Post surgery depression? Mum had a Knee replacement.

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Post surgery depression? Mum had a Knee replacement.

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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.

Depression Knee Replacement Mental Health

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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?

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She has a spinal with sedation. The Anesthesiologist did not feel a general was needed.

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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.

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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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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.

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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.

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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.

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GREAT news!

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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.

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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.

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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.

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JoAnn29
I did not know that about statins. I was recently put on one. Yikes!

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My husband was on them and in a week he was so confused, hear others talk about joint pain from them. PA said that is one med she would avoid too.

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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.

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Agree knee surgery is the worst operation for anyone over the age of 65. After my grandma had surgery all the pain medicine led to dementia, Better than that this person is eighty-five years old, shouldn't she stay in the hospital or nursing home for the first week? At lease until she can start therapy? It would be less stress on her, and the caregiver to heal the elderly under going a knee operation.

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My husband was in rehab for two weeks and it set him back. With COVID he was isolated and spent most of the time in bed alone. Got up twice a day for exercise.

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Change - especially surgery that affects body image or mobility - can cause a lot of what you mention. Lack of sunshine, decrease in normal activity level, pain medication not totally cleared from her system, and change in level of social interactions are also factors to consider. My daughter suffers from Seasonal Affective Disorder and keeps it in check by "upping" her doses" of healthy food, sunshine, exercise and social interactions. Probably the same should help your mom.

Other causes of her "blues" maybe grief over loss of friend, dealing with her own mortality, or even a small insult to her brain (most likely a small clot breaking off and travelling). If she doesn't respond to resuming normal activities, please have her checked out by her physician.

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My 74 year old husband gave me a kidney three years ago which was a very successful operation for both of us. BUT he was totally disoriented and belligerent when he woke up after surgery. Turns out he was in early stage of dementia (Lewy Body) and the anesthesia exacerbated it. He had seemed somewhat depressed after his second hip replacement in 2014 but would not talk about it, let alone see a doctor for it. I think, from our experience, there is a correlation. But your mum’s depression sounds more like an effect of loss and fear. And maybe loneliness despite you and your family’s excellent loving care.

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Am currently recovering from total knee replacement surgery at 66. Your Mom is doing amazingly well. This surgery is very painful and requires rigorous PT. At 4 months out - I still have pain entering and exiting a car or if I am on my feet for a prolonged period but otherwise have resumed all my activities. Very glad I did it (also had spinal anesthesia and overnight hospitalization then home).

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Thank you for speaking of your surgery. . Im 65 and facing total knee replacement as well. I am nervous about having the surgery, but i survived a bad shoulder surgery wth very intense therapy. Was so painful and difficult going through it but have not had one twinge or pain since then (2006). Hoping the knee does that well!!!

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Post-surgery delerium and depression are common, particularly in the elderly. It is suspected to be an after-effect of anesthesia: https://www.scientificamerican.com/article/hidden-dangers-of-going-under/

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You are a dear sweet daughter. May God bless you, help you, and protect you and your mum.I am 86 and I have had 2 knee replacements. i had a very wise and wonderful surgeon, Dr. Roger Lunke. I had also a great physical therapist which he chose for me.I learned that depression is usually caused by severe malnutrition and that malnutrition in old people is often caused by so called meds such as statins, diuretics, and narcotics. These substances all interfere with how nutrients are processed in the body. i am so glad your mum does not tae any of these things. The narcotics which were of course necessary for her surgerym may have caused temporary physical and mental problems. Please have your Mum take sublingual methyl B12 every morning and take it yourself, also.It does wonders for depression, anxiety, panic attacks, and any other nervous system disorders.It is both a preventative for you and healing for your mum.Also, you and she could benefit from eating magnesium rich foods every day plus a lot of a variety of organic berries, fruits, and veggies every day.Eat a lot of both spinach and nuts. A handful of delicious nuts every day will give you magnesium and other nutrients essential to a healthy brain and body.Also, drink a quart of whole milk from pasture fed hormone fre cows every day.i really do believe that I suffered no depression after my surgeries because of my very healthy diet and the extra B12.It is also good to eat one or more whole eggs every day and iodine rich wild caught cod fish weekly.Good food is good medicine.Some supplements are not safe. However methyl B12 is always very safe.Love to you and Mum.

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Mum has been through a lot. The knee surgery is tough and the rehab for it is really hard. She made it through those things and then her friend passes and her sister displayed actions that would scare or make any relative sad. You are doing the right thing - get her outside, active doing something. We are also getting into the cooler months that commonly bring on sadness for lots of people.

