Preparing for Surgery? 4 Ways to Reduce Its Traumatic Impact: Part Two
This is part two of a two-part article. In part one, I examined how surgical procedures can be potentially traumatizing and what symptoms could result from trauma. In this article, I outline four steps you can take to minimize the likelihood that the surgery will lead to trauma.
Under going surgery is a big deal, whether the procedure is planned or performed in an emergency. From your body’s perspective, being cut open and given an anesthetic is an invasive procedure and may be overwhelming or traumatizing to your nervous system.
By definition, trauma can happen when you feel out of control or helpless. Taking charge of the surgical process as much you can may will minimize your sense of helplessness and hopelessness. To help you prepare for and recover from surgery easier, keep in mind the following four steps:
1. Be pro-active when you engage with medical doctors
2. Choose the hospital carefully
3. Engage the help of friends and family
4. Use yourself as resource
Be Pro-Active with Medical Doctors
Before the Surgery with the Surgeon
Just as you would carefully select a big-ticketed item such as a car or house, think of yourself as a consumer who wants the best service for your money and time as you prepare for surgery. The first step often begins with choosing the surgeon. Seek to answer two questions when you select a surgeon: “Is he or she competent?” and “Do you have confidence in this person?” If time allows, take time to interview the surgeon. Your life will be in his or her hands!
Some questions to consider:
1. Do you want a second or third opinion in order for you to believe that surgical treatment is the best option? If you doubt that the surgery will be a helpful, keep talking to doctors until your intuition about the necessity of the surgery is confirmed or denied.
2. How much detail do you need to hear about the procedure in order for you to know whether you feel confident about the doctor’s skills? If you know that too much detail can overwhelm you, settle for hearing about just the basics.
3. Can this doctor meet your emotional needs? Those with good bedside manners can significantly reduce your anxiety.
4. How many times has the doctor done the procedure that you need?
5. Will the doctor give you names of former patients so you can interview them?
6. Do you have a choice of when the surgery will be done? Having too little or too much time to prepare may influence your anxiety level.
Insist that the doctor answer all your questions. Having someone with you, who can take notes or run a tape recorder, when you interview the doctor will give you ways to review the information later.
Paying attention to what your intuition tells you about the surgeon, to the softness and kindness felt in her handshake or to another’s experience with the surgeon are some of the ways you will know if the doctor is the right one to do the job.
Before the Surgery with the Anesthesiologist
The other significant person during surgical procedures is the anesthesiologist. As with the surgeon, you will want to have someone who is competent and inspires your confidence. If possible, meet the anesthesiologist who will be in the operating room with you one day to one week in advance. Meeting this doctor just ten minutes prior to surgery may not give you adequate time to develop trust.
Some questions to ask include:
1. What medication will be used and what are its side effects? This includes pre-op and post-op pain medications. Having the option to have the pain medication dispensed out of a special machine that you control can help significantly reduce the pain and thus speed the recovery process.
2. Can you have a pain block administered at the site of the incision even if you are under general anesthesia? General anesthesia does not prevent the unconscious brain from registering pain and thus trauma. Local pain blocks, however, prevent the pain signal from going to the unconscious brain.
3. If you will be awake during the surgery, what should you expect about the local or regional anesthesia?
4. Is the anesthesiologist willing to make healing statements during the surgery? During surgery your auditory system still registers words and you are highly suggestible. In many cases what is heard, can actually be recalled later!
5. Will the anesthesiologist be willing to touch you a certain way as you go under the anesthesia? A comforting touch could significantly reduce your anxiety.
During the Surgery
What you hear during surgery can impact your nervous system. Operating rooms can be very noisy; the loud and sudden sounds of machines can sound obnoxious or intrusive to the unconscious mind. In a drugged state, you may hear just parts of conversations among the surgical staff and you may misinterpret what is said. For example, if a doctor tears a glove and says, “I can’t do this, give me a new one,” you may hear “I can’t do this” and interpret that to mean the doctor is giving up.
If you overhear a discussion about a negative diagnosis you may think the situation is worse than it is. You can minimize the shock of this news by asking your doctor not to discuss it within earshot or only after you have regained full consciousness.
To block out operating room sounds, ask hospital staff is you can listen to pleasant music through headphones during the surgery.
Because anesthesia can put you into a highly suggestible state, ask the surgeon or the anesthesiologist to read healing statements to you just as you go under and just before the end of surgery.
These can include:
“ Following this operation, you will feel comfortable and heal very well.”
“Your operation has gone very well.”
Taping these statements on to your hospital gown and giving a copy to the doctors may remind them of your wishes.
Choose The Hospital Carefully
If you are fortunate to have several hospitals from which to choose, select the one that best meets your needs. You may be making a mistake to choose the one closest to your home. Your research could make the difference in cost and ease and speed of recovery.. Your physician and a search on the Internet may help guide you.
One excellent source for non-technical information is the Medicare’s website at www.medicare.gov. On this site, select “resource locator” then “hospitals.” This site allows you to search hospitals by location and medical procedure. You can then compare the results according to ten different criteria such as: “How often was patients’ pain well controlled?” and “How often did patients receive help quickly from hospital staff?”
