Understanding and Dealing With a Fear of Surgery

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What is Surgical Fear and Anxiety?

Depression and Surgery Image
Worried About Surgery. Image: © Andrea Morini/Getty Images

Surgical anxiety is a psychological issue where a patient’s fear of surgery is so significant that they can begin to have physical symptoms such as a racing heart, nausea, and chest pain. A severe bout of anxiety is commonly known as a “panic attack” can be caused when a patient afraid of surgery dwells on their fear or begins the surgery process.

Patients with an anxiety disorder may be more prone to surgical anxiety and fear than the average patient, but many people first experience it when preparing for surgery. Reasons for anxiety vary from fear of the unknown to having a bad experience with previous surgeries.

Surgical anxiety can be caused by fear of the result of the surgery, like an alteration in the appearance of the body, such as a mastectomy. Another surgery that can affect the self-esteem of the patient is prostate surgery, where the patient is facing the risk that they may lose sexual function. While all surgeries have a risk of death, some surgeries have a higher risk than others, resulting in the patient pondering his/her own mortality.

Regardless of the cause of anxiety, it is essential to seek treatment so the patient’s health does not suffer. Anxiety can be a vicious cycle, with the stress and physical symptoms causing sleeplessness, which in turn makes the anxiety worse as the ability to cope is diminished. Many patients with severe anxiety will postpone or avoid surgery, even if it is very harmful to their health. Controlling the anxiety well enough to allow surgery to proceed is essential.

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Arm Yourself With Information

An important step in dealing with surgical anxiety is to become as well informed as possible regarding the illness, prescribed therapies, and surgical treatment. Having a complete understanding of the procedure, why it is indicated, and how it is performed can relieve a great deal of worry. An understanding of anesthesia and the low risks of having anesthesia may also help with concerns about surgery.

If anxiety is caused by a lack of knowledge about the procedure, it is essential that any patient ask questions and find answers until the decision to have the surgery and the choice of surgeon is fully understood. For many, anxiety is a normal response to being expected to make a life altering decision with minimal information. Once the patient has the necessary facts the anxiety may be relieved.

If the anxiety is based upon financial concerns, determining the availability of sick time or disability coverage may relieve worries, as will determining what health insurance will cover and what costs will be passed on to the patient.

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Talk to Your Surgeon About Your Fear of Surgery

In some cases, anxiety occurs when the patient has no idea of what the surgery entails and is left to imagine what the procedure and the result will be like. The physician performing the surgery can provide a realistic idea of what the outcome of the surgery will be and a typical course of recovery.

When the anxiety is related to the surgery itself, and explaining the procedure does not provide relief, some surgeons will recommend prescription drug therapy to calm the patient enough to make the surgery possible. Antidepressants and anti-anxiety medications are typically used for this purpose.

If the patient has had a bad experience with surgery, or has had a loved one who has, speaking with the surgeon may provide reassurance that this is a different surgery and a different situation.

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Explore Alternative Treatments for Surgical Anxiety

Some patients benefit from treatments that are considered alternative medicine, such as acupressure, acupuncture, massage, “tapping”, yoga, hypnosis, biofeedback and herbal supplements. Patients who are open to the use of these non traditional remedies often find some level of relief, even if it is just being able to sleep more deeply. It is important to know that alternative medicine should be used as a way to combat the anxiety associated with surgery, not as a treatment instead of surgery. These complimentary treatments are not a replacement for a needed surgery, but a way to better cope with the the stress surrounding the procedure.

Herbal supplements, including teas, powders and other “all natural” plant extracts should not be used without consulting the surgeon. Many herbs, despite the label “all natural” are known to interact badly with anesthesia and other medications. Some can cause “blood thinning,” heart arrhythmias, and other reactions that are not desirable during surgery.

Studies have shown that something as simple as reading a book during the preoperative phase can alleviate anxiety by taking the patient’s mind off of what is about to happen. Relaxing music can have the same effect. If the patient has a normal stress reduction routine, such as taking a bath or a walk, it should help with surgical anxiety.

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Seek Counseling if Your Fear of Surgery Persists

If anxiety persists, even with a full understanding of what is realistic during and after the procedure, counseling may be an option. In situations where surgery can have an impact on self esteem, such as the removal of a breast or surgery that causes erectile dysfunction, counseling may help the patient cope with the changes.

Patients who are having surgery for life threatening illness, such as cancer, may also benefit from speaking to a counselor. Being able to discuss concerns openly with someone who is not directly involved can be very therapeutic, especially if friends and family members are unable to be impartial.

Counseling may also help patients who have had a bad experience with a surgery or healthcare in general to conquer their fear. Most therapists are able to recommend exercises to help control anxiety and the physical response to stress.

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Helping Your Child With Surgical Anxiety & Fear

Children are unique when it comes to surgery because they often take on the attitude of their parents, good or bad. If a parent is obviously fearful of surgery, the child can often pick up on that emotion and become fearful. Addressing anxiety is very important as studies have shown that children who are calm before surgery have better outcomes.

Children should be told of the procedure with enough time to have their questions answered, surprising a child with a surgical procedure can lead to lasting fear of healthcare and should be avoided whenever possible.

A child will usually adopt a parent’s healthy attitude toward surgery, so it is important to be upbeat and positive about surgery in general. A great example is this: “After your tonsils are removed you will be able to eat ice cream and popsicles” rather than “after your surgery you will get cold things to eat because your throat will hurt”.

The best way to approach surgery varies with the age of the child. With young children parents often decide not to tell the child about the surgery until a few days prior to the procedure to prevent the “are we there yet?” type of response. Older children may be well aware of the scheduled surgery, but should have multiple opportunities to ask questions of the surgeon.

In older children, their view of surgery may be skewed by what is seen on television, so a “reality check” type of meeting with the surgeon may be necessary. Most pediatric hospitals offer pre-surgery tours and information sessions to help relieve anxiety, and offer many programs to help their patients.

More Information: Preparing Kids For Surgery

Sources:

Anxiety Disorder. Patient Version. U.S. National Institutes of Health, National Cancer Institute. January 10, 2008.

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