Depressed after surgery?

I had rectal prolapse surgery 4 days ago and I came back home 2 days ago. I wanted my surgery to go perfectly because I know that there's higher risk of rectal prolapse recurrence through my type of surgery(delorme). I wasn't advised to do the keyhole surgery which was supposed to prevent rectal prolapse recurrence slightly better because there is a risk of impotency for males.

On the second night of my hospitalisation. For some reason, one of the nurse told me that I really need to go to the toilet and defecate. For some reason, one of the nurse told me that I really need to go to the toilet and defecate. Because I was still feeling dizzy from anaesthesia, I stupidly listened to her and I went to the toilet and put a tiny bit of strain to my anus to see if any feces would come out. After I did that, a little bit of watery blood came out.

The next day, the surgeon came to see me and reminded me to not strain. But he also wanted to see if I can defecated before I was released from the hospital. Each hospital night costs over $1000 so I had pressure from Surgeon and nurse to defecate as soon as possible. So I put a little bit of force to my anus about 2 more times but only watery blood came out.

On the 3rd day, the surgeon released me even though I hadn't defecated yet. After I got back home, I managed to defecate naturally without having to put any force at all. I don't know why the nurse and the surgeon really wanted me to defecate on a second day.

Now that I'm back home, I've been feeling depressed and crying many times a day and I can't stop. I'm depressed mainly because:

- Although I shouldn't have done any damage to the anus after straining a very tiny amount, I'm feeling remorseful and anxious about it. I'm scared that the strings that's holding my anus together is stretched now or it's not going heal properly because I strained a tiny bit on the second day.
- Fear and anxiety of my rectum getting worse in the future or even getting another rectal prolapse. I had to deal with rectal prolapse for 1 year so I know how debilitating it is. I could barely hold down a job, had hard time going outside, completely stopped socialising, couldn't attend school and couldn't sit still for hours.
- Being only 22 y/o and not having the normal anus that I used to have. I find it harder to hold and push the feces now and I'm worried that it's going to affect my future job.

I wonder, If I had done the keyhole surgery that my fear of rectal prolapse recurrence would be less or not. But like mentioned earlier, it wasn't advisable for young males because there's risk of impotency.

I know I should be happy that I don't have rectal prolapse anymore but I'm depressed because things didn't turn out the way I expected. I thought I was going to get an anus that I had before the prolapse, but it feels a little different.

I don't know why I'm feeling this way but I've been crying so much for the past 3 days since I got back home from the hospital. I have anxiety about my future and I don't want to have to rely on my mother to look after me again if something happens. My brother is 4 years younger than me and he's in college and holding down a job which makes me even more depressed as well.

I don't know if psychiatrists can help me because I'm not good at explaining my thoughts well.

I heard that people tend to get depressed after surgery from general anaesthesia. But I don't think that's the case because for few minutes after I wake up in the morning, I usually feel happy. It's only when I come to realisation that I had surgery makes me depressed.

How can I stop feeling so depressed?

Post Edited (Heinstein) : 5/18/2013 7:39:17 PM (GMT-6)

Hi again. I didn't want to have to rely on your guys help but I've been feeling down again. I've been doing my best to let my rectum recover properly but unfortunately I had to go through trial and error and I made a couple of mistakes along the way. I wish the hospital helped me during the recovery process but unfortunately they don't provide that kind of service so I was left on my own to recover. At the very least, I wanted a written instruction/advice on what I need to do after the surgery but they said that they didn't have anything of that kind. I want to know what exactly I should avoid, for how long and when I can start doing them again. I could not find any information online either.

why doesn't the hospital provide rehabilitation program for rectal prolapse patients? I really wish there was a service that helped me during the recovery process. I would have paid thousands of dollars if someone could have helped me emotionally and assisted me with letting my rectum heal properly. But I guess in the real world no one really cares about me...I would have thought that the hospital wanted me to become a productive member of society again but I guess they don't really care.

