Autonomic nervous system
After undergoing surgery for liver cancer in September (a 5 cm liver resection at an early stage), I have been experiencing daily chest tightness, chest pain, and difficulty breathing.
I have consulted many specialties (cardiology, pulmonology, otolaryngology, family medicine, traditional Chinese medicine, psychosomatic medicine, and currently following up with gastroenterology for liver cancer) and only found arrhythmia; all other tests were normal.
They suggested that it might be a psychological issue.
I am now aware that I have autonomic nervous system dysfunction.
How should I treat this? Currently, I am only taking Sereal 10 mg.
Which specialty should I consult now?
Hui, 30~39 year old female. Ask Date: 2004/12/09
Dr. Tang Xinbei reply Psychiatry
Dear friend,
Facing a serious illness can be incredibly shocking and frightening at first, especially when confronted with an uncertain future: Will it be completely removed? Will it recur? Are there any postoperative complications? For the vast majority of people, this requires significant mental effort and time to adjust.
Particularly since you are still young and have many ideals and goals to pursue, this process can indeed be quite challenging.
I am relieved to hear that the initial lesion was a 5 cm liver resection.
Many individuals facing serious illnesses or trauma go through an emotional process that requires adjustment and experience.
Initially, there is shock and an inability to accept the reality of the situation.
Some may fall into depression, anxiety, or blame others.
After receiving treatment, individuals often experience the worries I mentioned earlier (facing an unknown future), frequently feeling fear and doubt about whether their illness has been completely eradicated, leading to anxiety over bodily changes and seeking medical opinions everywhere.
I suspect you may be in this stage.
I recommend that you consider visiting a psychiatrist for psychological counseling to reassess your life, your feelings towards yourself, your family, or any concerns you may have, and to make some arrangements for the future.
It is also advisable to return to your normal life, work, and social activities in a healthy manner as soon as possible.
If you have had any unhealthy habits in the past, such as smoking, excessive drinking, staying up late, or irregular lifestyle patterns, it is essential to change those!
Death is an inevitable part of life, but when faced with the possibility of death, most people tend to avoid the topic and are unprepared, often feeling regret at the end.
Having gone through this significant illness, you must have a different perspective on life.
This experience is a blessing bestowed upon you, and your willingness to talk about it is indeed the first step towards facing it!
Wishing you peace and joy!
Reply Date: 2004/12/09
More Info
Managing autonomic nervous system disorders after liver surgery can be quite complex, especially when the patient experiences symptoms such as chest tightness, chest pain, and difficulty breathing. These symptoms can be distressing and may significantly impact the quality of life. Given your history of liver surgery for early-stage liver cancer, it is essential to approach your symptoms holistically, considering both physical and psychological aspects.
Firstly, it is important to understand that the autonomic nervous system (ANS) regulates involuntary bodily functions, including heart rate, blood pressure, respiration, and digestion. After significant surgeries, such as liver resection, the body undergoes various physiological changes that can lead to disturbances in the ANS. This can manifest as symptoms like those you are experiencing.
Potential Causes of Your Symptoms
1. Post-Surgical Changes: After liver surgery, the body may experience changes in blood flow, hormone levels, and overall metabolism, which can affect the ANS. This can lead to symptoms such as chest pain or discomfort and breathing difficulties.
2. Psychological Factors: Anxiety and stress are common after major surgeries, especially when dealing with cancer. These psychological factors can exacerbate physical symptoms and lead to a cycle of anxiety and physical discomfort.
3. Medication Side Effects: The medication you are taking, Sereal (which contains sertraline, an SSRI), can have side effects that may include changes in heart rate and gastrointestinal disturbances, which might contribute to your symptoms.
Recommended Steps for Management
1. Consult a Specialist: Given your symptoms and the complexity of your case, it would be beneficial to consult a neurologist or a specialist in autonomic disorders. They can perform specific tests to evaluate your autonomic function and determine if there are any underlying issues that need to be addressed.
2. Psychiatric Evaluation: Since you have been told that some of your symptoms may be psychological, a consultation with a psychiatrist or psychologist specializing in post-surgical recovery could be valuable. Cognitive-behavioral therapy (CBT) or other therapeutic approaches may help you manage anxiety and stress, which could alleviate some of your physical symptoms.
3. Physical Therapy: Engaging in physical therapy or rehabilitation can help improve your overall physical condition and may assist in managing symptoms related to the ANS. Gentle exercises, breathing techniques, and relaxation strategies can be beneficial.
4. Lifestyle Modifications: Incorporating lifestyle changes such as regular physical activity, a balanced diet, adequate hydration, and good sleep hygiene can positively influence your overall health and potentially improve autonomic function.
5. Medication Review: It may be worthwhile to discuss your current medication regimen with your healthcare provider. If you are experiencing side effects from Sereal, your doctor may consider adjusting the dosage or switching to a different medication.
6. Monitoring and Follow-Up: Regular follow-up appointments with your healthcare team are crucial. Keeping track of your symptoms, triggers, and any changes can provide valuable information for your doctors to tailor your treatment plan effectively.
Conclusion
In summary, managing autonomic nervous system disorders after liver surgery requires a comprehensive approach that includes medical evaluation, psychological support, lifestyle changes, and possibly physical therapy. It is essential to work closely with your healthcare providers to develop a personalized treatment plan that addresses both your physical and psychological needs. By taking these steps, you can improve your quality of life and better manage your symptoms.
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