Seeking advice on how to face a hospital stay

[NMTB]

Hey all,

As I have mentioned elsewhere as a Newb to this forum, I am a veteran of a 40 year battle with anxiety (GAD, Social Phobia, PD, Agoraphobia) and over the past 10 years Depression added to the mix. I haven’t left the house, except for medical appointments for that decade (and with a few heavily medicated family gathering exceptions). I haven’t seen my boy play football or do athletics in person (he is 9 years old) nor attended assemblies where he has been given awards. I haven’t even kicked a football with him in the local park. Such things are the source of much sadness and self-loathing. Anyway – I digress.

Over the journey I have seen more psychologists and allied therapists than I care to remember but during the last 20 years or so I have restricted myself to psychiatric care and take a special interest in developments in medication rather than trends in psychotherapy (I emphasise that if CBT, hypnotism, meditation, mindfulness or a combination benefits you I think that’s great – just doesn’t work for me).

So against that background, the recent diagnosis that I needed a hip replacement has put me in a quandary. I have previously only stayed in

hospital during the day and indeed on one occasion discharged myself rather than stay the night after a motorbike crash. Don’t think that is an option this time!
My psych will write a letter detailing my issues and medication regime but two issues loom large (i) I will be out of my house and my routine – just writing that sends the heart racing and the familiar symptoms cranking up (ii) I will not be in control of my medication. For most of them that is OK, but with the benzodiazepine class I adjust my dosage according to what I am facing. It is something I have done and refined (so as not to make them

useless via development of tolerance) over the 30 years I have taken them. Yet in hospital, unless I keep a private stash, I will get an inadequate standard dose.
Of the two issues (i) seems insurmountable. Has anyone else faced this sort of challenge and, if so, how did you deal with it?

Cheers.

[jess334]

Hi NMTB,

Thanks for your post.

I think a lot of people are terrified about staying overnight in hospital. It is definitely a big fear for me.

During my recent pregnancy I was desperate to have a home birth. Mostly so that I could avoid the hospital because I prefer to be in control of my own body and I dont feel like you get that option in hospital. Unfortunately my body had other plans and I ended up being booked in for a c-section on a weeks notice.

I spoke to my surgeon and midwife about my anxiety and concerns. They agreed to let me participate in an early release program, so I was able to go home after just one night. This worked great for me - because I knew when I would be going home I could focus on that.

Obviously a hip replacement is a very different operation, bur you would be surprised how many hospitals have early release programs, especially if you can demonatrate you have help at home.

I dont know what state you are in, but there are many organisations that provide home nurse support. Some hospitals have their own home nurse systems to try and reduce patient stay.

I understand wanting to keep hold of your own medication. I would have difficulty trusting the hospital staff with it especially since you know your anxiety will be much higher.

However, I would be cautious about self medicating after a surgery as your surgeon may prescribe pain medication that could have potentially dangerous consequences with other medication. Especially if the hospital doesnt know much you have taken.

[White_Rose]

Hello NMTB

Surgery can be daunting in the best of circumstances and part of that is not being control of your body. Jess has pointed out the potential danger of taking your meds with any meds prescribed by your surgeon. Can you talk to your psychiatrist about mentioning this in his/her letter? For your own safety It seems there will be a need for co-operation with the hospital staff. Why not keep a copy of the letter with you in case one of the nursing staff or doctor refuses your meds. I think it would be beneficial

I think you are correct that leaving hospital immediately after the surgery is not an option. However I know several people who have had this surgery and are home much earlier than I would have thought. Will there be someone to look after you by cooking and possible assistance for you to get around? How do you feel about using a nursing service where someone comes to your home to help with things like showering?

I had this nursing when I broke my leg because I live alone. I also had Meals on Wheels as standing was uncomfortable. It was the surgeon who told the nurse in hospital to organise both services. Such a relief not to cook and I felt so much safer having someone with me when I showered. Standing on one leg is not my best skill.

Do you know when you are getting the surgery? I hope it all goes well and you and your anxiety stays withing manageable limits.

Mary

[NMTB]

Hi Jess and Mary,

Thank you both for sharing your experiences. Jess, I am in awe of your courage, being out of hospital after one night following a C-section!! Both our kids were by C-section and I just can’t imagine.

To both of you, I will have to look into whether there is any possibility of early release. Although I am sure my psych would highly recommend that I be given access to that if possible, everything I dig up says minimum of 3 days.

I have no difficulty at all with a home nursing service coming in if I could get out early, so I will also look into that if early release is an option. I am fortunate in that my wife will be able to organise meals and the usual routine things.

The point about self –medicating is taken. I have had day surgery under general anaesthetic on a few occasions. I have needed to take a higher than standard dose of sedatives (as well as anti-diarrhoea and anti-nausea medications) simply to get to the hospital – I have had accidents previously before intense events, such as job interviews. Whilst awaiting these past procedures I have practised a variety of techniques from CBT, mindfulness etc doctrines (which have never tangibly assisted me despite my best efforts) and my rational self has reminded me that taking more sedatives before undergoing GA was not a good idea.

Then there was the primal urge to flee. “Stuff the pain of the impacted wisdom teeth, GET OUT!!” The result on each occasion was to quickly swallow tablets – act before thought. Fortunately on each occasion everything went smoothly, but I do understand the “fortunately”.

Mary, your question as to when I am to have the surgery is a major problem. I have health cover, the diagnosis is done, the surgeon comes highly recommended and my psych is well aware of the situation and happy to help. That was also the case in early July. Over 3 months later, and despite the pain/inconvenience of a dead hip joint, I have taken no action. The physical pain is as nothing to me compared to the anticipatory anxiety I experience when I think of making this thing happen (I am feeling those familiar claws tightening their grip as I type this). In fact I will have to take a break I think, sorry. I am seeing my psych today so that means a trip out of the house so I am already in a heightened state over that.

Thanks again so much for replying to my post.
Cheers.