Nursing & Depression - page 26

While visiting in the lounge one day, we discovered that every nurse there was on an anti-depressant. I have had 'Treatment Resistant Depression' for about 20 years--as long as I've been a nurse. ... Read More

  1. by   sphinx kitty Pebbles had her surgery on Wednesday. She had a radical mastectomy, removed her entire mammary chain on the R side as week as lymph nodes. Vet says everything looks fine, and they sent off tissue for pathology. She has a HUGE incision, and had a drain, which they just removed today. They had a Duragesic patch too, which they also removed today, if she needs a new one, I can take her in for that. She seems to be doing good......eaing and drinking, and fiesty as ever. We have to give chase every day when it time to give her her antibiotics!. She goes for a follow up next week.

    Wish I was doing as well.have been more tired than even usual, and I am usually very tired! It's been bad to where I feel like I am gonna fall asleep driving, at work, occasionally find my car going towards the side of the road. I've been blowing stuff off whenever possible, but since my case load was getting low, my boss transferred a bunch of patients to me, and I am so confused and disorganized, I couldn't tell you thing one about them, let alone manage their care! I told her I was really disorganized, and she's like "aren't we all", or some such nonsense.

    Meanwhile, my dysfunctional gallbladder hurts more and more.......pretty much all the time. It's never felt like classic gallbladder symptoms, now the pain has actually moved to the right side, but in many ways is still not typical. I left a message with the PA at my GI doc's office to ask her some questions, but she didn't call back yet. Even though the HIDA scan showed problems, I can't help thinking the pain's all in my head. I imagine I'll want surgery, but getting off work.....I have no sick time, and I doubt I'd be off long enougvh for disab lility to help much, like it helps much anyway, after I had my TAH I got like 115$ a week disability pay.

    Then, I'm having a hard time adapting to the whole step son thing. My husband and I and my kids have been a family for 4 years, and it's really hard having a new kid around, in our lives. Esp since him and my youngest fight like Rabid Dogs. We were talking about Christmas today, and that is my most special favorite holiday, with special traditions, and I get very upset when things are changed. So were talking about this today when we out at breakfast, and I was feeling quite depressed and down, cuz what can ya say? He is my husbands son, ya know?!

    THEN, on the way home, some a**hole rearends us. My special car, the nicest car I ever had that was just mine. The car I got for work. MY car. The back panel is cracked and will need to be replaced. And I'm confused. My husband and the guy just exchanged insurance info....I thought you always needed a police report? Also, I thought you were supposed to call your insurance right away....he says he can't call till Monday. This is gonna be another big expense, if insurance doesn't cover it, and if it's screwed up because he is doing it wrong I am going to be so pissed! We just forked out 1300$$ for my kitty's surgery, if insurance doesn't cover this, it'll run at least 500-1200$$, and my husband can't even remember our deductible, so it might be 500 anyway, and here I am looking at having surgery and spending time off work, WAS thinking of quitting to relieve stress, well forget that now! Our savings will be gone, no cushion to fall back on, not to mention we've been planning a vacation to Vancouver next fall, our first vacation together, and my first vacation in, oh.......15 years or so. Plus I really felt the impact, my knees hit the dashboard, the seatbelt across my abdomen, and my head snapping forward (and now I have a killer headache). My husband's out talking with the guy, buying his lame story, when fact is, he wasn't even looking! His brakes didn't even make a screech sound, he just slammed into us straight away! So when the guy and my husband were out there laughing at something, it reminded me of my divorce, when the opposing attorneys would get together and shoot the ****, talking and laughing like best buds.

    I said to my husband, I hope the next person who hits us would just kill me and get it over with. He said "it's just a car, it can be fixed". He doesn't get it, he just deoesn't get it. He usually understands, but I think he's got his head in the sand mode. I don't think he'll ever clean out the garage, so much for our nice new house, with our nice garage to keep the snow and ice off the car.

    I'm in a mood. Sorry. Bad day. Bad week. Bad month. Bad year. Bad life.
  2. by   micro
    Hey, all..........

