Trigger warning: graphic descriptions of medical procedures.
As my Facebook friends are no doubt sick of hearing, I have a blocked tear duct. Turns out you really need your tear ducts! Give them a hug, because they are important! If they’re not working right, then tears that would normally drain through your throat run down your face and grow stagnant in your sinuses and breed bacteria, which leads to swelling and pain all around inside your head. My ophthalmologist thinks that when I broke my nose in high school colorguard fifteen years ago (yes, I was a flag team geek), some debris made its way into the duct and led to scarring, which eventually closed it up. That’s causality for you.
Over the past few years, I’ve been growing steadily more exasperated with my body – my creaking, grinding, breakable body, my body with its killer monthly cramps and its wild hair that got me picked on in school and its hunched shoulders and crooked nose (my mom claims, bizarrely, that a nose job should solve my tear duct problem) and its spazzy brain (since I’m no longer cross-posting on a site with my full name, I feel safe saying that the “chronic pain” I mentioned a while back is depression/anxiety with OCD) and its tear ducts that have now pooped out. I feel like my 2001 Saturn – every day a new issue. It wasn’t until very recently that I learned not to blame my body for its problems, but I still feel off-kilter in that mode of thinking. It’s so much easier to be mad at my body.
I’ve already had one procedure to try and open the duct. The doctor, dressed in full surgical scrubs while I sat in a chair in my street clothes, numbed the area between my eye and nose and proceeded to jab at the inside of me with a tiny flexible rod. At one point he punctured a membrane and my nose started bleeding. At another point I had to ask him to take the thing out because I feared I would throw up from the trauma of it. Finally I felt something give in one duct and he irrigated it; water flowed down my throat as he emptied a syringe into the tiny hole in the corner of my eye. The other duct, though, remained blocked.
When I got home, my eye swollen almost shut and splotched with red, I joked around with my husband and ate some dinner and then let my guard down and shook and cried for the rest of the night. I’d neglected to mention the anxiety disorder before the doctor started. I really should have.
The next step is surgery: dacryocystorhynostomy, or the creation of a new duct. Sometimes it works like an ear piercing; you put a thing in there and eventually it stays open. Other times they have to insert a tiny, permanent tube. In the operating room, the surgeon will make an incision between my nose and eye so that he can access the intricacies underneath the skin. It’s a relatively minor surgery, just a small thing, in and out of the hospital in a few hours’ time. But I keep thinking about the scar. Will my glasses cover it? Will people see? After decades of being told I was ugly, I finally consider myself pretty-in-a-way, and I’m scared that a scar on my face will obliterate my modest progress.
I’m also afraid of general anesthesia, which I’ve never had. When I was a kid, I prayed I’d never have to have my tonsils removed because I was afraid people would laugh at me while I was asleep, or that I’d lose control of myself before or after and blurt out all my secrets. All my life, I’ve kept myself under tight control, never letting people in, hating myself for moments of weakness. I hate myself when I have cramps and I ask my husband for tea. I hate myself when he cooks dinner because my back is out again or I’m too depressed to move. I’ve always been irrationally annoyed by people with lots of little health problems, because I’m disgusted by that aspect of myself. I hate feeling fragile and weak. I hate fearing that I’m acting like a baby.
My biggest fear, though, is waking up to pain. This blogger had the same surgery that I’ll have and she says they put a tube down her throat while she was under, and that afterwards her throat hurt. I came across a picture showing how deep these tubes go – boy, that was a mistake. I’m terrified of the violence of modern medicine: needles and tubes and catheters and monitors and machines. (I had a catheter once and it was awful.) At some point in my life, I became terrified of harsh touches, so much so that sometimes my husband can barely touch me without triggering some ancient, objectless fear. After the tube and the incision and God knows what else, I’ll have to wear a stent for three months before the doctor snips a knot and I blow it out through my nose. The pre-op anxiety has triggered the worst of my mental health problems. I don’t think we as human beings have the instincts to really deal with phenomena like this.
Then there’s the money. Lord, I can’t even think about that right now.
I feel like at some point, I and others around me were trained to be blasé about minor surgeries, to brush off the fear, to treat them like nothing special. There’s no room for the profundity of willingly forfeiting your free will to someone you’ve barely met so that they can hurt you. Even this post feels like a frightful indulgence, considering all the bloggers who have written about cancer, about childbirth, about experiences I can’t imagine.
I feel like I’ve been given no room to really deal with the effects of modern medicine on my mental health.
