Patient meltdowns in surgery - Dr. Kaveh LIVE Q&A

I am usually calm when I go in for surgery. This time I was not. When they got me on the table and positioned they started to tie my arms down but the anesthesiologist stopped them. He said to me…. Give me your hand , and then said “am going to hold your hand until you fall to sleep “ and every thing will be fine. He was one of a kind!!

My last surgery, I was definitely the crier. Ruptured bowel, septic, and they weren’t sure I was coming back out. All I knew was I would end up with a colostomy if I made it. It was very emotional. I had a fantastic team, good recovery, and have learned to deal with and appreciate the colostomy and surgery that saved my life.

Doctor, if there were more doctors like you we would all be better! In every way. Thank you again and again!

I'm a retired OR RN. I graduated in 1979 - during the first half of my career we worked in all different types of specialties, and then we were encouraged to specialize. Here's my take on Pre-Op Anxiety. One of the facts I learned in Nursing School was the relationship between anxiety and rates of Post-Op infections. It should be no surprise that patients who are relaxed and calm preoperatively have a lower infection rate. That opened the door for RNs to make the most out of the Pre-Op interview. In those few minutes, the opportunity exists to connect with patients, evaluate their anxiety level, address it, and walk every patient through that door calm, focused, and confident. When patients hear their concerns validated and addressed, they regain a sense of control and are reassured that their well-being is the team's priority. It also requires that the Circulating Nurse be focused on the patient's verbal and nonverbal language during the interview while we check the chart. Taking an extra two minutes allows the crier (for example) to let the tears flow, blow their noses, collect themselves, and pee one last time. When the nurse communicates respect for the patient's vulnerable status, and meets them at their level, they begin to relax and trust the process. I understand today some hospitals install cameras in the OR to monitor efficiency, because turn-around time is costly. I propose instead that hospital administrations become educated about the value of trusting the professionals they hire. Good patient care is grounded in science as well as technology -- but the inescapable fact is it takes time to evaluate and integrate a plan of care that ensures the best possible outcome for every patient's unique circumstances, including their mental health.

I’m the patient that has been sick for 2 decades, gone through many a life threatening crises. Now facing more surgery and I’m just worn out, I know that are many like me.

I’m the redhead LOL We are a special group, and I am SO grateful that the medical community is realizing that we aren’t making things up. And you seem to be a particularly compassionate person, thank you❤️

Thank you 100 times for covering this topic. I worked many years in the OR and cannot tell you how many times I would break scrub to go stand with a patient who was obviously having a difficult time. Just telling them We'lll take good care of you" often doesn't relieve their angst. I had a little girl climb down off the table sobbing for her mama. The nurse wasn't getting her attention so I broke scrub knelt down on her level and assured her I felt how frightened she was, that even I am scared of surgery (not so, but it helped,) and that her mama was waiting very close by. I asked her if I could pick her up and put her back on the table so she wouldn't fall and we were good to go. I have no clue where anesthesia was at this moment but not in the room. So I had to open another gown & gloves, it was so worth it. I have no doubt handling patients is covered in anesthesia training but you either have a compassionate nature or you don't and many do not. We had one traveling nurse who would slap faces to stimulate them as they were waking up. I couldn't take it any longer. I reached over and put my hand on hers and suggested stroking their face would do nicely. I am sure she didn't learn that move in training. Time is money but everyone needs to be mindful of the silent cries and be available for that patient at that moment.

For the doctors: it could really help if the staff, doctors and nurses, would say something comforting and affirming to the patients while they are unconscious: like: "this is going to go well, you are going to be fine, you are going to heal quickly." And keep making these suggestions.. Use the power of the unconscious/ subconscious to give a positive and healing message.

