Emotionally Preparing for Surgery

Last updated: October 2022

Surgery – a necessary part of living with RA, unfortunately, and a major event in a patient’s life. Since this is part 2 of a 2-part series on preparing for surgery, we can dive right in. In part 1, we talked about some of the things you want to do physically to prepare. Preparing your body, preparing your suitcase, and preparing your environment for the surgery. This time, though, we will talk about the other half – the mental side necessary for getting ready to go under the knife.

Mentally preparing for surgery

Yes, just like a good peanut butter and marshmallow fluff sandwich, there are two sides to surgery preparation, and one of them is decidedly more of a mess than the other. Sure, the peanut-buttery physical side of preparation is easy to spread and goes on smooth, but the ooey-gooey, sticky, can’t-get-the-last-bit-off-the-knife mental marshmallow fluff side of preparation isn’t quite as neat. Surgery is a major event, even if the doctors want to act like it’s routine, and it can really mess with your head.

Fear of death

First, there’s the big scare – death. I think we need to get that out of the way right off the bat. Yes, there is a risk, albeit small, that you simply won’t wake up from anesthesia or you will die on the table. It happens, and there’s no way to ignore that. Statistically, though, you are more likely to get hit by lightning while eating a pheasant than dying on the actual operating table.

Dying after surgery is a bit more common, but it is still a fairly low percentage overall and the largest contributing factors are heart disease and length of hospital stay. So, in other words, get the heck home as fast as you can. Bottom line – yes, it’s a risk, but no more a risk than you take every day riding in a car, and you can remind yourself of that.

Mentally preparing for an unideal outcome

In addition, there’s always the risk that the outcome may not be optimal. This is a much more realistic fear and anyone who has had RA and chronic illness for a prolonged period like me has probably experienced this one. Joint surgeries can be difficult and while doctors do their best, sometimes that just isn’t enough. Of course, if you ask the surgeon they will most likely play down any talk of a “sub-optimal outcome,” as they call it because surgeons are the Top Gun of the medical world and they all think they are Tom Cruise’s Maverick. Note to surgeons: you can’t all be Maverick, there’s gotta be a few Gooses out there. Geese? Whatever.

Anyway, the point is, do your own research and ask the hard questions beforehand. Allow yourself to think about the possibility that you may have to live with the outcome no matter what it is, or you may have to get an additional procedure. Yes, it’s disappointing, but it isn’t the end of the world, I promise. I’m going through it now, myself, with my third surgery on the same ankle coming up.

Surgery-day nerves

Then, before you know it, you’re there. It’s the day of the procedure and you are gowned-up, questions asked, and ready to go. You’ve even taken a black Sharpie marker and written “not this side” on the joint that the doctors shouldn’t be operating on because, hey, you never know. You are fully shaved and ready. This is when you will experience the most mental stress and if a case of the nerves is going to hit, this is when it will happen.

Now, each of you has to find your own best way of dealing with it, but you want to know what I do? I make myself look forward to the 30 seconds or so before I fall asleep on the table when the drugs first go in. Those 30 seconds are bliss. The special cocktail they use makes you feel relaxed as all get out and for a few amazing seconds, you feel no pain for the first time in a long time and it’s wonderful. That’s what I tell myself and how I mentally prepare.

Find things to look forward to

I anticipate that moment because it reminds me why I’m going under the knife in the first place – to get me one step closer to that pain-free, blissfully physically normal life that others take for granted. It steels me against those lingering doubts that inevitably creep in as you leave your loved ones to travel down that long, cold, sterile, hallway and sit there, uncomfortable and cold on an operating table where you feel like a bit player in the movie that is your life. Things are happening all around you as if they have a mind of their own, and it’s easy to get overwhelmed. Try to focus on that incoming bliss and use it as a springboard of positivity right before you close your eyes for the last time with that pesky joint or deformity.

Well, that’s surgery in a nutshell folks. When you get to be a pro like me, you’ll develop your own rituals and routines, but for those first-timers out there I hope this helps to give you some insight into what to expect and how to prepare. Yes, it’s scary, but it’s also a step forward, not back, and most times worth the risk. Good luck and talk to you when you wake up!

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