Friday, January 16, 2015

Pre Surgery Anxiety/Jitters Are Not Created Equal

Pre-Surgery Jitters are real. Most men and women face a range of mild to severe jitters, days or weeks prior to their surgery. Since I'm blessed with a wife who has a wonderful sense of humor, She and I decided to hold a contest to determine which one of us had the longest list of pre-surgery fears.

My wife is an RN and I've had training and experience as a Medical Social Worker. Between the two of us we came up with a very long and impressive list of fears. After reviewing Brenda's list of fears and sharing my own list, I declared that I'd won the contest. Brenda disagreed. She was certain she'd won. We both shared a hearty laugh and we were laughing at our fears! Humor is a wonderful way to cope with fear. Our laughter didn't take away our fears, but it did take away some of the power away from them.

No matter what type of surgery you are facing, it's possible your anxiety or fear can become so debilitating you think about canceling your surgery, even if this would have an adverse effect on your health.

Here are a few of the concerns/fears that most people face no matter what type of surgery you are scheduled for:
*The fear of dying on the operating table.
*The fear of losing control once you are given anesthesia.
*The fear of waking up in the middle of the procedure
*The fear your surgeon will make a mistake or that the surgery won't go well
*The fear of post-operative complications
*The fear of post-operative temporary and/or permanent changes that will occur post-surgery
*The fear of post-operative pain
*The fear of staying in a hospital overnight
*The fear of the unknown, especially if this is your first surgery
*The fear of the known, especially when you've had serious problems after a previous surgery.
*The fear of post-surgery complications, such as an infection or an adverse reaction to a medication
*The fear of failure that surgery won't correct or solve the problem you hope it will.

This list is far from conclusive, but it's certainly long enough and stressful enough to create anxiety, sleep loss, difficulty concentrating, irritability, and ongoing, unwelcome and intrusive thoughts about surgery throughout your waking hours.

I've learned through experience not all pre-surgery jitters are the same. The reason for surgery creates surgery specific jitters.

For example when I had my prostatectomy I was extremely concerned whether they would find cancer outside of my prostate. I was very worried about whether or not I'd have double nerve sparing surgery which could enable me to recover my erectile functioning. Before my prostatectomy I was worried about a potentially life threatening cancer and whether surgery would cure me. My pre-surgery jitters made sense to me.

Four years later I'm facing another surgery. This is not a life threatening situation. In fact it's the opposite of life threatening, it is a restorative and life enhancing surgery. Despite double nerve sparing surgery and penile rehab I did not regain my erectile functioning. Year after year things got worse rather than better, until nothing worked at all. That's when I decided to treat my ED with a penile implant.

Since this is my 5th or 6th surgery in my life time and it's an elective procedure that I want, I expected a jittery/anxiety free pre-surgery experience. That's not what happened. Instead I simply created a new surgery specific list of fears. Some of them are:

* The fear the device will be defective leading to a second surgery to remove it and a third to get a working implant.
* The fear I'll develop a post-surgery infection causing everything related to my first fear to happen.
* The fear a pump placed in my scrotum will cause discomfort causing me to regret this surgery.
* The fear the implant will damage my urethra in such a way I'll need a corrective surgery.
* The fear I won't be able to find the release trigger which will result in very embarrassing and humiliating emergency room visit.
* The fear sex won't be the same and I'll  end up feeling disappointed and discouraged.
* The fear I'll be in the 2% where the pump simply won't work, leaving me with permanent life-long ED.

There's some good stuff keeping me awake as well:
* The anticipatory excitement of making love to my wife- That can't come soon enough for me!
* The excitement of planning a romantic get a way.
* Getting back something that cancer took away.

Combine both these lists together and you have a stressful brew that could easily set the stage for difficulty sleeping. I can regretfully say that's exactly what's happening with me.

I have no solutions, but I am taking positive steps. First I'm addressing the concerns that can be addressed. Issues such as pre and post surgery pain control. Additionally, I've worked to improve my health by using an exercise bike. I bike ten miles a day 6 days per/week. I'm lifting weights 3 days a week. I've lost 5 lbs in the last month. I'm doing all I can to be in top physical condition before going into surgery. I'm also working to manage my expectations so I won't face total devastation if the surgery is not successful.

At night I've stopped eating anything within four hours of going to bed. I avoid alcohol or caffeine. I'm keeping my bed time consistent. I start my night with a minimum dose of sleeping medication. If I'm not asleep in 20-30 minutes I get out of bed to take a full dose. I read for a half hour or so and then I go back to bed.

I've discovered what I read at night matters. If I read about the implant surgery my anxiety increases. If I read my Bible and pray my anxiety is reduced.  Only seven more days until surgery!

Rick Redner & His Wife Brenda Redner are the authors of:
I Left My Prostate in San Francisco-Where's Yours?

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