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.

But what limits this perfect healing system? Negative emotions, anxiety, anger, and sadness as well as limiting beliefs expressed in non-supportive self-talk in the vein of “I can’t do this” and “I don’t deserve this” prevents us from accessing this resource. Medical studies have shown that negative emotions contribute greatly to the development of ailments such as heart diseases, chronic pain, autoimmune diseases, as well as cancer. Positive thinking and optimistic beliefs, on the other hand, have been known to stimulate and enhance the healing process.

This mind-body connection has been further advanced with the discovery of neurotransmitters, small proteins that are released in the body in response to a person’s thoughts and feelings. These proteins not only bathe every cell in the human body, they also control the functioning of those cells.

Each individual has experienced physical pain at one point or another. For some, however, pain can be both severe and persistent and develop into chronic pain.

Traditional medicine offers two modes of treatment for this type of pain: surgery and medication. However, surgery, while beneficial in some cases, is not always a viable option. Medication, aimed at reducing the inflammation or suppressing the symptoms, does not address the underlying causes. Generally, medication is most useful for short-term treatments. Long-term reliance on medication can result in toxic side effects.

Dr. John Sarno, the former director of the Rusk Institute of Rehabilitation Medicine in New York, discovered that the majority of musculoskeletal pains were, in fact, tension-related, and not due to any structural damage. He referred to this condition as tension myoneural syndrome (TMS) [Sarno J. Healing back pain, New York: Warner Books, 1991].

He points out that the body’s own autonomic nervous system is, in fact, responsible for most chronic pain conditions. He theorizes that the pain being experienced is the mind’s defense mechanism against unconscious mental stress. The sufferer is distracted by the physical pain which prevents the conscious awareness of the mental stressor. The physical pain experienced by the patient blocks out the emotional pain. The body’s autonomic nervous system controls blood flow circulation. The absence of sufficient blood flow to a particular tissue results in reduced oxygen levels, which, in turn, is felt as pain, numbness, tingling, weakness, et cetera. These symptoms, which can occur in the neck, knee and other parts of the human anatomy, tend to migrate to other parts of the body. This migration, once observed, is also an important indicator that it is TMS.

Some people, to distract themselves from difficult emotions, will resort to overeating, smoking, drinking, drugs, et cetera. These activities shift an individual’s focus from emotional pain to a different sensation, in much the same way that physical pain is the mind’s way of shifting the focus for us.

Repressed emotions could stem from certain childhood experiences like abuse or lack of love; personality traits like perfectionism, conscientiousness, or the need to be liked by everyone; pressures of daily living; aging and mortality; as well as instances of conscious but unexpressed anger.

Understanding the various causes of this type of pain permits the development of effective methodologies for pain management.

Sufferers from this phobia, in terms of their dental health, are unable to visit their dentists because of a prior painful memory when they were young. They remember the visit as a particularly painful one.  This memory manifests later in life as an unconscious desire not to visit the dentist resulting in dental appointments being constantly delayed or missed entirely.

Most people prefer not to suffer pain. For dental phobics, however, just the mere idea of pain is far worse than the actual pain itself. Ironically, because they are unable to regularly visit their dentists, they suffer almost constant pain from their neglected teeth.

It is important to note that the fear of pain from visits to the dentist is often from memories of long ago. These memories tend to become warped over time. Modern dental practices have reduced the pain involved in dental procedures from what they were even as recently as a decade ago.

People afflicted with this type of phobia often do not receive suitable levels of dental care. By not having any sense of relationship with their dentist, they are unable to articulate their fears or get any kind of professional reassurance. By staying away from their dentist, they further increase their fears since nobody is able to provide information that will counterbalance their imaginations. They are stuck with a mental picture of the dentist based on painful childhood memories.

These phobics also miss out on the benefits from the advice, new ideas, and preventative care that dental practitioners offer.

Pain phobics will exhibit symptoms such as shortness of breath, breathing difficulties, and anxiety at the mere thought of visiting the dentist.  What happens is the patient’s brain warns the rest of the body that pain is approaching. However, the problem is that the body’s response to the warning becomes disproportionate to the perceived threat.

Fortunately for these individuals, dentistry has progressed so that efforts are being done to address dental phobia in all its aspects.  Improved treatment modalities are now readily accessible and understandable for most people. Dental professionals are going out of their way to put their patients at ease and make sure that they realize just how valuable customers they are.

With this kind of phobia, which concerns the fear of pain as well as the pain itself, it is vital that patients understand the treatment and care that they can reasonably expect. The solution can be as simple as finding a dental environment where they can relax and be comfortable as much as possible. A well-run dental practice will provide an atmosphere that is calming.  The waiting times will be short, and the reception will be most welcoming.

