Anxiety Over Upcoming Surgery - Any Suggestions?

[barefoot]

So, time seems to have flown by and I'm having this surgery early next week. And I think that has only just really hit me.

I think I am possibly starting to lose my shit about it while, at the same time, I also feel weirdly calm. It is a strange thing to try to explain...

I have put some things in place to try to manage my anxiety and hopefully reduce the potential for getting triggered:

I've flagged my anxieties to the consultant and anaesthetist via the consultant's PA who was lovely and very supportive and reassuring.

They have said I can take a Valium at home beforehand if I need to and that they can give me a sedative pre-med when I get there if I need one.

The anaesthetist is going to talk to me about pain-killer/sedative combinations to try to find something that will work for me (hopefully countering side effects I have with some strong pain killers plus hopefully minimising the possibility of night terrors as I'm worried about having one and causing some damage when I'm supposed to be keeping all weight off my leg)

My partner will be there when I wake up. And I'm going to suck up my embarrassment and take my cuddly toy in with me to sleep with. And my nice cosy bed socks!

My partner is now aware that doctors/medical things are challenging for me as they relate to old traumas. This "reveal" has been quite stressful for me though she has been great about it. And it probably helps going in to it knowing that she now knows and understands that there are lots of layers around this for me.

My therapist has been really great helping me to prepare. The things she has suggested have helped me to feel calmer about the two things I was ruminating on before (not wanting the doctor/his instruments inside me and feeling like I can't get away). I have been mindfully focusing on the here and now (those concerns belong in the past with old experiences, not now with this upcoming surgery) and on the fact that this doctor has my permission to engage with my body. Those two focuses have really helped.

I thought I was doing well.

Now, I think I have just suddenly really realised that I'm having an operation in a few days.

I think my anxieties about it up until now have been ptsd-related and they have dominated any other thoughts about it. I have managed to ease those - not completely but significantly and still working on it. Now it feels like I have those much better under control - now it is maybe just the normal nerves anyone would feel about having an op..?

It suddenly for the first time feels like a real thing - that I am having surgery very soon.

I found out yesterday that I won't be being operated on in the afternoon after all. I'm now first up so need to be at the hospital for 6.30am. Which means leaving home by 5am. I am feeling spooked by this change. Probably just because it is a change. On the plus side, it's less time for me to hang around getting more and more anxious...

And a few friends have now started giving me tips and advice for when I get back home. I think I've just been thinking I won't be in pain because I'll be so drugged up and that I'll just have quite a nice, relaxing couple of weeks at home doing nothing except sleeping or watching box sets. I'm now getting the impression that it's going to be much harder and more painful than I've considered.

My partner said this morning that it has only really just hit her that I'm having this op next week and that it's serious and there will be an impact over the next few weeks. So, I think I am also feeling unsettled and more anxious by the fact that she is starting to look anxious about it.

My last session with my T was over a week ago and I won't be seeing her again until I'm back on my feet again (likely to be about a month or so). And I *know* that's going to be ok and that I can manage a few weeks without her even though I'd prefer to be able to see her. I'm just having a bit of a wobble so thought I would post here.

Any calming words or other practical suggestions for recovering from a hip op??

Sorry...a long ramble! Thanks for reading.

 

[barefoot]

@Justmehere - if you don't mind me asking, have you had your surgery yet? And, if so, did it go ok? Hope all is well!

 

[Justmehere]

I did have it done! I can say this: it has been worth it. I had very rare complications and the doc said I was the worst case he's ever done, and my recovery much slower than expected. But it's been so worth it and I'm so glad I did it. My therapist says it's been healing to my mind and body. Go figure. I have to run, or rather walk slowly (lol) but I will write more later.

You got this. :hug:

 

[barefoot]

Hooray! Sorry you had some complications and that it's been a slower healing process as a result. But so glad to hear that you think it's been worth it. Great result!

