Whole Living Guide > by Don Cohen
Mindful Preparation for Surgery
Illustration by Jim Bliss

Surgery is not generally on most people's wish lists for summer vacation. Yet, many people do schedule surgery of all types during the summer or other vacation times to give themselves extra time to recuperate. Every surgery, large or small, is stressful. Managing your stress can affect the outcome of your surgery since stress depresses the immune system and provokes fear and its attendant chemical implications, which often complicate recovery.

Researchers at Harvard and UC Davis have documented the benefits of preparing for surgery and reducing pre-operative stress. People who are mentally and physically prepared for surgery generally experience an easier surgery because the body is more relaxed. The more relaxed you are, the fewer complications you have. Relaxed patients are reported to endure more pain, need less medication, and have shorter hospital stays.

Unfortunately, many patients don't prepare themselves. They often go into surgery passively, unaware that taking charge of the experience can be tremendously beneficial. Similarly, too many doctors don't yet help patients prepare their minds, their bodies, and their spirits for elective, reconstructive, or cosmetic surgeries. Preparation that reduces anxiety can make a critical difference in the surgical outcome and the recovery.
For me, the need to prepare for surgery was precipitated by the discovery of pre-cancerous cells in my colon. As a patient with Crohns' Disease for 26 years, my doctor strongly recommended corrective surgery as soon as possible.

As a psychotherapist who practices with a mind/body approach, I decided to use this experience as an experiment and scheduled my procedure six weeks hence. My goal was to concentrate on aspects of my physical, emotional, and spiritual self to see if I could make a difference with the stress and fear I was feeling. Here's what I learned.

Breathing Sets Your Body Rhythm. Breathing exercises clearly had a relaxing affect on my mental state. When tense, your breathing becomes shallow, relegated to one's upper chest. Full, deep, slow breaths were not only calming but also allowed the emotions that I had been suppressing to come to the fore.

Feel Your Feelings. By putting myself in touch with my sadness, anger, and fear rather than suppressing or denying them, I had the chance to work with each feeling by myself and with my therapist. For example, when anger arose about my surgery and the sudden change the surgery forced in my career plans, I discovered that laughter, induced by listening to comedy albums, relaxed me. As I expressed each emotion, I found that stress lifted for a time until the next feeling emerged. It was quite freeing to discover that cycling through a feeling completely often led to a relaxed state. Over the weeks, with repeated practice, I was surprised to discover that I actually was able to feel peaceful and even joyful after articulating and releasing my feelings.

Draw on Your Dreams. I recorded all my dreams in a dream journal. This exercise paid big dividends. One night, I had an astonishing dream that led me to believe that I would get through the surgery successfully. In the midst of tumult, it was extremely important to find an inner sense of guidance, and this dream provided it. So, too, guided visualization exercises, a form of "waking dreaming," helped me imagine the surgery going smoothly and reduced my fear of uncertainty and the unknown.

Get In Shape. I decided to train as if I were going to run a 5K race. I reasoned that if my body were in shape, the trauma would be better absorbed. I ran on the treadmill every day, ate healthfully, made sure I took a good regimen of vitamins and supplements, and got a weekly massage.

Create A Support Group. You don't have to go through surgery alone, though managing the information you decide to share is important. I asked family members, friends, and my spiritual community for prayers over the six-week preparation period, and especially on the morning of surgery. Just knowing that I had so much support buoyed me in my worst moments and effectively balanced my anxiety.

Educate yourself about surgical and hospital procedures. Gather information about your condition on the Internet or in the library. Ask your surgeon what she will allow you to bring into the OR with you (e.g. tape player, music, affirmations). Try to meet your anesthesiologist beforehand. Get to know the policies and procedures of the pathology slide department. Request copies of all tests and pathology reports for your files. Donate your own blood before your surgery.

Connect With Your Spirit. Meditation, prayer, and asking God to help me visualize and bring into being the desired outcome helped lift my spirits, remain centered, and induced calm.

Pragmatically speaking, most people may not be willing or able to spend six weeks preparing for surgery as I did. Know that, essentially, anything that brings you relaxation will result in pre- and post-surgery benefits, even if you begin just a few days prior to surgery. Don't reinvent the wheel. Start with things you already enjoy. Listen to calming music. See funny movies. Paint. Sew. Dance. Imagine yourself full of life and energy. If possible, add one new practice like deep breathing or guided visualization to your daily regimen.

How did I fare? The morning of my surgery, I walked into the OR with a 110/80 blood pressure. My pulse was 65. I was feeling relaxed and confident. My stress was in the "green" zone. I introduced myself to the surgical team and asked them to talk to me as if I were awake. Taking some deep breaths, headset with calming music in place, I signaled the anesthesiologist to begin. My surgery went easily and I was home on my way to a complete recovery within a week.

Don Cohen is a holistic psychotherapist with a private practice in New York City. He can be reached at (212) 288-1929.
www.doncohen.com