Very anxious about upcoming surgery - need help calming my nerves
March 11, 2013 8:07 PM   Subscribe

I'm having a total hip replacement in five weeks. While this is a fairly routine operation, I had some pretty traumatic experiences with surgery/hospitals/recovery during my childhood, so it's hard for me to think about this whole process without digging up those memories. I'd like advice on how to manage my anxiety in the coming weeks. More details inside.

Between the ages of ten and thirteen, I had seven hip and leg operations. Of these operations, three involved complications that led to worlds of unexpected pain for me. Even aside from the complications, I grew accustomed to doctors telling me something wouldn't hurt, only to wake up from anesthesia in absolutely excruciating pain. My recovery time was spent largely bedridden and isolated, as my parents both worked, and I didn't really have friends at the time. For the worst of the operations, I developed anorexia (unintentionally), as I was in so much pain and so depressed that I simply didn't have any appetite (and trust me, under normal or even most stressful circumstances, I eat a lot!); I got down to 60 lbs in sixth grade. All of this is to say that these were incredibly difficult years from me. I am still not at the point where I can think about these experiences without crying.

Fast forward 18 years of arthritic, chronic pain later, and I've decided to have a total hip replacement. I've been wanting this for years -- the promise of increased mobility and much less pain is something so incredible to me that I really can't even imagine it. I'm grateful that I have access to healthcare and can take this step for myself. However, I'm still scared shitless. I don't know how to think about a pre-op room without seeing my panic-stricken 10-year-old self; how to imagine waking up and not hating the doctors for lying to me; to see myself through recovery, without the depression and loneliness accompanying it. I know, rationally, that this is not the same as before. I'm more equipped to handle it now, I know as much as possible what I'm getting into, I have tons of support, and really, it shouldn't be anywhere near as painful or difficult as my past operations. Those rational thoughts really do almost nothing for my anxiety, though.

I see a therapist already, and we are talking about this. It's helpful, but I wanted to put this out to metafilter for any possible tips or pieces of advice. I'd rather not spend the next five weeks feeling as anxious as I do now.
posted by amandi to Health & Fitness (16 answers total) 2 users marked this as a favorite
My mom had both done at the same time last may. By august she was playing 18 holes of golf. It's super routine surgery. Work your physical therapy and you'll be fine.
posted by Oktober at 8:22 PM on March 11, 2013

Have you talked to the doctor about your previous experiences? If he/she knows that you've had difficult recoveries in the past, he/she may be able to reassure you about (a) improved techniques that should make your recovery easier, and more importantly (b) steps that can be taken to address complications should they arise. You're much more empowered now than you were as a little girl to call the doctor and say, "hey, my pain isn't under control and it needs to be addressed quickly." And tell your doctor you have a lot of anxiety about it. IANAD, but a prescription for Xanax or the like to see you through doesn't seem like a terrible idea (if it doesn't interact with your pain meds).

I went through a bad period of mysterious facial pain a while ago (the clinical term is "suicide pain" if that gives you any clue), and for me the worst part of it was the uncertainty and the not knowing what the next steps were for dealing with it. The next time it happened, I was better prepared. It still hurt and it still sucked, but it didn't almost destroy me like the first time. I just accepted it and that made it easier to endure (if not ignore--it was impossible to ignore).

And finally, just, well, feeling my feelings helped. I'd get anxious and upset, and then eventually I could say to myself, "I'm feeling anxious and upset about this." And just naming it helped me control it. It was a symptom I had to deal with, like everything else. Yoga and meditation helped with me.

Good luck and best wishes for a quick, uncomplicated recovery.
posted by elizeh at 8:29 PM on March 11, 2013 [2 favorites]

Tell your doctor about your previous experiences and the (absolutely positively justifiable) fears your previous experiences left you with. Ask your doctor to be open and honest with you about the kind and level of pain you can reasonably expect. Make sure to include an extensive discussion about pain management options.
posted by erst at 9:16 PM on March 11, 2013

Definitely talk to your doctor about your concerns. See if you can meet the nursing staff ahead of time.

FWIW, standard of care has really changed towards a customer-service focus in recent years. I had (minor outpatient) surgery last year, and I was really impressed with the interaction I had with each nurse, tech, etc (the surgery was done by one of my doctors). I remember them telling me before the surgery that when I woke up to let them know as soon as I started feeling pain. I vaguely remember having some pain a few minutes after waking up, saying something about it, and a few seconds later it going away. It was really a positive experience even though having surgery is scary.