So I’ll ask you: what are your thoughts on surgery? What are your experiences (especially those of you who deal with anxiety or OCD)? What have you felt and learned? I’d love some reassurances here. People, I’m serious about the mental health thing – I’ve been in a continual state of panic (shaking hands, tears, racing heart) for five days now, and the surgery is almost two weeks away. I don’t know how my body can keep this up. When I say anxiety, I mean ANXIETY. When I say obsession, I mean OBSESSION. When I say disorder, I mean that things that are supposed to be in order are not in order at all.
I have anxiety and depression; I’ve had a few major surgeries in my life and have another one coming up in about a month. Honestly, I just want it to be over. If I could just jump through time and get there right now, I would. What bothers me most is having to be ready to fight – I’m fat, and medical staff are all too often the enemy. I have met the surgeon, and he’s very fat-friendly, so that’s a good start, but he’s just one link in the chain! At least I’m in Australia, so I will pay very little for the surgery and don’t have to drag myself back to work still sick to pay for it like two USians I know.
My brother had the tear duct operation twice on the same eye, and had no visible scarring, so there’s a bit of comforting anecdata for you!
I had tear duct surgery as a baby…
” I feel safe saying that the “chronic pain” I mentioned a while back is depression/anxiety with OCD”
Oh, me too. I think you know that. Minus the OCD, but the anxiety and depression can get really, really bad.
As far as what to do? Well, maybe people will have better suggestions, or maybe these are already things you do, but clear your schedule. Take xanax or whatever else you can get liberally, and don’t beat yourself up every time you have to do it (maybe not everyone does that particular thing; I do). I find that I can handle panic attacks better when I have stimulation for multiple senses at once–computer games, or handheld games, combined with radio or TV will keep me calm. It’s not a solution that gets you working or on your feet, but it keeps me from screaming on the couch.
If you don’t have access to xanax, but can get vicodin, that may work. (I try not to take vicodin because while I don’t feel like xanax is addictive, I would take as many vicodin as I could get my hands on, but that’s just weird on my part, I think.) I haven’t tried pot, but it’s supposed to help.
Be very generous with yourself. If you don’t accomplish what you would normally accomplish while this is going on, that’s okay. If you need to do things you would normally consider off-limits… like stop cleaning the house?… do that. Create as much space in your life as you can. And don’t beat up on yourself about it, if you can avoid it. I know I never can.
…on reread, maybe you’re not looking for practical advice of that sort. How do I cope philosophically with problems with the medical industry? I don’t. At all.
Also, you’re very pretty.
If you’re not in an emotional state to discuss fully with your doctor how the procedure will affect you mentally, you should postpone it. When I read “I’d neglected to mention the anxiety disorder before the doctor started. I really should have.” I said to myself “She needs counselling more than she needs the surgery.” Not just for your own benefit – but for your husband and your doctor. I’m sure the doctor would be horrified to know he’s causing you all this anguish!
I know everyone means well, but I’m going to have to nip all the advice in the bud here. I’m having conversations with my doctor and my therapist; I’m doing all I can to be well. I don’t want to postpone this and have it hanging over my head that much longer.
So far, everyone I’ve talked to has had a myriad things to say to me, but almost no one has said, “it’ll be okay.”
ETA: Oh, and Mandolin, thank you for the compliment. :)
Hi, lurker emerging here.
Your post has said so many familiar things that I’ve never seen anyone say that I am now trying not to cry at work (from sheer relief, though).
The anxiety about medical procedures, and “sudden harsh touching”, the self-loathing about perceived weaknesses, the “triggering ancient objectless fear”.
I have anxiety/depression. I may have obsessive tendencies as well, but those seem to crop up mostly when the anxiety is on the rise. I’m extremely nervy about medical prodcedures, but in a seemingly unpredictable and arbitrary kind of way. I have numerous anecdotes from my early childhood which illustrate that, but I won’t clog up your comments.
As an adult, I’ve got pain and various other things which I suspect are connected to the anxiety/depression, and lately many fears and obsessive thoughts about various things about my body.
My only experience with general anaesthetic and “real” surgery was uncharacteristically stress-free…even dealing with the needles (oh god, needles…). I think it’s because the issue (3 fully-impacted wisdom teeth) had been causing so much pain and disruption that in the weeks leading up to it, all I could focus on was trying not to pull the damn things out myself, and I temporarily forgot my multiple fears of people making dramatic changes to my “physical geography”, fear of dying under anaethestic, fear of needles. I was kept distracted by external things like finishing my degree and preparing to apply to grad school.
