This situation seems to be true with adults as well as children. A 2006 study involving 241 children aged 5 to 12 was conducted. These children, who were scheduled for outpatient surgeries, were evaluated based on levels of anxiety prior to surgery. Each child remained in the hospital for 24 hours after the surgery and their pain levels were assessed every 3 hours. The evaluation continues for 14 more days with pain medication standardized for everyone.

The results showed that the more anxious children prior to the surgeries have significantly more pain 3 days into the recovery period. They also consumed more pain medication, exhibited more anxiety and had problems sleeping.

These studies have shown that preoperative anxiety is a serious issue in both adults and children, one that needs to be addressed to better aid them in on the road back to health. In general, one can conclude that increased anxiety prior to surgery results in more anxiety, pain, and slower recovery.

Dental anxiety is another example of fear and anxiety affecting one’s health status. A number of studies have shown that patients who were highly anxious are more prone to visit their dentists irregularly and/or, worse, avoid dental care altogether. Statistics show that people with high levels of dental anxiety are more likely to have not been to the dentist in the last 2 years, and were more likely to miss, hesitate in making, or cancel their appointments. These individuals, even if they do attend regular dental visits, are likely to skip on the follow up appointments that are required to complete the dental treatment. This ironically results in a greater need for oral rehabilitation.

Dentally anxious patients tend to have more missing teeth and less filled teeth compared to non-anxious patients. This spiral situation can then lead to feelings of inferiority and shame which, in turn, result into greater anxiety and further avoidance of dental care.

Fear and anxiety also affects the more mature members of our communities. Some older individuals are fearful of becoming senile and suffering from dementia. Another fear is the fear of being hurt in a fall. This is due to the fact that a fall by an elderly person will have a far worse consequence compared to a similar fall in a younger person. This could lead them to fear falling any time they engage in some form of activity. The result is physical stagnation and frailty, in effect, the realization of the fear itself.

Clinical studies have documented that anxiety can actually intensify pain, prolong recovery and lower the effectiveness of the body’s immune system.

What can be done? There are psychological preparation programs that can be tailored to an individual’s specific needs. Guided imagery, for example, is a form of relaxation that uses stories and calming music. It can have a huge impact on stress levels by “gently guiding” a person to an imaginary place in the mind where he/she feels safe, peaceful and protected.

It has been shown in the 2006 study cited above that children aged 6 years and above will benefit most if they participate in a preparation program 5 days or more before a medical procedure. This is attributed to the way that children in this age group process new information.

PreEmptive Healing is a unique tool developed by board certified anaesthesiologist Anthony DeMarco that employs the mind-body connection to prepare your body for optimal healing before, during and after a medical, dental or surgical procedure. Preliminary research has already confirmed this system’s success and PreEmptive Healing is continuing to help bring healing and relief of anxiety to more and more people every day.

The 1988 Adult Dental Health Survey in the UK reports that 8% of respondents have an existing fear of injections (Todd & Lader 1991). Other studies suggest that nearly 5% of the population may be afraid of needles in general.

The level of fear is different among various individuals. While some people are phobic of dental injections in particular, others are afraid of almost any kind of needle. Some people will even go to extremes to avoid injections.

Most needle phobics have had a particularly bad past experience with a dental injection. There are a number of reasons why this came to be:

• The dentist lacked empathy. While dental students are taught compassion at dental school, not all dentists are created equal. Some will have more empathy with their patients than others.
• Lack of using topical anesthetics or numbing gels. While it is possible to give painless injections without it, numbing gel should always be applied.
• Using a dull needle. This has become quite rare because of disposable needles, but it was a common cause of painful injections. This can occur today with multiple injections. In practice, a single needle should be changed after three or four uses on the same person. Under no circumstances should needles ever be shared between patients.
• Technique for administering anesthetics. Some tissues need to be stretched to make the injection comfortable. Applying pressure on some areas can block out feelings of pain. This is true is areas such as the palate where painless injections are very difficult to do.
• Rapid administration of the anesthetic. The most common cause of injection pain is that some dentists administer the anesthetic too quickly. These rapid injections can tear the tissue, resulting in immediate pain, which then results in soreness.

While it is impossible to guarantee that each and every injection will be painless, the level of pain can be reduced by making sure that the topical anesthetic is left on for long enough for it to work properly, by injecting the anesthetic very slowly, and by applying pressure for certain types of injections.