Before the surgery, I did as much research as I could about my surgery options despite the debilitating condition I was under. My surgeon only focused on how my surgery was going to be performed. He never informed me about the importance of the recovery process. So after I knew what surgery I should do, I thought I was prepared for it but I didn't know how tough and important the recovery process was going to be. If I had known this, I probably had waited another 6 months or a year before going through a surgery. Because my home wasn't a good place for me to recover.

At home, I'm always lonely and I didn't have much emotional support from anyone not even from my father because he moved to another country right before my surgery. Although he never lived with me anyway and divorced my mother when I was 15, it still feels painful to not have any emotional support from him. Also, my younger brother is giving me a hard time at home and takes advantage of me which is not helping with my healing process either. He bullies and puts me down a lot saying that he has a job and already goes to college but I don't. I never thought I would feel this way but I've been wishing that my younger brother never existed so that I didn't have to have competition with him and my life would be easier. I went through so much more injuries and health problems than my younger brother and it's painful to watch him go through life easier than me.

During a month of recovery, I became increasingly more tired because I wasn't allowed to exercise. My depression was getting worse because I couldn't exercise or work. So I started relying on coffee to help mask my depression.

But for some reason, coffee was causing tentions in my rectum and causing sharp rectal pain occasionally so I knew it was probably better if I avoided it. But it was the only thing that was helping me deal with my depression. I probably could have avoided coffee if I could exercise but like I mentioned, I wasn't allowed to exercise. So I just convinced myself that it was okay to drink coffee because my surgeon said it was fine to drink coffee when I asked him after surgery.

I did my best to avoid heavy lifting, constipation and any other things that may affect my recovery. But I still ended up making few mistakes which made me remorseful. Here's the mistakes I made so far during the recovery process:

1. Lifted grocery over 10kg and walked home with it for 15 minutes (4th day after surgery, 16th May)
2. lifted table and chair at home (2 weeks after surgery)
3. Tried eating spaghetti and it gave me difficult to come out feces(2 weeks after surgery)
4. Felt rectal pain for 2 weeks after rectal exam from follow up appointment with the surgeon(11th of June)
5. Rode bicycle for an hour which caused slight soreness outside my rectum(I peddled standing up the whole time)(24th of June)
6. I had difficult to come out feces again. My rectum automatically tried to push it out quickly which gave me a slight rectal pain.(2nd of July)

I think I did a pretty good job of looking after my rectum for the first month. In the first month I was very cautious of everything from sneezing, coughing, jumping, walking too fast etc. And I think everything was going okay. But on 11th of June, I had a follow up appointment with my surgeon and he did a rectal exam on me. He told me that my rectum was still intact . But ironically straight after the rectal exam, I started getting sharp rectal pain whenever I was urinating, defecating or standing up for too long. So I think the surgeon must have pulled my rectum too hard during rectal examination. It has got better now but I still feel occasional rectal pain when I lift anything heavier than 15kg which did not happen to me before.

I'm going back to work in few days and I'm a little worried. My work requires me to lift piles of plates which can weigh 15 - 20kg. I felt like I was ready for work before I had rectal examination but now I'm not so sure anymore.

Also, whenever I drink coffee or tea it causes slight tention in my rectum as if my rectum is trying to strain/push itself out and it causes me to have spontaneous rectal pain after a while. Although this isn't nowhere near as uncomfortable or delibilating as before, it still bothers me and it forces me to sit a certain way on a chair. I get the same feeling i'm close to having a bowel movement.

My surgeon told me that the feeling should go away once my rectum's muscle strengthens. But it's been almost 8 weeks and while it has gotten slightly better, the feeling is still bothering me.

If these uncomfortable feelings doesn't go away 100%, I don't know what to do. It's nowhere near as debilitating as before but I was hoping to have a completely normal rectum again. Was my expectations too high?

Every time I make mistakes, I become really depressed and worry that i might have damaged my rectum and ruined my life again. I then lose my motivation to look after my rectum and I start thinking about how it's easier to just commit suicide. I did my best looking after my rectum for the first month but I just can't stop feeling remorseful about the fact that I made mistakes. I just hope that my mistakes weren't too much to damage my rectum. I wish I could go back in time so that I could have been better prepared for recovery.