Engage the Help of Family and Friends
Your friends and family can play an extremely important role in the preparation for and recovery from surgery. Helpers are needed to serve two functions: to provide emotional support and to act as advocates in your health care if you cannot do this for yourself. These people may be available to you even when you need an emergency surgery.
If you are helping a child prepare for surgery, ask the hospital if they have orientation classes for children. They may be able to let the child see the operating room, the hospital room, the doctors and any equipment that will be used. If this is not possible, use story telling and role-play with the child at home.
Following surgery, you can take steps to minimize trauma happening for the child. Stay with the child as much as possible before and after the surgery. Ask the staff not to strap the child down if she is frightened. If the child has pain afterwards, ask her to gently shift her attention between the area of pain and another one that is pain free. This helps the child to feel less overwhelmed by pain.
Emotional Support
Choose a few people who are calm, compassionate and kind who would be willing to send you well-wishes. They may be people from your faith community or those who trust in the power of thought to influence another’s well being. Make a specific request that they send you love, tranquility or peace just prior to surgery. Share with them any images that have meaning to you such as seeing you sitting quietly near a mountain stream. If possible, have someone with you as you go under anesthesia and when you awake. This can help you to surrender to the anesthesia and be less disoriented when you wake up. During your recovery, let them know if you would also like some form of touch or perhaps the company of a pet, if the hospital allows this. Emotional support in the form of practical assistance with house chores and childcare while you are recovering may significantly reduce your anxiety.
Health Advocate
A person who takes on this role understands the need to closely observe the doctor’s orders and how they are being carried out. Mistakes, some of them lethal, do happen. A health advocate, who is not flustered by strong authority figures, may be able to help prevent these mistakes by simply asking questions. For example, she would not be reluctant to question a nurse who brings in food after the doctor just announced that food is forbidden. The presence of a health advocate lets the hospital staff know that you have someone watching over you.
Use Yourself as a Resource
Your mind is a powerful healing tool! Use it to help with relaxation and to create a positive outcome of the surgery.
Practice Relaxation Technique
As I discussed in part one of this article, there are many aspects of surgery that can induce the stress or threat response in your nervous system. Knowing how to counter this kind of response through relaxation can significantly improve your recovery process and reduce the likelihood of you becoming traumatized. It reduces the production of stress hormones and turns off the switch that tells your nervous system to be on-guard. In addition, the relaxation response increases the body’s capacity to fight infection through the production of natural antibodies. Doing the relaxation exercises before and after the surgery is the most effective.
There are many ways to elicit the relaxation response. One way is to recall or imagine a pleasant or peaceful experience.
Ask yourself:
Where are you?
Who is with you?
What are you doing?
What is the time of day or year?
To each question, notice what you see, hear, smell, touch or taste. By paying attention to how your senses respond, you can engage with the part of the brain that controls the threat response.
Another technique is to work directly with the sensation in your body. You can do this by starting at your head and working toward your feet, alternately tensing and releasing each area of your body. Pay particular attention to tensing your tongue by pressing it against the roof of your mouth then letting it drop. You may notice that this simple technique will also relax your pelvic area!
Create a Positive Outcome
Professional athletes understand the power of visualization. Many practice “running” the course in their mind, seeing each yard of the track and every hurdle they have to pass over. This gives them as much of a workout as if they had actually ran the course.
Your mind has the same capacity to influence how you respond to a surgical procedure. Before the surgery, begin to focus on a positive outcome. Notice that you have a choice whether you follow the anxiety provoking thoughts.
Talking to the doctor about what the positive outcome will look or feel like may be a good place to start. If you like to know the details, envision each step of the surgery going smoothly and with ease. Imagine blood vessels opening or closing to allow just the right amount of blood to pass. See red and white blood cells at the site to repair tissue and fight foreign organisms.
If you are not clear about the bigger picture of why you need surgery, engage in a conversation with the injured body part. Visualize it in front of you and ask:
Why are you not well?
Is there something you want me to learn about my life?
What healing process needs to take place during the surgery or in other areas of my life?
Before and following surgery, focus on seeing and feeling the part healed. If healing means the removal of a body part, thank it and say goodbye. Envision and feel yourself engaging in relationships and activities that bring you joy following the surgery.
Summary
Actively engaging in the steps leading up to and following surgery can significantly impact how easily you recover and how much your nervous system becomes traumatized by the surgery. There are several steps you can take to maximize the outcome. These include
1. Being pro-active with medical doctors, including the surgeon and anesthesiologist before and during the surgery.
2. Choosing the hospital that best meets your needs.
3. Engage friends and family to offer you emotional support before and after the surgery and to act as health advocates to watch over you post-operatively.
4. Use yourself as a resource. Practice relaxation techniques and imagine positive outcomes of the surgery.
Next Step?
An excellent resource is the book with an enclosed CD of guided relaxation techniques Prepare for Surgery, Heal Faster, by Peggy Huddleston.
If you would like additional support or are struggling to relax due to anxiety from previous traumatic experiences, you may benefit from working with a professional counselor, who understands how trauma affects the body and knows how to help you actually discharge it. Learning how to just cope with the symptoms of trauma may not help you navigate the threats surgery presents. For a list of therapists, go to the Foundation for Human Enrichment at www.TraumaHealing.com
If you are considering whether I may be the right one to help, I offer a 30-minute complimentary consultation. For those in the greater Denver area, I can be reached at 720-635-7943.
