Preoperative Anxiety Spine Surgery

Nervousness, fear, anxiety, and discouragement are common and natural feelings to have while awaiting surgery. Preparing for spinal surgery can cause individuals to experience what is known as preoperative anxiety. A study suggests that preoperative anxiety affects from 60 to 80% of individuals. There can be a lot of unknowns going into spinal surgery. Individuals can experience preoperative anxiety:

• Over the procedure itself.
• By imagining what could go wrong?
• How is the body going to recover?
• The temporary changes in functioning post-surgery.
• The post-surgical pain and discomfort.
• What will the results be?

Learning how to decrease surgery stress will improve the procedure and recovery. There are ways to overcome this anxiety with tips from a pain psychologist. 

Getting Educated and Informed

A pain psychologist recommends spending as much time as needed to discuss the surgery with the surgeon/provider. Ask the doctor if it is possible to speak with other patients who have gone through the same surgery to learn more about the procedure and what to expect with the recovery. Searching the internet is fine, but it is recommended not to get caught up searching non-reputable websites as there is a lot of misleading information that can lead to unnecessary stress. Ask the doctor to share statistics of positive outcomes versus complications to provide reassurance and to determine if surgery is the right option based on the specific condition.

Going In With The Right Mindset

Having a heightened level of anxiety or depression can contribute to poor surgical outcomes. Individuals that focus on the worst-case scenario are more likely to have higher levels of pain after surgery. Having the right mindset, staying calm and positive can decrease preoperative anxiety and can optimize recovery.

Preparation and Planning

Mental preparation and planning for surgery will set the mind and body at ease. This means:

• Knowing the anticipated healing timeline.
• The recovery phases the body will go through.
• How long they will last?
• What is needed for optimal recovery?
• Support during each step.
• Recommended medical follow-up.
• Post-surgical treatment/rehabilitation plan.

Understand the Pros and Cons

Before surgery, it can be beneficial to understand the pros and cons of the surgery. Speaking with the surgeon to learn this information can create a clear, concise picture of what to expect and the recovery timeline.

Relaxation

It is important to learn relaxation skills to stay positive and calm before and after surgery. Relaxation exercises can be very effective at all stages of pre-and post-surgery. Learn how to:

• Manage thinking positively.
• Avoid catastrophizing.
• These can be accomplished through:
• Meditation
• Slow walks
• Gentle yoga as long as it is cleared by the doctor.

Understand the Time

Knowing what will go into post-surgery recovery and having realistic expectations will create a sense of confidence.

Support System

Having a healthy support system will increase positivity and can speed up recovery. This can include:

• A partner.
• Family members.
• Close friends.
• They can help before and after surgery with physical assistance or just to listen.

Consult a Professional Pain Psychologist

Help from a behavioral health specialist or a pain psychologist can be beneficial in reducing anxiety and promoting positive surgical outcomes. They help deal with the pain, pre, and post-surgery, rehabilitation, life moving forward, etc.

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Body Composition

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Carbohydrates Simple and Complex

Simple carbs are a quick, scattered source of energy, and complex carbs are a healthy source of steady energy. Complex carbs are not as readily available for immediate energy as simple carbs are, but they are more efficient and healthier. Complex carbs provide sustainable energy, meaning the energy is constant with no crash like simple carbs. Complex carbs release slowly and should be the most significant component of daily energy intake. When it comes to muscle gain, complex carbohydrates can help:

Prevent Muscle Weakness

Glycogen is stored in the muscles. When the muscles are used during physical activity or exercise, the body taps into the glycogen stores for that particular muscle. Athletes take advantage of glycogen by consuming carbs (carbo-loading) a day or more before a workout to maximize the muscle glycogen stores. This helps delay fatigue and improve performance, making for a better workout and stronger muscles.

Prevent Muscle Degradation

One concern about consuming a low-carb diet is muscle loss. A study compared a low-carb diet to other diets and found that restricting carbohydrates results in protein loss. This is because restricting carbohydrates causes an increase in the amount of nitrogen that gets excreted by the body. Nitrogen is a component of amino acids that forms muscle proteins, with a loss in nitrogen indicating that the muscles are breaking down.

References

Beck, Kathryn L et al. “Role of nutrition in performance enhancement and postexercise recovery.” Open access journal of sports medicine vol. 6 259-67. 11 Aug. 2015, doi:10.2147/OAJSM.S33605

First, Get Educated: The Spine Journal (July 2018) “Anxiety and depression in spine surgery—a systematic integrative review” https://www.sciencedirect.com/science/article/pii/S1529943018301281.

Hearris, Mark A, et al. “Regulation of Muscle Glycogen Metabolism during Exercise: Implications for Endurance Performance and Training Adaptations.” Nutrients vol. 10,3 298. 2 Mar. 2018, doi:10.3390/nu10030298

How Attitude Can Affect Recovery: Journal of Neurosurgery. (November 2017) “Influence of catastrophizing, anxiety, and depression on in-hospital opioid consumption, pain, and quality of recovery after adult spine surgery” https://thejns.org/spine/view/journals/j-neurosurg-spine/28/1/article-p119.xml

International Journal of Surgery Open. (2018) “Prevalence and factors associated with preoperative anxiety among elective surgical patients at University of Gondar Hospital. Gondar, Northwest Ethiopia, 2017. A cross-sectional study” https://www.sciencedirect.com/science/article/pii/S2405857217300475