By Katie Fultz, PA-C and James Davidson, MD
Blanchard Valley Orthopedics & Sports Medicine

Medical testing and procedures can sometimes present a challenge both physically and mentally for a patient and their caregivers. Understanding those types of stressors and having tools to help manage them can help patients have a more positive experience. Eustress is positive stress that represents positive challenges and positive changes. Distress is negative stress that can come from negative or difficult challenges. 

Medical testing and procedures can bring both stressors as well as other feelings such as anxiety, depression, fear, worry, accomplishment and relief. When these challenges are present in patients’ and caregivers’ lives for a certain period of time, they can manifest into physical symptoms such as headaches, disturbed sleep, gastrointestinal upset, increased blood pressure, chest pain and increased postoperative pain, to name a few. 

Without stress management tools and coping mechanisms, patients can turn to unhealthy ways to manage that stress such as inappropriate use of prescribed drugs, use of illegal drugs, increased use of alcohol and smoking.

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A patient’s preoperative mental health state impacts their surgical experience and recovery. Patients with increased feelings of anxiety and depression are more likely to experience an increased risk of poor healing, delays in physical therapy, and difficulty with pain relief. The side effects of their anxiety preoperatively are likely to continue or increase postoperatively, manifesting in physical forms such as bowel/bladder dysfunction, heartburn and disturbed sleep.

There are several techniques and tools that are available to help manage the stress around medical testing and procedures. If you have an established mental health provider, stay in regular contact with them and continue to take your regularly prescribed medications by that provider. Stay informed about your procedure so that you know what to expect during your perioperative period. 

Talking with your healthcare providers can assuage fears, and knowing who to contact when you have questions helps with planning. Breathing techniques during a test or procedure, listening to music and knowing approximately how long the procedure will take can help manage the stress of a procedure. 

Be an active participant in your healthcare. Read and understand your surgical instructions. Avoid engaging in unhealthy coping strategies such as drug or alcohol use, smoking, angry outbursts or threatening behavior.

Support your body to heal. Eat a healthy diet, remain active within the guidelines of your surgical team or physicians, get enough quality sleep at regular hours, remain hydrated and work towards a healthy weight. Music therapy, meditation, acupuncture, massage, yoga, journaling, counseling and aromatherapy can also help manage stress. Using aromatherapy is safe and effective during the perioperative period. Lavender, orange (mood), peppermint/spearmint (stamina and nausea), ginger (nausea), eucalyptus (joint pain), and rose scents (anti-anxiety) are all examples of good scents for aromatherapy. 

Caregivers and healthcare providers can help by educating the patient and supporting the patient’s perioperative care plan. Caregivers can help supply stress management tools and can also participate in those management activities. Healthcare providers can take the time to educate the patient through patient-centered communication on the multimodality approach to pain relief. 

Caregivers and healthcare providers must take the time to care for their own needs and manage their own stress in order to be more effective caregivers for their patients. Being organized, setting realistic goals, asking for help, hiring help, maintaining personal relationships, talking with someone (friend, family, counselor, support group), prioritizing activities that relieve stress and bring enjoyment, and taking care of one’s health are all appropriate goals for a caregiver in order to maintain their own mental and physical health. All of these help a caregiver establish a support system and care for themselves while also caring for a loved one.  A great resource for caregivers can be found at www.helpguide.org.

Healthcare providers should also follow a similar format to avoid burnout and compassion fatigue. Acknowledging your feelings and speaking with a trusted friend, family member, colleague or counselor is one way to help navigate the pathway through caregiving stress. Having a mentor can help a healthcare provider navigate challenging situations. 

Making one’s health a priority, including physical activity and sleep, will keep a person feeling well and mentally acute. Engage in activities that relieve stress, bring you joy and give you a break from your caregiving duties. Consider relaxation breathing techniques, yoga, meditation, humor and journaling as quick ways to relieve stress. Maintaining healthy boundaries and priorities to help balance multiple responsibilities will help a person reach all of their goals successfully. 

The State Medical Board of Ohio provides a resource called Well-Being CARE Service, which is simple, free and anonymous. This service provides a voluntary and anonymous way to seek help to avoid and treat stress, anxiety and burnout. Well-Being CARE can connect a healthcare provider with a licensed mental health professional if needed. This resource can be found at med.ohio.gov/for-licensees/provider-wellness.

It has been shown that a multimodal approach to relieving anxiety and pain during the perioperative period and medical testing helps with recovery and reduces the dependence on pharmaceuticals such as narcotic pain medication. Patients should request all information about the test/procedure and ask questions to relieve anxiety during the test/procedure. A caregiver who helps manage their health and stress will be a better caregiver for longer. If you are experiencing any feelings of anxiety or depression, seek help from a healthcare provider such as a counselor or primary care provider. Calling 988, texting 988, and going online to 988lifeline.org can connect a person with immediate support 24 hours a day, seven days a week.