Heads up…I wanted to entitle this blog “The $hit Nobody Tells You About Surgery and Chronic Injury That you Really Need to Know.” Nobody talks about this stuff because, frankly, it’s grim. You certainly aren’t going to openly talk about it with friends or family. Likewise, you aren’t compelled to turn to Facebook and lament about your partner/caretaker freaking out on you or excruciating and recalcitrant post-op constipation. That’s OK; here we’re going to talk about the crummy stuff nobody else will tell you, and, we’ll talk about solutions. You’ll take away resources for injured athletes, or for any human being who is struggling.
The concepts here apply to acute and chronic injury, surgery, chronic illnesses, and most life challenges. Your experience may be more or less difficult, but the concepts apply to everyone.
Also, you may substitute friend, family member, or other caregiver for partner.
Fresh off hip surgery, with palpable disgruntlement and distress in his voice, my client said, “Do you have any advice for dealing with my wife? She’s agitated that I’m physically unable to help around the house. Her communications have devolved to one-word brusqueness. It’s not like I did much to set her off. For goodness sake, I can’t even get up off the toilet by myself.”
I made another mental hash mark next to the “surgery sucks as much for the care giver as it does for the patient” column in my “Things Nobody Tells You About Injury” list.
We assume that the injured person being sliced and anesthetized to within an inch of his or her life carries the most stressful burden. Through my own and my clients’ experiences, I know that family and partners struggle mightily too.
Injury breeds stress, and when in stress we digress.
The prospect of surgery breeds stress with the ambition of a thousand rabbits, and that’s where many relationships come unglued. Most folks aren’t inclined to openly share post-surgery interpersonal strife, leaving those headed into their first surgery unaware of the extra challenges that crop up during recovery. Given this lack of forewarning, most of us get bushwhacked (read: surprised) post-op with partners who, seemingly all of a sudden, react hysterically, take things personally, and communicate like a 6-year old.
Bushwhackings are never fun, irrespective of their origin, so I’d like to stack the odds in you and your partner’s favor as surgery approaches. To do this, let’s talk about an injury taboo–how surgery affects your relationship.
Raise your hand if post-injury, but pre-operatively, you’ve experienced waves of stress with your partner. I get it… Things have been stressful with your partner because of your limitations and the emotional fallout, and now surgery? You don’t even know how to prepare. (You can read my blog on how to prepare for surgery here.) Frankly, things are going to get worse during your recovery…unless you recognize a few things.
First, don’t assume anything, ever.
Regardless of our injury, we assume surgery will fix everything, and set us straight on the road to recovery. I wish it was this straightforward. Whether it’s day surgery or inpatient, traditional or “minimally invasive” (read: it’s every bit as invasive, it’s just that access to the area is now achieved by a tiny instrument, like a scope), surgery equals trauma. Plus, anesthesia is essentially a tool to take you to the brink of death and keep you there while someone slices away at you.
Surgery represents a traumatic physical intervention to set the stage for proper healing. You’ll gain wounds, the after effects of anesthesia (while it may be out of your system in 24 hours, the effects are a gift that keeps on giving in the form of fatigue, nausea, and wretched constipation), and side effects of pain medication (bonus constipation)–something we all can’t wait to experience!
Don’t assume surgery will make you better immediately. Rarely, it does. For most of us, the opposite happens. We experience a wave of feeling worse before we feel better. Just from the insult of surgery (read: cutting and slicing only), your body may be 1/3 healed in one month, 2/3 healed in 2 months, and fully healed in three months. Don’t assume your partner knows this and don’t keep this information a secret from him or her.
Don’t assume your partner has it easier than you. You hate seeing your loved one suffer, and your partner will feel the same about you. You may be the one with pain and limitations, but it’s tearing your partner up to see you hurting.
Also, at some point, one of both of you will experience anger toward your injury. Take note, because your partner’s anger about your injury may be cloaked as anger directed at you. As hard as it is to turn the other cheek, don’t take it as an insult…and keep reading. I’ll discuss a tool for such interactions.
Don’t assume your partner understands what you’re going through. It seems obvious that he or she should know, but it doesn’t work that way.
