08.12.2020
Your doctor says that it is useless to continue conservative treatment of the joint. You seem to trust him - after all, you tried to find a good specialist. And at the same time, at the mere thought of surgery, some kind of chaotic mess arises inside, and you are ready to take literally handfuls of pills, just to avoid “going under the knife.”
Sound familiar?
It remains to understand what to do about it.
Surgery with local anesthesia
A local anesthetic numbs the area of the body being operated on. The patient is conscious and can observe the progress of the procedure or not see what is happening from behind a screen by agreement with the surgeon.
Often, such operations are performed quickly without serious tissue damage and do not pose a threat to the patient’s life. But if you still can’t calm down, then try the following:
- Discuss the progress of the operation with your doctor. Ask to talk about the risks, the time of the procedure, what the doctor will do and how dangerous it is for you. Ask about how other patients experience surgery, how long it takes them to recover, and what concerns they usually have.
Many patients are anxious primarily because of fear of the unknown, and everything incomprehensible seems dangerous to the brain, so awareness can play a key role in calming the patient.
- Ask your doctor if you can take any sedatives before the procedure and ask for a prescription if possible.
- Rest the day before the procedure. Take a walk in the fresh air, get some sleep, chat with your loved ones. Eliminate emotional stress and stress.
- Share your concerns with a loved one and enlist their support. Have them escort you to the clinic and pick you up after surgery to give you peace of mind.
- Think about how the procedure will benefit you. Focus on the result, not the process of the operation itself.
WHY PEOPLE AFRAID OF GENERAL ANESTHESIA
The modern history of plastic surgery begins at the end of the 19th century, when new surgical instruments were developed, antiseptics appeared, and anesthesia began to be actively used. Agree, it’s somehow strange to go through pain and suffering to improve your appearance, in fact, to improve your quality of life. It was only when anesthesiology reached its peak that women went in droves for rejuvenation.
The first plastic surgeries were performed under local anesthesia, and their radicality was minimal and their effectiveness was moderate. For example, anti-aging facial plastic surgery consisted of excision of a small strip of skin in front and behind the ear and suturing the wound: no detachment, no SMAS lifting, just skin. This rejuvenation could be performed annually.
As the operation became more complex, so did the anesthesia. Today we have the opportunity to safely carry out serious complex operations aimed at correcting all parts of the face. The duration of anesthesia can be from one to eight hours. All types of pain relief can be divided into local, regional and general.
The diagnosis has been made, what to do next?
Next, everyone needs to calm down and sort out the life of the patient’s family “on the shelves.” Everything has already happened - the tumor has grown, there is no point in analyzing the reasons for its occurrence. Causes of cancer - past, present - long and difficult treatment. Not abstract therapy, but a specific operation and hospitalization date for the surgical stage, or multi-week chemotherapy and radiation treatment.
It is necessary to discuss with a relative with cancer who will help with getting a bulky bag to the emergency department on the day of hospitalization, who will visit and on what days. Who will help me go to chemotherapy several times a week or attend radiation sessions every day? Finally, how will the family function during this period, who will take responsibility for the children or elderly parents left at home, who will take care of the dacha, who will walk the dog.
Everything is very specific and with a detailed discussion of practical issues, because each time it becomes more difficult for working relatives to ask their superiors to accompany their loved one to a medical institution. It is likely that assistance will have to be distributed to all family members.
It seems that the first days after receiving the diagnosis are not the best time to discuss family life. But it only seems, firstly, that this forced distraction from painful thoughts will eliminate the “funeral” mood. Secondly, the cancer patient sees how important his opinion is to the family; one cannot “go limp” if many problems cannot be resolved without it. Thirdly, it is by their desire to help that loved ones demonstrate their love. For the patient and his family, discussing plans for the near future is an important job that eliminates unnecessary thoughts.
Rule one. You shouldn't endure pain just to avoid anesthesia.
Almost any manipulation associated with causing severe pain is more harmful to the body than anesthesia. Therefore, in the civilized world they adhere to this point of view: where it is possible to relieve a patient of pain, this is certainly done. Modern medicine has very wide possibilities for this.
In addition, anesthesia with the use of artificial respiration devices significantly expands the capabilities of surgeons and allows them to provide assistance to those patients who cannot be helped with other types of surgical intervention. Of course, all contraindications of the patient, his age, and body capabilities are taken into account.
MYTH No. 5 “Anesthesia does not work on a drunk person.”
Anesthesia affects any living person! The only question is choosing the right combination of drugs and their dosages. Alcohol intake affects anesthesia in two ways. Chronic alcohol intake in the early stages leads to constant “combat readiness” of the liver, therefore the activity of its enzymes that destroy molecules of both alcohol and many anesthetics increases and large doses of anesthesia drugs are needed to achieve the desired depth of anesthesia. With prolonged alcoholism, patients develop cirrhosis of the liver and the detoxification capacity of the liver drops sharply - as a result of this, much smaller doses of anesthetics are needed.
During acute intoxication, the effect of many anesthetics is enhanced, and some are modified. Therefore, you probably shouldn’t drink alcohol before going under anesthesia...
"How can I help you?"
Nadezhda Kuzmina, AiF.ru: How to help a relative in the first moments when he first learned the diagnosis?
Irina Savenkova: For everyone, without exception, the news of a serious diagnosis, which entails complex and lengthy treatment, is always a shock. It takes weeks, even months, for some to accept this. These days a person wants to hear words of support: “Everything will be fine. I’m close”, “We are together”. A person, like a helpless kitten, does not know where to go or how to act. Take some of the troubles on yourself - look for clinics, find doctors who are knowledgeable about the disease. In other words, pull up all the information available. If a person goes to look for it on the Internet, his condition can only worsen - he will start reading “horror stories”. You can keep a “cool mind” and help you choose the right treatment tactics in the future.