The best way to find a dentist who gives comfortable injections is by asking for recommendations. It’s also a good idea to ask your potential dentist outright if he or she is capable of giving painless injections and if they apply numbing gel.

Some dental office also uses a device called the Wand which guarantees painless injections, because the speed of the delivery of the anesthetic is computer-controlled. The device, which doesn’t look like a syringe, has been touted to work wonders with needle phobics.

A number of psychological approaches and techniques have also helped other people cope. These include hypnosis, systematic desensitization, deep breathing, visualization and guided imagery, positive affirmations, and reward systems. There are some therapists specializing in phobias and anxiety disorders who work in tandem with phobic-friendly dentists.

For some needle phobics, there is the option of intravenous sedation where nitrous oxide is used to relax the patient enough to tolerate the venflon. The area where the venflon is put is first numbed with EMLA cream or Ametop.

Remember, there is no reason for you to avoid going to the dentist. There are many ways that you can deal with your dental phobia. Most importantly, find a dentist who understands your fear and knows how to handle patients who are scared of dental procedures.

Reduce or overcome your fear of needles

Dental Phobia – A Guided Meditation for Dental Fear and Anxiety is an audio download that can help you reduce and even overcome your fear of needles and dentistry. This audio download can help condition your mind for your upcoming dental visit and procedure. If you follow the guidelines as directed by Dr. DeMarco, you will be better prepared, more relaxed and you will be surprised at how well you recover when you take fear and anxiety out of the procedure.

You don’t have to be scared to visit the dentist. Visit our website, read our blog articles about Fear and Anxiety and sample our wonderful audio product, “Dental Phobia  – A Guided Meditation for dental fear and anxiety.”

There are various elements that causes flying phobia.  Among them are other types of specific phobias such are:

• Fear of heights or acrophobia
• Fear of confined/closed spaces or claustrophobia
• Fear of people or sociophobia

Other caused of fear of flying are:

• Worries causes by news/stories related to air disasters.
• Fear of not being in control
• Fear due to concerns about bad weather conditions and turbulence during the flight.
• Traumatic experiences brought about by past flying experience.

The symptoms associated with fear of flying are similar to other specific phobias: uncontrollable shaking, sweating, stomach aches and heart palpitations.  In some cases, a person who has a phobia of flying feels upset and irritable weeks and even months before the actual flight.

The stress and anxiety brought about by fear of flying affects people’s lives, significantly.  People who have severe flying phobia would do anything to avoid plane rides even if it means missing special family event, canceling vacation trips or  turning down a very good job offer that involves flying.  These people would even experience panic attack just by engaging in conversation related to flying, setting foot in an airport or seeing an airplane overhead.

Overcoming Fear of Flying

There are several options available to help overcome fear of flying.  Among them are fear of flying courses offered by airlines, counseling to determine the cause of your fear, psychotherapy and hypnotherapy.

You may also opt to overcome your fear by using the PreEmptive Healing method of guided meditation and hypnotherapy call Fear of Flying – A Guided Meditation, this audio download can help condition your mind for your upcoming flight and even support you thoughout your flight.

You don’t have to be scared of flying or avoid traveling by air your entire life. Visit our website, read our blog articles about Fear of Flying and try out our wonderful audio product, “Fear of Flying  – A Guided Meditation.”

What aspect of flying are you afraid of?

-        The idea of flying high in the sky?

-        Being in a small room full of strangers?

-        Having little control of your flight?

-        Being away from people, places and things familiar to you?

-        Turbulence?

When did you start being afraid of flying?

Try to recall whether you’ve always had a fear of flying or if there’s an event from your past that had caused you to feel scared.

-        Did you have a traumatic experience associated with a past flying experience?

-        Did something happen in your life that made you feel unsure of flying?

-        Did someone cause you to feel hurt or angry or scared before you develop your fear of flying?

-        Did you experience some discomfort from a previous flying trip?

Understanding where your fear of flying is coming from is the first step to help you manage your flying phobia.  Looking at the nature of the problem can help you realized that you might need to address some other issues and not just your fear of flying.  Did you have a traumatic experience that caused your flying anxiety,  it’s possible you may need to seek the advice of a professional.

