Anxiety and Nervousness Before Surgery
It is absolutely normal to be nervous when facing surgery, even if it's a minor procedure. Despite knowing that millions of surgeries are done daily with relatively few complications, it is often difficult to calm yourself before surgical procedures.
Day surgery refers to an operation that is done on an outpatient basis—that is, no hospital stay after the recovery room is required. Some people find it reassuring to know that they will be back in their own home right after surgery, whereas some people get more nervous knowing that no medical professionals will be around to monitor them or care for them afterwards.
So, what are some ways to calm yourself down before a day surgery procedure?
Get a Tune-Up
Not everyone who faces surgery will be perfectly healthy. But, if your surgery is scheduled at an outpatient surgery center, or if you are slated to go home after surgery, then your doctors have determined that you are not among the sickest of patients or are not undergoing a terribly high-risk surgery.
Surgical and anesthesia risk is often related to pre-existing medical problems, and the risk cannot be eliminated. But, it can certainly be minimized by making sure any ongoing issues are addressed.
Diabetics should have good control of their glucose, people with possible symptoms of heart disease should have a full workup to make sure they aren't at risk of a heart attack or stroke, and anyone with sleep apnea should make sure they are using their oxygen or CPAP and should plan on continuing after surgery, as well. There are dozens of common examples of issues that should be optimized before undergoing surgery and anesthesia.
Still, one of the best things you can do is to get a medical "tune-up" before your procedure. Your regular medical doctor cannot make your medical issues go away, but they can make sure (with you) that you are in the best shape possible before your big day.
Education About the Surgery
Learn what is going to be done to you and why. While this is basic and seemingly self-evident advice, it really is easy to get confused by all the "medical" speak. Any time you are facing surgery, it is natural to be overwhelmed. By the time you see a surgeon and schedule surgery, many options may have been presented.
You should make sure you understand why your doctor thinks surgery is the best option for your problem, and be sure you agree with that assessment before proceeding. Don't be afraid to get a second opinion if you have any hesitations.
A lot of anxiety comes from unanswered questions, even if you are unable to figure out exactly what the questions are that may be lingering in your mind. Usually, the gaps will be filled by making sure you have a thorough understanding of your issue and the reason why surgery should be the most helpful solution.
Some people want all the information they can get about the procedure being done to them, up to watching a video on YouTube of the actual surgery. Other people want a basic idea of the procedure, expected outcomes, risks and benefits, and not much more. You must have enough information to make an informed decision. Beyond that, it is really up to you. You should seek as much information as helps to allay your anxiety. Just make sure it is from a credible medical source and not from random blogs or comments on others' blogs.
Learn About Anesthesia
And now, to repeat what will become a recurring theme: educate yourself about the anesthesia. You may not get to meet your anesthesiologist before the day of surgery, but you can become familiar with the basic choices you may have. Start by asking your surgeon what is "usually" done for the type of surgery you will have. For many surgeries, such as laparoscopic abdominal surgery, there is no good choice other than general anesthesia. In a way, this takes some pressure off of you. You don't have to make hard choices about something that can be hard to understand.
Research the type or types of anesthesia that you will most likely have if the anesthetic is a source of anxiety for you.
Please, do not rely on anecdotal blogs or stories for the bulk of your information. Start with reputable sites (such as WebMD, etc.—and my articles will always be factual). The danger of reading personal accounts or blogs isn't that the authors are lying, but that often, erroneous associations are made between the anesthesia and some effect that occurred later on, or there was some reason that a particular effect occurred (like a preexisting medical condition) that isn't mentioned in the account.
There are side effects, some of which are pretty common, and complications, most of which are very rare, with anesthesia. But, you want to make sure that you are getting real and true information, or you could just add to your anxiety unnecessarily.
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At some point before your surgery date, you will probably be contacted by either the anesthesia provider or by a nurse in the anesthesia department. Be sure to give them your most up-to-date information on medical conditions, symptoms and medication. Sometimes, the person calling is qualified to answer specific questions about anesthesia, and sometimes they are not. But it can't hurt to ask. If you have questions that you would really like answered, see if there is someone who can call you that can answer them.
If you aren't able to get answers prior to the morning of surgery, they aren't being intentionally evasive (usually). There are a lot of factors that go into anesthesia decisions, and some of that info doesn't come together until the preop evaluation (including blood work and other tests), the surgeon's final report and the anesthesia provider review are all in one place—in the preop area.
If you have a preference for the type of anesthesia, be sure to ask. It won't always be an option for various reasons, but it can't hurt to ask and at least understand why not.
Know What to Expect After Surgery
Knowing what to expect after surgery is very helpful, as well. With day surgery procedures, you will be going home after the recovery room stay. Because you won't be in the hospital with doctors and nurses attending to you, you and your chosen helper/caretaker will be responsible for helping you get around, perform necessary activities and administering medication.
Prepare in advance by asking how much help you will likely need and for how long. You must have someone stay with you for the first 24 hours after surgery. But, some procedures will require strong pain medications for several days beyond this. Because those medicines can make you "woozy", you should plan to have someone around for this time. Also, you cannot drive while taking these medicines, so plan for help. Only go out on these medicines if you absolutely must (like to a postoperative doctor's visit).
Prepare your home as well. If you are going to be required to sleep upright (like after shoulder surgery), have this set up before you get home. Also, remove all obstructions in common pathways in the home. Make sure loose rugs are secured and don't allow electrical cords to run across walking paths. Many types of surgery and medication make your movements limited, slow or more clumsy. Prepare for this before surgery. Ask your surgeon's office for other things you may not have thought of to help you prepare.