No matter how much you think he or she should, you’re partner isn’t going understand how enraged you feel when you can’t work out or take care of yourself. Sit down and talk about it. Say something like, “Hey, I don’t want you to fix a thing; I just want you to listen. I’d like to talk about things that are hard for me right now, and I’d like for you to do the same so we can understand each other’s challenges.”
Remember: communication fosters connection; assumption breeds contempt. Contempt has no place in surgery recovery.
See where I’m going with the word should? It’s best to eliminate it from your vocabulary because should begets assumption.
Next, don’t take things personally–both of you.
Communication will devolve into breviloquent quips; your bottled up frustration will involuntarily unload onto your partner; both people will feel offended; connection will unravel…unless you make a pledge to one another to not take things personally.
Accept that recovery from surgery will be physically and emotionally taxing, but so is care taking. You’re both going to be exhausted. Your caretaker will feel overwhelmed and overworked trying to tend to your needs and run a household. You’re both not sleeping well, and we all know what that means. Sleep is the foundation of your recovery; I talk more about sleep in this blog.
You’re both embarking on a process where things become more difficult before becoming easier. Allow each other to be human. You’re going to make bad decisions because you’re tired. You’re going to say nasty things that you wouldn’t otherwise say. You’ll exercise your bad judgment muscle. While it’s helpful to be honest, in this instance, it’s also helpful for both partners to plan ahead to extend extraordinary patience to each other and not take things personally.
Surgery is a team sport. It can throw you and your partner in and out of waves of stress that force you into survival mode. You know what, though? You’re both doing the very best you can, even if your best seems paltry.
Take things day by day. If either one of you dwells upon weeks of restriction or weeks of added chores and responsibility, you’ll feel completely defeated and massively cantankerous.
I love road and mountain biking, two sports that serve as life metaphors in many ways. While watching a particularly mountainous stage of the Tour de France, the commentator said, “It’s important to take things one day at a time in these stages. Sometimes it’s even less than a day at a time. In the case of the sprinters, who struggle in the mountains, it’s a case of take-it-one-mountain-at-a-time. And when you get to the bottom of a mountain, don’t look up. Just keep pedaling. You’ll be there eventually. It makes it worse when you look at the top because it seems never ending.”
Finally, communicate–even about the hard stuff, even when you’d rather not.
The more uncomfortable and upset you feel, the more communication serves as a lifeline.
Before surgery, talk candidly about expectations, fears, and plans for communicating with each other…and take notes! Things may not play out as you had imagined, but you can look back at your notes and revise the plan.
Give each other credit; acknowledge, and talk about each other’s struggles. I cannot over-emphasize the importance of talking about the awkward and hard things. Maybe the first few times you’ll feel as uncomfortable a child heading out for her first ride without training wheels, but if you crash, the ground isn’t too far away. Just get up and try again like all kids do.
A few small but intentional actions will help along the way. Here are some suggestions:
1) Set up a commitment every day to, for example, have a quick dance at 7:00pm and tell each other “I love you,” or “I appreciate you.” Note: Schedule this before your surgery because planning it when you’re in a moment of despair isn’t realistic. Or, if you’ve already had surgery, schedule this when the two of you are having a good day–for those days that aren’t as good.
2) Set up date nights, even if the date is just watching a movie on the couch. Refer to the same note in #1.
3) Write each other letters the old fashioned way with a pen and paper. Express your appreciation and love. Acknowledge each other’s position in the recovery. Give thanks!
4) Establish a time each day (not right before bed) to discuss how each of you is feeling. Don’t ask for problems to be fixed, just take the time to share.
I’m an unwavering Prairie Home Companion fan (I’m still in mourning after the recent final episode), and I adore Garrison Keillor. On one of the last episodes he said, “Good judgment comes from mistakes made with bad judgment.” Both of you are going to make mistakes; that’s reality. However, now you have practical knowledge that will feed your patience and understanding. No…not patience…extraordinary patience.
Heidi – thanks! You hit this one out of the park! Your suggestions for some solid communication skills are critical – and I have got to continue to express thankfulness to my other half for his many years of encouragement and thoughtful help during this most recent injury. He’s a saint. Regrettably, I’ve got some time left on this rehab assignment …..
Thank you, Nan. I’m wishing you a smooth recovery and sending lots of love to you.