Anxiety After Hospitalization: When Medical Treatment Leaves Emotional Scars

As the title of this article implies; the emotional effects of a hospital stay (even a "short" stay) can linger - even if the relevant medical procedures were an overwhelming success. The emotional effects may not manifest immediately upon discharge, but rather show up in an individuals psyche weeks, months or even years after being discharged from hospital. If you ever find yourself needing an operation (whether you end up being put to sleep, or you can remain awake during such); people (myself included) have requested the relevant medical staff involved to only speak kind words (no laughter at and no gossip) to and about one another, including their colleagues outside of the operating room at the time of your operation/surgery. Even if you happen to be unconscious with general anaesthesia; your mind still takes in everything that is going on in the operating room/theatre at the time. And only focus on the well of positivity in general such as good news stories, and investments going well for example. As you would have gathered by now, this article is part-memoir, part-wisdom. I wish to thank the entire team in the operating room for respecting this wish of mine, and for being so caring.

This is a big deal, as words (even the wrong choice of words) that are said directly or indirectly to a patient in hospital carry more weight than anticipated, and hence could have minor to serious mental health effects. In the hospital environment, patients are asked to treat healthcare staff with respect, and therefore it is only fair and wholesome for that respect to be reciprocated to the most vulnerable of humans in hospital; the patients. Yes, hospital stays succeed in either saving your life, and/or improving the quality of it. Some hospital procedures end up being that all vital cure to certain illnesses. (In the specific case of an unstable ankle fracture, to be able to walk again without support.)

On the whole, no one asks for chronic illness to come into their life, and no one asks for freak accidents/injuries either. On the physical standpoint, medical procedures in hospital can and do go wrong (from medication to surgery), and the physical side effects can be a given sometimes, from seizing up to vomiting from anaesthesia, or the need for more tests and procedures. Having trouble falling asleep once discharged from hospital is another common physical (and emotional) side effect after spending at least one night in hospital. The emotional side effects (in other words, emotional trauma that may or may not lead to PTSD) are in the silent majority, and hence why this article is written to raise awareness, and to help people be more mindful of such.

In the retail and hospitality sectors, it is commonplace today for signage to be in shop front windows to remind customers and patrons to be "kind" to staff. One of these signs says "We wear your words." Such wisdom, if only some of the nurses (especially from a recent public hospital stay) were mindful of that. I get that healthcare workers are overworked, sometimes underpaid and absolutely burnt out due to common staff shortages in the sector; yet that is no excuse or copout to say in a shared room of four patients involuntarily admitted for emergency surgery that "We never run out of customers." (Yours truly heard those exact words, or something along the lines from a nurse or orderly while bed bound after major ankle fracture surgery, unable to walk, and unable to get out of bed.) Really? Patients in hospital are exactly that: patients, despite hospitals technically being a business. In emergency surgery situations, no sane human being wants to be in hospital, ever. If you choose to go to a homewares store and intentionally buy some dinnerware, then yes, in that scenario you are definitely a customer.

Another example, evidence that some frontline hospital staff need further development on patient empathy, despite the stresses of their role. In emergency situations (in my case, having waited ten days at home from emergency presentation to being admitted as an inpatient at the same hospital); it is natural to enquire to one of your nurses as to when your surgery might happen, while resting and waiting in a hospital bed, where your vulnerabilites and anxieties are at an all time high, to only be asked "Do you have private health insurance?" in the public system, where universal health care happens to have your back for the surgery and hospital stay component, principally for emergencies. That is not the place of nursing staff to be asking this question to patients, as this question was already managed at the administration and admission stage. Private hospital cover in Australia (let alone anywhere in the world) is not cheap, and can be a slap in the face to ask someone who could not catch a real break between chronic illness and injury, and who pays their Medicare levies, and has not been in hospital as an inpatient for at least one night for 42 years prior. (And who paid for a day stay surgery in a private hospital a few months prior, fully out of pocket, only getting 20% of that operations cost back on Medicare.) Not cool.