I am one of the Zen Masters when undergoing surgery. I had a NDE (Near Death Experience) at age 5 when I was buried alive by a bulldozer and I remember leaving my body and how loved and safe I felt. All the trauma of suffocating immediately disappeared. So I have no fear of death (which is always a tiny possibility with any surgery). Despite being somewhat anxiety prone, I have always been totally relaxed going into surgery (I've had about 10), regardless of what the surgery is for. The reason is, I am not expected to do anything in the Operating Room except go to sleep. The doctors, nurses and medical staff have all the responsibility and the expertise and they do everything. So I go in smiling and joking, completely relaxed and I tend to wake up the same way.

I'm a nurse anesthetist & how I deal with this issue is by introducing the patient to the team, giving constant instructions to keep them engaged & then lots of chit chat. We have music going & have such a friendly team that the patient has no time to fret. For those not distracted by the conversation, I tell them flat out that as soon as I get another set of Vitals I will give them the sleepy medicine.

I've had many surgeries, and the level of anxiety I have always correlates with the doctors and nurses . They can be cold and indifferent, or warm, caring, and comforting. That makes all the difference in how I go under anesthesia.

I had to have an endoscopy, and my anesthesiologist sang for me, and then my nurse did the same. It was great. I remembered them each time I’ve had to have a procedure.

One anxiety trigger for me is having my eyeglasses taken away too far in advance of being put out. Not only am I in an out-of-control situation, but I cannot see facial features clearly while multiple people are scurrying around talking at me, poking me, etc. Secondly, having any sort of thing put in my mouth (for GI scopes)or strapped to my head or neck. The feeling of not being able to communicate is like being held just under the surface of water while drowning. Truly panicked.

The last procedure I had was lithotripsy for kidney stones. I’ve been through many ortho surgeries as well. I have anxiety panic disorder and so I get scared and I just tell them I’m scared. The anesthetist said “I’m glad your a little scared because you should have a healthy fear. But your vitals are good and I promise you we will take good care of you and she rubbed my shoulders and that was it. I woke up peacefully. I really appreciated her talking to me.

Today had cataract surgery. What helps me is praying ahead of time for the doctor & what he does & then put all in God’s hands. It also very much helps to have a family member drive me, giving me support.

I get put under anesthesia every six months for a procedure. It never gets easier. I am the “meltdown” patient every time. My reasoning is because I don’t like people having control of my body without me knowing what exactly is happening to me. This causes me huge anxiety. They give me the warm blankets and they give me something to start relaxing before rolling me into the surgical suite. It doesn’t help. The thought of losing control of my body literally makes me sick to my stomach. Not sure where this comes from, but I don’t think I will ever get over it. It is not fear of dying or anything like that. I just feel violated in a sense because I don’t know who touched me or how exposed I was in the room full of people or what was said about me. Heard too many stories of doctors doing stuff to patients under anesthesia I guess. I’d rather be awake and experience a huge amount of pain just to have control of my body.

You anesthesiologists are amazing

Wow, I was never afraid of surgery before, but hearing you tell me I'm on the edge of death changes everything. 😮

Ok Doc - you probably won’t read this, but I have too share this with you and your subscribers. I was on a mission to lose weigh because my next goal was too have a tummy tuck. I lost over 60 lbs. All I needed now was to follow up with my tummy tuck. I was so freaking excited that I walked in the operating room telling the staff “Thank you all for being part of my journey. And off to sleep I went. However, no sooner that I started to come out of anesthesia the staff told me that I woke up with a cheese smile and couldn’t stop thanking everyone. That evening I managed to get up and use the bathroom and go for a walk down the hallway holding each drain in my hands. Once at home recuperating I got a card in the mail from the entire team wishing me a speedy recovery and everyone in the operating room signed it. I’ll never forget this card I got. It meant the world to me. That was my experience,

The baggage that people bring with them is related to their lack of trust based upon prior experiences from the past. Giving your trust to someone who is there to help you improve the quality of your life should make you feel grateful. We are forms of energy and one thing you can do is project yourself coming through the operation successfully. It means putting your trust in a positive outcome. You are the Scriptwriter of your Life, so write a wonderful script. I live by this concept. I’ve had a pacemaker installed and replaced twice. I’ve had two knee replacements. Doctors have given me a wonderful quality life. I’m 91 and still kicking ass.