 

[barefoot]

So, I had the surgery last week. Surgeon was pleased with how it went and he's confident that when I'm fully recovered I will have very positive results.I liked him a lot and felt comfortable with him. I have a follow up appointment with him in a couple of weeks, which I feel ok about.

Unfortunately, I had a difficult experience with the anaesthetist who just seemed to completely ignore everything that had been flagged to him in advance about how to help me with the experience. I lost my shit a bit - got totally gripped by panic and terror so was crying and shaking and trying to get off the bed while he was trying to find a vein in my hand for the cannula. His response was to shout at me to calm down, to hold me down on the bed, to tell the nurse to come and hold me in position so that I couldn't move and to start removing my gown so that I ended up laying there half exposed, shaking, crying and with no idea what was going on, just more and more fear and panic.

I'm disappointed that having got in touch to flag my needs/requests in advance (which was a big deal for me to do that) he was then quite insensitive. And I'm annoyed with myself that I let my anxiety get the better of me. Prepping for it was supposed to mean that I had some power and dignity in the whole experience, which was important in and of itself and also in the context of some old trauma stuff. And I didn't end up having that empowered experience because I couldn't manage to control my fear. It just felt frightening and humiliating and I felt helpless. It felt pretty traumatic, to be honest.

I wish I hadn't even bothered to ask for what I needed. Because asking for it and then having it ignored feels worse than shutting up about it in the first place.

My sleep is not good. I don't know whether that's just the effects of the anaesthetic, the side effects of tramadol (tramadol makes me very wired so he prescribed me sleeping pills as well to counter that but they don't seem to be working - I managed about three hours sleep last night) or whether it's because I feel anxious about the experience and there's loads of adrenaline pumping round. I can't seem to rest.

Also, I don't have a therapy appointment in the diary as it's going to be a few weeks before I'm able to be mobile enough to make it to session.

My therapist emailed a few days ago to ask how I am/how it went. I briefly told her that physically it had gone well but that emotionally I didn't feel great because of what happened with the anaesthetist. She hasn't replied and I'm not really expecting her to as we don't really get into therapeutic stuff on email. We haven't discussed stating in touch during my break. I feel like I want to talk through how I feel about what happened. But I don't know if I'm supposed to just wait until I'm able to physically get to session. It feels to needy to reach out and ask if she will do a phone session (I don't even know if she would). But it feels like I want to talk to her.

I also don't know if I'm just feeling wobbly emotionally because I've had an op/a general anaesthetic. And that actually the anaesthetist was just in a bit of a rush and I am now making a big deal about it.

I just feel like I messed up an opportunity to have an empowered, positive experience this time round. I feel disappointed in myself that I couldn't get myself under control.

 

[AngelKeeperJ]

((( @barefoot )))
Bravo that your surgery is over! I know that you feel disappointed in yourself for not being in control. I would like to suggest that the anesthetist was in the wrong for disregarding EVERY precaution you took! How insensitive and downright obnoxious!!! I HATE the know-it-alls who like to think that THEY are in control...and they actually are...but SHOULD have read your chart, and talked to you before they tried to find your veins. It's THEIR D**N fault, and definitely contributed to your anxiety level.

Most hospitals send out questionnaires about your experience. That would be the time to state that you had covered YOUR bases by giving them a heads up about your anxiety. I would tell them about the rude interaction, and the complete disregard for your state of mind! He/she will continue to be a horses rear end to the next patient with anxiety. I worked in the medical field and there is NOTHING more disgusting than a medical professional acting like the "God' of every procedure.

Try not to be disappointed in yourself! YOU did your part PERFECTLY! The protocol which you had been assured would be taken into consideration led to your state of mind when all you did proved to be a "waste" of your time. THAT was wrong!