Knowing your home is ready for you will help to put you at ease before the surgery.
Ask what type and how much pain medicine people usually need. Surgery is very likely to cause some discomfort because, well, it's surgery. Expecting no pain is unrealistic. It's better to know ahead of time how much is usual and what type of pain medicine is usually most effective.
Ask what else will be expected of you after surgery.
Will you have dietary restrictions? The first day or two after surgery, you may not feel very hungry and should start eating slowly anyway with foods like soup and other gentle, soft items. Will you start physical therapy right away? Do you need ice packs ready to place on the site?
Having plans in place for these things ahead of time can make you feel prepared and more calm going into surgery.
Talk About Your Fears
Often, when I visit a patient in the preoperative holding area, I can feel their anxiety before I get within a few feet of them. If I ask the general question, "How are you?", I invariably get a "fine" or "a little nervous" for an answer.
If I ask, "What is your biggest anxiety or fear right now?", this leads to a variety of answers that I wouldn't have known about otherwise. Sometimes, people feel their fears are silly. Sometimes, they think that expressing them means they don't trust us, and they don't want to make anyone think they are being difficult.
None of these things are true. We'd rather know what you are thinking. We cannot take away all of the risks that go with surgery and anesthesia, but we do a lot to minimize them. If you are fearing some component of the operation or the anesthetic, chances are we are already planned and ready to prevent, alleviate, or treat it.
Talking about your concerns and fears is the best way to calm yourself before surgery. Many of the fears people have are based on fear of the unknown. Worries about certain risks, surgical failure, uncontrollable pain or nausea, problems during anesthesia . . . these are all very common. Usually, a brief conversation about what is realistic likely will significantly decrease anxiety and help you to calm yourself down before surgery.
Practice Relaxation Techniques
If you are really prone to anxiety, practicing relaxation techniques before surgery can help you a lot.
Breathing exercises, visualization, and biofeedback can all be used. The details of how to do these are beyond the scope of this article, but can be found elsewhere from reputable online or print sites.
Medications are used to help calm you, but only right before surgery. If you have a diagnosis of an anxiety disorder or think you suffer from more than normal anxiety, talk to your doctor about various treatment modalities that may be available.
Medications can be useful, but are used in anxiety as a last resort when other interventions, such as the above relaxation techniques and possibly psychotherapy have been ineffective.
Do not attempt to self-medicate; Call your doctor for help if you think you need it.
Before using any herbal remedies or supplements, please consult your surgeon and anesthesiologist. Many common herbals, including those used for anxiety, can have side effects and drug interactions that can delay or complicate your surgery.
- Knowledge is power, as they say. Learning about your surgery, anesthesia and recovery can go a long way toward allaying anxiety. The more you know, the less there is to fear.
- If you know you are prone to anxiety, attack the problem before the day of surgery. Try to identify what factors are causing you stress. Once you pinpoint them, direct your learning to those points. Ask questions and find out as much as you can. The fear is often out of proportion to the reality.
- Try various relaxation techniques. The best ones will be the ones (like breathing exercises) that you can use right up to the day of surgery.
- Before using medication or herbal supplements, ask your doctor for advice or at least make sure that what you plan to use won't create a problem during or after surgery.
- If you have been scheduled for day surgery, the anxiety leading up to surgery will likely be worse than the actual day of surgery. Before you know it, you will be back in your own home. Better yet, before you know it the whole thing will be a distant memory, probably one where you say "it wasn't as bad as I thought, and all that worry was unnecessary"! I hope so, anyway.
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
Stephen Gregory on August 21, 2016:
my thought is being forced to sleep.when i have had general anaesthesia waiting to fall asleep they try to put the oxygen mask on but this feels like I'm drowning in shallow water. they now give the mask to me until I'm asleep.its silly i suppose but its my fear.
Shannon on April 28, 2015:
I don't really have a fear of surgery ive already had 2 knee surgeries and heading on my 3rd.. I now know what the aftermath of the surgery is and im upset because I don't want to have to go through it again, im only 15!
Kenneth Avery from Hamilton, Alabama on August 06, 2014:
This is an excellent piece of writing. To be totally-honest, it can easily be described as amazing.
I loved every word. Graphics were superb. This hub was helpful, informative and I found it very interesting.
Voted up and all the choices because you deserve it.
You have such a gift for writing. Keep writing no matter what.
Kenneth Avery, Hamilton, Alabama
David from Idaho on December 02, 2012:
When I had surgery I was surprised how calm I was since it was going to be my first procedure I have ever had. However my calmness was lost once I slipped into that fashionable gown and got ready.
Good tips, voted up and useful.
Suzie from Carson City on October 31, 2012:
This is outstanding. It's very obvious you are a professional and know what you're talking about. The best part is that you know how to say it! Doctors are great, but most have their limits. As for surgery....I've been there a few times. I actually don't get all that nervous prior to....but I AM miserable afterwards. I don't do well with the after-effects of anesthesia....
We always look forward to the pre-op "Happy meds," don't we?? All is well with the world...lol.......UP+++
Deborah from Las Vegas on October 31, 2012:
Hello TahoeDoc, great information with very important points. This is so helpful people who are scheduled for a procedure. Voted up and shared!
Marcy Goodfleisch from Planet Earth on October 31, 2012:
I agree with you - the more I learn about a situation, the more I feel I am in control of it (or at least have a shot at it!). I know some who don't want details, but that's not for me. Day surgery can be stressful, even though you're in and out so fast. But you've helped people know how to prepare for it - great job!
Voted up and up!