the OR"). Voice all your concerns to him as well as the surgeon. Best of luck. Knee surgery is tough.
cherokeegrrl54 Oct 2020
I am 65 and need a rt knee total replacement. I have suffered almost 3 years and finally (now that i am on medicare wth a very good secondary ins. Can you tell me about your surgery and how long before you were up and moving, physical therapy, post op pain, etc. i am scared but looking forward to being somewhat normal again post surgery. You can send a private message if / when you have time. I would so much appreciate your input. Thank you, Liz
JoAnn29 Sep 2020
Your Mom is 86. Don't u think she thinks her days on this earth are numbered. A friend has died, she sees her Twin slipping, that could be her. And going thru a surgery, even done with a local, is still a shock to the system. Seems like she doesn't sit around and mope. I would just wait a while and watch her. She maybe depressed because she realizes her memory is not what it used to be. But, we do decline mentally as we age. One thing, is she on a Cholesterol Statin. These have been found to cause cognitive problems and contribute to Dementia. If she is, I would ask her Dr. to do a liver function test and if her enzymes are high, take her off. Statins effect the liver. Even if she comes up OK, I may still take her off. There have been members who have seen cognitive improvement when a LO has been taken off a Statin.
Tothill Oct 2020
Hello Joann,

No Mum takes no medications at all. She has weaned herself off the Rx pain meds and is just using Tylenol and Ibuprofen for pain management, mostly first thing in the morning and at bedtime.
Chickie1 Oct 2020
Having surgery of any kind can be depressing. I am 72 and have had hip replacement, knee replacement and last spring, emergency heart surgery.

In my opinion, you are doing the right thing. By taking Mom out, spending time with her and having visits with grandsons are great medicine. Get her out as much as you can. Have friends and family visit or call. It really helps.
I know it has helped me. The patient has something positive and "normal " to focus on. Glad things are looking up.

BarbBrooklyn Sep 2020
Tothill, what kind of anesthesia did your mom have?

General anesthesia can apparently cause all kinds of mood and cognitive disorders in elders. Have you been in touch with your mom's surgeon to talk about this? Or has mom done so?
Tothill Sep 2020
She has a spinal with sedation. The Anesthesiologist did not feel a general was needed.
IamAmy Oct 2020
My mother is 86 and had nearly the same story as your mom except that mine had spinal surgery at 86 and had general anesthesia. She was under anesthesia for two hours. That was almost a year ago. Since then she cries very easily, hasn’t near the amount of energy she had just before surgery and her memory took a hard turn as well. I really believed it was the result of general anesthesia but since your mother didn’t have general, it makes me wonder. Maybe it isn’t the anesthesia at all.
My mom went on a short term antidepressant but it really didn’t help.
I hope this problem resolves itself for your mother. I’d say she has a good chance of coming around since she wasn’t under gen anesthesia.

Caregiversister Oct 2020
Everyone has given wonderful advice, and I am glad to hear about your outing to a restaurant and a drive that helped your mom!
I want to add something that BarbBrooklyn mentioned, anesthesia. I had a reaction to a sedation drug, either Fentanyl or Propofol (don’t know which one) that caused 10 weeks of depression. I knew it was related to the procedure because the depression began shortly after I came home from the hospital. Fortunately, I looked at the medical report that they gave me and found out the names of the sedation drugs. Didn’t help the depression but at least I knew the cause of it.
I pray for a lessening of your mom’s depression! You are a wonderful daughter to care for your mom and be concerned for her recovery. May it all go well for you all. Please take care of yourself also. ❤️

geddyupgo Oct 2020
Congrats to Mom on a successful knee surgery. It is very common for people to be depressed after surgery and the Covid -19 pandemic is certainly depressing by itself. And then losing a good friend - always depressing but more so as we get older. I watched this with my Mom and I feel it with myself at 76; it is very much like having the fabric of your life ripped away.
Even though it is not possible for her to pursue her old group activities at present perhaps there are new activities she might like to enjoy. I'm trying to read some of the million books and articles that I never seem to have time for, listening to all the wonderful music (A-Z) that has been written, playing brain games on the computer and taking up photography and editing. My friend has taken up beading and another friend has taken up crocheting and is making baby blankets to donate to foundations who help struggling parents (and let me tell you, she was a miserable, sad, old lady until she starting crocheting and found a welcoming place for her wares; now she has a smile on her face every day, has learned to use her computer and participates in Senior Center virtual activities); what a difference a little purpose in life can make.

Your Mom is also very fortunate to have a loving and caring daughter to spend time with her. Getting outside, playing with the dog will help both of you and strengthen the already strong bond you have. Prayers, thoughts and hugs to both of you!

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