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Have hypothyroidism. Have had gallbladder removed. Is something wrong with pancreas or liver?

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Practicing since : 2003
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What post gallbladder depression? I had my gallbladder removed in July, I thought that after I got rid of the pain I would be able to get back to my goal of going to the gym before work. I used to get up at 5:15 to get to the gym and to work before 8, now I can barely make myself get out of bed before 7:45. I had one weekend of severe depression where I pretty much stayed in bed all weekend, and even called out sick on Monday - granted I was running a slight fever of 100.6, but my biggest sypmtom was tiredness and weakness. I have seen people in my family get depressed and stop dealing with life... I have always promised myself that the sitting and doing nothing solves nothing so I might as well push myself to get out of bed, go to work, and then go to school and on the weekends go to church. But I am so tired, fatigued, and can't think clearly. I have also had problems with forgetting things which is a stressor when I'm in school taking Organic Chemistry and I need to remember all my mechanisms, reagents, reactants, products, stereochemistry... I also have hypothyroidism that I take 50 mcg of synthroid for each day. I take zoloft for anxiety and lunesta to sleep. I have been told that my vitamin D is low, so I have been taking 1000 mg/day - problem is, I don't always remember, but I go in the sun any chance I get. The other thing is, I am starting to have pain where my gallbladder pain had been, in my upper abdomen and in my back, sometimes extending to my shoulder. I thought it was residual pain, but, it's been almost 3 months, so I am wondering if something is wrong with my pancreas or liver. I haven't had any high fevers, no vomitting, I have had some nausea and some very pale colored stool. Is there anyone who can help me? I just want to have energy to get my life together.
Posted Wed, 17 Oct 2012 in Liver and Gall Bladder
Answered by Dr. Jonas Sundarakumar 2 hours later
Hi and welcome to Healthcare Magic. Thanks for your question...

I am sorry to hear that you are going through a tough time and can understand how difficult it must be for you to try to keep staying afloat.

Now, the symptoms which you describe - tiredness, fatigue, lack of energy / initiative, difficulty in concentration, forgetfulness, etc. are all indicative of depression. You also seem to have more than one risk factor for developing depression. Though not specific to gall bladder surgery, there is an increased risk of developing depression following any major surgery. Certain endocrine / metabolic disorders, e.g. hypothyroidism have also been associated with depression. You have also mentioned that you have a history of depression in your family, which may also put you at an increased risk.

Whatever be the underlying factors, the fact remains that you getting depressed and it is causing you a lot of suffering as well as dysfunction in your day-to-day functioning. Hence, it is important that you seek help to come out of this. Help is available in various forms, but in your case, you do require professional help, preferably from a psychiatrist. When you have so much of reduced energy and drive, it is practically very difficult to try to motivate yourself and carry on with your normal routine. So, I think you should not be too hard on yourself or feel guilty that you are not able to push yourself more.

Professional help can be in the form of medication (anti-depressants) or psychotherapy (talking therapies like CBT - Cognitive Behavioural Therapy - which is a specific form of therapy aimed at improving your way of thinking and thereby your performance). If your depression is severe, then you would need to be started on medication - the newer antidepressants available now (like SSRIs) are relatively safe and do not have any addictive potential. Your doctor would be able to decide on what antidepressant, dosage and duration of treatment after a detailed psychiatric assessment.

You also need to check if your thyroid problem is under control, because uncontrolled thryoid problems can precipitate your symptoms of depression or even cause resistance to treatment.

As far as your pain in concerned, it is not uncommon to continue to have a sense of discomfort or mild pain in the same areas related to the removed organ - this is called 'phantom pain' and usually subsides gradually on its own. But if your pain is significant and troubling, then I would suggest you to have an review examination by your surgeon.

I hope I have clarified your doubts.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
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