As a woman, you would be super unlucky if you happened to have gotten that time of the month early while in hospital for major emergency surgery, and being unable to walk without support from said accident. Patients do run out of sanitary products; especially when their hospital stay gets extended as a result of such. Telling a patient to "just bleed on the bed" is not nice. I was (and still am grateful) that the hospital (on my most recent public hospital stay) had extra pads to provide, although common sense would tell you to have larger pads available for patients, as being in hospital unexpectedly is traumatic enough, without that time of the month adding to the (emotional aspect of) trauma.

Everyone responds to the emotional effects of staying in hospital for at least one night differently. There is a vastly different energy to day stay procedures. Panic can set in while passing a hospital in transit, to being hyper-vigilant to any bodily sensation when the grief of spending time in hospital hits - even if the care was marvellous otherwise. Isolation and the lack of privacy that being in hospital for at least one night also provides can also be emotionally taxing for many people, combined with the loss of bodily control, whether temporarily or otherwise.

Avoidance of doctors and other health care professionals, and missing follow-up appointments is another emotional indicator of hospital trauma. Medical uncertainty, sensory overload (bright lights, alarms, noise, and constant interruptions) are also emotionally draining. Knowing that another patient is in heavy emotional distress (for example, banging the meal table with cutlery while simultaneously shouting out in pain disregarding the other patients in the room trying to sleep, and wanting to die) gets transferred to the ICU also exudes a heavy emotional load on other patients around them. (True fact - yours truly had to wait a little longer for another blanket from the nurses as a result.)

Knowing that you had a close brush with your own mortality is not helpful. People who are admitted to hospital who are already experiencing anxiety, who underwent a complicated procedure, and who had a prior history of trauma are at higher risk of being emotionally exposed. Same if you have a limited support system outside of hospital. Long ICU stays would be horrific from an emotional standpoint.

There are great solutions and support mechanisms to help people overcome their emotional hospital trauma. These solutions include, yet are not limited to the following. These definitely work, speaking from personal experience:

• Journal your thoughts and feelings when emotional triggers from a recent inpatient hospital stay arise. What do you see? What do you hear? What does that feel like?
• Create a gratitude journal writing down everything (no matter how simple, even if it is just finding a dime on the street) that you appreciate in your life right now, of which is going so great. Gratitude is a great attitude. When you shift your focus away from the negative emotional trauma of having been in hospital (mainly words from healthcare staff said to you either directly and/or indirectly) - it ultimately dissolves, and/or there is less space around such.
• Movement. Long walks in nature. Earthing at the beach. Yoga (trauma sensitive sessions are more ideal, if not any form of yoga is fine - whatever form your body allows). Meditation (no matter the technique) is also incredibly helpful.
• Cognitive Behavioural Therapy (CBT) and/or EMDR if this form of therapy resonates. CBT is great at reframing negativity and trauma. Others can help you see things from another perspective. EMDR is all about reprocessing those traumatic hospital memories towards healing and graded exposure.
• Exposure therapy. For example, slowly and steadily returning to medical facilities. If it helps to have a trusted person accompany you to your next appointment, that is ideal.
• Other nervous system regulating activities that build back trust and safety. Whatever resonates. Pets are fantastic in that regard, with the unconditional love they usually provide.
• Avoid doomscrolling, and constant medical related Google searches, as anxiety from the emotional aspects of staying in hospital only amplifies.
• Allowing your physical scar/s from surgery, and/or scar tissues from IV infusions, cannulas and blood tests to be a reminder of the battles you've won as a hospital inpatient; metaphors for the emotional resilience that you've conquered to get this far in life, both during and/or after your physical recovery. Emotional recovery will follow, and you will shown the way towards such.

In concluding, remember that it is not what happens to you, it is how you respond or react to what happens. If the emotional trauma from your most recent hospital stay kicks in further down the track, it is kind of left field and scary at first. Hospital stays from one night onwards can and do leave emotional scars; however our brains are fantastic at rewiring beliefs and emotional reactions, thanks to neuroplasticity. Time heals all wounds, including all of the body's systems. Know that a life of safety and empowerment is not far off. Trauma is created, and it can be burnt down again. Trauma is just like a dysfunctional relationship; in a way (metaphorically speaking) it gets built and then destroyed. Burn It Down by Linkin Park is an appropriate song choice. Give yourself permission to burn hospital trauma and/or any other emotionally charged life experience to the ground...