Not sure what to do--any ideas?

[dodiad1971]

Dear Doctor,
First of all, thank you for taking the time to answer questions in this forum!

I am a 36 year old woman with an extensive medical history. I've had many surgeries beginning when I was only 1. However, over time, my need for surgery has continually become worse (most have been minor needs) and the medical reasons are getting more serious. Now I am faced with the need for surgery (at least two procedures as soon as possible) for much more serious conditions.

Throughout my medical travels, I have seen many traumatizing experiences, some rather significant. I've since been diagnosed with major depression and PTSD.  Ironically, over time I've managed to deal with intense anxiety as I've endured my surgeries. I also would never do the procedures with more than local or regional anesthesia either, despite enduring pain and discomfort that most people wouldn't dream of dealing with. I believe I am absolutely phobic.

The anxiety/phobia (?) is so bad now I can't even schedule the procedures I need, which deal with conditions that at minimum have left me with in a disabled state and could even be life threatening. But just the thought of them even being scheduled is intolerable.

I get counseling and am trying different methods to deal with this. I try to change my thoughts. I am a spiritual person and engage in bible study and prayer. I have tried medication--several different antidepressants have left me with cardiac side effects (I have a cardiac history) or feel stoned out of my mind. I have tried xanax but had a paradoxical reaction.

But now I feel I'm on the path of becoming increasingly more disabled (or worse) because I am not willing to go forward with the surgery. I want to feel better, but can't stand the thought of more surgery.

I'm sorry for such a loaded question and story. What do psychiatrists try to do for people like me? I feel like I am flat out of hope here.

Thank you!

[accipiter]

Whatever you do, don't resort to alcohol to dull your anxiety.  I've done it.

It'll work...for a short while, but I found that it began to take more alcohol as I went through it and the anxiety always came back, and always WORSE!

I know your in a bind, but alcohol isn't going to help.

Do you have any family/friends that can support you emotionally?

[dodiad1971]

Dr. Gould, thank you for your response. Unfortunately, my situation is very complicated.

I am unable to get the REAL risks because some doctors think I am too high of a risk for any surgery whatsoever. Other docs I've been too think they could do anything to me regardless of what I tell them about my history--and I often feel the consequences of their actions and their response is "wow, you weren't kidding" when it comes to my history (as I suffer from an avoidable consequence).

This leads me to mention that when it comes to full trust, as much as I really want to trust them, I just don't feel I can. In fact, the thought of having surgery is actually aggravated by having to deal with the staff.

Unfortunately I am currently living with a permanent reminder of what I consider the worst mistake I ever made--taking the advice of several physicians for medical diagnosis and treatment that later rendered me without health insurance and becoming permamently uninsurable at the ripe old age of 24. I have been in a downward spiral ever since. I feel like my life has been ruined by healthcare, and yet I need those professionals and still have great respect and admiration for them. I've just dealt with few too many bad apples in the bunch.

I do want to feel better and hopefully improve my future with the surgery, but these issues keep stopping me. I am contemplating whether I should start drinking or something to try to dull the anxiety because it's so bad.

[Roger Gould, M.D.]

You are in a tough spot.  The only thing that can help you is a deep conviction about reality.  If the procedure is absolutely necessary to prevent long lasting disability, then that is the reality that you must face, and deal with. I totally understand the horrible images you have in your mind about the surgery, which lead to catastrophic predictions, so the next thing you can do is sit down and talk to the surgeon and get a full explanation of the procedure, and ther REAL risks.  the third thing you can do is consider anaesthesia...break the pattern of the  past...in the end you are talking about trust..trusting the medical team, so do everything you can to decide whether you have full trust in them or not.