Whatever the cause, you must remember that fear of flying is a learned fear.  Something that can be unlearned and overcome.  Whether you choose to seek help from a professional or do some self-help remedy, resources are readily available to help you manage your fear of flying.

Extensive research on commercial flight safety reveals that the death risk per flight is only one in 7 million. Based on this, if you fly on a daily basis, it would take 19,000 years before you encounter a fatal accident. In fact, flying is ten times safer compared to a trip by train, which is generally viewed as one of the safest mode of travel. There is a greater chance of dying from being stung by a bee, one in 5.5 million, compared to flying.

However, all the statistics about the safety of flying seem to be of little value since the fear has nothing to do, at all, with the risks associated with flying. It is an anxiety disorder that results from the simple awareness that life is fragile and vulnerable. It is a fear that can have several components, including the fear of heights, the fear of being over water, the fear of the dark, the fear of the unknown, undue concerns about accidents or deliberate attacks, claustrophobia or fear of enclosed spaces, of being idle for extended periods of time, the loss of personal freedom, concerns about turbulence and weather conditions, unawareness of the normal activities during a flight, the loss of control and of being dependent on technology or other people, as well as some underlying issues from past psychological or physical trauma.

People react to aerophobia in a variety of ways. Some will avoid flying entirely and go to great lengths to arrange their personal and professional lives to avoid it. Other reactions include sweating, rapid heartbeat and breathing, and nausea. Others will use drugs or alcohol to deal with it or become abusive to other people.

What Can You Do If You Are Afraid of Flying?

A number of the major airlines, realizing that this fear can affect their business, offer courses that are designed to help overcome the fear of flying.

These are normally day-long workshop where crew members explain the mechanics of flying, such as the noises the aircraft makes and the reasons for them. This technique is called cognitive behavioral therapy.

It is also possible to practice a number of self-help techniques, including breathing exercises or meditation.  This can be done both before and during the flight. Some people find that visualization, imagining themselves on the plane, with the sounds and sights that scares them, can help them cope better with their fears prior to an actual flight.

When preparing for a trip, it is also helpful to bring a travel bag full of books, magazines, CD player and other items that can help distract you while waiting to board the plane.

Eating a filling and nutritious meal can help you sleep on the flight. This will help you feel better upon arriving at your destination

Avoid sugary snacks, tea, coffee, or other caffeine-filled drinks.  These can make you feel more stressed and they can over-stimulate your already active imagination.

How Can PreEmptive Healing Help You Manage Your Fear of Flying?

PreEmptive Healing has developed a new guided meditation audio that can help. Using the PreEmptive Healing method of managing fear and anxiety, we can successfully reduce fear and anxiety by 30-50%.

Here’s how it works:

We start by conditioning your mind.  Conditioning means to undergo a change so that an act or response previously associated with one stimulus becomes associated with another.  We guide you to substitute courage, strength, love, and empowerment for fear and anxiety. We are going to condition your mind to lower your fear of flying.

We will condition your mind through suggestions and visualizations that you will implement before, during the flight and while you’re plane is landing. To learn more about Fear of Flying – A Guided Meditation, click here.

Click Here to listen to the sample excerpts or purchase this wonderful audio download.

Many instances of dentophobia often involve fears that are more defined, specific and individual. Here are some examples:

The fear of dentists: Dentists represent authoritarian figures that check how well we’ve taken care of our teeth. This fear is the effect of traumatic childhood visits to the dentist.

The fear of needles: One of the most common phobia since it is nearly impossible to look away since the needle is injected in your gum or cheek.

The fear of anesthetics: This includes the fear of waking up and feeling the pain, not responding to the anesthetic or being allergic to it.

The fear of the dental drill: The iconic symbol of dentistry.  The distinct sound alone often triggers anxiety attacks in patients.

The fear of pain: Patients who experienced pain when they visited the dentist as a child often find it difficult to visit again.

The fear of numbness: The fear of being unable to call for help or control the level of pain they are able to receive once they are under anesthesia.

The fear of choking: Another common phobia particularly since the dentist needs to work in the mouth area.

The fear of being embarrassed: A fear that feeds on itself since the more you avoid going to the dentist, the worse your oral health becomes.

The fear of diagnosis: The fear of a simple check-up becoming an expensive and long procedure.

For some people, just passing a sign or an advertisement for dental services can set off panic attacks or some severe symptom of anxiety.

