Coping with the Emotional Impact of Orthopedic Surgery
Snap, snap, crackle, pop. That was the sound of my life changing in an instant during a summer stroll. I fell on slightly uneven pavement and broke three bones in my ankle and severely dislocated it, leading to a surgery and months of recovery.
An orthopedic injury is typically a traumatic event. The recovery can elicit many emotions. As a psychotherapist, I was surprised not much has been written on coping with the psychological impact of such an injury and the following recovery.
By allowing emotions to arise without judgment, we allow them to move through us. We can also take committed action to make positive changes as a response to these reactions. The following list notes emotions and reactions that might be felt as part of an injury that requires many weeks to months of recovery. This list does not imply that every patient will experience all or even most of these, but many patients will feel at least several of the following:
Trauma can be anything we experience or witness that threatens life or well-being. Depending on how the injury occurred, studies have shown 20-50 percent of orthopedic injuries can lead to Post Traumatic Stress Disorder (PTSD). Risk increases with age. While most patients won’t develop full PTSD, the physiological trauma reactions immediately following the injury may include shaking, chills, nausea, insomnia, and lack of appetite. Such reactions may also happen once the cast is removed and one sees the limb or foot looking quite different from what it did before the injury. Trauma first produces physiological responses and then brings psychological reactions, such as flashbacks, fears and avoidance behaviors. Calm the nervous system with slow, deep breathing through the nose. Bring yourself into the present moment by noticing five separate neutral things you can see, hear and touch in this moment. Listen to good quality guided imagery or meditation. An excellent source is www.healthjourneys.com or a meditation app. Also, ask your doctor or nurse what to expect before the cast is removed so you are at least somewhat prepared for what you’ll see.
Fear and anxiety
Our fears can help keep us safe. Patients understandably fear re-injury. Our brains help us by noticing actual dangers so we can avoid them. Sometimes our brains work a little too well and create more anxiety than is helpful. Anxiety and fear can also apply to the distant future, as patients worry if they will ever again regain full or even close to full mobility. Talking with one’s doctor or physical therapist can help allay these fears.
Many patients replay the injury and blame themselves. When my doctor asked how my injury happened and I began with, “It was really stupid…”, he told me everyone says that. Ask yourself what was the original intention of whatever it is for which you are blaming yourself.
You will probably miss enjoyable events or outings while recuperating, or at least not be able to participate how you would have planned or wanted to. Of course, this will be disappointing. Remind yourself this is a temporary state.
Some people will feel ashamed of the less-than-able shape they are in as they heal. You can ask yourself, “Is this a helpful thought?”