One thing that helped me was to plan to make things as comfortable as possible for after the surgery. My surgery was way less serious than yours but did involve a few days at home. I made sure I had my favorite foods, some DVDs, magazines, etc stocked up, that really helped.
posted by radioamy at 9:19 PM on March 11, 2013 [1 favorite]

Given your history it is reasonable to assume that this won't be as straightforward as operating on a vigrin hip. Talk to both your surgeon and your anesthesiologist about your concerns, and remember that you don't have to have the surgery until these concerns are addressed. Some hospitals offer an acute pain service that your surgeon can consult with post-op. You also might want to see if using an epidural for post-op analgesia is an option for you. Given all of the options for pain management that are out there now, they should be able to keep you comfortable.
posted by TedW at 10:00 PM on March 11, 2013

Fear is usually linked to feeling like you have no control. You are in control of this, much more so than you were when you were a kid. You are the one signing up for the surgery, and after it's over you can fart around online and watch the movies you like on Netflix. These days we have so many options that you probably didn't have when you were a kid. You're not going to be stuck in your room, bored and lonesome. It's a different time.

You say you have some support now, and I think it could help to talk this through with your loved ones. They can come around to visit you, talk to you on the phone, etc. If possible, it would be a very good idea to have a loved one stay with you for a while.

You could think of this as time to get something done, to work on projects, to finally read Moby Dick, to watch the full run of one of those critically-acclaimed TV shows you've always meant to check out. Schedule the time, make it your own.

Also: Vicodin.
posted by Ursula Hitler at 11:29 PM on March 11, 2013

Hi, I used to well I guess I still hate hospitalizations, because who doesn't? These are my two workarounds:

a) Set OUTRAGEOUS reading goals. Like, reading Pynchon's Mason & Dixon in a week. I would read read read, then give myself an hour of teevee a night. Setting a schedule and achievable things that you can do there helps me, at least.

b) Nurses can just be the awesomest. But a lot of patients (often those who haven't spent much time in the hospital and don't really grok how much pressures nurses endure) will be another source of stress for them. I totally butter up my nurses. Give them jokes, thank them. The result, just in my experience, can be that nurses will want to make you comfortable, rather than avoid you as a source of stress. I mean, it varies; one nurse opened up to me about her love of the Saw movies and proceeded to retell the plots and I was like 'really' but other nurses have been awesome sources of laughs, comfort, and even some have gone to bat for me vs. doctors.

Good luck.
posted by angrycat at 4:05 AM on March 12, 2013

I had a hip replacement and other ortho work done as a result of an accident. That was my first hospital stay since about the 1 year old mark, so I have nothing to compare to, but I think I can say pain management has come a long way. I was pretty jacked up because of the injuries, but what I observed was that the patients who were in for non-trauma replacements were in and out quickly - walking in a day or two and gone the 3rd day, at least. I myself, with a much more difficult situation, am walking limp-free now.

Nthing DO THE THERAPY.And talk to your doctors about your concerns.

PM me if you have specific questions.
posted by randomkeystrike at 4:43 AM on March 12, 2013 [1 favorite]

I don't know how to think about a pre-op room without seeing my panic-stricken 10-year-old self

This week, or as soon as you can, go to the hospital where you will be getting surgery and familiarize yourself with the layout, where you will have to go to sign in, where you will be waiting for pre-op. If it's not to busy in the waiting room, have a seat and wait for a bit. Read something pleasant. You might want to see if they have wifi while you are there.

You might not be able to see the pre-op room beforehand, but you can at least give yourself some newer and not-panic stricken associations with where you'll be before the pre-op room.
posted by yohko at 4:49 AM on March 12, 2013

Talk to your surgeon about how he or she plans to manage your post-op pain. Will you have a PCA pump? Will there be a 'breakthrough' painkiller available to you when the standard method isn't enough to keep you comfortable? Knowing the pain management plan well in advance can be very comforting as you can envision being cared for even when you imagine a 'worst case scenario' of pain.

Excuse me if I'm wrong, but I assume with hip surgery you won't have any limitations on your diet after surgery. If that's the case, I would arrange with a friend to have your favorite meal or snacks brought to you from outside the hospital. It can be tremendously comforting, and it may nip any resurfacing feelings of anorexia in the bud to have a happy meal (no pun intended) instead of unfamiliar hospital mush.
posted by telegraph at 5:48 AM on March 12, 2013 [1 favorite]

When I was facing some difficult medical treatment which I knew was going to arouse some bad memories this year, I visited a hypnotherapist. I have been to him before, so I was able to set in phrases for him to use "I will be calm when undergoing injections and other medical procedures" etc. I had one session which he taped, I then played that every night as I was going to sleep and during my procedures. While waiting for an anaesthetic, my blood pressure noticeably dropped when I was listening to this. If you can find someone with good training and experience with phobias and fears, it can REALLY help (and I was sceptical and claimed I couldn't be hypnotised - yeah, right).

