Disabling symptoms after surgery

[CoachTbone]

ago
Hello everyone, I have had some very debilitating symptoms for the past 6 weeks since undergoing a distal bicep repair surgery and desperately need your help. Prior to the surgery I was an active, pretty healthy 48 year old. The surgery was conducted under general anesthesia in which I was put on a ventilator. All indications are the surgery went well. I wasn’t worried about the surgery in the least, and had debated even getting it repaired as it didn’t hurt and wasn’t impacting my golf game. However, a day and a half after the surgery I got a very strange feeling that led to what I believed was a panic attack (I have no history of anxiety/panic so I wasn’t sure). Long story short after 5 hours of debilitating symptoms my wife drug me to the ER. Over the next week the symptoms never left and I had two more ER visits. For the first week and a half I never managed more than 2 hours of sleep a night due to the symptoms. For the past 6 weeks it has been a daily occurrence with only a short break in symptoms here and there. The best way to describe the symptoms is a rush of something akin to intense anxiety/panic that makes me feel sick and often leads to vomiting (especially early morning). However, my heart rate actually has plummeted into the low 50s over the past 6 weeks and never gets over about 62 even during the worst of the attacks. I bought an iWatch to monitor my heart rate and it is always low. I have lost 35 pounds in 6 weeks despite eating, and eating pretty normally the past week. I also get why I can beat describe as an altered state of consciousness, disorientation that comes and goes. I’ve tested negative for pheochromocytoma and even underwent a psychiatric evaluation which was completely normal. The psychiatrist even asked why someone would send me there as this was clearly a medical issue. Simply put, none of this is thought driven and I do not feel anxiety has anything to do with it. I’ve undergone extensive blood work which hasn’t shown cause, and the doctors are baffled. The endocrinologist I saw was sufficiently alarmed to refer me to Mayo, but my referral was rejected. At this point I can’t work, can barely function and am in a constant state of misery. Trazodone helps me get about 5 hours of sleep but I wake up at 4am and the symptoms start immediately. Any suggestions that I can take to my doctor would be so much appreciated!

[MBear01]

Hi, Coach.  Your post struck me because I went through something very similar after having a surgery.  It was debilitating and extremely frightening as I had never had any anxiety issues before (I'm 59 years old).  I, too, was convinced that it was a medical issue rather than a psychological one.  It lasted a full 7 weeks for me and I absolutely battled through every day.  How are you doing now?

[Paxiled]

Did the endo refer you to Mayo because he saw something with your hormones, or just because you're having these symptoms and nobody has been able to help you and he wants you to see better docs?  My take is, trust your instincts.  You know yourself.  Those of us with anxiety problems suffer from anxious thinking.  It seems to come suddenly and then if it becomes chronic it becomes a big problem, but actually, when we look back, we usually can see it was coming.  In your case, the most recent thing that happened was a surgery, and at least to me that makes it the most likely source of your problems.  When we have surgery, we are given a lot of drugs, and some of those drugs can have some pretty devastating side effects.  Doesn't usually happen, but if you look at the fine print in just the agreement with your anesthesiologist, you will see you are basically signing away your well-being, your teeth, all sorts of things because things do go wrong.  That's why most surgeons aren't eager to do surgery, although some are because it pays really well.  Some questions therefore you might want to find answers to are, what was used to put you to sleep?  Why were you put on a ventilator -- I've had surgery twice and was never put on one, so why were you?  Are there side effects of those drugs or the ventilator that don't usually happen but might happen.  Also, were you put on anti-inflammatory medication, especially steroids?  These can cause severe anxiety is some people.  Basically, if it were me, I'd want to exhaust this avenue of search because it's the big thing that happened before the symptoms arose.  Another odd angle is, a lot of what you're describing sounds like a thyroid problem.  I don't know why that would suddenly go wrong, but did your endo run a thorough thyroid screen, including looking at your T3 and T4 and not just Tsh?    

[CoachTbone]

Thank you for your reply!  They did not look at T3 or T4, just TSH.  I do agree about the surgery, and I was given almost a dozen different drugs during the surgery (I obtained my surgical records).  I was given a high dose steroid as well.  I am almost 7 weeks post surgery and unfortunately the symptoms are still very disabling.  I truly appreciate your feedback and will ask my primary about these things.  I was told that the ventilator is required with general anesthesia, which is why it was used, but I have also heard that most surgeons do a nerve block and don’t use general anesthesia for this particular surgery.  It is all a bit confusing but I definitely am not the person I was prior to the surgery.

[SassyLassie]

Hello~I am so sorry that you are going through this anxiety. Anxiety can take so many forms, and it could be due to the surgery, sometimes our bodies react in ways we were not expecting them to, and any type of invasive treatment is a shock to the body, even if the patient isn't aware of any symptoms.

It seems all your tests were good, but you said the endocrinologist was alarmed, so, that could possibly mean something due to hormones causing the issues. I really don't have any firm answers, but, I would contact the endo again and really try to push for a visit to the Mayo clinic.

I hope you get better soon, anxiety attacks and panic are no fun.

[CoachTbone]

Thank you for your reply!  I think the biggest alarm is that I continue to lose weight, even though I am now eating enough calories that I should be putting weight back on.  It’s been a drastic level of weight loss over less than 7 weeks.  My physical therapist seems to think my symptoms have something to do with cranial nerves and vagus nerve, and I’d have to agree that makes sense.  He’s dealt with a lot of strange issues and told me this morning that based on the severity of my symptoms, I really need to be at Mayo.  Sigh.  I truly appreciate your input and good thought!