Fortunately for such people, help is now readily available.  Many dentists are now advertising specific techniques designed to deal with such patients.

Fast acting sedative medications are now available that are able to relax the patient enough so that they can undergo dental treatments without any fear.

Other dentists use relaxation and desensitization techniques to help patients overcome their fears gradually.  In these techniques, the patient remains fully conscious without the need for sedatives.

Mobile Anesthesia Service Concepts, LLC (MASC) is an anesthesia service that specializes in office-based anesthesia.  We can be found at www.masccares.com.

MASC combines outstanding anesthesia practices with techniques that are designed to free the patient’s mind of their fear.

<strong>Reduce or eliminate Dental Phobia
</strong>

<a href=”http://preemptivehealing.com/preemptive-healing-products”><img title=”Dental Phobia – A Guided Meditation for fear and anxiety” src=”http://preemptivehealing.com/wp-content/uploads/2010/03/dentalsmall2.jpg” alt=”Dental Phobia – A Guided Meditation for fear and anxiety” width=”117″ height=”108″ /></a><strong>Dental Phobia – A Guided Meditation for Dental Fear and Anxiety</strong> is an audio download designed to help reduce anxiety and fear both consciously and unconsciously through the conditioning of the mind.  Instead of having the patient accept fear and anxiety, we are empowering his mind to destroy that fear and anxiety.  This results in a reduction of narcotics as well as a decrease in complications postoperatively.

This audio download can help condition your mind for  your upcoming dental visit and procedure. If you follow the guidelines as directed by Dr. DeMarco, you will be better prepared, more relaxed and you will be surprised at how well you recover when you take fear and anxiety out of the procedure.

You don’t have to be scared to visit the dentist. Visit our website, read our blog articles about Fear and Anxiety and sample our wonderful audio product, “<a href=”http://preemptivehealing.com/preemptive-healing-products”>Dental Phobia  – A Guided Meditation for dental fear and anxiety.</a>”

Whatever the individual patient’s situation, there is no reason to avoid visiting the dentist.  Whatever course of treatment the patient eventually chooses, bear in mind that the most important thing is to have a dentist who understands and who can help them handle their fears.

Here he is.  The patient has mustered as much courage as he possibly can.  He has correctly rationalized that it is very important to take care of his teeth.  He has already overcome a major obstacle just by being in that chair.  Now, what are you going to do for him?  Do you have the courage to face a patient like this, a patient who is truly afraid of you for no logical reason?  Do you have the patience, compassion, and understanding to care for this type of patient, a dental phobic?

Unless you have a phobia of your own, it is very hard to understand what this person is experiencing. As human beings, we try to empathize with others but, unless you have similar fears, it is very difficult to understand what this person is actually experiencing.  Even so, we still are compelled, as healthcare professionals, to do whatever we can for this patient.  How can we help this type of patient deal with this crippling fear?

As an anesthesiologist, I have tried to come up with a system that will help the dental practitioner deal with this difficult situation.  Why, as a board certified anesthesiologist, would I want to be involved with anyone that has a dental phobia?  Because I believe I have an innovative solution to a very difficult and recurring problem.  In my specialty, I always deal with patient fears and anxieties.  Why?  Because medical and surgical procedures evoke some level of fear and anxiety in every individual.  Just imagine yourself needing to undergo a certain procedure.  The date is set.  If this is set for the next day, that’s great!  The patient has no time to think about what could potentially go wrong!  However, the reality is that these type of procedures are usually scheduled one to two weeks out and, sometimes, even further in advance.  This situation gives the patient all the time in the world to think about what could or could not happen.  That is anxiety!

Over the past 15 years, I have developed a great system for making patients feel calm and comfortable during their pre-anesthetic visit.  This visit normally occurs one to two weeks prior to the actual procedure.  What happens during this interview?  First, I obtain a history from the patient.  I look for any anesthetic problems which might have existed in the past with either the patient or his immediate family.  Second, we go over medications, allergies, and any past and present medical problems.  This interview helps me to determine whether the patient is medically optimized for the procedure.  What does medically optimized mean?  Even though the patient might have a medical systemic disease, i.e., hypertension, is he in the best health he can possibly be in for the procedure?  I cannot cure him of high blood pressure, but I can make sure that it is under control and has not damaged vital organs, such as his heart or his kidneys.

