Disabling symptoms since distal bicep repair surgery. Any suggestions?
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!
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Thank you Rachel, I appreciate the reply and information! I am in fact a coach and have been a wrestling and football coach for years. I did watch the video and found it very interesting. I can see how the process of CSS would influence receptors to “trick” the body into thinking something is wrong. I will certainly keep that info in my back pocket as I go through the discovery process (well hopefully there is some discovery) and try to find solutions to my issues. I truly don’t feel that CSS is my issue but of course I would defer to smarter folks than me to figure it all out. My symptoms have morphed a bit in the past week and I am now getting tremors in the morning with a pounding headache, tinnitus (pulsing with heartbeat in left ear, ringing in both) and waves of nausea/dizziness/disconnected feelings through the day and night. I’m still quite restless and have been unable to sit and watch TV, read a book or do much of anything other than pace and walk all day. I do realize how odd this all sounds and my primary is equally perplexed. He’s run a lot of tests for autoimmunity and inflammation, but the only test that has come back concerning were a high complement total. Based on that and my rather extreme rapid weight loss he ordered an abdominal CT scan which came back clean other than the bladder wall thickening and diverticulosis. I am hoping I can get some answers soon as I am truly out of steam and running out of hope. I am not very smart with medical issues and would prefer to leave that stuff to the pros, but someone I know suggested csf pressure as a possibility. I truly have no idea…. Thanks again for the reply and information! It is helping me keep my sanity to have good people like you reply with information that I can mention to my primary.
Thank you so much for the empathy and sentiment. It is really helpful right now to have people like you who understand and care! I do understand that they have their hands full with other patients and can only take so many. They have to evaluate based on who they think they can help, prioritize based on necessity, etc. I totally get it and understand that my health is no more important than any other, except of course to me and my family. I have a good primary who is perplexed but still trying to figure it out, and the referral to Iowa city hospitals may bear some fruit. I can certainly hope so anyway!!! Thanks again for the reply and sentiments!
You're very welcome. I'm glad you are aware now, and I agree that it's too early to determine CSS.
You mention being out of work. Have you been able to journal your symptoms and time lines? I found this very helpful, not only to inform my doctors, but also for my disability claims. Also, when you're going through the stress of pain, symptoms and uncertainty, life gets overwhelming quick.
Keep fighting Coach 💪🏽...just like you'd expect from your athletes. I'm certainly rooting for you and will keep my eye on your forward, hopeful progress.
Thank you! My wife has been keeping a daily journal of my symptoms since this has started right after the surgery. I am hoping to get this figured out soon so I can get back to work. It has been frustrating for sure, and as I type this I am having a really rough morning which makes me a bit more pessimistic, but I am terribly worried that the doctors are not going to find the cause and I will have to trudge on like this for as long as I can until I develop symptoms that point to an obvious cause or I just run out of time. It’s frustrating…. Thanks for taking the time to respond and for your kindness!
Your wife sounds like a keeper!
She is! I feel so bad for her because she’s had to deal with all of this alongside me. I want to get better for her and the kids more than I do for myself. It’s hard to see all of the stress my illness has been causing them
Hello @stevetaylor721
I just read about your post-surgery health problems. I'm so sorry to hear that you are dealing with such difficult symptoms. It is frustrating to have a major change in your life and then have no answer as to why.
I'm glad that you will be getting another opinion. I'm not family with Iowa City Hospitals. Is this a university medical center?
@stevetaylor721-Hi. I have read through your thread, as the title caught my attention. What you describe, I experienced the same thing after a “minor” elective surgery.
-My profile was completely healthy 100%.
Active in every area of life. Zero health issues. Exercised daily. Ate very healthy. Slept 8 hours a night. Healthy community and family support.
-First-I want to point out the positives for you. It sounds like the surgical site is healing well and you are healthy there. And you also have a great support system.
-I will share with you what I have learned along the way, in hopes it could shed some light or address something that hasn’t been addressed.
-About 2 days after surgery I could not sleep more than 2 hours. Shaking, trembling, could not regulate body temperature. Weight loss despite eating. Severe rushes of cortisol/adrenaline all day.
Saw every type of doctor, had every type of test.
-I too was referred to a Psychiatrist after many doctor visits and tests. This psychiatrist explained to me how anesthesia works and how the body processes surgery as a trauma response. Anesthesia can alter people’s brain activity afterwards. The brain can also get stuck in a protection mode “fight or flight”, when you are no longer in danger.
