How to prepare psychologically for a surgical operation? Europe’s top heart transplant surgeon. 3
A patient may know that they have to go through major elective surgery. It is not emergency surgery. The surgical operation will be in one or two months. What can patients do to maximize their recovery chances? Dr. Anton Titov, MD. How to go through surgery successfully if they have one or two months to prepare? Dr. Anton Titov, MD. I think a patient can do a lot to help themselves to go through surgery. It is very important for a patient to plan the surgery in their head, in the brain. Because I’m fully convinced that the brain is the main commander for the body, so during an appointment at the clinic, a surgeon. But also anesthesiologist, coordination secretary. Nurses, should explain to the patient and the family how things are going to happen, at what time patient will come to the hospital, what’s going to happen when they arrive at the hospital. Sometimes it is very important for patients to look at their hospital room before surgery. Medical second opinion is important. They just can be sure they will feel good in the room [after surgery]. Sometimes patients want a detailed explanation about their future surgery. Sometimes patients don’t want any explanations. Then I will not provide a detailed explanation [of surgical procedure] if a patient doesn’t want to know. But, on the other hand, an explanation of surgery is very important to convince the patient that he has to go through this treatment. Whatever the treatment is. It could be surgery, interventional cardiology procedure, etc. Тhe patient should be fully convinced [of benefits and risks of treatment]. I will not operate on a patient who would say, “I’m not convinced that what I’m going to do to myself is good for me.” It is better to wait to do surgery, even if there is a risk [of disease progress]. Dr. Pascal Leprince, Transplant Surgeon. We can tolerate some risk because the risk is never 100% in two days. Medical second opinion is important. It is better just to postpone the surgery [if the patient is not yet fully convinced]. I remember one patient who had some a psychiatric condition. It took six months to have the patient accept surgery. He went three times to the psychiatrist before the surgery. It was very helpful. Because when he came for the surgery, he was stressed less. The surgery went well; he stayed one week in the hospital and was discharged quite easily. Then it took another two months for the patient to accept the rehabilitation. But eventually, he did well. Initially, he was so stressed that it was not possible to do his surgery. Medical second opinion is important. This is very important for the patient to understand. What’s going to happen? Dr. Anton Titov, MD. What process he or she will go through? Dr. Anton Titov, MD. How will the family be able to come to visit the patient? Dr. Anton Titov, MD. I think it is very important. This is usual in the United States. But it was not usual in France until a few years ago. It is very important for the family to be able to visit patients at the hospital 24 hours 7 days a week. It is very important to be open to the family. Medical second opinion is important. They can visit the patient, even to stay in the patient’s room. I remember when I used to work with Dr. Jack Copeland in Tucson, Arizona. It was 20 years ago. Already at that time. The families were allowed to stay in the room, even in the ICU. I always thought it was a great thing. Now we offer for the family to stay with the patient here. But it took 15 years in France to come to that point. Some patients do ask, ‘What can I do to come to the surgery in the best shape?’ Some patients are stressed. They ask this question. How can patients have the best mind [mental attitude] before surgery? Dr. Anton Titov, MD. I tell patients to spend 10 to 15 minutes a day just to think about the surgery. I advise you to think about the hospitalization, just to think about the surgery. Be positive about it. I am not sure it is going to help. I don’t know. But I think if the patient is positive 10 minutes a day about the surgery he will go through, I am pretty sure it is going to be pretty helpful. Medical second opinion is important. This is a advice we can give to patients and families before the surgery. It is individual. Some patients want more information. Some patients don’t want too much information, because it will help them to go through and visualize their upcoming surgery. But patient education is very important.
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