If I feel that the patient requires further tests, I will ask for those to be performed, such as a consultation with his cardiologist.  I will obtain an ECG within the last six months, as well as any further blood studies.  Our goal, as the medical team, is to make sure that the patient is safe during the upcoming procedure.

Once the anesthetic history is obtained, I then go through what the patient should expect to happen on the day of the procedure.  Does this help reduce anxiety and fear?  Yes. By how much?  I do not know.  But it is a process that definitely helps.  When a patient does not have any idea of what will happen on the day of the procedure, anxiety and fear goes up by about 50%.  This pre-anesthetic interview lasts for 10 to 30 minutes and is usually done one to two weeks prior to the procedure.  What does the patient do from the time I have the talk with him until the time of the procedure?  I believe this period of time is when fear and anxiety becomes manifest.  I also believe that, as a medical community, we should investigate how we can help these patients.  We need to help patients empower themselves, through their thoughts and actions, to reduce such anxieties and fears.  The medical community should be aware of the trauma caused by not addressing these issues. Remember that fear and anxiety cause significant increases in sympathetic outflow.  An increase in sympathetic outflow can cause an increase in heart rate and an elevated blood pressure.  What is the effect of an increased heart rate?  An increase in heart rate increases the amount of oxygen that the heart requires to function.  What does this do?  Due to the increased oxygenation demand, there is a need to increase the supply of oxygen to the heart.  When the heart is not supplied with enough oxygen, the heart starts to fail.  This failure of the heart is called an ischemia, which is the lack of oxygen to the heart’s tissues.  Ischemia can occur with the person unaware that it is already happening.  An increased heart rate can actually cause ischemia.  Will the patient feel the cause of the ischemia?  No, not always.  Thus, the patient can have an undetected problem due to fear and anxiety.

An increase in sympathetic outflow can increase blood pressure.  How does this happen?  The nervous system can actually constrict all the blood vessels in the body.  A constricted blood flow does not help in the healing process.  By constricting blood flow, the nervous system is inadvertently causing the pooling of blood in certain areas of the body.  Unfortunately, these are not the blood rich groups that aid in the healing process.  What are these?  Blood rich groups are composed of organs with enriched blood flow, such as the heart, lungs, liver, kidney, and brain.  In short, these are the organs that promote the healing process.  Are we then, in effect, slowing down the healing process when we increase anxiety and fear?  Yes!  If we are able to decrease anxiety and fear prior to the procedure, can we then improve the healing process?  Yes!  How do we do that?  We can help do so by simply listening to a CD that I have created.

This CD is called PreEmptive Healing.  Have the patient listen to the CD twice daily:  once in the morning upon waking up and once at night prior to falling asleep.  PreEmptive Healing is designed to be used from the time a dental procedure is scheduled to the date of the dental procedure.  I also suggest that patients be allowed to listen to the CD during the actual procedure.

During the testing of PreEmptive Healing, I noticed a decrease in the degree of anxiety and fear by 30-50%.  There is also less use of narcotics as well as a decrease in complications postoperatively.  The CD is designed to help reduce anxiety and fear both consciously and unconsciously.  How does it work?  The mind must be approached at all levels of consciousness in order to consistently and persistently lower fear and anxiety.  Simply stated, this is done through the conditioning of the mind.  Conditioning, by definition, is repeatedly going over something in order to have the thought imprinted.  In practice, instead of having the patient accept fear and anxiety, we are empowering his mind to destroy that fear and anxiety.  Conditioning is the only way to consistently and persistently free someone’s mind of the fear and anxiety in having dental work performed.

We have now taken care of the first part of the fear and anxiety a dental phobic has to deal with while waiting prior to the procedure.  How do we then take care of the fear and anxiety on the day of the procedure and during the procedure itself?

While on the way to the dentist, I suggest that the patient repetitively listen to the PreEmptive Healing CD in the car up to the time of the procedure.  Again, if allowed, it would be an excellent idea to listen to the CD while actually having the dental procedure.

How is the actual dental procedure done? The actual procedure is done by giving the patient anesthesia.  What kind?  I recommend heavy sedation.  Who are we?  Our company is called Mobile Anesthesia Service Concepts, LLC (MASC).  MASC is an anesthesia service that specializes in office-based anesthesia.  We can be found on the World Wide Web at www.masccares.com.

