Posts filed under ‘Music Therapy’

A Quiet Enemy to Recovery–Depression

Daryl Tomlin made a startling statement in an article published December 23, 2008 called “Depression After Open Heart Surgery.” He explained that “The greatest injustice done anyone facing open heart surgery is the lack of information and preparation for the depression that may follow.”  Well, sure, a 38-year-old adult may go through depression after such a major operation but what about our children?  Do they suffer depression after open heart surgery?

I discovered that the risk of depression after surgery for children is real and often present and overlooked.  A study performed in Korea at three major cardiac centers found that in 231 adolescents between the ages of 13-18, depression was a problem for 62% of patients (2008).  Some studies suggest that females have a higher incidence of depression following open heart surgery.

In 1998 the Alberta Children’s Hospital and the University of Calgary conducted a similar study.  This study contained similar results with more information regarding depression after open heart surgery.  Their study found that children with cyanotic heart defects (a defect resulting in deoxygenated blood passing through the body–often giving a blue appearance) were more likely to suffer from depression.  Their study stated that “children with cyanotic forms of congenital heart disease demonstrated more fears of the unknown, physiological anxiety, depression, and delinquent behaviors than the acyanotic children with congenital heart disease.”

While every child is different and every operation and recovery unique, parents of children and adolescents undergoing open heart surgery should be aware of this possibility.  Knowing the reasons and signs to watch for may help in the recovery process.

Some health professionals feel that their may be physical reasons behind this depression.  Tomlin states that some people believe the heart-lung bypass machine, no matter how safely screened the blood is, produces tiny air bubbles called emboli that are introduced into the body.  These tiny air bubbles can travel to the brain and block blood flow to the brain.  If too much air is present, mini-strokes or major strokes can occur.  Many feel that patients on the heart-lung bypass machine experience this mini strokes that alter areas of the brain slightly, causing depression.  Additionally, having decreased blood flow and higher oxygen levels in the brain can cause depression.  This may account for why children with cyanotic heart defects suffer more depression than those with acyanotic defects.

Others feel that the sheer volume of drugs and medications used during and after open-heart surgery may be to blame for the depression.  Tomlin states that blood thinners, pain medications, IV fluids, blood and blood products, and other drugs all received within a few days may “lead to a change in brain chemistry that could exhibit itself as depression.”

Depression is often hard to pinpoint.  For a child who has undergone open-heart surgery, complaints of pain, fears, sleeping problems, and other unusual symptoms may be present for two to three weeks after surgery.  These symptoms are normal and nothing to be alarmed at.  The body must adjust and heal before the patient feels “normal” again, however; if symptoms persist after four weeks, depression may be to blame.

Signs to watch for include:

*Apathy–apathy is a lack of interest or lack of enthusiasm for anyone or anything in the child’s life.  Apathy presents itself in a complete boredom or disinterest in all things that used to interest or excite the patient.

*Anger–anger now and then is normal for anyone.  Severe anger should be watched closely though, especially in a usually agreeable and calm child.  If unusual anger persists four weeks after surgery, you should talk to your child’s pediatrician.

*Feelings of doom–children may show strange fears of natural disasters or show feelings of sure destruction and doom.

*Desire for prescription medication–older children may develop a need for prescription pain medication.  They may look forward to taking it and  take it as often as possible.

*Seclusion–children may want to be left alone or stay in their rooms for hours alone.  They may not want to attend events where other people are present and may exhibit a desire to stay home and secluded.

*Persistent sadness–sadness that doesn’t seem to go away or a lack of happiness in usually happy activities can signal depression, especially in children.

*Persistent sleep problems–children who sleep too much, exhibit a fear of sleeping, or can’t fall asleep may have depression.

These signs are good to know and watch for following open-heart surgery.  Any of these signs that linger more than a month after surgery should be discussed with a pediatrician or other caregiver.

While some people feel that depression is inevitable in those who will develop it, other studies have shown disagreeing results.  The study conducted in Korea found that children with previously demonstrated resiliency to new situations, attentive and caring parent or parents, and proven high academic or personal achievements seemed to have less depression and psycho-social problem following surgery.  The study stated “that adolescents with higher resilience and an affectionate parent were less depressed.”

Additionally, some psychologists and therapists believe that having and learning coping abilities before surgery and, practicing them after surgery, may help children overcome depression.  Music therapy, meditation, relaxation, and deep breathing may help to relieve patients of depression and anxiety following open-heart surgery.

In his article, Tomlin stressed that if Cardiac Rehab is available, this can also help overcome the effects of depression.  Tomlin wants others to know that “if you or someone you know are facing open heart surgery, remember that depression is likely and a very dangerous enemy during recovery from open heart surgery.”

