According to the most recent statistics, about 51 million inpatient surgical procedures are performed annually. Surgery is a significant stressor for the patient. With surgery, the body goes through a host of changes, including changes in inflammatory, immune and hormonal systems. This is extremely stressful on the mind with anxiety and fear about the actual surgery and then with concerns about what will happen after surgery: Will there be any complications after surgery? Will I be able to function like before? Our sympathetic autonomic system has the upper hand after surgery, which is a normal response of the body when it is trying to heal itself.
But if this sympathetic response is too severe or too prolonged, it can be detrimental to healing, both physically and emotionally. Studies have shown too much fear and apprehension before surgery is associated with poor outcomes both during and after surgery. Despite continued technological innovation, today many patients endure moderate to severe negative post-operative outcomes.
For example, up to 40 percent of patients who undergo elective joint replacement surgery report sub-optimal functional improvement, pain relief and overall satisfaction after their procedure. These issues suggest there is a need for complementary therapies to support existing therapies in a surgical setting.
There are different complementary therapies which have been found to be beneficial for patients undergoing surgical procedures. The most important initial intervention is sitting down with the patient and discussing the procedure and answering their questions and addressing their concerns.
Mindfulness Based Meditation (MBM)
Research has shown mindfulness-based meditation done even a few days before surgery helps in the reduction of pain (meaning there will be less of a requirement for pain medication), less anxiety and even faster wound healing. By influencing psychological states, MBM may help address post-surgical complications such as pain and reduced functioning, by calming the sympathetic system and aid in faster wound healing. Many sources are available for MBM, like CDs, DVDs, YouTube and books.
Short breathing exercises like 4,7,8 breathing (search the term “4, 7, 8 breathing” online to learn more) before surgery, even in the holding area and then again after surgery greatly help in diminishing anxiety and calming down the mind and relaxing the body. These are very short, but effective interventions which take a minute or two and can be done multiple times a day.
Guided imagery is a form of focused relaxation that helps create harmony between the mind and body. It is a way of focusing your imagination to create calm, peaceful images in your mind, thereby providing a “mental escape.” Guided imagery provides a powerful psychological strategy enhancing a person’s coping skills. Imagery involves all the senses, as well as one’s whole body and emotions. An experiment was done to determine the effects of listening to audiotapes of relaxation with guided imagery. This experiment involved 24 patients undergoing gall bladder removal surgery. Patients were randomly assigned to two groups, one group with the audiotapes and one without. The group with audiotapes showed much less anxiety and faster wound healing.
Hypnosis either with the help of a clinical hypnotist a few days before surgery or self-hypnosis techniques have also shown to be beneficial for surgical patients. Patients who use hypnosis for surgical preparation have shown to experience less pain and bleeding and lower anxiety levels before and after their surgery.
Music before, during and after surgery has been found to decrease the requirement of pain medications and earlier mobilization. Also, patients have less fatigue at discharge from the hospital.
Nausea and vomiting are two of the most common complications after anesthesia and surgery. Antiemetics are only partially effective and may cause adverse effects, like sedation and headaches. Stimulating a PC6 acupoint, has been found to be highly effective in treating post-operative nausea and vomiting. This point is located three finger breadths below the wrist on the inner forearm in between the two tendons. To find and use this acupressure point, (1) locate the point by turning your hands over so the palm is facing up then (2) apply downward pressure between the two tendons, massaging and stimulating the area for 4-5 seconds.
After surgery, make sure the diet is healthy, and anti-inflammatory is extremely important for speedy and complete recovery.