Many people think anesthesia just “puts you to sleep”. It does so much more than that and acts on all different neurotransmitters in the brain. Each persons pathways are different. So it is not known how each persons brain will accept/respond to the affects. All of these alterations affect the Central Nervous System. It was explained to me as the brain gets turned off like a power grid. When you come out of anesthesia the grid comes back on in different areas and starts reconnecting. If the synapses don’t connect and start firing together these neurotransmitters together, that’s when the altered state can remain. Causing severe anxiety/panic. This then causes all kinds of real physical symptoms. Such as the sleep loss, nausea, vomiting, muscular tightness, trembling, weight loss etc...
-Anxiety/Panic is not just a response from external stimuli and thoughts. It can absolutely happen systemically from within as neurotransmitters from a systemic response and literally make you physically sick. As the lack of sleep continues, this continues the cycle as the brain can only recover with proper restorative sleep. This is why many of the first questions at appointments will be “hows your sleep?”. Without that, nothing can happen.
-At this time you would have to address brain health to balance the Central Nervous System. and many people are out of touch with that.
-Find someone who will explain to you the circadian rhythm/sleep cycle which is run by these neurotransmitters. The rushes you feel immediately in the morning-similar to that of dropping from a swing- are most likely bursts of cortisol/adrenaline. We all wake with a tiny release of this. This hormone is what actually wakes us. Rushes of it at once are not supposed to happen.
-I would recommend working with a Functional Medicine Doctor, one whom understands this as a common occurrence.
A Neurologist, whom understands, brain activity and neurotransmitter firing.
A psychiatrist whom understands and has worked with altered states to due anesthesia and how to help the mental part that this can put a person in.
-Neurotransmitters run the body. They are heavily connected to the gut. Which is why there is a name, “The Gut-Brain Axis”. Both continuously talk to one another. Some people after drugs/anesthesia have nausea and vomiting, this is a response.
-I want to reiterate these are just suggestions. As what you have shared is not rare. It is just not talked about or acknowledged. Anesthesiologists main job is to keep you out of pain and in a coma like state. So long as the surgery went well and they kept you alive, then it is considered uneventful and a successful surgery. To this day, they aren’t fully aware of the mechanism of action on the brain, as every person is so different.
-When the doctors brush you off and tell you it’s “anxiety”, they are doing you a disservice, because many people think of anxiety in a non chemical/systemic way and only with having anxious thoughts. This leaves a patient to think they are creating it. You are not. It is absolutely a chemical/systemic response.
- I will add an article that you can review.
You can bring this up to the providers that you are currently working with or new ones.
It would have to be a provider who completely understands the body as a whole.
-In the mean time, there are things you can do to help restore your nervous system.
A Functional Medicine Doctor can help you with that as well. Or have your wife look into somethings for you.
Focus on brain healing foods, that boost the neurotransmitters, not just calories. But good proteins, vegetables, and high vitamins/minerals. Anything that can promote relaxation and sleep. Keep moving and walking. Try for restorative stretching that can help your nervous system response.
*again-these are just thoughts or suggestions. By no means telling you, you have a certain condition.
If you have anymore questions, please let me know.
https://www.google.com/amp/s/www.the-scientist.com/features/general-anesthesia-causes-telltale-brain-activity-patterns-65501/amp
@nrd1 Hello. I'm happy you joined the conversation and am very impressed with the information you've presented to @stevetaylor721.
It follows along with the same principles of Central Sensitization Syndrome and the Central Nervous System being disrupted. The treatment and recovery plan lines up as well. Holistic, basic rebuild with proper nutrition, balanced sleep, physical and mental activity.
Thank you for such a thorough explanation of something that is valuable to know and understand for many.
May I ask how you are now doing since your bout?
I can’t thank you enough for the information and reply! There are definitely a lot of similarities to what you experienced. I hope you are doing better and we’re able to make a full recovery to your old self! I am absolutely going to ask my primary about this scenario as it makes a ton of sense and there are too many parallels. The psychiatrist I was referred to said similar things at first, but the last visit thought maybe enough time had passed for that to be the issue and felt it was anxiety/depression. I don’t really agree with that but do acknowledge that the longer this has gone on, the more anxiety and depression are becoming a factor just due to the stress, if nothing else. The rest of the doctors I spoke with blew off the suggestion that anesthesia (or the combo of 9 drugs they gave me) had anything to do with my symptoms. The refrain I got was that those drugs are out of your system in a day or two, so it couldn’t be that. I was skeptical of that because alcohol is out of your system in hours, but when I was younger I had a couple of hangovers that lasted for days! I am mostly joking, but the concept would seem to be the same. Thanks again for your most helpful input and I will definitely bring it up to the doctors I am seeing and update this post as I get answers.