Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

How The Patient Sees Surgery

I’ll discuss the exceptions in a moment, but for the average injured worker, surgery is a mixture of hope, fear, confusion, concern, and desperation. Few industrially injured workers, those with high school education and less, understand what their surgery will entail.

For better (although I believe for worse), their concerns are dismissed, or, at best, minimized when they ask questions or admit to fear. They are told that “there is nothing to worry about” and “this procedure is done all the time” and certainly “it is no big deal.”

To the patient, it is.

Recently, a patient of mine, injured four years ago, and having hip surgery two years ago, was told that he now needs lumbar surgery. He does not understand the procedure. He is pessimistic that it will be of benefit. He is fearful of going under anesthesia, and, unquestionably, he dreads the entire experience. His last surgery was fraught with complications including re-admission for post-surgical infection, inadequate orders for pain medication and a dismissive attitude from both surgeon and hospital staff.

In brief, it was, for this particular patient, a truly horrific experience.

Now here he is being told that he has no option but to have additional surgery. His concerns are dismissed if not derogated. If he could avoid surgery, he certainly would, but he is certain that there is no choice.

So imagine what that would feel like: dreading, fearing, and not trusting a procedure and being told that you must proceed regardless of your emotional response.

For this particular patient, he is in psychological care and has a venue in which he can de-burden himself of these fears, understand and confront them and move forward. But most patients do not have that option. They battle for authorization for a procedure, that they clearly do not want; fighting for something that they actually dread is certainly a miserable emotional conflict.

Managing the fear of impending surgery is not an easy task, and for many. it is not a task that can be completed without assistance.

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