Understand health
How to cope with pre-surgery anxiety
If you’re feeling anxious about having heart surgery or a procedure, you’re not alone. We have tips to help you feel better from an expert.
It’s normal to feel anxious before a planned surgery or procedure – you may be worried about having an anaesthetic, feeling pain or being away from home. You may also be concerned that the surgery won’t go well or that the recovery afterwards will take a long time.
“Before any surgery or procedure on your heart it’s completely normal to feel worried about the possible risks,” says Dr Anne-Marie Doyle, Consultant Clinical Psychologist at Royal Brompton and Harefield Hospitals.
Anxiety can make your heart race (palpitations). It can make you feel breathless, sweaty or like you’re about to be sick, and you may have trouble sleeping. It can also make any pain you have worse. If you’re anxious during an appointment about your surgery, it may be hard for you to take in and remember important information.
Remember you can have a better quality of life after surgery
Dr Doyle says that understanding what’s happening in the body when you feel anxious can help. “When we are worried, we go into ‘fight or flight’ mode, which gets the body ready to react to danger. This increases our blood pressure and heart rate, tenses our muscles and increases our stress hormones, and puts us on alert.
“It’s a normal response to stress but understanding it can help us find ways to deal with it. For example, if you focus on relaxing tense muscles, it sends a chemical signal to the brain saying: ‘I am safe’, and you may start to feel calmer.”
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Reflecting on your feelings in the run up to surgery can be helpful. “You might feel hopeful or scared. You might have tension in your jaw, a knotted stomach or headaches,” says Dr Doyle. “Simply naming your feelings and experiences can help relieve them.”
Some people find that understanding more about the procedure and what will happen helps relieve worry.
- To learn about common procedures and types of surgery, visit our information and support pages
- Get tips on recovering from a heart attack, stroke or surgery
The pre-assessment meeting you have with your surgeon or specialist is a chance to ask any questions you may have. But, Dr Doyle suggests, work out what level of information suits you best. “Everyone needs a different level of information,” she says. “You can shape the consultation to some degree – let the doctor know if you want it kept simple and short. If you want more detail, ask for it.”
Focus on the things you can control
Focusing on the benefits of having surgery can help you feel less anxious. “Remember that the procedure can improve your symptoms and give you a better quality of life,” says Dr Doyle. “You could think: ‘Afterwards I will feel less fatigued, I’ll have less pain, or I’ll be less breathless’.”
Look after yourself
If you are waiting for longer than you expected for your surgery, that period can be an anxious time. “You might find yourself dwelling on things that might go wrong,” says Dr Doyle. “Your anxiety can be quite high. Whereas when it comes to the day of surgery, it can be quite manageable.”
Dr Doyle says a long wait means it’s even more important to focus on the things you can control, such as looking after yourself while you are waiting. This means you will be as well as possible going into surgery. "The basics would be to get good regular sleep, eat healthily, keep moving and exercising within your ability, take your medication as prescribed, and look after your mental health.”
If you have the opportunity, talk you your surgeon about what the plan is for your surgery. Understanding what is going to happen can help calm anxiety about the surgery or procedure.
Dr Doyle says: “You can remind yourself: ‘I am in safe hands – I have expert surgeons who do this every day, and after the operation I will be well looked after’.
Tips and techniques to calm anxiety
If anxiety is affecting your quality of life, for example, you are fixating on negative thoughts, or having trouble sleeping, there are some tried-and-tested things that can help you feel more relaxed:
- Talk to trusted friends and family about your concerns. Sharing your worries can make them feel less severe.
- Distraction is a helpful technique; for example, try a craft or some other activity which will keep you absorbed and where you use your hands.
- Focus on pleasant activities; for example, watch a comedy or feel-good film, listen to music, or a podcast.
- Try tensing and then relaxing all the muscles in your body in turn, starting with your feet. Tense your toes for a few minutes, notice how it feels and then relax. Work your way up your body, tensing and relaxing, to your jaw and face.
- Practise relaxed breathing. There are different techniques, so find one that suits you. Learn about 3 deep breathing exercises to relieve stress.
- Try this self-soothing technique called the butterfly hug: hook your thumbs together over your chest so your hands form a butterfly shape and tap your chest softly with alternating hands in the way you would pat and soothe a baby.
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