For anxiety, especially the “obsessive dread” kind, I’ve tried to develop coping mechanisms that just let me temporarily *blank out* things, really to just keep me from flying destructively off the rails until Event X arrives. It’s like dropping down a mental wall. There are minor things that I do which basically play my other issues against one another in a more-or-less constructive kind of way. Example: there are people/places I will *not* get emotional when I am around, largely for reasons of pride. The key for me is finding that moment of strength to shove myself out of the door and, say, down the road to the coffee shop.
I bring a laptop, or a notebook, depending on my mood. I get whatever-drink-I-feel-like-dammit, sit in a corner and then just quietly and calmy *pour out* every thing that comes into my head. It’s the only time I write anything that is not-censored.
I do it until that sick feeling of *pressure* subsides. I’m working the “chilled out” external facade until the inside of me starts to align with it.
Now, my way of coping depends on a number of things: moderate physical mobility, lack of agoraphobia (though I do get spells of that), access to a mobile computer or ability to hand-write for potentially long periods of time, access to a safe and comfortable public space to hang out in. But most importantly, it requires a moment that I can summon enough…I don’t know what to call it, to nudge myself in the right direction.
I don’t know how helpful this is, because I find coping strategies to be so intensely personal. I suppose what mine boils down to is this: ecking out a safe (physical or intangible) space where I can give myself permission to be as self-indulgent as I want to be for as long as I need to be.
It will be okay.
I had surgery to repair my broken femur the day I was hit by a car. Despite huge quantities of morphine, I was terrified and cried and cried until the nurse was about to come in, when I went back to trying to act cheerful and unbothered. But it wasn’t as bad as I thought. One minute I was lying in the waiting room, the next I was in the recovery room. It took a while to fully wake up, and I was groggy and felt kind of icky. Surgery isn’t fun, but it also isn’t that terrible. You’ll probably be too groggy when you first wake up to feel much pain, and if you do, the doctor or nurse will take care of that.
I also have problems with depression and anxiety, though I haven’t needed meds for it in years. Unlike you, I didn’t have days to worry about the surgery, since it happened the same day as the accident, which was kind of a blessing. I didn’t really get a chance to wonder about the person I was going to be trusting with my leg and possibly my life (I met him later and he turned out to be professional, well-qualified, and very friendly). I did have the problem of trying to act like nothing was wrong, which was kind of a weird thing to do when I’m lying on a stretcher with the largest bone in my body in two separate pieces. And I still fell apart in the end and cried a lot and no one cared or looked down on me for it.
Overall, I think that it’s okay to be scared about the surgery. Surgery is terrifying. The doctors and nurses should understand that, and will hopefully be sympathetic. If your experience is anything like mine, the surgery won’t hurt, and it won’t hurt much when you wake up, and if it does they’ll give you painkillers for it. Recovery will be not as fast as you want and sometimes it’ll hurt, but you’ll slowly feel better.
I’ll put the advice here at the end so you can skip it: if you can, let your husband take care of you after the surgery without feeling too bad. I have a lot of guilt issues about being cared for, but my boyfriend at the time was happier when I could accept his help than when I pushed myself too hard. Your mind and body will need rest after the surgery, and if you can relax and accept care, it will be better for both.
I work in a hospital scheduling procedures (more invasive than the kind you’re having). First, you should know that the majority of doctors are stingy with narcotics/pain control because they are unfamiliar with you, your tolerances, drug-seeking attitude, what works and what doesn’t, etc., and each one will have an “acceptable level” of pain on the 0 to 10 scale. Some think that 5 is acceptable. Some think that 3 isn’t acceptable.
Second, your anesthesiologist is going to consent you prior to your procedure. Take that opportunity to discuss how you are anxious at the thought of waking up in pain from being extubated, what you currently use for anxiety and pain management (e.g. tylenol 3 works for me, but advil doesn’t). I dunno about you, but any narcotics make me literally freezing cold, and I always need heated blankets.
Third, frankly, the medical industrial complex makes sure that it’ll be mostly ok. But they’re not that concerned that every procedure have a perfect outcome. Because it is just impossible. It just is. So I can’t tell you it will be 0k. It likely will be. It may not be. It’s hard to say definitively. I know that’s not comforting. Sorry. I don’t do mental health work.
each one will have an “acceptable level” of pain on the 0 to 10 scale. Some think that 5 is acceptable. Some think that 3 isn’t acceptable.
