Anxiety and Apprehension - Dealing with pre-op stress

Anyone that has had surgery knows that it is very stressful, whether it be simply having a mole removed, or open heart surgery. In the last two weeks I have had two surgeries and my thought, feelings and anxieties were vastly different for both.

The first operation that I had is clinically known as a cystoscopy with laser stone destruction. Simply put, they destroyed my kidney stone with a laser that they put up into my kidney through the urinary system and blasted it Space Invaders style. Pre-operatively, I had a number of concerns that I needed to deal with or overcome.

Personally, the main stress I had to deal with was purely psychological. Before the surgery I felt fine. I could go about my daily business normally, I had no pain or discomfort but I still had a kidney stone that would eventually cause me no end of grief if left unchecked. Unfortunately though, I found it hard to focus on the fact that I needed surgery now to avoid problems later and instead I focused on the fact that post op I would feel exhausted, in pain and in discomfort, and if I chose not to have the surgery I would feel fine. At least in the short term.

I have dealt with this previously in four ways:

1. Rational Thinking- This requires discipline, and is very effective when your mind has wondered into thinking about the negatives of surgery. Instead, I try to remind myself of the reasons why I need surgery and the potential negatives of what I might go through if I choose not to have the surgery. I find that this helps to suppress unwanted emotions and helps maintain focus.

2. Distraction- Once you have arrived at the hospital and are in the system there is a great deal of waiting around to be done. That is probably why they call us patients. During these times the mind can wander and you start to think about the negatives. I find the best way to avoid this is to keep yourself busy. Unfortunately, hospitals are very boring places, so you have to go prepared to entertain yourself. Books, magazines, portable DVD's, hand held game consoles, puzzles etc are invaluable. Take as much as you can.

3. Thinking about the Finish - If you have to think about the surgery, think about the end result, the benefits you will gain and the potential strife you will have avoided.

4. Drugs- If anxiety still gets the better of you, there is always drugs. You can ask your doctor for a pre-med, however, these days they are reluctant to give you one. Anaesthetists commonly give Medazolam (a sedative like valium) as part of the anaesthetic cocktail prior to surgery, if you are anxious enough and ask nicely they will normally give it to you earlier. My experience with the drug is that I tend to feel great. Worry and anxiety almost slip away entirely. However, one must remember that the drug is there to serve a purpose and not for messing around with.

Another stress that I had to deal with was with my kids. At four and six they were now old enough to know what was going on and they worried about whether I was going to die. Kids aren't stupid, so don't lie to them. I decided to tell them the truth and also let them know that hundreds of people have surgery every day and it is extremely rare for people to die, and those that do are normally very sick and having complicated procedures. My wife also bought a kids book on going to hospital to help explain it. We also let all the children's other care givers (teachers, other parents etc) know what was going on in case one of them became distressed and my wife or I were not around. Fortunately the kids coped very well after our initial chat.

The only problem that I had with my second surgery was really quite minor. After the first surgery my surgeon left a stent from my kidney to my bladder and for the ten days I had it I was quite uncomfortable (I'll talk about this next time). I was actually looking forward to the surgery to have it removed, but with the lack of other anxieties, I became really hungry. 8 hours fasting is fairly standard for general anaesthetics, but that doesn't stop the hunger. It really isn't that big an inconvenience, but the best ways to counter it are to have a nutritious (but not too large) meal prior to your fasting cut off, stay away from food and food smells the next day, and distract yourself.

Well I hope you enjoyed my blog. Please feel free to write to me with any comments or suggestions. Until next time, stay well and I will catch up with you then:)