The 7 Stages of Accepting That You Need Surgery

As many people who have dealt with chronic illness know, a lot of time is spent seeking answers and diagnoses. There are a lot of maybes and possible treatments, but when the hypothetical becomes reality, there is then the process of having that reality actually sink in.

I am currently experiencing that, as I found out today that I will be having surgery to fix the issues I have been having with my esophagus. After having severe acid reflux combined with esophageal spasms, chest pain, and difficulty swallowing for about three years, which led to emergency room visits, several endoscopies, various diet changes, medication, and little improvement, I finally have a solution.

While I was living in Boston for college, I was mostly seeing general gastroenterologists, who tried their best to help me but ultimately could not figure out what would solve my problems. Nothing that they suggested was working, and my episodes of esophageal spasms were becoming worse. Towards the end of the year, I made sure not to eat before a major interview, presentation, or event so that I would not experience intense pain or make strange noises at inopportune moments.

When I moved back to New York after graduation, I made it my priority to find a specialist who specialized in whatever was wrong with me. It’s difficult to find a specialist when you don’t know what you need him or her to specialize in, but I found a surgeon who focused on esophageal motility disorders and corrective surgery. He suggested several tests, including one that involved an endoscopy, in which a small chip was inserted into my esophagus. I then had to carry around a Bravo PH monitor around with me for 48 hours, pressing a button to indicate if I was experiencing a symptom, eating or sleeping. The results from this test indicated that my esophageal function has been impaired significantly from the reflux.

Based on this, my doctor  determined that since my symptoms had not responded to medication, I was a candidate for the surgery.

He then gave me lots of information, on the surgical process as well as the recovery, and the risks and benefits of the surgery. It will involve five small incisions on my abdomen, which he mapped out since I already have a fair amount of scarring there from my previous surgeries. What’s five more, right?

If everything goes well, the surgery will be minimally invasive, I will stay overnight at the hospital, and then go home to recover. I will then hopefully be reflux-free, which means no more medications. I will even possibly be able to eat acidic foods that I have avoided for years (Grapefruit! Orange juice!).

This is not my first time at the rodeo. The surgery will be my fourth in almost 10 years, so by now I am used to hospitals, doctors, and recovery time. I know to ask for an extra hospital gown and hospital socks so that I don’t freeze before and after the surgery. I know to ask the nurse to insert the IV line into my hand instead of my inner elbow, since it is easier to move my arm that way. I know that I will have a bad reaction to the anesthesia and wake up super confused and upset, but that I can’t avoid it. And I know not to push myself too hard during recovery.

Knowing all of this is one thing, but fully processing and accepting it all is an entirely different animal. I am realizing that this occurs in stages. Each person’s unique medical situation means that no two cases are the same, but there are shared feelings and experiences that many people can relate to.

While the order and intensity of the emotions may vary from person to person, I think most people with chronic conditions can relate on some level to the following seven stages that occur after learning about an impending surgery:

1. Relief. It’s not that having surgery is exactly what I would like to do next month, but I am relieved to have found a doctor who understands my condition and has found a probable solution. I am used to inconclusive tests and non-answers, so hearing that I can do something to help me feel better was reassuring. I can’t quite imagine life without reflux or esophageal spasms, but I’m hopeful.

2. Curiosity. Then the questions started rolling around my brain. How long will the surgery take? What kind of anesthesia is required? How long is the hospital stay? How will this effect my job? What are the chances of still experiencing symptoms after surgery? I asked as many as I could think of and jotted down the doctor’s answers in the small orange notebook that I carry everywhere, but I know that more will occur to me that I will have to email or call him about. Thankfully, I have a relatively accessible doctor who I feel comfortable talking to, which is important.

3. Apprehension. Now that I have more answers, I can worry about dealing with time off from work, losing weight rapidly post-surgery and making sure I stick to the required liquid diet after, and the overall prospect of lying on a surgical table. Again.

4. Anger. I then get frustrated and angry that I have to deal with the whole surgical process again. I don’t want to take off of work, not when I just started in June and finally feel like I am getting the hang of the day-to-day office life. I don’t want more scars, or another bad experience with anesthesia, or another night in a hospital.

5. Numbness. All of the competing emotions eventually settle until I feel…nothing. At this stage, I don’t want to deal with any of my thoughts or questions. I just want to ignore everything and focus on my work, or dinner plans, or what color to paint my nails. So I do that for a while, until I am ready to think everything through again.

6. Acceptance. When I am able to fully process what will happen and that it is neccesary and hopefully worthwhile, I begin to accept the fact that I will spend the next few weeks planning my surgery in addition to moving to my new apartment (yep, great timing right?). I accept that this is part of my journey, and that although it’s scary, I won’t be going through it alone. I have my amazing support system of family, friends, and colleagues who have already asked what they can do to make anything easier for me.

7. Determination. I’m not quite at this stage yet, but my goal is to get to the point where I have accepted the surgery, and decide that I am ready to face it head-on. Or, as the case may be, esophagus-on. I will be determined to be as prepared as possible, while still realizing that you can’t plan for everything. I will try to focus on the time after the recovery period, when I can approach eating without fear of pain or the food coming back up. I will get through this, like I have gotten through all of my previous challenges.

It may sound cheesy, but for me this surgery is a detour, not a total roadblock. It will be, hopefully, one that will reopen paths that were closed to me while I was dealing with my symptoms.