The Patient Mind: Before, During & After Heart Surgery
By Adam Pick on February 24, 2016
As many patients and families will tell you… The heart valve surgery process can be an emotional roller coaster. As I personally experienced, there can be wonderful highs (waking up with a fixed heart) and there can be unexpected lows (cardiac depression).
For this reason, I jumped at the chance to interview Dr. Kim Feingold, founder of the Cardiac Behavioral Medicine Service at Northwestern Medicine, and Dr. Duc Thinh Pham, a cardiac surgeon, about their approach to helping patients mentally prepare for surgery.
On behalf of our entire community, I can not thank Dr. Feingold and Dr. Pham for sharing their research and their clinical experiences on this very important topic. In my opinion, these tips are invaluable to having a complete recovery of the body… and the mind!!!
- Visit Dr. Feingold’s profile page
- See Dr. Pham’s Interactive Surgeon Profile
- Discover Northwestern Medicine’s Heart Valve Microsite
Keep on tickin!
P.S. I have provided a written transcript of my interviews with Dr. Feingold and Dr. Pham below:
Dr. Feingold: I’m Dr. Kim Feingold. I’m a clinical psychologist, and I work exclusively with cardiac and cardiac surgery patients. I’m the founder and director of the Cardiac Behavioral Medicine Service at Northwestern Medicine. I help patients deal with the whole mind-body approach to cardiovascular health. Anytime somebody is diagnosed with a new chronic condition or a cardiovascular event, it’s normal to have a wide range of emotions – sadness, anxiety, and anger. We’re human beings, so range of emotions is really normal and typical, and there’s nothing wrong with that. One of the emotions that come up, especially when people are waiting for surgery is anxiety. People tend to focus on the unknowns. It’s always important to rein those thoughts in and focus on what you do have control over, from researching their medical team to where they want to have their surgery. There’s a lot that patients have in their control, so focusing on that is helpful.
Dr. Pham: My name is Dr. Duc Thinh Pham. I’m a cardiac surgeon at Northwestern Medicine. When I first meet a patient, I try to give them a realistic expectation of what the recovery is going to be like. In general, I tell them that it’s going to take about six to eight weeks to fully recover from that. Additionally, I like to let them know that during those six to eight weeks there are going to be good days and bad days. They are going to go through a whole spectrum of emotions. All of that is pretty much normal.
Dr. Feingold: In the recovery process, I find there are a couple different places where people get really frustrated because their expectations might be too high. One of them is in the hospital. There are hiccups after surgery, and I like patients to remind themselves about what their main goals are for surgery, which usually are survival. Getting out of surgery with your head intact and your heart intact are usually patients’ main goals.
Dr. Pham: At Northwestern Medicine, we’re fortunate to have a very strong group of clinical psychologists in our division of cardiac behavioral medicine. For patients who undergo emotional stress and depression following cardiac surgery, they provide an excellent resource.
Dr. Feingold: After cardiac surgery, 20-40% of patients will experience an episode of clinical depression. The good thing about depression is that it’s treatable. Things like psychological intervention or even medication management could be helpful, but there are certain strategies that I’ll teach to patients and their family members. It’s very different than just sadness. Sadness is an emotion that, as human beings, we’re going to have. We’re going to feel down. We’re going to feel disappointed, and we’re going to feel sad. When we talk about clinical depression, we’re talking about a constellation of symptoms that linger together for at least two weeks that include either feeling sad or down in the dumps most of the time or include what we call anhedonia, which is a loss of interest or pleasure in things that you used to enjoy.
Dr. Pham: When patients come into the surgery knowing that there are going to be good days and bad days, their recovery is not as surprising when it does hit a snag and things slow down.
Dr. Feingold: My main piece of advice for patients who are getting ready for heart surgery is that they are so much more resilient than they gives themselves credit for. They have the resources within them and around them to get through any traumatic event. This happens to be cardiac surgery. It tends to be, for most people, elective. No one wants to go down this road, but what patients will find when they go down this road is that there’s actually a lot of hidden gifts on this road that they wouldn’t have found if they were on a different road. They might find things like recognizing their own strength and resilience. They might recognize the amount of support they have around them. They might recognize an appreciation for things that are important to them, so helping patients recognize that a lot of positives might come out of this journey help most patients come out of it with their priorities intact and recognizing how strong they are.