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When hospitals make you ill.

BUTTERFLIES in the tummy are nothing new to Lorraine Smith, who has had to face regular operations to repair a hernia since the age of seven.

Lorraine, now aged 18, of Chelmsley Wood, Birmingham, was still coming round from her sixth operation at Solihull Hospital when she explained why she hated the build-up to surgery.

"I always feel horrible," she said. "It's all the waiting around which makes it worse and I end up feeling even more scared.

"I get particularly nervous because I know I'm going to have an anaesthetic and it makes me really sick afterwards."

Sore and tired after her operation on a femoral hernia, Lorraine was glad it was all over.

Lorraine is not alone. The prospect of going under the surgeon's knife can leave some patients in a state of mortal terror, even for the most minor conditions.

But anxiety preceding an operation can have a negative effect on recovery, damaging the immune system and leading to infection.

Christopher Vasey, aged 15, of Solihull, was anxiously waiting in the children's pre-op ward at Solihull Hospital to be taken up for dental surgery. He admitted he was a bit nervous about the anaesthetic because it meant losing consciousness.

"I'm not looking forward to the needle but at least they showed it to me when they explained everything about the operation," he said.

Christopher was looking forward to getting home for the Manchester United v Juventus match, just hours after his surgery.

Reducing anxiety in patients is seen by nursing staff as beneficial to everyone. The patient has a better experience of surgery and recovers more quickly with earlier discharge from hospital.

Lynn Toogood, research nurse at Leicester University, said: "If a person is really anxious, their adrenaline and cortisol levels will rise, interfering with the healing of a wound after surgery.

"And an imbalance of electrolytes in the blood can affect the immune system, increasing the risk of wound infection. So it really is better to stay calm."

Lynn has seen some serious cases of anxiety in her years as a nurse.

She said: "People can be so terrified they can't speak, or are constantly crying. Severe anxiety will often mean the patient can't communicate at all, so it can be very difficult to get the right information across about their operation.

"I've seen patients sweating, trembling, unable to stop talking, or abnormally cheerful before an operation. They may be blocking out what is about to happen.

"Frightened people will look out of the window and not pay attention to what you are saying and they often refuse to look at you. It's quite surprising but an operation on an ingrowing toenail can lead to far greater fear than major surgery.

"People who have had less time to come to terms with a condition that may not even be as serious can be absolutely petrified.

"And it is the anaesthetic that they fear most. Patients fear the fact they are going to be put to sleep because they are afraid they will not wake up."

The rise in day-surgery cases means more patients are booked into a pre-assessment clinic like the one at Solihull Hospital, where they are offered information and the chance to ask questions.

Staff nurse Suroj Parmar said: "We give patients a questionnaire to fill in three weeks before the date of their operation and leaflets about their condition.

"Then they come in for a visit, when we go through their history, show them around and give them the chance to ask questions."

Lynn Toogood said: "I advise people to write questions down in advance because if the nerves do take over you can forget what you wanted to know and your mind goes totally blank.

"It is also good to have leaflets to take away and read. This gives patients a sense of involvement in their operation and can prompt more questions later."

Sometimes patients are so nervous they may beg for tranquillisers but Lynn says the practice of giving drugs before an operation is dying out.

"We prefer to talk to a patient to calm them down. One man had such a fear of needles he said he would pass out," she said. "We were able to help him, talk him through it, and he didn't feel a thing when the needle went in.

"Patients mustn't be afraid to say they are terrified.

"It's a good starting point and nurses would rather know what they are dealing with."
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Article Details
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Author:Palfreyman, Louise
Publication:Sunday Mercury (Birmingham, England)
Date:Apr 25, 1999
Previous Article:Karen Kay; It's showbuzz Blast from the past.
Next Article:Talking eases fears of facing operations.

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