Other techniques available to these patients include sedation and distraction techniques, which are also used to help people exhibiting more acute phobias.

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.

Let Us Help You

Mobile Anesthesia Service Concepts, LLC (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 combines outstanding anesthesia practices with techniques that are designed to free the patient’s mind of their fear.

Conditioning the Mind before a Dental Procedure

Dental Phobia – A Guided Meditation for Dental Fear and Anxiety 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, “Dental Phobia – A Guided Meditation for dental fear and anxiety.”

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.

To help you with this transforming process, Dr. DeMarco has created an audio guide titled PreEmptive Healing. The guide is divided into three parts:

Part 1. The promise and benefits of PreEmptive Healing

Part 2. How to strengthen the relationships with the important people in your life.

Part 3. A guided meditation to help you relax and to prepare yourself both physically and mentally for your upcoming procedure.

PreEmptive Healing will integrate your mind and body–through music, words and visualizations–and will empower you to lower any fears and anxieties you may be experiencing prior to your procedure. Through this preparation, you can empower your mind and body to begin healing prior to the procedure, in other words, to begin “PreEmptive Healing.” Our promise to you is that we will help prepare you for your procedure, regardless of its complexity.

Here is the science behind this approach. First, it is importantto understand that blood flow is essential for healing. When blood flow is constricted (squeezed), healing potential is significantly decreased. High blood pressure constricts the blood vessels in your body. So, the goal is to reduce blood pressure prior to and during your surgical procedure. This is difficult for most people because anxiety and fear about the procedure cause high blood pressure.

The PreEmptive Healing audio guide will lower your anxiety and fear. By lowering fear and anxiety, you will lower your adrenalin or, in medical terms, reduce your sympathetic outflow. By lowering your sympathetic outflow, you will lower your heart rate and blood pressure. When this happens, blood flow throughout your body increases. With increased blood flow comes improved healing. Invest in your recovery by treating yourself to the PreEmptive Healing audio guide.

Once you have tried PreEmptive Healing, come back and let us know about your experience. ALL COMMENTS ARE WELCOME!

Hippocrates wrote, “The natural healing force within each one of us is the greatest force in getting well.” In his quote, Hippocrates has given a definition for mind and body medicine, emphasizing on the moral and spiritual aspects of healing. He believed that the person’s attitude, the environmental influences and the many natural remedies available are essential for health treatment.

What is Mind and Body Medicine? Mind- body medicine has revolutionized our modern healthcare. Mind and body medicine is an approach to healing that explores the complex and profound interconnection of the mind and the body. The power of thoughts and emotions are used to influence and achieve good physical health. It suggests that there is an innate healing connection in the body and that there is a role of self-responsibility in the healing process.

Mind-body medicine dates back to 2000 years ago, when the concept of the mind became an integral part of the treatment of diseases. This points back to the healing approaches of traditional Chinese and Ayuverdic medicine. It is after then than science was redirected and focused on the separation of human emotional dimensions from the physical body. At present, mind-body medicine has become an important consideration in the medical community, utilizing this approach to treat diseases and maintain a better and balanced quality of living.

MIND-BODY TECHNIQUES

Mind and Body techniques work on the theory that physical health is achieved and is influenced by mental and emotional factors. Other factors that help preserve health and prevent diseases are behavioral, psychological, social and spiritual methods.

In recent years, the use of mind-body techniques has become massive, with the abundance of scientific evidences that these techniques are effective and beneficial to one’s health. Mind-body techniques are used to treat chronic pain, depression, anxiety and panic disorders, insomnia, incontinence (loss of urinary control), childbirth, coronary artery diseases and many more.

Mind-body techniques aim to train the mind to focus on the body. It is believed that when one achieves a state of “focused concentration”, he will be able to be more in control of his mind and emotions, to change his outlook, his general health and wellbeing.

MOST COMMON MIND-BODY TECHNIQUES
Biofeedback. Biofeedback is a technique of bringing unconscious biological processes under conscious control. In this method, the individual is taught and trained to control internal and involuntary bodily processes such as blood pressure, heart rate, muscle tension and brain surface electrical activity. A machine is used to measure these internal activities, with a monitor that allows the patient to view his or her body’s internal processes. This allows him to use this information and gain control over these “involuntary” activities. Biofeedback is found to be effective in treating pain such as tension headache, migraine headache and chronic pain. It has also been found to achieve effective results when used to treat stress, insomnia, urinary incontinence, attention deficit disorder, tinnitus and Reynaud’s syndrome.