MASC provides outstanding anesthesia practices.  Our service is designed to provide increased efficiency, safety, and patient satisfaction.  MASC comes to the office prior to the case to make sure that we are able to provide safe and effective anesthesia.  Does the office need to provide any of the equipment?  No, we take care of those.  The only equipment not provided is oxygen.  Because oxygen is flammable, MASC does not carry oxygen in our vehicles.  The dental office is therefore required to provide it.

In the case of a dental phobic, heavy sedation works great.  What is heavy sedation?  Heavy sedation is an anesthetic technique using propofol, Versed, and local anesthesia.  The technique is called a total intravenous anesthetic or TIVA.  The procedure is as follows.  MASC will bring the patient in the room.  All consent forms are signed.  The patient arrives in sweat pants and sweatshirt to reduce the risk of being cold.  Why is this required?  Being cold under anesthesia increases oxygen consumption by the heart by up to 300%.  It also delays awakening after the procedure.  Once in the room, the patient is seated and a tourniquet is placed on the arm where the IV is going to be placed.  All the monitoring equipment are then put in place:  ECG, supplemental oxygen in the form of a nasal canula, noninvasive blood pressure cuff and pulse oxymetry, which measures the oxygen saturation of the body.  All the monitoring equipment has the same standard of care used in most operating rooms.  Once the monitoring devices are in place, the IV is placed and secured.  MASC is now ready to sedate the patient.

The four areas of anesthesia which must be employed to have a complete anesthetic are hypnosis, amnesia, analgesia, and surgical anesthesia.  MASC provides all four levels of anesthesia with heavy sedation.  We begin with 2-4 liters/minute of oxygen delivered via the nasal canula.  Then 2-4 mg of Versed to calm and cause amnesia.  Then a propofol drip is started to place the patient into a sleep state.  Once the patient is asleep and not moving, i.e., surgical anesthesia, the dentist then places a block with local anesthesia to provide analgesia intraoperatively and postoperatively.  Once all four levels of anesthesia are achieved, the procedure can begin.  The dental phobic patient is now asleep and will not remember anything regarding the procedure.  The dentist, on the other hand, has a calm and comfortable patient, thus making the procedure go quickly and smoothly.

Once the procedure is completed, the propofol drip is stopped.  In 10 to 15 minutes, the patient will awaken.  Following emergence from the sleep state, the patient will be monitored for 30-45 minutes.  This monitoring period is done in order to give time for the patient to recover from the anesthesia.  After the recovery period, the patient is walked to the car and sent home.  The patient will be advised not to make any major decisions or drive in the first 24 hours because it takes that much time for the propofol and Midazolam to be fully metabolized.  At home, the patient can relax and recover further from the anesthesia.  As far as meals after the procedure, from an anesthetic point of view, the patient will be able to eat anything.  Since no narcotics are used during the procedure, patients are less likely to have nausea and vomiting postoperatively.  Propofol also decreases the risk of nausea and vomiting.  Patients have been observed to do well with this anesthetic technique.  They recover rapidly with very few or no side effects.

I believe that this system is a win for the patient.  He has no recall of the procedure, which gives him a positive dental procedure experience.  This, in turn, starts to break down his fears and anxieties about going to the dentist.  The dental phobic can now take care of his teeth and have better oral hygiene in the future.  This system is also a win for the dental practitioner because, now, he has a solution for these type of patients.

The most evident form of physiological response is that which is known as the “fight or flight” response. When we are faced with what we consider to be a dangerous situation, the first noticeable change is an increase in perspiration, as well as heart and respiratory rates. This physical reaction is due to the activation of a small, walnut sized structure in the fore-brain, called the amygdala. This structure, in turn, then stimulates the hypothalamus to produce CRH, or corticotropin-releasing hormone. This hormone, then, triggers the production of adrenocorticotropic hormone, known as ACTH, in the pituitary gland, a small, oval gland at the base of the brain. Finally, this signal travels to the adrenal gland, sitting just above the kidney, which produces cortisol, causing an increase in glucose production to provide additional fuel for the muscles and brain to deal with the stress. This complex series of direct communications between the hypothalamus, pituitary gland, and adrenal gland is known as the hypothalamic-pituitary-adrenal, or HPA, axis, a vital and major part of the neuroendocrine system that controls the reaction to stress, amonsgt other body processes. Clearly, the simple physical responses to fear are the product of a chain of biological events.