    Two days off and taking time to self, my own self. Doing what I want to do. Well, almost. But Sean Connery was otherwise engaged.....hehehehe

    poor attempt at humour.....

    Actually just checking in. Hey all. It is good to see all hanging in in this thing called life. Life can just be a kicker sometimes.....and then it kicks again.......
    But I guess.....all I can do is what I can that I will.........
    hey, the smiles are real when they come......... :-)

    no wisdom here, just 'LUV' to all,

    "story of my day, week, month, lifetime"
    News at 10.................not!!!
  3. by   abrenrn
    Sphinx -

    You are depressed because you are overwhelmed as anyone would be. But, you do what I do. I nurse everyone but myself. It is time for you to nurse yourself - or you won't be able to nurse anyone else.

    Set priorities.

    First - physical.
    Abdominal pain - sounds a bit funny, could it be pancreatitis? Please note all - I am not diagnosing, just suggesting a dx Sphix may want to bring up with MD. I just read a little about it - radiation to back, etc. often seen. Try to avoid fats as much as you can until you see the MD or PA - works for either gall baldder or pancreatitis. If severe, go to ER, make sure they hear every symptom you have - and, if you have to, the liability attached to not taking these symptoms seriously if, indeed, there is a problem.

    Fatigue: Can be due to many sources - anemia, illness, stress, and depression. If other sources have been ruled out I would ask your psychiatirst why he is choosing to be so conservative when you are the one suffering. Offer to write a letter taking full responsibility for any adverse outcomes resuling from taking Provigil, say. Again, something to discuss with MD - I AM NOT PRESCRIBING OR RECOMMENDING ANY SPECIFIC MED - just topics of conversation. And, of course, I expect your psychiatrist has ruled out other sources.

    (Sorry for shouting folks. Just trying to prevent an expected fall out that came on another thread.)

    2 - Work stress

    Um, you might want to offer to take a few patients, that's all. Your manager's stress is NOT your stress, it is not your responsibility to relieve it. You can help her by doing a fair part of the job, not all. I know you need money but if you are fired for this, you will be entitled to unemployment. Check with others. They cannot ask you to do 16 hours of work in an 8 hour day, so "firing with cause" is crap. I know there is paper work, fighting involved - it's less than what you are doing now.

    If the place you work has half a brain, all you have to say is something like, "well, this is impossible, I will have to leave and apply for unemployment", will give you want you want. Better to go to Human Resources, if possible, say you don't know what to do, you've asked for a reduction in work load, the manager refuses, you know it's impossible. Wait for their response. If they do not offer to correct, say you will have to leave, go for unemployment.

    If they do reduce your workload, go back to your manager and say, "Thank you. I just couldn't handle that workload, I'm so glad you can see that."

    It is ridicuolous to have to go through this but it works. Start manager, if nothing human resources, if nothing unemployment, fight if necessary.

    But, you do need to follow these steps to document to those above that you have followed them. Unemployment will require this type of thing.

    HOME Stress:

    Car breaks gets hit, husband says, "Just a car" say "Thank you, for offering to take care of it for me. You're right, it's just a car. I just don't have time."

    In other words, spread the nursing around. Allow others to nurse you at home. You can't nurse everyone without a little nursing in return.

    These are things I have leared very slowly. But, you do need help. Do what you must to get it.

    Would you do any less for a patient?
    Last edit by abrenrn on Nov 2, '02
  4. by   sphinx
    Originally posted by abrenrn
    It is time for you to nurse yourself - or you won't be able to nurse anyone else

    <<<well, I've heard that...I guess my answer is, that's what I do, I lay around on the couch all the time, I do nothing around the house...don't cook, don't clean, I mean nothing>>>>

    First - physical.
    Abdominal pain - sounds a bit funny, could it be pancreatitis?