Ask for help if your child needs help.  Make sure their recovery from open-heart surgery leaves them with a Perfect Broken Heart both physically and emotionally.

May 25, 2010 at 4:57 am 2 comments

Art, Music, Therapy!

Have you ever heard of music therapy?  Sounds kind of fishy, right.  However, the field has studies to back it up as well as some scientific claims to soothing the heart and helping stroke patients, CHD patients and other heart problems.  The following excerpts are from an article by Bianca Tora:

“One such patient is an 18 year old girl profiled in the July 1 2009 issue of the Wall Street Journal. At age 9, she had her second heart transplant. Her body was determined to reject the first heart. She went into cardiac arrest six times in 2 hours. She recalled being “awake” when the doctors were frantically trying to revive her.

Fearing that they would pull the plug on her, she tried desperately to tell the people in the hospital room that she was alive.Recuperating at home was no easy matter; she kept having recurring nightmares in which she watched herself suffering cardiac arrest.

Things, however, began to change when she took up the pen. She began writing down her thoughts about being helpless and scared. She turned these details into poems and stories. Eventually, the nightmares disappeared.

Now 18, she has successfully completed high school and is looking forward to nursing school in the fall.She credits her writing for helping her deal with her heart and surgery. It was her creative expression through writing that enabled her to transform something frightening and painful into a positive goal – to make something of her life.

Researchers are taking note of the positive relationship between art therapy and the heart. Some current clinical data on this relationship include the following:

a) Psychosocial factors like depression and stress have been found to be strong risk factors for heart attacks. In fact, these emotional factors are considered as strong as physiological factors like high blood pressure and diabetes.

According to researchers at Washington University School of Medicine in St. Louis, depression increases the risk of heart disease more than genetics or the environment. This means that any intervention that can reduce depression can benefit the heart. Scientists are working to determine how artistic expression can be considered a valid form of clinical intervention to be used along with exercise, diets and medication for reducing heart disease.

b) Researchers at Temple University in Philadelphia have found that music can offer substantial benefit to patients who are stressed and anxious about undergoing treatment for coronary heart disease. Listening to music decreases blood pressure, heart rate and levels of anxiety in heart patients. In fact, music therapy is getting increased recognition as a viable form of treatment for depression and mood.

Take for example, Justin P, a young boy born with a heart defect. At 8 months, he had heart surgery. Since he was five years old, he has been experiencing attention and behavior problems at school. Unable to “settle down” in the classroom, Justin nevertheless responds well to music, especially songs with a strong upbeat tempo.

His parents decided to place him in a music therapy class when he turned six. Now 7, Justin can play the piano; he is more focused in school; he is just starting to read and he is a happier child.
According to his parents, music relaxes him and makes him more open to their suggestions.

Creative expressions in art, writing and music can be very effective therapeutic processes for children with heart disease.”

These therapies are good for patients and soothing.  They encourage healing and recovery as well as rehabilitation.  The Congenital Heart Information Network claims that “Music Therapy can be defined as the clinical use of music by a music therapist, as a therapeutic intervention for persons who have special needs. It does not claim to cure or to prolong life in the medical sense, but rather seeks to develop the potential of the individual and to improve the quality of human life. Music Therapy uses music as the basic tool for dialogue in much the same way that traditional therapies use language. Because music has universal appeal and is a form of nonverbal communication, music therapy can benefit persons who might be less responsive to verbal therapies. Benefits of music therapy treatment may include the development and maintenance of motor skills, reduced pain perception, enhanced self-esteem, improved speech and language skills, and alleviation of anxiety and depression (Wilfrid Laurier University, 1991).”

If you don’t believe any of these medical claims, then just take it from Paul Cardall.  Cardall is an accomplished musician and amazing pianist.  He was also born with tricuspid atresia, a CHD and is currently on the heart transplant list.  He has been awaiting his transplant for just over a year.  His blog, Living For Eden, has a post entitled “Music Therapy and Good Friends”.  The blog entry shares some great video footage of his friends who include Ryan Shupe, Peter Breinholt, Sam Payne, Charlie Jenkins, and Mindy Gledhill, all musicians who visited and shared a night of music and healing.  Cardall tells his readers “Thought I would share with you some brief video from an intimate night of friends and music that I’ll never forget. I am forever indebted to friends. I’ve said many times doctors have the ability and skills to heal your body but friends heal your mind and transport you from your suffering.”  All scientific evidence aside, Cardall claims that music does lighten the load and promote the healing of his broken heart!

September 1, 2009 at 2:41 am Leave a comment


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