Some think it depends on what the patient thinks is acceptable. I’ve had patients describe their pain as 10/10 then refuse pain medication because it’s not really all that bad* whereas others are clearly in intolerable pain (and showing all the physical signs of _extreme_ pain) and describe their pain as 1. If a pain level of 1 is too much for you in a given situation (especially post-op or similar acute situation) then it’s too high and it’s time to at least try something for it. Pain related to anxiety and depression is notoriously hard to treat and just dialing up the morphine can be counterproductive but pain control options need to be introduced any time there is pain that the patient feels is more than trivial.
*Or, more often, because they’re worried that the effects of the pain meds will be worse…which is only occasionally true.
I have my own issues with medical anxiety, so I can’t tell you “it will be ok.” I CAN tell you that your courage in talking about your fears here feels helpful for me. There’s a lot of background pressure to be blase about pain and fear, especially when we’re trying to show we’re strong and brave and deserve to be taken seriously. It so much a background thing it’s easy not to notice it’s even happening, but it causes all kinds of of problems in how doctors think of patients and how patients think of themselves. Thank you for daring to write about that aspect of your experience.
I hesitate to offer advice when you’re feeling so overwhelmed. You may already be doing this, or it may not be workable in your situation, but it often helps to bring a support person along for doctor visits, and for scary medical procedures.
I’ll add my “It’s going to be okay” to the chorus.
I had to have my gall bladder out and I was terrified about going under. I’ve read too many stories about people not waking up from anesthesia. My gall bladder surgery was scheduled for 1:00 and I had to report to the hospital at 11:00. I work for the University where my hospital was, so instead of sitting at home until it was time to go the hospital, I went in and worked for a couple of hours. One of the faculty members I worked for at the time made me so mad I didn’t have time to be scared. I’m still mad at her and it’s been several years since the surgery. I remember them putting something in my IV (which was another one of my fears I had to get over) and then I was sort of sleepy and cold and they put a nice warm blanket on me. I remember being wheeled into the room and seeing a big clock on the wall (I’m fairly blind as a bat without my glasses) that said it was 1:00 and then next thing I know I’m in the recovery room.
The nurses were “Wake up” I was all cranky until they asked “Do you want some Water.”
Cranky “NO”
“What about Coke?”
Very polite “Yes Please!”
I was in a lot of abdominal pain but ibuprofen was better for me than any pain meds, but that’s me.
Seriously, it all sounds really scary but I’m sure you will be just fine! For me, it was easier because I didn’t wait that long. I saw the surgeon on Thursday and he scheduled my surgery for Monday morning. I spent the weekend cleaning the house really really good and doing some work work since I was going to be out for 4-6 weeks. If I had to wait 2 weeks, I’d be a mess too.
One of things that has been really helpful to my depression is Mindfullness. It seems to be the new “Cure All” for all sorts of mental illness and other issues, but it has helped me. Someone broke into my house yesterday and I dealt with all the mess pretty well. I sat down and cried for about 30 minutes and called my brother (Mom is traveling and out of contact). Called and left a message with a friend and then playing on the computer for the rest of the evening., killed me a lot of Zombies (Plants vs. Zombies). Even this morning, I got teary about the whole experience, but I could laugh about things too. It is something you might think about looking into. If it works, great. If not, well then you know you tried.
Good luck! And all of our bodies are giving out on us. Planned Obsolescence! :-)
Telling doctors you suffer from anxiety is complex, because they may stop seeing you as an autonomous, intelligent person. It gets worse if you have other flagging factors, such as being fat or trans.
I’m here to confirm your worst fears. And then hopefully un-confirm them, because a lot of the bad stuff happened a long time ago and didn’t happen again years later.
I’ve had a few surgeries in my life. When I was little, I had a similar but not the same surgery. I was old enough so that I remember everything.
It was awful. I can’t say if I had genuine anxiety as a child, but I most definitely do now, and I have a feeling I had some kind of undiagnosed childhood manifestation of … something. Hyperactivity? Childhood anxiety? childhood depression? Childhood suicidal ideation? Something like that. Never diagnosed though. And it never fully went away.
Anyway the surgery I had as a kid was one of the worst things ever. I had general anesthesia. I fought it and I fought the anesthesiologist. I don’t think I was adequately prepared for the medical stuff that was going to happen to me, but at the same time I don’t think I would have felt okay with “And here is the scalpel we are going to use to cut you up with” type of TMI explanation.
I have memories of pushing the oxygen mask off my face and screaming until I blacked out… then coming to again, too early. And then I started screaming again. My parents tell me that the anesthesia was an older type – sodium penthathol? And it has weird effects on some people. Like screaming.
When I woke up the surgery was over, but since I woke too early, I was not allowed to have food or drink. My throat hurt from the tubes and I was thirsty. And I was pretty out of it for a few days after.
