Question
Hi Sharon,
I had a Total Hip Replacement 10 weeks ago and have done remarkably well (my surgeon's words). I can't seem to shake this sadness, inattentiveness and generalized anxiety. I am a business consultant with a job that requires much enthusiasm, public speaking, teaching and working with clients. I am on a surgical leave and am terrified to go back to work. I traveled extensively and always enjoyed my job. I find now that I am avoiding clients and postpone returning phone calls. I am unable to focus enough to read a book when I am  usually adept at writing presentations and developing marketing strategies. Is this a frequent occurrence after major surgery? Many years ago, after a traumatic divorce and losing my house to a fire, I had a bout of depression and was treated with Paxil but I didn't like the side effects. BTW, I am young for this procedure - only 50. What do you think?

Answer
Hi Deborah

I absolutely understand what you are going through.  I had my first set of hips put in at 16, and up to now I have had four sets in revisions.  When I was younger, depression did not hit me at all.

When I had my third set put in, I was married, had two little boys, a part time job and I was the do-it-all person, and because my surgery was so hard, my mother and mother in law had to come and help.  I saw that as a failure to take care of my kids and husband and house.  It didn't matter that I KNEW the surgery was the thing that took my independence, all I knew was that I was useless.  I began to get panic attacks and I cried all the time.  I couldn't even go to the bathroom and wipe my own backside.  My mother had to do it for me.  I had hit rock bottom.  I did go on anti depressants.  I also learned that with each revision I had, I needed to go on antidepressants until my life returned to normal and then I could wean off of them.

In your case, you were, and will be again, a very active woman.  Before you go back to work, I would urge you to go see a therapist that is able to prescribe medication.  I would also urge you to go back to work on a part time basis, at least for a few weeks until your life begins to return to normal, and I want to assure you that your life will return to a normal pace.  You will have changes in what you can and cannot do, but you will return to a rhythm and slowly you will see the depression and anxiety lift.

I used Celexa when I went on anti depressants.  I was terrified of gaining weight and celexa was the only drug that did not cause weight gain. It also helped with anxiety and panic attacks.  Not all anti depressants deal with panic disorders, the celexa did help that.  Additionally, Celexa takes a shorter time to kick in so in about a week, I felt like the fog was lifting.

Your shortness of attention can probably be related to pain killers if you are still on them.  I found while I was on pain meds, I had a short attention span and didn't even bother with books.  And I am an avid reader, sometimes reading three books at one time.  I had the same problem as you, the inability to focus so I found that reading magazines and watching TV was better for me than reading books.

As for your returning calls to clients, my suggestion would be to give yourself a goal of returning, say, three calls a day.  Hit that goal and then walk away for the day.  Your workday is done.  It's always hardest to start up again where you left off.

As far as you being young for the surgery, I just turned 50 as well on July 1.  It's not a fun age and I dreaded it.  In fact, on my 50th birthday I broke a tooth and will need to have bridge work done. That's not something I am looking forward to.

So, in a nutshell....

1. See a therapist
2 Get medication for a short term basis
3. Set a goal of working an hour or so a day, then walk away
4. Read magazines, not books

Get back into life slowly, and then wean off the anti-depressants.  I bet you will slowly lose the fog.

My best wishes to your continued recuperation.

Sharon