Anticipatory anxiety roller coaster
Anticipatory anxiety. You know that feeling. It is rampant around the end of year holiday season. It’s that looming feeling of an approaching event or experience and you just can’t get everything done before it. The more you feel that way the more you don’t get things done and your anxiety increases.
Anticipatory anxiety is a real psychiatric condition. It is part of the fight-or flight mechanisms of our bodies. Some people have a physical response like rapid heartbeats, sweating palms or disturbed sleep. While others may have a mood response like sadness, fear, hopelessness, anger or irritability. For me, it was the latter two. I found myself having angry outbursts and being really irritated with little things.
Pre-surgery always brings that feeling. Maybe it is a way to deal with the anxiety of the surgical risks. Maybe it is normal but it’s my coping mechanism. Either way, it was high on my way to Cleveland and it slowly starts to fade as the hours draw closer and at some point your only job is to relax, stay healthy and put yourself into the hands of the research team, the ultimate trust.
The day before surgery was testing and review of the plan to help the team understand what my preferences would be within the contingency plans and decision trees during the surgery. It is not like they can wake me and ask me. So those decisions need to be clear beforehand. If this happens then will this work?
A few markings for surgery, measurements and then stimulation for the new electrodes. The new electrodes would provide ankle function and potentially help with balance while standing. Surface stimulation on the left side first with good and strong plantar and dorsiflexion response. Right side all plantar flexion and an extremely weak dorsiflexion, almost unnoticeable. Ouch. Do we still implant? After much discussion, we decided to stick with the original plan, implant.
The night before surgery, they gave the instructions: no food or drink after midnight, no dark nail polish, no hair or skin products, no makeup, and anticeptic wash in the morning.
But I had to do it one more time. With no walker or crutches with me, I used the grab bars in the bath and stood with the old IRS-8 electrodes. The original implant that is not being touched in the surgery but if the wrong wire is cut then it will not work either. One more time, looking down at my feet from a standing position, stretching out the body and feeling that upright world. Knowing, knowing that there is a possibility that this can all go away tomorrow if something goes wrong. Anticipatory anxiety.
The morning of the surgery, music was my calming therapy; a little Judah & The Lion and Revivalists. I’m feeling good. Entering the hospital doors, you just relax. At this point, I’m in the hands of the team. Check in at surgery registration with a waiting area filled with people queuing to get surgery and those waiting for loved ones to be through surgery. Big screens on the wall have patient numbers with color coded status or transmitting the morning news. There is a pastor in the area reading scripture to a few people, comforting.
Back behind closed doors is Pre-op and a whirlwind of activity. Nurses coming and going, the surgical team pops their heads in and the anesthesiologist promises to mix me a good margarita with a minimal hangover. With all the questions and activity, a nurse no taller than 5 -ft says “I warmed the bed for you, are you ready?”
The last thing I saw was a big wall poster of the surgical plan that we reviewed the day before. Out.
Waking up hours later in the recovery center, a calm and quiet place. After a six hour surgery, surprisingly I had no pain but feeling a little groggy. The anesthesiologist was right no hangover. Surgery went well and the new IST-16 is implanted and the jumper cables to the lower legs were installed. Due to the length of the surgery, they decided to split the procedure and implant the lower leg electrodes in a separate surgery. That means there will be a second Act. We are currently in intermission.
Note: The statements and views posted here are of my own and do not reflect those of Case Western Reserve University, the Department of Veteran Affairs, Metro Health Medical Center or the National Institutes of Health along with their representives involved with this program. If you are interested in this clinical trial, please visit https://clinicaltrials.gov and search NCT00623389 or NCT01923662