I really don’t remember anything about pain levels.
Then I had to have two more surgeries.
Good news! I told the doctors about my bad experiences with the first anesthesia. So for the second surgery I had, the doctor used an IV of general anasthesia to knock me out. I remember thinking, “I’m getting really dizzy!” and then it was over and I woke up in another room. Must have been something other then sodium penthathol. I don’t think he used an oxygen mask with me (wisdom teeth removal.)
I was still pretty sick & out of it for the next day though and I threw up at one point. I was in discomfort that turned into pain later because recovery is hard. But it was still better then the first time.
And the third surgery I’ve had, the doctor knew I dealt with anxiety so he was not surprised & gave me a few minutes alone with my relatives when I broke down bawling right before the surgery. If you gotta cry – give a heads up that might happen & do it. There was no fighting it, the anxiety was just overwhelming.
The last surgery wasn’t so bad, actually. The anesthesiologist let me hold the oxygen mask over my own face until the IV of general anesthesia knocked me out, so that I felt like I had *some* control over what was happening. I told him I didn’t want to remember anything and he said I wouldn’t. And I don’t. I know what happened from reading about it but I don’t remember anything except going to sleep peacefully and waking up equally peacefully.
I felt fine when I woke up. Uncomfortable but okay – kind of bored since there wasn’t anything to do. I wasn’t nauseous. I didn’t scream. I woke up and felt aware of my surroundings and I was allowed to eat & drink in a reasonable amount of time. Recovery was hard, the pain kicked in a few hours after since the local anesthesia wore off. But the surgery itself went smoothly.
It’s going to be okay. I haven’t had this surgery done but recently (Jan- March of this year) I had to go under anesthesia for the same procedure three times. It was a cystscopy dealing with my kidney and bladder. It’s a long story, but this was in 2 different surgery out patient centers.
I also about 4 years ago I had my wisdom teeth extracted under anesthesia because of my dental anxiety (I started having a panic attack when the oral surgeon was explaining how my wisdom teeth could be removed in the office and as soon as he saw my reaction he told me that was off the table).
Out of the four times my throat only hurt 2 times. It felt like when my allergies bother me and I get drainage down my throat at night and then wake up with a sore throat. Some throat lozenges helped.
Every one was very helpful and nice and I asked a bunch of questions and they answered them and weren’t annoyed or put out. I’m over weight and I never felt like I was being treated differently because of that.
I don’t have this kind of anxiety but I do have bipolar disorder and have dealt with anxiety issues and one thing that has helped me is writing down what I feel. I’ve got journals where there is only a few words per page because I was so nervous/upset that I was scrawling in big letters. But it helps me process through everything I’m feeling. Even if you just tore up the pages later because you didn’t want to keep them it might help to write everything down.
It will be okay. You will be okay.
I identify with a lot of the issues you’ve touched on, Julie – the need for complete control, the anxiety/depression (oh god, the depression and not being able to move and thinking you’re worthless because you just can’t get out of the goddamn bed and no one understands), and feeling ugly. I had a lazy eye for my whole life until last year, and it was the source of much shame. Last year, I had the surgery to correct it.
I have no idea what you’re going through, but for me, the end product was acceptance. It’s almost like the stages of grief….fear, denial, anger, etc. but with surgery. I was terrified that something would go wrong, that I would go blind, that they would destroy my larynx with the breathing tube. In the end, I had to say yes to all that could happen. And it allowed me to feel some kind of peace.
I don’t know you, but I wish you the best. You will be okay. The fact that you’ve lived with anxiety/depression and OCD tells me that you’re very strong – those are not easy conditions by any means. You’re stronger than this surgery.
I don’t know if this will help you, but it’s meant to. I live with a trach and vent because of muscular dystrophy and weak breathing muscles. Just over four years ago, before the trach and vent, I spent time in ICU intubated (with a breathing tube down my throat) for about 2 weeks before finally getting trached. I was on some serious pain killers and anxiety meds during that time but I was conscious and communicating with pen and paper much of that time. The intubation was miserable (interestly, the trach isn’t anywhere near as uncomfortable as you might think) but I made it through, without general anesthesia until getting the trach. And it isn’t anywhere on my top 50 list of hardest things I’ve ever done.
Yeah, it’s terrifying, any one piece of what you’re facing. And I don’t mean to make light of the anxiety, but the intubation part, I can say with confidence, is totally doable. If you have any questions about experiencing conscious intubation feel free to ask me.
Best of luck to you.