Relaxation Techniques. Relaxation techniques aim to reduce the activity of nerves that trigger the stress response, the sympathetic nervous system. During the time of stress, the body responses in alert, and thus vital signs such as heart rate, blood pressure and respiratory rate increase. Relaxation techniques help relieve tension and strain, by lowering blood pressure, easing muscle tension and slowing metabolic processes. There are three major types of relaxation techniques:

1. Progressive muscle relaxation (PMR). This PMR technique involves a two step-process. The first step is to deliberately apply tension on a certain muscle group, and then very slowly releasing each muscle group individually. Start with the toes and up the head. Notice how the tension flows away as the muscle relaxes. Do this repetitively and you will learn to distinguish the associated feelings of a relaxed muscle and a tensed one. This simple knowledge will allow one to activate muscular relaxation as soon as muscle tension is experienced.
2. Autogenic Training (AT). This technique is used to train the body to respond to verbal commands. AT teaches one to create a feeling of warmth all throughout the body until a profound state of physical relaxation, mental peace and bodily health is achieved. In this practice, the individual uses verbal commands to tell the body to control breathing and relax. All other internal processes follow suit – blood pressure, heartbeat and temperature. Also called Autogenics, this technique is used to manage stress, overcome addictions such as smoking or alcoholism, to resolve anxieties and fear such as flying or fear of heights or change unwanted behavior such as procrastination or nail biting.
3. Meditation. Meditation is probably the most popular method to achieve a profoundly relaxed bodily state. In the United States, there are two forms of meditation. One is the Transcendental Meditation, wherein the individual is asked to repeat a single word or phrase (Mantra). The second form, Mindfulness Meditation lets an individual focus on their moment-by-moment thoughts and the sensations they currently feel. Meditation helps to achieve physical relaxation, metal calmness and other emotional states such as loving-kindness and even-temperedness.

Hypnosis. The term hypnosis comes from the Greek word “hypnos”, which means sleep. This technique focuses on achieving a trance-like state of mind, where the body relaxes and the thoughts become more focused and attentive. This is done with the help of a hypnotherapist. When this state of concentration is achieved and the body is deeply relaxed and calm, the individual become highly responsive to a hypnotherapist’s suggestions and less critical or disbelieving. Today, hypnosis is used to treat people with certain addictions, with anxiety disorders, phobia and chronic pain.

Guided Imagery. Guided imagery is one technique that is used quite frequently. It is a program of directed thoughts and suggestion, making one imagine toward a relaxed, focused state. This process is achieved with the help of an instructor, an audiotape or a script. The individual is asked to imagine details that are comfortable and safe like a beach or a garden or recall happy moments they has when they were young. The individual usually responds positively, achieving a more relaxed and peaceful state, making him more in control of his emotions and thought processes. Guided imagery can improve a person’s attitude, health and sense of wellbeing.

Cognitive Behavioral Therapy (CBT). This technique helps an individual recognize and therefore change dysfunctional thoughts that usually lead to maladaptive emotional patters and behaviors. Cognitive restructuring is used, wherein the therapist examines assumptions behind the individual’s thought patterns. Behavioral therapy techniques are also used. CBT is used as a treatment option for psychological disorders such as depression, eating disorders, insomnia, obsessive-compulsive disorders, anxiety, phobia and panic disorders.

HOW MIND-BODY MEDICINE WORKS
Mind and body medicine focuses on how the mind, the emotions and other internal body processes can influence the physical body’s health. Studies have shown that emotions can have a great link or influence in the development of a disease. Stress influences our everyday emotional response. When a person is under a stressful situation, stress hormones are activated. These stress hormones are the ones responsible for unhealthy emotional responses such as anger, depression, hostility and etc. these unhealthy emotional responses are associated with many disease conditions, particularly the development of high blood pressure and coronary heart diseases.

The goal of mind-body medicine is to reduce the stress responses and activate the relaxation response. When a person is relaxed, he develops in himself improved coping skills to reduce tension and pain and lessen the need of medication. A relaxed body will also have a great influence on the immune system, making it efficient and increasing one’s susceptibility to infection.

OTHER DISEASES TREATED WITH MIND- BODY MEDICINE

• Depression
• Insomnia
• Anxiety and phobic disorders
• High blood pressure
• Asthma
• Coronary heart disease
• Obesity
• Cancer-related symptoms such as pain
• Nausea/vomiting related to chemotherapy
• Diabetes
• Stomach and intestinal disorders (indigestion or dyspepsia, irritable bowel syndrome, constipation, diarrhea, ulcerative colitis, heartburn, and Crohn’s disease)
• Fibromyalgia
• Menopausal symptoms such as depression, irritability and hot flashes
• Tempomandibular joint disorder
• Neck and lower back pains
• Muscle tension and involuntary muscle spasms
• Headache such as tension or migraine headache

Mind-body medicine promises many potential benefits and advantages. Further research and study on this medical approach leads to a more enhanced and effective mind-body interventions, giving opportunities to individuals to tailor their thinking about their moods, emotional responses and physical health. The mind-body medical approach is proven to have positive effects on psychological functioning and a balanced quality of life.