I hope things settle down, once you get a bit farther out from your surgery. TRY to give yourself a pat on the back for having it done, and for having had the courage to make your needs known. I would also tell your surgeon, at your follow-up how you were treated. Write it out if you think you might have a hard time discussing it. (I know that surgeons can be intimidating, but he should know. I doubt if he was informed of how you were treated. It probably wasn't documented....because it would make the anesthetist look bad.

Sending you positive thoughts, blessings, and prayers that you will be back to normal sooner than soon!

 

[j13]

From your description, I think you had the same surgery I will be having. I hope your recovery is going well and you are not in pain. I'm sorry the nurse was not more compassionate - that must have been terrifying. I am having arthroscopic surgery to repair the torn cartilage in my hip and a torn ACL. Logically, I know my surgeon is the best and that I need this surgery to get my life back (currently can't walk without a cane). But I am still consumed with thoughts of being drugged and unconscious and naked while they poke their instruments inside me. How did you control the anxiety in the days leading up to surgery? Did you have to be completely undressed? (I am planning to wear shorts under the hospital gown, even if they say I can't.) What was it like waking up from the anesthesia? I'm afraid I'll wake up in horrible pain and unable to move.

 

[barefoot]

Thanks @AngelkeeperJ/AKJ and apologies for my delayed response. I read this at the time but didn't have the oomph to reply and then forgot. Sorry!

Things have settled down quite a bit and I'm doing well, thanks - and my therapist thinks what happened with the anaesthetist and my reaction to it (i.e. I didn't dissociate) shows real progress for me and that there's something we can work on there, so that's where we're now going to put our attention.

Thanks for your kind words.

 

[barefoot]

@j13
Yes, I had a hip arthroscopy - to repair a labeal tear and to reshape some bone.

I had it done almost five weeks ago and I've done well, physically. The doctor is pleased with how it went and I have been impressed by the speed and ease of recovery.

To just quickly answer the concerns you've raised:

Yes, had to be undressed under the gown apart from the paper underwear they gave me. And when I woke up, I wasn't wearing those, so they must have taken them off me to do the op once I was under anaesthetic (the thought of which feels pretty ugh to me!) I was not allowed to wear my own underwear, I had to wear their paper ones to keep the sterile environment so I very much doubt they will let you keep your shorts on. I know they wouldn't have let me do that anyway - they absolutely insisted I had to put their paper ones on. Not trying to scare you - just trying to manage your expectations so that you can maybe take some time to get your head around that possibility and see how you want to approach that.

When I woke up from anaesthesia, I felt surprisingly good. Was a bit groggy and a bit uncomfortable but not in bad pain. Body just felt quite heavy - a combo of the anaesthetic and the surgery itself, I think. Instead of pain, it was a bit more of a weird sensation of it feeling not quite like my leg, because it felt heavy and not very easy to move.

How much you can move may depend on whether you have a spinal block. My anaesthetist recommended one for pain relief - he said I would be in less pain when I woke up if I had a spinal block beforehand, so I said ok. When I came to it though, I was freaking out so much with him just before the surgery with him trying to put a needle in my hand that, in the end, I said I didn't want the spinal block. Partly because I was shaking so much that I couldn't say I could lay still enough for him to put a needle in my spine (and me wiggling around with a needle in my spine could have been dangerous). Also, I had a bad experience having a lumbar puncture as a teenager, so I think the thought of that made that anxiety worse. So, in the end, I didn't have the spinal block.

I'm glad I didn't have it as I think I would have found it too stressful. But if the thought of a needle in your spine doesn't freak you out and if you can be still and calm when they do it, it may be a good option for you. He did tell me though (when I still thought I was having it) that I would feel my legs go numb after the spinal block and before they gave me the general anaesthetic. So that may or may not bother you. I imagine that, if you have the spinal block, you may also not be able to feel your legs straight away after the op. I think that would have freaked me out. And the pain really wasn't bad when I woke up. So, I'm glad I made the decision not to have it in the end. But if those aspects don't freak you out, it's another layer of pain relief.