When one is confronted by a perceived threat, there are many more physical responses that are less evident, such as: pupil dilation; increased muscle tone; decreased blood flow to the skin, intestine and kidneys; and bowel and bladder emptying. Consider the last time that you watched a horror movie. When you were startled by a suspensful scene, the first thing that you probably noticed was your heart and resiratory rates quickening. After that, you would probably have begun sweating. Your skin became paler as the blood flow was redirected to your muscles, which increased in tone and strength to facilitate the “fight or flight” response. Even in a situation that is a false alarm, so to speak, your body would still respond to the stimulus. This is because the amygdala responds before the conscious mind can make any determination. While the degree of these reactions can vary, the response is still the same.

When the stressor that triggers these fearful responses is inescapable, such as an impending medical procedure, the fear often leads to anxiety. Anxiety is a period of prolonged fear, or worry, and is usually accompanied by heart palpitations, fatigue, nausea, chest pain, shortness of breath, stomach aches, or headaches. Think back to your high school years. Many of us experienced a great deal of anxiety at this time, most often during our final exams. As most students do, you were probably concerned about how you would do. You studied for hours, trying to remember everything that you went over throughout the semester. Even after the test was taken, you worried about the score that you would receive, and wondered if you could have studied harder.

Often, manifestations called panic attacks can develop. These episodes carry many of the same symptoms as heart attacks, and are often misinterpreted as such. Anxiety can last for as long as the stressor is evident, and it has been linked, through various studies, to a myriad of health issues, such as arthritis, migraines, allergies, and thyroid disease.

Most commonly, continuous anxiety has been linked to gastrointestinal problems, such as peptic ulcers. While a mechanism tying these disorders together has yet to be discovered, studies have shown a remarkable correlation of people who have experienced both generalized anxiety disorder, or GAD, and stomach ulcers. Chronic anxiety has also been linked to cardiovascular disease. Once again, specific links have yet to be identified, but it is believed that the link is due, in part, to prolonged stress on the heart from physical responses, such as increase in both heart rate and blood pressure.

Anxiety can cause both physical and mental scars, and can easily complicate one’s life. Given this, it is important to regulate fear and anxiety. . The key is not to eliminate fear, but to effectively manage it so it doesn’t spiral out of control.

The Setting
Have you ever looked at your doctor and thought “he (or she) has no idea what I am going through”? Well, you might be right. I am an anesthesiologist and for the first time I got a close and look at the patient experience.Re I was working in a gastroenterology office with a “stomach doctor”, giving anesthesia to patients before colonoscopies and upper endoscopies. In case you are not familiar with this procedure, this means that a tube with a tiny camera on the end is inserted into the colon or upper digestive tract to see inside.

It was October 2003; I was 41 years old. I had worked with the gastroenterologist for a month, and thought he had good medical judgment, common sense, and was great with the optical fiber scope. We were becoming good friends, so I asked him half-jokingly if and when I should get a colonoscopy. I know that everyone should have one before the age of 50. He asked me for my family’s medical history, and I told him that my father had a history of colon polyps and that my grandfather had survived three bouts of colon cancer.

To my surprise, the gastroenterologist insisted that on the basis of my family history alone that I should get a colonoscopy immediately. I was shocked and afraid. I walked over to the appointment desk and heard myself saying “Karen I need a colonoscopy”. As I waited at the desk, I felt strangely disconnected, as if all this was happening to someone else. “We can fit you in next month” Karen said, bringing me back to reality.

The Reality
This was it. In a month I was going to have to fast for 24 hours, drink lots of liquid and then spend half the night following the procedure in the bathroom with a book. Karen handed me an information packet welcoming me as a patient of the “scope club”. Now I was no longer just a board-certified anesthesiologist—I was now officially a patient. Panic, anxiety and confusion set in. Now what? What was going to happen to me? How would it feel? I forced myself to focus, and decided that I needed to read the instructions. I did not want to be one of those patients who didn’t read the instruction booklet.

As soon as I got home, I discussed the appointment with my wife, and that helped me feel better. She would be off work that day and could drive me to and from the doctor’s office. Everything was set: the time, the date, and transportation. But it was a whole month away. A month!