    <<<<<That's was my original thought when it all started almost 2 years ago. I'd have pain in the epigastric area when I had a BM....felt like a butcher knife being stabbed and twisted. Had tests up the wazoo, all negative except for a slightly raised lipase level, which went up a little more, then dropped to normal when that pain stopped. Then I started getting chest pressure on my sternum. My internist sent me to GI guy, who did endoscopy, found gastritis. Also had HIDA scan to "rule out" any probs with gallbladder. A week before that test, I'd started getting some pain on the right side, not bad then, under my rib cage, going right around to my back. I actually thought it was a pulled back muscle. I never believed I had gallbladder problem....HIDA scan says I do have a problem. Meanwhile, past 2 weeks, that pain has gotten progressively worse. I generally do eat low fat, doesn't help much. Just pain all the time. Nothing makes it better. Had muscle relaxant left over from a shoulder injury, tried that, and it did nothing. Gotta admit, it does hurt worse about 2hours after eating. When would it be bad enough to go to the ED? I'd feel like an idiot going in for a problem that has supposedly already been diagnosed. >>>>>

    Fatigue: Can be due to many sources - anemia, illness, stress, and depression.

    <<<<<Recently had blood work.......not anemic (checked hct, Fe, folic acid, also checked B12, and TSH for good ,measure)>>>>>>

    If other sources have been ruled out I would ask your psychiatirst why he is choosing to be so conservative when you are the one suffering.

    <<<<<<he just says "therapy". Esp if he knows I am going through any stress, he doesn't seem to think meds would help much>>>>>>.

    Offer to write a letter taking full responsibility for any adverse outcomes resuling from taking Provigil, say.

    <<<I always feel funny asking for a specific medication. I don't know why, I just do. Like, that's what I pay this guy for.>>>>>

    2 - Work stress

    Um, you might want to offer to take a few patients, that's all. Your manager's stress is NOT your stress, it is not your responsibility to relieve it. You can help her by doing a fair part of the job, not all.

    <<<<I guess part of the problem is, even with the increased case load, it is still not in the "unreasonable" area. I am lower than some others on my team. It's *me*, I just can't take it, esp when they are piled on so fast. I did refuse one patient though, proud to background is OB, with some post-op stuff from several years back, and this was a patient with a fresh trach, fresh g-tube, spouse needed extensive teaching .....and I can hardly remember how to do that stuff myself! Anyway, it is me that can't handle the load, and without revealing my history of serious depression (which I don't want to do), I can't see how I can ask to be treated differently than others on the team.>>>>>>

    HOME Stress:

    Car breaks gets hit, husband says, "Just a car" say "Thank you, for offering to take care of it for me. You're right, it's just a car. I just don't have time."

    <<<<<I'm just upset cuz it seems like he doesn't even care, like "oh well". He came home and took a freaking 3 hour nap! I've just been freaking! >>>>>>

    <<<<I feel like I am arguing with you...I don't mean to be. I'm just getting to the end of my rope. >>>>

    . But, you do need help. Do what you must to get it.

    <<<<right now, I just want to give up. I wish I could. But all I can think is "how would everyone manage without me" how pathetic. Who needs a crappy mother/wife/whatever like me. I suck.>>>>

    <<<<<<<well, thanks though, I guess being depressed and in physical pain make for one crabby person. I appreciate your words though. It helps, even if it doesn't show.>>>>>[/B]
  5. by   abrenrn
    Sphinx -

    I don't have any problem with your responses, they are your explanations - and they help me understand better.

    But also note, I have the same problem - not in the same place, certainly do not have anywhere near the stressors you have, which is why I can sound so wise now.

    I think if your pain is that bad, you're not getting results, it's interfereing with your life, go to ER. Don't tell them how long you had it. They will treat as a "hot abdomen" and do full work up. Since there has been minimal response from your primary care provider over this, you have no choice. You are in pretty significant pain, I think. In the abdomen can always be something serious (note - can be, may not be, but a decent ER must act as if it is serious until they are sure it is not).

    As to leaving the house for a while to go, wake your husband up.