I stayed on pain killers (tramadol) plus paracetamol and ibruprofen for about five days, then dropped the tramadol. Two weeks after the surgery I dropped the ibruprofen. So, I have since just taken paracetamol as and when since then.

And I totally followed doctor's orders. Was partial weight bearing on crutches for first two weeks but all I did was sit propped up in bed watching easy box sets and I just got up to go to the bathroom or pop downstairs (stairs were do-able, right from day one!) So it really was rest, rest, rest apart from a few easy laying down physio exercises from the hospital physio. When I went for my two week review, doctor was really pleased with me/my progress and said the biggest mistake most people make (so they don't have greatest result at that point) is that they do too much. So, I really would recommend that you rest up and take it easy and follow doctor's advice and not try to push it. Easy to push if pain is under control with pain killers and you're under pressure to get back to work/life etc. But I do think I've done more well because I really did do total rest for two weeks as instructed.

Any other questions or concerns I can help with, please do ask. The op itself and the recovery has really been very straightforward and I'm glad that I had it done. But I also totally understand where you're at right now as that was where my head was six weeks or so again. So do please post more here if it would help.

 

[barefoot]

@j13
Just to add re your question about managing my anxiety in the run up...I did some prep with my therapist and this really helped. In particular, there was an inner child exercise that really helped - and I had always been v anti inner child stuff up to this point. I actually wrote the below on someone else's thread about self-compassion, so am just pretty much copy and pasting, so apologies if it doesn't quite all address your question, but the gist of the exercise that really helped should hopefully be there!

So:


Before my recent surgery, I was feeling very anxious because there were two thoughts that just seemed to be playing on a loop all the time and it was very Anxiety-making. The thoughts were:
1) my foot was going to be in traction for the surgery and I kept thinking that, with my foot in traction, i wouldn't be able to get away.
2) that I didn't want the doctor (or his instruments) inside my body.

I didn't flesh these thoughts out much more than this - there was just a building frenzy about my anxiety around these two points that just seemed to be on repeat in my head.

I could understand that these thoughts were probably as a result of stirring up memories from old doctor-related trauma. But I could also see that I was being stupid, irrational, obsessive, ridiculous, over-dramatic, that the anxieties didn't really make sense/weren't relevant now etc. Because not being able to get away because my foot was in traction was stupid and irrational - I would't be able to get away, not because my foot was in traction, but because I'd be unconscious! And I won't need to get away anyway. And not wanting him in my body was largely irrelevant as it was keyhole surgery, so I don't think he was actually going to be in there in any way anything. And not wanting his instruments in there...well...that was ridiculous because of course he has to put instruments in my body to do the surgery! Stupid!

When I told my therapist, she gave me a big explanation of the difference between here and now and the past and said that the feelings and the fears I was experiencing were real and correct but they were in the wrong place. So, my fears about not being able to get away and having things inside me were real and correct but that they belonged in the past, with other events and had nothing to do with the upcoming surgery. It was a really useful conversation and made lots of PTSD-related things really fall into place for me.

And then she said that calling myself stupid, irrational, ridiculous etc was probably the worst thing I can do - because the fears are not those things. They are real, correct, understandable fears based on things that had happened as a child. And that anxiety was now being triggered big-time by the upcoming surgery.

Then I asked, so how do I stop the thoughts because those two things are playing on a loop the whole time. And she said that when that "voice" starts to play (getting anxious around those two thoughts and then my "voice of reason" kicking in to tell me that I'm not making any sense, that I'm being irrational, so STOP IT!"), I need to try to bring it a different voice that will calm, reassure, support, understand, look after etc.

I had no idea what she was talking about.