Does she have any hobbies? Does she belong to any sort of group like church, ladies clubs, etc? Add any of that to her plans to help get her mind off things.

Even though she's off the pain meds, our bodies don't bounce back from those like when younger. Some older folks seem to have changes, mentally, for a period of time after surgical sedation. That could also play a role in in.

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My2cents,

Prior to Covid, Mum was incredibly socially and physically active. But many of her activities have been canceled due to Covid.

Mum is a Dragon Boater, active in her church, has belonged to Beta Sigma Phi for well over 60 years, gardener, volunteer for many organizations and met with friends several days a week. When Covid hit, all the activities except gardening were canceled. That led to the first depression this past spring.

She and some of her widowed friends have decided to break the rules of social distancing and are meeting once a week to play Dominos. They had started doing that last winter and decided that they would start up again and take on the risk of spreading Covid. Over the summer she and another friend went to the beach most days for an ocean swim, but that of course is not possible post op, plus the weather has changed.

I decided to make special plans for Thanksgiving. We are in Canada so it is this month.

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Seniors don't handle anesthetics and meds well and it takes a long time to get out of the system. I'm 83 and notice that activities that I can handle physically distract me and make me feel better. Keep her mind busy and active, positive input.

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Post-op depression is real and fairly common. Can sometimes take weeks to be overcome. Keep giving her positive experiences as you are doing and encouragement through her rehab. If she isn't showing signs of improvement in 4-6 weeks post-op, talk with her primary care provider and/or surgeon.

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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.

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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

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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. ❤️

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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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Imho, perhaps her depression will fade - in time. If it doesn't, address it then. Prayers sent.

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I have replied to some of you individually and I wanted to post a general thank you to all of you. Those who have shared their own experience having orthopedic surgery as a senior and mental health challenges after the fact.

Mum had a couple hours with the baby this afternoon. She enjoys spending time with him and as he has both cut a tooth and started rudimentary crawling, it was a fun visit. I will be taking her for Physio at the hospital in the morning and then to do a bit of shopping after that.

She is discovering if she over does it one day she feels the effects the next, but she is getting around quite well. She asked if she could come when I take the baby home on Sunday. That will be a nice drive (about an hour from my house) and if it is sunny we will go for a drive around the waterfront in Victoria.

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I do not think it was coincidence nor luck that prevented me from ever experiencing any depression, etc. i believe it was my excellent diet plus extra sublingual B12. I am 86 now and had very successful knee replacements at ages 70 and 78.Of course I also had a wise and wonderful surgeon and therapist.i did also have a lot of good muscle from being very active all my life.However, my intense activity may have caused my torn minisci. Smile. Life is difficult and mysterious. Love to all

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Well we went to Butchart Gardens after dropping off the baby on Sunday. Mum was able with her walker to walk around 1/2 the gardens. It was her longest walk since the surgery.

Today we are heading to the cottage for Thanksgiving. We will need to break as we have been dealing with a very stressful family situation. One of our family members has serious mental health issues. This time we had to get the police involved.

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Pallative nurse told me, my aunt needs tylenol daily to keep aches and pain away.. She is from Nw Zealand and this is a no brainer for elders with dementia to take tylenol. They may not be able to say they are experiencing pain, but the look they give you tells differently... It has helped.
a friend had knee surgery, not replacement, and he did not look good. Young, under 60. Guess he was right, he's going in for another opinion.
glad your mom is doing okay. I hear it can take awhile to feel normal.
I understand hips are easier, then the knees, and one of the weirdest ones: total ankle replacement. friend had one done. he doesn't feel that much better. another had ankle surgery, and she finally told doctor to take out the screws. She doesn't know if that was a good decision. Her ankle feels weaker.
total knee replacement seems to be THE SURGERY OF THE DECADE. my cousin had partial knee replacement,, didn't go so well, think they had to redo that one.
another friend said, if you got to get it done, get the total knee replacement, all hardware, it is basically the same recovery time, and a whole new knee.
a wonderful man I know had both done at the same time. He and the doctor decided less time under... He scheduled a board and care with physical therapy for 6 weeks. I need to find that insurance. He said it was great. back to work after a few months off. He is so happy with his new knees. :)

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I sure hope i have that experience when i hav total knee replacement!! This pain....it’s horrible and im trying to put it off as long as possible because of covid.....but ive been in phys therapy for numerous back/hip issues so trying to keep muscles strong!!!

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Post surgery depression? Mum had a Knee replacement.

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