Article on the topic
Difficult diagnosis. What you can and cannot say to a patient
— What should you not say or do to avoid further psychological trauma? How to find words of support without pity?
- There is no need to distance yourself from the person. These are all phrases like: “Hold on,” “Everything will be fine.” They have no basis in reality. How are you holding up? For what? And what does good mean and when will it happen? There is no need to downplay the depth of human suffering. After all, even everyone’s pain threshold is different, and we cannot know how much pain/scary/bad a person really is. It’s better at this moment to simply ask: “How exactly can I help you?” Sometimes simple words are enough - “I sympathize with you” and the simplest actions - drink tea together, help prepare breakfast or dinner, discuss the latest news. There is no need to read morals, offer self-medication recipes overheard from someone or read on the Internet. You just need human communication - invite someone for a cup of coffee in a cafe, give them a gift. Books about people who have suffered serious illnesses and overcome them will provide good support and motivation.
How rare people survive. Treatment of orphan patients requires huge amounts of money Read more
How to help a patient accept changes in appearance?
Active treatment does not make anyone look better, surgery and chemotherapy deplete one’s strength, facial features become sharper, the skin becomes pale, and some medications cause hair loss. It is very difficult for women to endure these changes. You can reassure the patient that “I always like you,” but the woman will not be reassured by an untruthful stock phrase.
Changes in appearance are upsetting and frightening. One can hope that after completion of therapy everything will improve - this indeed is the case. Or you can, as in the “Fashionable Sentence,” change here and now: buy new clothes, put on makeup, cover up your hair loss with a bright scarf or hat. It is ideal to visit a stylist, it immediately changes your mood and increases your self-esteem.
Anesthesia: features and nuances
General anesthesia allows the surgeon to perform his work efficiently, and the patient not to experience pain, fear and discomfort.
General anesthesia is characterized by:
- complete loss of consciousness when the patient is put into medicated sleep
- lack of response to surgery and external stimuli
- loss of sensation
- muscle relaxation
These states are achieved through the introduction of anesthetic substances into the body. The choice of specific medications for medicated sleep is the task of the anesthesiologist.
Preparation for anesthesia includes the following steps:
- tests (general and clinical blood tests, urine tests)
- undergoing examinations by specialized doctors (therapist, cardiologist, dentist, gynecologist, etc.)
- undergoing diagnostics of organs and systems (cardiogram, ultrasound of the heart, etc.)
- history taking
- identifying allergic reactions to medications
A few days before the proposed operation, the anesthesiologist studies the research results, talks with the patient, and then selects the type of anesthetic drug and dosage.
Here and now
— How can you cope with stress when your loved one is seriously ill?
- In fact, relatives of seriously ill people also suffer and go through the same stages - from shock to denial and aggression. It even happens that a relative is physically ill, and loved ones receive such psychological trauma that the same organs themselves begin to suffer. Therefore, there can only be one piece of advice here - stay in the present, do not fantasize about various options for events and drive away gloomy thoughts. There is no need to bury anyone in advance! After all, at the moment your loved ones are alive, which means you can enjoy communicating with them. Whatever it may be, everyone is alive here and now!
Live for a new episode of your favorite movie
— What to do if a person is hysterical, and he says, conditionally: “Everything is bad. I will die"?
- Everyone will die. As the saying goes, “No one gets out of here alive.” We need to help the person switch his attention to the positive aspects of his condition. As the heroine of Porter's book, Pollyanna was glad when she was given children's crutches that she did not need them. It is necessary to help a sick person find the good sides in his condition. To the point of banality - you can see, but some are blind from birth. You can walk, talk, hear. It all depends, of course, on the disease and its degree. But sometimes a person simply does not notice these obvious things.
Article on the topic
Bed rest. Is it possible to fight bedsores in bedridden patients?
The topic of death in modern society is highly taboo. But you can’t escape from it either. This is what awaits everyone in the future. Absolutely. Saying, “You will not die,” is stupid. It is better to try to switch the attention of your loved one to something else, so that he “no longer wants to die.” But this should not be from a series of long-term perspectives like - “What will happen to the parents/children/cats/dogs?” Otherwise, there may be a new round of depression. It’s better if these are short-term tasks with a bit of irony - “If you don’t watch the new episode of your favorite movie,” “If you don’t try my new pie, I’ll be upset.”
FEAR ONE: “I’M AFRAID OF NOT WAKING UP AFTER GENERAL ANESTHESIA”
This is why some patients ask to have the operation performed under local anesthesia or a “lighter” intravenous anesthesia.
Let it be known to you that endotracheal anesthesia, when the machine breathes for the patient, is the most controlled, manageable and safe. Thanks to the endotracheal tube, the patient's tongue never sinks - which is precisely what intravenous anesthesia is dangerous for.
There was a sad situation in my life when my friend died after a gynecological operation due to retraction of the root of the tongue. They didn’t keep track of the position of the lower jaw, and oxygen stopped flowing into the respiratory tract.
It is to control the state of breathing even during intravenous anesthesia, for example during minor operations lasting up to two hours, that our anesthesiologists always use air ducts or laryngeal masks, which help control the position of the lower jaw and the root of the tongue.
Modern anesthesia machines are sensitive to the slightest change in pulse, pressure and oxygen level in the patient’s blood. In case of danger, they sound such a siren that it is simply impossible to miss this state. In addition, almost all drugs used by anesthesiologists for anesthesia have antidotes: substances that neutralize them. So, I hope I managed to dispel this fear.