Memail me if you want more info on this. And good luck. Good advice on here from the others, too.
posted by LyzzyBee at 6:09 AM on March 12, 2013

If you want to try the method described above about visiting the hospital in advance, you might contact the social worker's office and see if they can get you an escort who can walk you around the pre-op rooms and places that a random person can't access.
posted by CathyG at 6:55 AM on March 12, 2013

I am a younger guy in my thirties recovering from a hip replacement that I had 5 weeks ago. I understand your concerns as I definitely had some real anxiety going in as well. My last surgery was as a child. I developed severe anxiety about medical stuff when I got older. That is getting under control once I realized that I need to be proactive about my own health and quality of life.

My thoughts:
Like others have said, talk to your surgeon. If he/she is dismissive then consider finding another one. Make sure you are comfortable with them and that they listen to your concerns. I did my homework and found the best specialist I could find. Thankfully he is local and is a leader in the field of total hip replacements.

Tell the nurses during your pre-op appointment. The nurse I had knew I was anxious and asked me if I would like to have some drugs immediately after I arrived for surgery to take the edge off. I don't think such a thing is too uncommon.

Learn about the surgeon and the procedure. One of the best little anecdotes that a friend of mine gave me was "Hip replacements are basically like changing a tire on a car for these surgeons, they have done it a million times and can probably do it in their sleep" Seems silly but it did ease my mind.

And really the technology has come a long way. I walked from my gurney to my hospital room bed four hours after the surgery. I was walking up two flights of stairs to my apartment with crutches two days later.

Post surgery, be sure to communicate and be your own advocate. Be vocal and let the caregivers know what you do and don't need. Don't want to move or be moved because of pain then tell them. Need more pain meds, tell them. Think they are doing something wrong, tell them. Think something doesn't feel right, tell them. Also, like others have said the nurses can be the best part of surgery. I had some great ones and I was grateful for that. Part of it was because of my age and they sympathized with me a bit more I think.

For comfort the best thing I had post surgery was some sugary candy, like hard candies, lollipops, and tons of ice water. I was too high to read or even watch television. Also having my wife and family visit was nice.

One thing I should mention is that I had unrealistic expectations about the surgery. I kept hearing from other people how they were practically running four weeks after the surgery. I am going on week six and still walk with one crutch. That has been frustrating and it took me awhile to realize everyone is different and everyone heals different. Also, people are liars. The other thing people told me is that the pain is minimal. That was not the case for me. It was fairly significant and I discovered that a lot of the pain meds didn't do much for me but they did take the edge off and allowed me to do my PT.

Sleep will probably be an issue post surgery. It was for me and everyone I know that has had this done. But it was hard for me pre surgery too so it hasnt been much of a change. I know it will get better.

I am getting there, and I just noticed a few days ago that I no longer develop severe pain after sitting for more than 20 minutes. Five years of that pain is now nothing but a terrible memory. Try and stay positive and good luck and feel free to message me on here if you have other questions.

Oh one more thing I found a forum filled with people going through the same thing:

Some real good info on there and real supportive members.
posted by WickedPissah at 8:42 AM on March 12, 2013

To get more specific about that forum (i did not sign up but got some good info on it) this list of links was very helful to me: Recovery from THR
posted by WickedPissah at 8:49 AM on March 12, 2013

I was just in the hospital for several days. Like others have mentioned, the nurses are a fantastic resource. Please don't feel like you're being a bother by asking them for help. That's why they're there. In fact, they're going to get upset if you _don't_ ask them for help when you need it. If you're anxious, ask for suggestions on how to mitigate it. For instance, I was having issues with the hospital noises and mentioned it to one of my nurses. She hunted through all the empty rooms and came back with a box fan that provided excellent white noise for me at night. Because nurses are awesome like that!
posted by Addlepated at 8:52 AM on March 12, 2013

I have had two periacetabular osteotomies for hip dysphasia (and I had several eye surgeries as a kid). For me, the worst part by far was the anxiety before the procedure. It's such a relief waking up afterward and being grateful it's all over.

I also played a recording made by a hypnotherapist (who I saw for fear of flying, but still....) and I visited the Facebook group called Adult Hip Dysplasia, which helped me feel less isolated before and after. Others have asked their doctor for medication.

I hope your surgery relieves the pain you're in now, and that you find something to help you relax.
posted by mgrrl at 12:44 AM on March 13, 2013

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