    Don't mean to sound flip. I know a lot of the feelings, pain behind this. Sometimes you just have to do what needs to be done regardless of the feelings and pain. That's what I have to do. That's what you do for your patients.

    We'll get to your "lack of organizational skills" later. There is often more to this than meets the eye. I have found after believing that it was always my poor organizational skills that made me seem slower.

    Hang in.
  6. by   abrenrn
    Also - another reason for ER - this could be a very acute gall bladder attack. Nothing to ignore. My brother tried to ignore his until he couldn't take it anymore - ended up with gangrene, bad infections. Got lucky, after antibiotics they were able to do minimally invasive procedure instead of opening him up.
  7. by   cargal
    I don't remember if we have asked about this before, but have you been r/o fibromyalgia? The tiredness, the brain fog.....
    When I started taking elavil I improved immensely.

    Just a thought......
    And glad to hear your kitty is doing well...
  8. by   sphinx
    when they check you for fibro, that's when they check the trigger points right? If so, then yes, I was tested......For years I had severe pelvic pain and after treating it medically, went to a pelvic pain doc, who believed in ruing out ALL possible causes, fibro being one of them.
    I would think elevil would make you more tired and foggy? how different is it from it's "cousin" pamelor? I've been on that-twice-and it made me a major zombie.
    Now I'm going to retire to my heating pad before deciding if I want to go out in the cold and then sit for hours in this city's overcrowded ED's (yes, closing that hospital was a grand idea, idiots).....grrrrr........
  9. by   sphinx
    oh, I don't have a fever....I checked, so it seems unlikley I have an infection.
  10. by   almostanurse
    Originally posted by NancyRN
    Adrienurse I'm so sorry this has happened to you! I am going through a meltdown myself these past weeks. Personal problems at home combined with a stressful work environment caused me to just crawl into a shell when I lost a patient. I've asked to be taken off the schedule for the next 6 weeks so I could heal. I keep in touch and have filled in a few 4 hour shifts. No one asks how I'm doing. It's like they can't take on ONE MORE THING! I can't blame them.

    Mario, it was like a lighting bolt to read your post. Of COURSE it's horrible to be around someone who's depressed! I don't know why it never occurred to me that my family also suffers when I get this way. I suppose I just don't have anything left to give, so they are the ones who get the brunt of it.

    My Grandma used to say, "If you don't have any apples in your basket, you can't give any away!" When someone was in a bad mood we'd say, "She hasn't got any apples today!" Simplistic, but it makes sense!
    Im so sorry your going through this. please dont make it harder on yourself by thinking that you are making your family suffer. Im sure they love you very much and would do anything for you. I can tell just by the way you said all of this that you feel you dont deserve the concern or sympathy, but you do. you are a good person. you have much to give. are you taking anything? do you feel responsible for this death at work. I feel bad, because I can hear your pain from here, i really can. I hope things get better. I will pray for you.
  11. by   cargal
    Elavil works by helping you complete your sleep cycle correctly. Without it, I could sleep 8-10 hours/night and a nap and still wake up in the am like a truck hit me kind of tired, and go through the day like I was walking or swimming through mud-every second was such an effort. I also had Left shoulder muscular pain, sharp and stabbing, hurt all over skin pain , deep bone pain, and with elavil they have all gone and I wake up refreshed. I still tire easily and have to pace myself and eegads, nap, but I feel so much better, so much more clarity of thought, brain fog gone. I too was negative for the trigger points, but I have the elavil and feel better, so...... who cares what you call it. I don't believe they really know how to diagnose this condition and in the future it will change. I read recently somewhere that 'growing pains" in kids may be a precursor to fibromyalgia. As far as pamelor and elavil, I really don't know if they are closely related. I will look into it and get back to ya....also about the sleep cycle explanation.