I probably should have made an appointment with a psychologist long time ago but it's probably too late now. I made too many mistakes already and I didn't make one because english is my second language so I'm not very articulate.

Are there any service were someone will look after me until my rectum fully heals? I'm willing to pay over a thousand dollars for a service that will make sure I won't make any mistakes while recovering...I'm just really worried that I might do something wrong that will prevent my rectum from healing properly.

And what should I do about my coffee problem? I know that as soon as I stop drinking coffee, I'll instantly become really depressed and emotional. Should I just keep drinking it anyway since it's been 2 months already?

And how strong is the rectum after Delorme surgery? Is it strong as the average persons rectum or is it much weaker than usual? I know that there's 20% of rectal prolapse recurrence through Delorme operation but it doesn't state why.

If after another 2 months of recovery and I'm still feeling slight discomfort, do you think it's related to the mistakes I made or it's just the result of the surgery? And is it possible to redo the surgery to somehow get rid of the discomfort? Or am I going to have to live with slight uncomfortable feeling for the rest of my life?

Thank you for your help.

I can relate to feeling depressed after surgery... I didn't have the same operation, though. I had a colectomy with end ileostomy and that has been more difficult in some ways than I thought it would. For example, the disappointment in not being 100% better - holy cowbell, can I relate to that. It's just something you have to try to accept. One place you can start with is by stopping torturing yourself with the minor mistakes you made. None of them sound like they would have made any difference anyway.

Surgeons only do surgery, really: I don't think they are very informed about the recovery process. And hospitals in general are just not good at providing emotional or practical support. In fact, they are dreadful: the caring, hand-holding nurses and surgeons you see on a show like Holby City (probably won't know it if you're not English, but it's a medical soap opera set in a fictional NHS hospital) are a complete myth. Most consultants, in my experience, have zero people skills. On top of inadequate hospital communication (I've been there), you have also had to deal with a rather - hope you don't mind me saying this - undignified condition. In hospital you lose your dignity anyway; with anything involving faeces or the rectum, you lose your dignity with a cherry on top. It's difficult for anyone to deal with, tbh, but even more so for somebody who has no inner feeings of self-worth to carry them through.

I feel like I'm just waffling a bit now, because I don't really know what to say to make you feel better. But one thing I can say is: it's never too late to make an appointment with a psychologist, so do that ASAP if you can. As for coffee, how much do you drink a day? I think there's something of the placebo effect going on there with regard to the antidepressant effect, to be honest, but if you think it's giving you rectal spasms it's worth trying to stop or at least reduce your caffeine intake. Perhaps try a weaker brand or decaffeinated coffee.

I dunno about the Delorme surgery. That's a fairly technical question. If you're not happy with the answers your current surgeon gives you, by all means seek a second opinion. Ditto if you're not feeling better in a couple of months' time.

Families are another story. What your mum, does she support and care about you?

Best of luck...

It is good to hear that the exercise is helping your depression. Healing should coming faster, with a positive attitude! Keep up the good work!

Peace
Trina

Hi again.

It's been almost 8 months since the surgery and here are the good and not so good things that I've noticed:

The Good:

• I no longer get severe tenesmus or mucous discharge. I can finally go outside again without worrying about having toilets near-by and I can work irregular hours as a waiter again.
  
• I don’t get as much bloated stomach after eating.
  
• I also no longer get chronic constipation or impacted stools and my stools are mostly back to normal. I can finally drink tea and coffee and eat any kind of food without getting severe tenesmus.
  
• I also put back on healthy amount of weight.

The Not so good:

• Several weeks after the surgery, I started feeling slight tension in my rectum which was slightly uncomfortable and annoying. While it's nothing compared to the extremely uncomfortable and debilitating rectal prolapse I had, the slight tensions are noticeable and I wish it wasn't there. I was hoping that my rectum would feel normal again like the way it used to before I developed rectal prolapse. But that doesn’t seem to be the case.
  