The human body’s response to fear and anxiety (stress) is exactly the same whether a threat is real or imagined. It is a remarkable example of the effectiveness of one of our internal communication systems, and is intended to help you fight off, or run away from an adversary.

The biological and chemical mechanisms that govern our emergency responses hark back to primordial times and helped our ancestors deal with threats from predators, and other tribes. Without them they would have been easy pickings. These days the things that make us fearful and anxious are benign by comparison to life as a caveman, (there are no saber-toothed tigers lurking around the corner) but our bodies deal with threats in the same way, and it is the stress hormone cortisol which regulates this red alert system.

Hormones are Chemical Messengers
Hormones are powerful chemical messengers that help our bodies to function. They travel through the blood stream and control or regulate the activities of groups of cells or organs. Hormones are named after the Greek word hormaein, meaning “to excite” or “set in motion.”

Cortisol
Under normal circumstances cortisol is continually secreted throughout the day by the adrenal glands. These are triangular-shaped, and they sit on top of the kidneys. Cortisol secretion follows a 24 hour, or circadian rhythm, with peak levels occurring in the morning (from about 6.00am-8.00 am) and the lowest levels are at about midnight. There are many factors that influence cortisol levels including fasting, exercise, and anxiety.

The Biology of Fear and Anxiety
During periods of fear and anxiety your muscles need more oxygen and glucose, and these are carried in the blood. So the heart has to pump faster and blood pressure must increase if your body is to get more of the vital fuel that it needs. The entire process involves several different steps and many chemical reactions, and it starts with sensory cells alerting a part of the brain known as the hypothalamus that there is potential danger. Cells in the hypothalamus transmit a signal to another area of the brain called the pituitary gland which then releases a chemical messenger into the bloodstream. This chemical is called ACTH (adrenocorticotropic hormone) and its destination is the adrenal glands.

When ACTH arrives it stimulates both glands to crank up cortisol production. Molecules of the chemical bind to small receptors on the surface of adrenal cells and this initiates a complex manufacturing process that turns cholesterol into cortisol. The newly-created hormone is then pumped out into the body to start a cascade of reactions that leads to increased heart rate and blood pressure.
Cortisol’s main job is to increase the sensitivity of the heart and blood vessels to the stimulating effects of two other hormones, called epinephrine (also known as adrenalin) and norepinephrine (also known as noradrenalin). Epinephrine and norepinephrine work by stimulating receptors in heart cells which increases the rate at which the heart beats and the force with which the heart muscle contracts. And you can feel it happen when your heart starts to pound wildly during fearful and anxious moments. That’s the hormones going to work!

Simultaneously, cortisol ensures that blood vessels are also receptive to epinephrine and norepinephrine. The two hormones bind to specific proteins, which brings about the narrowing of blood vessel walls. This increases blood pressure and it enables blood to be diverted to essential organs and muscles.

Worried Sick
In today’s modern world our stress response system is activated so often that the body is not given a chance to return to normal. High levels of cortisol are required during an emergency situation, but over time they can wreak havoc on our cardiovascular system and long term health. It is true that we can become worried sick.

Prolonged high levels of cortisol can damage the heart, contribute to obesity, and weaken the immune system. The scientific literature is full of research studies demonstrating the downsides of constant exposure to high levels of the hormone. A team of researchers from the School of Medicine at the University of California, Los Angeles discovered that increased levels of cortisol actually prematurely age immune cells, making people more susceptible to illness. The hormone suppresses the action of an enzyme called telomerase which keeps cells young. (Rita B. Effros et al. Reduced telomerase activity in human T lymphocytes exposed to cortisol. Brain, Behavior, and Immunity. 2008; 22 (4): 600-605).

Further negative implications include high levels of cholesterol, reduced bone density, and depression. And scientists at Heidelberg University in Germany discovered how cortisol production leads to an increased amount of fatty deposits in the liver, which creates a range of metabolic disorders. (Stephan Herzig et al. The Glucocorticoid Receptor Controls Hepatic Dyslipidemia through Hes1. Cell Metabolism, 2008; 8 (3): 212-223).

Learn to Chill Out
Avoiding the harmful effects of cortisol can be achieved by relaxing and resetting your body. If you experience a stressful situation you need to give yourself time to calm down and recover, otherwise your life could turn out to be one continual emergency. Visit PreEmptiveHealing.com to learn more.

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