Dear Margarete,
I have to have surgery next
month and I’m terrified. It’s my gall bladder, so it’s not a high risk surgery,
and I think I’ll only have to be off work about a week, but I just get all
panicked and worry about the whole thing, like what if something goes wrong,
what if I’m miserable afterward, and just the thought of going into the
hospital and being put under freaks me out. I’ve never had anything done, but
I’ve heard from friends who had surgery how awful it is. I had dental work done
before and I had an anxiety attack before the dentist even did anything. So
this is even worse for me to think about. What do you tell patients to do?
Sarina, Western Suburbs
Dear Sarina,
Fears about surgery are
understandable, but being terrified is an extreme feeling that is excessive for
the situation, so I am very glad you wrote in for some help. People can have
very different reactions to a pending surgery. Often past experience, either
theirs directly or through someone they know, influences their thoughts,
feelings, and expectations. You’ve got at least two negative factors going on
here: friends setting you up to be terrified and a bad previous experience with
a dental procedure (sounds like it wasn’t the procedure per se, but rather how
your own thoughts and emotions came into play). Despite their best intentions,
friends or family can do more harm than good by filling your head with
nightmare scenarios. While having supportive people involved, you need to
recognize that some information or ‘advice’ may be counterproductive and that
it’s okay to shut that off, even telling someone thanks but what they’re doing
is not helping. You are fortunate that you have some time to prepare yourself,
so there are several really good things you can do to make this a very
different and successful experience. If you haven’t already, talk with your
doctor about your fears and concerns, so she/he can dispel any myths or
inaccurate info about the surgery process itself and what you can expect to
experience afterward, during recovery. With your doc and using other resources,
such as reputable websites, talking with others who’ve had the surgery, and
talking with other medical staff, educate yourself about what the recovery
process likely will be like. That said, people do vary in how much post-surgery
discomfort they have, how long it takes to get back to work, even the types of
complaints they may experience. The main point here is that you’ll have a
balanced view going into surgery, which should help lessen your anxiety and
make you better prepared to cope with recovery. People have different pain
thresholds, so talking with your doctor about this and what she/he may
prescribe or recommend you do ahead of time or after surgery is really
important for you physically and mentally. Besides the usual pre-surgery ‘what
to do and not do’ checklist the staff or hospital rep will call you about,
there are other steps you can take to really get mentally prepared, especially
given your history of anxiety attacks. This isn’t addressed by the hospital or
your doctor, so you may need to take initiative here and ask for someone to
contact or research some counselors who can work with you on a pre- and post-surgery
plan. I’m very serious about this step. There’s plenty of research that shows a
host of positive effects from doing so, including reduced pain/discomfort,
faster recovery times, significant decreases in pre/post surgery anxiety or
depression, fewer complications. I’m a strong advocate of the idea that this
active planning should be available to patients before any surgery, not only
for the patients’ benefit but for some very real cost savings to patients and
the healthcare system. It’s a win-win-win. Some interventions include
relaxation strategies, distracting techniques, breath work, and imagery work.
Like any skill, you can’t expect these things to work on the spot or to their
maximum without learning them and practicing. Just talking about them isn’t
enough either; you’ve got to actually do them. You’ll probably need to make
some adjustments based on how these work for you and what combination of these
techniques gives you the best results. Also, using them under ‘normal’
circumstances isn’t the same as when you’re anxiety is up or you’re not feeling
well, so practice really is essential. I am confident you’ll come through this
much better if you invest some time in yourself and follow through on these
suggestions. Good luck and let me know how things go.
Some general tips and guidelines for handling medical
problems:
Whether you’re dealing with a
short-term medical issue, like going through a surgical procedure Sarina wrote
in about, or coping with something more chronic like diabetes, heart disease,
or a severe injury, you’ve got to be very proactive and get a plan in place. If
it’s a time-limited situation, this means having before, during, and after
steps outlined. If it’s a chronic situation, then a different approach is
needed that should focus on handling the known, existing difficulties while
also considering preparedness for unexpected changes in your condition. This
last point doesn’t mean becoming an alarmist or expecting the worst; it means
you’ve given thought to potential problems so you’re better prepared mentally
and medically.
A plan should include several
components:
- First: Get informed about your
diagnosis!! Educate yourself about what the condition is and IS NOT,
treatment options, and what can impact your condition both positively and
negatively, such as diet, exercise, stress, work/physical environment,
other medical issues. A caveat here: when researching conditions and
treatment options, there’s a lot of info on the Internet, some good, some
very bad, so you’ve got to be attentive to what you read and not react to
something but follow up with other sources and your doctor on what you
find out.
- Ask your
doctor all questions you have about
your specific case; do not think any question is silly or insignificant!
This is part of his/her job, so ask away.
- Evaluate
your diet and exercise regimen
(if you have one, if not, get moving on this!). Again, your doc needs to
be involved, since there may be things you need to avoid as well as things
you should absolutely include. Internet research can be helpful, but
everyone’s situation is unique, so your doc is your key resource here.
- Re-assess
your stress levels – what the
sources of stress are, how you typically respond that’s helpful and not
helpful, and how you can modify both to maximize your body’s and your
mind’s ability to limit the harmful impact this can have on you. Stress
and worry you already have compounded by the stress and worry over your
medical issue can impact your recovery process, so this needs attention.
Existing stressors are one thing to look at; the added stress of a medical
problem can be quite different, and may call for different or additional
interventions.
