Advice from a General Surgeon: Reducing Anxiety Before Surgery
Faced with the prospect of surgery, many people feel anxious and afraid. They worry about anesthesia, they dread pain, they fear the unknown and loss of control. While some anxiety is normal, patients need to know that surgery is safer than ever due to advances in anesthesia, minimally invasive procedures and pain-control techniques. H. Clark Federer, MD, a surgeon on staff at Swedish Covenant Hospital, offers his advice.
Q: What can people do before surgery to feel less anxious?
The patient needs to trust the physicians, and communication is the key to trust. The best thing you can do is to sit down with your surgeon prepared with a list of questions and concerns. Give a great deal of thought beforehand to what you want and need to know, and then ask everything.
Q: How safe is anesthesia?
According to the American Society of Anesthesiologists, complications from anesthesiology have declined dramatically over the past 25 years. In the last decade, the number of anesthesia-related deaths has decreased from one in 10,000 to one in 250,000. You are far more likely to be struck by lightning.
The advent of the pulse oxygenation monitor, which measures the amount of oxygen in the blood, was a huge advance in safety. Now, if a patient's blood oxygen level drops, we know it immediately and can deal with it on the spot. Anesthesiologists at Swedish Covenant Hospital use new brain wave technology to monitor the depth of anesthesia. This can be reassuring to patients who are afraid they'll get too much - or not enough - anesthesia.
Q: What can be done to minimize pain?
There will always be some pain after surgery. But many of the new minimally invasive surgeries result in less pain due to smaller incisions and new pain management techniques that use local anesthesia along with general anesthesia. We put a long-acting local anesthetic agent directly into the wound, which numbs the area and kills pain for several hours, and reduces the need for narcotics. Narcotics tend to cause nausea, vomiting and constipation, since they effectively put the bowels to sleep, so the less we use, the better.
For example, people often complain of shoulder pain after abdominal surgery. This is actually referred pain from the diaphragm, which has been pressed by the carbon dioxide we use to inflate the abdomen. By injecting local anesthesia into the abdomen, shoulder pain is greatly reduced.
Q: What about complications after surgery?
After surgery, it's very important to get up and moving as soon as possible. The less pain you're in, the more you are willing to move, and the more you move, the less apt you are to develop pneumonia or other complications.
In the vast majority of cases, the benefits of having surgery far outweigh the risks. People often tell me that the surgery was smoother and less painful than they had anticipated. They'll say, "I'm so glad I finally did this. Why did I put it off for so long?"
H. Clark Federer, MD, is a board-certified general surgeon and a fellow of the American College of Surgeons. He received his medical degree from the Texas Tech University Health Sciences Center School of Medicine and completed his internship and residency training at Rush-Presbyterian-St. Luke's Medical Center in Chicago and is a member of Swedish Covenant Hospital's medical staff.
To reach Dr. Federer or any other Swedish Covenant Hospital physician, call Physician Referral at (773) 878-6888.
To find a physician at Swedish Covenant Hospital, visit Find a Doc online >
Questions to Ask Your Physician Before Surgery
Surgery can be an intimidating, confusing experience – but it doesn't have to be. Just remember to ask questions about your surgery so you know what to expect on the day of the procedure and throughout your recovery. Questions you may want to ask include:
- Does my insurance company need to approve my stay by the time I am admitted?
- Will hospitalization be necessary? If so, for how long?
- How will the surgery improve my health or quality of life?
- Are there any alternative forms of treatment or less-invasive procedures available?
- When I go home, what kind of assistance will I need with my daily activities?
- Do I need check-ups or other follow-up care, such as physical therapy, occupational therapy or home health services?
Remember, the best person to answer these questions is your doctor and your healthcare team, and they're happy to help. So if you have a question, just ask.
To find a physician at Swedish Covenant Hospital, visit Find a Doc online >