The Fears
For the next 4 weeks, I tried not to think about the colonoscopy. During the day I was fairly successful at putting it out of my mind because I was busy working and taking care of the kids. At night it was a different story. I had no problems getting to sleep, but I was waking up at 2:00 or 3:00 a.m. every night. Once awake I would think about the painful parts of the procedure, like getting an IV.

Believe it or not, I hate needles. Ever since my grandfather, who was also a physician, gave me flu shots every year, I have hated needles. I remember when I was about 7 years old, running away and climbing a tree to get away from the injection. Eventually I gave in because my father threatened me with worse than a needle! It is funny how frightful memories come back when you’re feeling vulnerable.

My own memories helped me realize where my needle phobia came from. I also realized that without being injected, I would not get the medication called propofol that would put me to sleep. I knew that having a colonoscopy fully awake was not a very good idea! Besides, I had gotten an IV years before when I had a bad stomach flu. I remember not eating all day, and an IV was started so that I could get a liter of saline into my system. I remember feeling much better after the IV, and was also surprised to remember that it had hurt much less than my childhood shots! This was because the IV needle is much smaller, and also the vaccine was injected directly into the muscle.

I had worked through one worry. The IV would make me feel better and would not hurt that bad. But, I had other worries. What if I had complications? I might be nauseous and vomit afterwards. I worried that I may not be able to pass the air trapped in my colon after the procedure. And worse, what if the doctor found a mass, cancer, or even a perforated bowel?

Being a doctor is a double-edged sword, because I knew that these complications were real even if they were very rare. I repeated to myself that these complications were very rare, and that FEAR is False Evidence Appearing Real. There is no point in getting all worked up over problems that have not even occurred and have little chance of occurring. I also knew that I needed to sleep so that I could perform my job as anesthesiologist to the best of my ability.

What Helped
This reasoning worked a little, but I was still awake and worrying every night. I started reading a simple “how to” book on meditation exercises that suggested I focus my attention on something else. One exercise in particular was simple and effective. To try it, count from 1 to 10, visualizing each number as you say it in your mind. Say “1” and visualize the “1” with your mind’s eye. Do this up to “10”. In my case, I was usually asleep by 4 or 5. Because this worked so well for me, I used it every night until the day before the procedure, when I drank a lot of fluids. During the “preparation” night before the procedure, I had no problems with falling back asleep. I was too exhausted from being on the toilet!

The Results
The day of the procedure arrived. I woke up as late as I could (6:00 a.m.), took a shower and helped my kids get ready for school. We got to the doctor’s office around 11:45 a.m. and I waited until my name was called at 1:30 p.m. That’s right—I got no special treatment, even though I knew all the doctors there! While waiting, I talked to my wife, tried to read a book and watched T.V. At this point I was more fed up of waiting than worried, and I just wanted to get it over with.

When I was finally called in, I remember being relieved to know it was almost over. I also remember that I was not at all hungry. In just a few minutes, it was all over. All the anxiety, sleepless nights and anticipation had been for nothing. The procedure was quick, relatively painless and uneventful. The doctor did find some polyps in my colon, but they were harmless. I breathed a sigh of relief. Getting it done had put my fears of whether I had colon problems to rest. I was glad to have had it done and have even had another one since then. In fact, I will continue getting one every 5 years.

Let Me Help You
My experience as a patient made me realize what an isolating and frightening experience even a simple procedure such as a colonoscopy can be. I now understand from the patients’ perspective how important it is to be really prepared for a medical procedure. Knowing the facts about the procedure is important, but it is also good not to imagine the worst. It is possible to analyze your fears and overcome them, whether it is by meditation or by realizing that the procedure may not be that bad.

The things I feared about my procedure were:
1. Pain getting the IV
2. The doctor not getting the tube around in my colon
3. Nausea and vomiting afterwards
4. Gas pains after the procedure
5. Cramping afterwards from not passing gas
6. Having a perforated colon
7. Having a mass in my colon
8. Having colon cancer
I worked through each of those fears prior to having my procedure.

Before a procedure, it is necessary to not only prepare the body, but also to prepare the mind by reducing fear and anxiety. Such preemptive healing empowers and helps bridge the gap between scheduling the appointment and having the procedure done. I can show you how, visit PreEmptiveHealing.com to learn more.

Blessings to all,
Dr. Anthony DeMarco