• It’s now much harder to hold in bowel movements. When I feel like passing stool, I can only hold it in for short period of time otherwise it becomes too uncomfortable to hold it in. This is possibly due to the end of my rectum been surgically removed.
  
• I sometimes pass gas unintentionally when I crouch down which is very embarrassing especially at work. I also think this is due to the end of my rectum been surgically removed and not having the normal rectal muscle anymore.
  
• I still get impacted/pellet like stools when I don't eat enough high fibre meals which wouldn't happen to normal healthy people. When I had a colonoscopy, the gastroenterologist told me that I had a elongated, floppy, slow transit colon. He claims that this is inherited but I don't believe him because I never had constipation or small round stools growing up. My bowels have never been the same after I developed IBS from food poisoning and anxiety.

When I spoke to my surgeon about my concern with slight rectal tension in a follow up appointment(28 days after the surgery), he told me that the feeling should go away once my rectal muscle strengthens. But it's been almost 8 months since the surgery and I continue to get slight rectal tensions. So I have a feeling that it's not going away.

I tend to notice the most tension in my rectum when I'm stressed out/anxious, lift heavy objects, drink several cups of coffee/tea and when I’m few days/hours close to having a bowel movement. I try not to think about the slight rectal tensions but I can definitely notice it and it annoys me even when I try to not think about it. The slight rectal tensions seems to lessen a bit after the bowel movement.

I might be able to use Cognitive behavioural Therapy or Meditation to help me get less annoyed by the slight tension in my rectum. But I'm not sure if that's the right way to approach the problem.

I’m hoping that this slight rectal tension isn't caused by my rectum not healing properly. Because during the first 6 weeks of recovery, I was supposed to avoid lifting anything heavier than 10 - 15 kg. But I had to walk home for 15 minutes with more than 20 kg of grocery foods every week because my mother hardly helped me with anything whilst I was on my recovery. I also couldn't drive to the supermarket because she was using our only car all the time.

Also, when I went back to work after the recovery period(6th week), I still didn't feel like my rectum had fully healed yet. But I still went back to work because my recovery time was over and I was required to go back to work by the government because I'm getting Centerlink payments. I thought about cutting ties with Centerlink so that I wouldn't be forced to go back to work. But my mother wouldn't let me do that because she said she needed the money to support me and my younger brother at home. So I had no choice but to go back to work even though I didn't feel ready yet.

And while I was working and lifting heavy objects at work, I could feel my rectum stretching and it kind of felt like my rectum was almost about to pop out from my anus from too much stretching. But I didn't feel any pain so I tried to not think about the stretching feeling of my rectum and I continued to work. The stretching feeling of my rectum eventually went away after another 3 weeks.

Overall, my quality of life has improved dramatically and I’m glad that I can do more things like a normal person but I would feel a lot more happier if I didn't continue to get the slightly uncomfortable rectal tension. It’s depressing to not have my normal rectum back and have to continually feel slightly uncomfortable tension in my rectum almost daily. I sometimes wish that I had the non-recommended surgery(keyhole surgery) because I heard that it has a higher success rate. But the only issue with it was that it has a 1% chance of causing impotence in males which is why the surgeon wouldn't do it on me. It really sucks that I’m a male and happen to get rectal prolapse.

Do you think it's possible to do something about my slightly uncomfortable and annoying rectal tensions or am I going to have to just deal with this for the rest of my life?

I'm planning on discussing about this with my surgeon in January next year. Do you think it’s too early?

Lastly, thanks a lot guys for the help so far. Words cannot describe how much I appreciate you guys help.

Are there any exercises that you could do to make the muscle area stronger faster? I agree with AV, it takes a long time for our bodies to heal. Plus the surgery is a shock to the system. So give it some time and try to be patient. I hope that you feel better soon.

Meditation makes muscles relax. But you may be able to do that to strengthen too. I am not sure.

CBT is always good for us...

Hugs, Karen...

I removed your email address from your post because you could so easily get a lot of spam, anybody can see it here. I recommend putting it in your profile so only members can see it.

I hope that you feel better soon.