The Pressure for Normal

Not only am I a counselor. I am also a minister, and part of your job title is doing weddings. Several months before my bypass I had agreed to perform the wedding ceremony for two wonderful couples.  One of the young women had been a student of mine when I taught in a private high school. The other had been the maid of honor at my daughter's wedding. The only catch was that I was living in Knoxville and both weddings were to be in Memphis, and they were both on the same day. I got together with both couples and everything looked like it was going to work out when I found out that one wedding would be an afternoon affair and the other would be in the evening.  Then my near heart attack happened followed by the surgery all exactly one four weeks before the weddings.  My wife told me that she would call the two couples assuring me they would understand, which of course they would. I asked her not to call because I thought I could still do the weddings. She said I was crazy. I told her that I wanted to get back to normal as soon as possible. I still don't know why I put so much pressure on myself to "get back to normal." What happened in four weeks?  I went to Memphis and performed tow wedding ceremonies. I still remember how it felt to push yourself too far. I was so exhausted, but I did it, but instead of making me feel better it actually had the opposite effect. I became consumed with getting back to normal not knowing that there was a new normal out there that I couldn't find for looking for the old normal. I hope I haven't been too confusing, but I know now that deep down I was scared that I would be viewed as some kind of cripple if I didn't do all the things I did before.  There is the healing of the body, and there is a timetable for that. There is also a healing of the mind, and the timetable for that is often very different.

Depression and Heart Disease

I found the following statement and recommendations only reconfirm what I have seen in my own life and the lives of many others.

Heart patients should be screened, treated for depression
Heart patients should be screened for depression — a common condition that can profoundly affect both prognosis and quality of life — according to the American Heart Association’s first scientific statement on depression and coronary heart disease.The recommendations, which are endorsed by the American Psychiatric Association, include:early and repeated screening for depression in heart patients; the use of two questions to screen patients – if depression is suspected the remaining questions are asked (9 questions total);
coordinated follow-up for both heart disease and depressive symptoms in patients who have both. “The statement was prompted by the growing body of evidence that shows a link between depression in cardiac patients and a poorer long-term outlook,” said Erika Froelicher, R.N., M.A., M.P.H., Ph.D., a professor at the University of California San Francisco, School of Nursing and Medicine and co-chair of the writing group.Dale Briggs, who experienced depression after his heart valve surgery, said the statement is welcome news. “I think it’s long overdue. It is unfortunate that some patients aren’t warned of the possibility of some depression after surgery,” he said. Experts say depressed cardiac patients have at least twice the risk of second events in the one to two years after a heart attack. Furthermore, studies have shown that more severe depression is associated with earlier and more severe second cardiac events, Froelicher said.Co-authors include J. Thomas Bigger, Jr., M.D.; James A. Blumenthal, Ph.D., ABPP.; Nancy Frasure-Smith, Ph.D.; Peter G. Kaufmann, Ph.D.; Francois Lesperance, M.D.; Daniel B. Mark, M.D., M.P.H.; David S. Sheps, M.D., M.P.H.; and C. Barr Taylor, M.D. Individual author disclosures are included on the manuscript.

Am I Depressed?

I want to say up front that I am not a doctor, but I still want to share my thoughts about depression.  Even though I have a master's degree in counseling I had some trouble seeing depression in myself.  I knew that I did not feel emotionally well after my bypass surgery, but it was easy to label that feeling as anything but clinical depression.  I never wanted to admit that I was depressed. It was OK to feel down in the dumps, but depression was for other people. I finally started to come to grips with my own depression when my wife started to make it clear to me that I just wasn't anything like my old self. My first thought was, "I guess you wouldn't feel like your old self if you had just had your chest cracked open." But she persisted, and I started to listen and then I started pulling out some of my books from graduate school. I also went on line and took a simple online screening test for depression. You can find a good one right here.  I filled one out and it was off the charts. I think that, as much as anything, made me go to the doctor.  Finally admitting that I was really depressed also got me talking and helped me take the first step down the road to recovery.

Happy 50th Birthday to Me!

I guess I shouldn't wish myself a happy birthday, but after all that I have been through I am going to do it anyway. You see, I wasn't satisfied with quadruple bypass surgery. I have also had major neck surgery, shoulder surgery, and a right total knee replacement. My goal for my 50th year is a year without a surgery. I think that is a pretty modest goal. I will keep you posted. In all seriousness, I am so glad that I can look back on my many travails and laugh. Not because surgery is funny, but because laughing just feels good and I think it is really good for you too. I have a good friend who has fought breast cancer twice and she credits the ability to laugh in the face of the disease with her ability to beat it. I think she might have something.  Wow, I actually made it through my forties.

Dealing With Your Own Mortality

On Saturday I turn 50. I think that is pretty cool considering what I have been though during the last few years. I have told you about my bypass surgery, but that was only one of several surgeries that I have faced since then. I now know I am going to die. Doesn't everyone. Not really. When I was a teenager I don't think I even had a concept of dying. I don't especially like the fact of someday dying, but there is not much that I can do about it. For me that was one of the toughest parts of going through my bypass surgery. For the first time in my life a doctor, in fact two,  told me that I almost died, and would have without the surgery. That kind of information kind of gets to you, at least it did me. I think part of my emotional recovery has been to learn to be at peace with the reality that I am getting older and my past is longer than my future. I think I have finally gotten to the point where I am much better at living in the present and finding the joy of a single day. In fact, today was an especially good day. I even took the time to take some pictures in my neighborhood of the beautiful fall foliage. Life is good.

Passion

I have always been interested in politics, and have kept up with every presidential election since I was a kid, which means Johnson and Goldwater. This election seems different to me, and I am not talking about the potential firsts like first African-American, or first female Vice-President. I am talking about level of passion. People are voting in record numbers. People are voicing their opinions. I just hope people will behave after it's over. Passion is a funny thing though. It is pretty easy to get, but is also equally easy to loose. It really doesn't matter what the passion is. Most people loose it. Now what in the would does this have to do with bypass surgery and heart disease? More than you think. When I was cracked open over three years ago I was told all the changes I would have to make to my lifestyle, like diet and exercise. In the beginning it was easy to make those changes. The passion was there, but eventually things settle down, and the pain and fear go away, and a feeling of normalcy returns. That is when passion is hard to maintain. The sad fact is that most people that I know who have had bypass surgery have long since abandoned their special diet and the exercise bike makes a great place to hang clothes. But I do know a few, just a few, who have held on to there passion to live different lives, and their passion has paid off.