So, then she modelled to me what I could say to my(younger)self and she spoke for quite a while saying things like "I know you're feeling scared because of what happened before, but that was a long time ago with someone else who did things he shouldn't have done. I know you're frightened and I will help you with that old stuff. But we need to wait until after this surgery. This surgery is going to be a good thing and I have given the doctor and all the medical staff there permission to engage with my body so that they can do the surgery and help to get rid of the pain I've had for years...." Etc etc. She said quite a lot and as I listened, I found it quite hypnotic. To start with I think I was listening thinking, this is weird, I can't do this. But then I found it incredibly soothing hearing her talking to "me" like that.

So...I went away pledging that I would engage with my younger self whenever the anxieties and the punitive language came up to try to reassure her and calm her down. And I did that every time it happened. And the anxieties began to quieten. And I still kept doing that every day in the run up to surgery, even if the two troubling thoughts didn't crop up. I figured I could do with all the calm and reassurance I could get so what was the harm?! :)

I can't explain it and I am really surprised because it is the first time I have ever really been open to any of this younger self/inner child stuff. Maybe something just clicked? Maybe I was just so desperate to calm the anxiety that I was willing to try anything? I don't know. But it did seem to really help.

One thing I did notice was that, when I was introducing this other, more compassionate voice, it wasn't my voice. What I actually found myself doing was remembering what my therapist had said - so I was re-listening (in my head - I didn't say anything out loud) to her saying soothing things...it was her words, her voice or picturing her voice. The following week, I told her that I'd done this exercise every time the fears had cropped up and that it seemed to help but that I'd noticed that it was her voice/words not mine so I didn't think I'd done it right. She said it was still a very valid way of doing it - that even though I had not felt able to use my own words and voice, I had still chosen to "press play" on her compassionate message rather than the usual one I would have played and listened to, telling myself I was being irrational, ridiculous and obsessive etc.

I am still not in any way totally down with this stuff - far from it! But I was very surprised by how effective this exercise was. It really, really helped. But without my therapist modelling it to me and me then using that when I was on my own, I think I'd have been totally lost and wouldn't have known what to do. And then I probably wouldn't have kept trying. Could you maybe ask your therapist to do something similar - she give you a demo of how you could speak to yourself differently with an example that comes up for you? I actually really wish I'd have recorded her...it was a surprisingly soothing, moving experience listening to her, whereas I would have expected it to just feel really cheesy and fluffy and yuck!

 

[AngelKeeperJ]

Things have settled down quite a bit and I'm doing well, thanks - and my therapist thinks what happened with the anaesthetist and my reaction to it (i.e. I didn't dissociate) shows real progress for me and that there's something we can work on there, so that's where we're now going to put our attention

GREAT learning experience, and a chance to realize how far you have come! It's easy to forget that when we have a long road ahead. Sometimes it's ok to look back at how much of the "mountain" we have climbed!

Thanks for taking the time to check in!
AKJ

 

[j13]

@barefoot
Thank you for your reply. I am also having a labral repair, possibly with bone shaving, and an ACL reconstruction - at the same time. (Turns out, I am too old to jump on trampolines.) Thanks for telling me what to expect - I figured they wouldn't let me wear shorts. Maybe I can ask them to put something on me before I wake up, so I don't have that feeling of waking up drugged and naked. I am going to try and talk to them in advance about my anxieties - this is v. hard for me to do. I had been seeing a therapist years ago, but have been doing well recently. I was unprepared for how badly this surgery would trigger me. I feel like I am having ... not flashbacks, because it hasn't happened yet, but intense flashes of watching myself undergo surgery.... not sure if that makes any sense. Like watching myself, unable to move, while they do things to my body. And my leg will be trapped in the machine and I won't be able to escape. And then I feel full on panic, crying, shaking, all of it. I haven't felt this way for years now. I called the therapist I had seen before, and she has apparently closed her practice. I made an appt with my regular dr. to see if she will prescribe me something for the anxiety. I am also going to try your method of introducing a new voice to the noise inside my head. "This surgery will fix the pain in my knee/hip. The doctors are doing this to help me, and I have given consent for them to do what is needed to fix my leg." Sorry this is all over the place, I am not doing too well this morning.