    I do agree with the postor who said get thyself to the ER. The pain you are experiencing now may be independent of what you had previously been diagnosed, at the very least!
    BTW, we bought a car for my 17 yo daughter. She drives too fast sometimes, doesn't quite "get it", and hydroplaned recently with $1400 damage, and I am alot like you, but this time I did say that both she and my other daughter in the car are safe, and this may have a positive outcome that we may never know- as she has slowed down. Messed up her special car! I figured that was worth $1400. I realize there may not be a lesson with your car, but you weren't injured, and your children are safe.
    My grandmother committed suicide when I was in first grade, and I was very angry that she robbed me of someone I needed. I did forgive her as I grew older and I realized how deep one's pain could be. But when you talk about being a sucky mother, we all are sometimes and they love you and need you. You will get better; don't even think about robbing them pleez.

  12. by   Youda
    Sphinx, could you describe the pelvic pain in a little more detail? I have an idea. But, I don't want to suggest it until I know a little more. Also, do you have headaches, mostly in the temple? Or any tempo-mandibular pain? Pain, aching, anywhere else? When is it worse? When is it better? And, finally, how old are you? I don't need exact, just give me the decade. Also, any visual disturbances, even minor? Any rash or skin involvement, especiially lower extremities? Was the onset of the pelvic pain gradual or sudden? As I said, I have an idea, so indulge me, OK?
    Last edit by Youda on Nov 2, '02
  13. by   sphinx
    Well I don't have the pelvic pain anymore. It did come on suddenly, I guess, I never had it till after my tubes were tied, about 2 years after.It was a sharp pain on my lower left side, accompanied by cramps that were so severe I'd be sick to my stomach. I would also have low back pain, like what you get with cramps, but way worse, like a burning, boring pain. I also bled a LOT with my periodsI had a laproscpy to check for endometriosis, but none was found. Yet my Dr did not then decide I was a nut case, and decided to treat me medically. I did a 6 month coourse of Lupron, which pain at all. But that put my into a deep depression which led to another hospitalization. After the 6 month course was over, I had a few months with no pain. With my first period, I was in agony, in tears. My GYN put me on continuous birth control pills (no placebo). I continued to bleed every day, even with taking a break every few months. I eventually went through 5 types of pill, all with higher and higher dose, basically bleeding every day for at least a year. The last pill worked.....for 2 months, then the bleeding started, and I was so upset, I went off it. By that time, I'd been getting side effects from the higher doses, and didn't want to increase to a higher dose. My GYN sent me to the specialist, who did a very thorough exam, and his suggestions were about the same as what we'd already tried, or a TAH and LSO, which he thought had a good chance of helping the pain (and of course 100% chance of stopping the bleeding). They knew it wasn't endo, thought "maybe" it could be adenomyosis, but they did the hyst, and the path showed nothing significant...just some minor cysts, but nothing that would have caused the pain. BUT I have had NO recurrance of the pelvic pain, OR the back pain since then, not even a hint. Now this other pain, which at the time was mostly epigastric, was happening at the same time, so I was a miserable camper. I felt like all I did was so to one doctor or another, and all the tests were negative. I felt like a head case, totally.
    OK, anyway...yes, I get headaches...often. Usually daily, usually a general all over type. Other pain......I tedn to get jaw pain, certain antidepressants bring on bruxism, and beyond that I'm a big time clencher anyway. I use a neat gadget called an NTI splint, which is great, helps with jaw pain and some headaches too. Other pain? I have had R shoulder pain, for a while, PT dude feels it,s related my tendon as well as muscle. It's gotten a lot better, it helps now that I don't lug so much stuff on my shoulder; use a wheeled backback to haul all my crap around in. I have some visual thingies....when I first wake up, I see lines at the edges of my vision. My eye doc worked me up, says its nothing. Skin? Not really. I will sometimes get itchy wrists, but it seems to be related to anxiety......I'll scratch and scratch, then later it's gone. And...I am 34.
    I have taken to hardly eating these days....I just don't want to. In addition to all this mess, I have had big constipation probs for a few years.
    OK, back to watching a movie and vegging out a while. Gets my mind off "things". Besides, sitting "up" hurts the worst of all. Let me know your thoughts?