- Get a
support system in place
immediately!! People, especially guys, tend to keep medical stuff to
themselves. This does not mean broadcasting your problems to anyone and
everyone, rather, having some key people aware. This serves several
functions: It keeps you in contact with those who can offer encouragement,
perspective, and assistance if you’re physically unable to do stuff for a
day or a week or a month. Friends or family can be good company, distract
you, keep you grounded and keep you from getting isolated. Talking about
your situation puts you in contact with others who may have gone through
something similar or know someone who has and can talk you through the ‘what
to expect’, ‘what to do or not do’, and a dozen other questions you may
have. Unless your doc has gone through what you’re going through, she/he
can’t really understand, so
talking with someone who has can make a huge difference.
- Social
and Fun Stuff – whatever your
situation, you can’t underestimate the importance of this, both from a
medical standpoint and an emotional one. You may have to make small or
bigger adjustments to how this looks, due to short- or longer-term
limitations in physical mobility, energy, attention, etc., but there are
so many options for maintaining social connection and having fun, to
maintain the quality of life and balance you deservethrough tough times. You may need some
creative brainstorming here, so again reach out to other people as much as
possible.
- Professional
help – whether it’s a major
health situation or something less serious, getting some professional
support can be valuable and not only help you with the immediate concern,
but may lead to ideas and changes you can make that improve things beyond
what you initially need or considered. This does not have to cost an arm
and a leg; it can involve a consultation or brief series of visits that
give you information and skills to make a difference in your future. This also
gives you a neutral, not-emotionally-involved resource to turn to.
Especially with chronic or long-term medical problems, even the most
supportive and helpful family member or friend can suffer from caregiver
fatigue, so another person to field issues, vent with, problem-solve, etc.
is essential for both you and your caregivers.
Dear Margarete,
I don’t think you’ve answered
this question before, so I hope you print it. I work in a very high stress
environment, information technology related field, where the stakes are high,
deadlines and pressure can get insane, and sifting through huge quantities of
complex data and reports consumes more and more time. It’s constant adrenaline
rushes. Here’s the issue: I’m a news junkie, part of which is important to the
work I do, so the information processing never stops, but recently I’ve become
so jaded by everything that I’ve been shutting down.Things you hear at work and on TV, in the
news, out with people, all the sick and crazy things happening everywhere, the
fear-mongering. That’s all everyone talks about, and not like anything good
comes from all this focus on the bad in the world and how things are getting
worse, less safe. I’ve almost stopped watching TV – I know, I’m a guy, so this
is hard to believe but it’s true! And I’ll only scan certain info from web news
sources because it makes me react. I mean I really become anxious and angry. I
have no idea why this is happening and I feel like some nut case. I go out with
friends and if there are TV monitors blasting news and sports I’ve actually
walked out on them. I was too embarrassed to admit what was going on, I just
made up something about a project at work that was on my mind. I noticed I’m
not sleeping well either, and I get off track at work, which is totally not
like me. What’s your take on this? Have you heard of anything like this before?
The I’m-not-Crazy Guy in
Dear
No, based on this scenario
you’ve outlined, you’re not crazy. And yes, I have dealt with similar
situations. This is fixable, but it will likely require some real commitment on
your part to make some much-needed changes. Your body and your mind are sending
you some loud messages, you just may not have linked up all the signals or been
listening to make sense of it. Seems to me you’re operating on overload – your
work, the fact that you apparently give yourself no real break from work, the
absence of things to do to counter the stress at work, the lack of people to
talk to about any or all of what’s been going on. The escalating pace and
quantity of information we all have to process, sift through, and prioritize is
a frequent discussion topic with many people I work with; you’ve got the
‘bonus’ of having this in your face so to speak all day long because of the nature
of your work. Anyone whose work environment is chronically revved up with
deadlines and high stakes is operating at an unhealthy level of stress. That
adrenaline you mentioned, that’s exactly what I’m talking about. It’s one of
the stress hormones that helps us mobilize so we can respond to an acute
situation, drives us to act, but as a steady diet it’s destructive to our
health because this heightened response mode (elevated stress hormone levels)
has bad effects on our immune system. So, your body and your mind are telling
you to DO SOMETHING now. Overreacting to people, news, whatever means you’re
tapped out my friend. Unless a major job change is right on the horizon for
you, you’re the only one to turn this problem around. You’ve got to set some
boundaries on yourself: leave work at work; listen to TV or surf website
sections that give you what you have to review for work and ignore the rest.
When at work, make it a must that you set aside some mini breaks to decompress
by walking, grabbing a healthy snack or soda, talking to someone there or
elsewhere about something positive, fun, upcoming events, weekend plans, a game
you saw, whatever. Other mini-break ideas: just 5 minutes of breath work can
lower your stress/anxiety level (do not laugh! This gives immediate response to
counter anger, anxiety, stress, racing thoughts about all the things that are
driving you ‘crazy,’ you learn some of these techniques and then practice
them). Or some basic yoga poses – again, do not laugh or mock this. Huge benefits
await you. Give it a shot. After work and on weekends: get moving – you know
how incredible sports are, not just the watching of the games but getting
physically involved in them. Find some outlets at the gym, by joining a team,
by walking or taking up jogging on your own. Set aside time to do some other
things socially and for fun, where you control the environment and limit the
negative input. Look into some options for contributing in your community or
somewhere else. Do some walkathons, offer your time at some charitable events,
join some organizations. Nothing like combatting all the (increasing) negative
insanity in the world by becoming active in a cause that motivates you. We
can’t change the world, but we can have influence on and start to change our
immediate world by learning some good ways to block out or minimize all the
fear-mongering, national obsession with disaster (real and perceived), and
everything else that intrudes on our daily life. These are just some ideas for
how you can channel all that anger and anxiety, which is, by the way, a very
normal response to a very abnormal world we inhabit. You bet.
