Cataract surgery, acute anxiety and tremor.

Posted , 6 users are following.

I am an eighty year old lady and have had Essential Tremor (hands) for the last thirty years.   I also suffer from anxiety which at times makes the tremor much worse, extending to head and even legs.   I need cataract surgery which means I will have to lay absolutely still for about thirty minutes.  I have read and made myself familiar with all the procedure and of course it sounds 'no problem'.  

I went  through  the pre-op checks and  explained about my anxiety and tremor and whether I could manage to be 'shake  free during the procedure.    The consultant wasn't really interested and said, "You'll probably be OK. as your head doesn't shake all the time."  

Came the day of the operation and I had tried to calm myself and was determined to 'see it through.  On pre op checks at the hospital  my pulse read as 215.   Another nurse, very wisely thought that the tremor may have something to do with the high reading so she tested pulse manually.  It was still high at 108. but obviously the tremor had affected the reading.  At that stage I began to panic a bit and felt like walking out but I didn't.

I also had a slight chest infection so the surgeon said, "We cannot carry out this procedure today.  Go back and see your doctor."

My question is,  Why for very anxious patients and those like me with additional problems, (tremor and asthma) is there not a simple injected sedative, to relax the patient and make this 'so called simple' procedure completely stress free.?   

I just wish the whole thing would 'go away'

Thank you for reading.  Just wanted to have a moan.

0 likes, 14 replies

14 Replies

  • Posted

    Are you in the U.K. 

    In the U.K there is a sedative injection that can be given to relax you . You should ask you optician /doctor or consultant about this 

    • Posted

      Yes I am in the Uk.    Thank you for your helpful reply.   I will ask about this.
  • Posted

    Oh bless you Grete,  that  must have been quite upsetting for you after getting that far. 

    I've not had my op yet, I had a letter to say it was scheduled for the 13th September, but I have a major hang up when it comes to 13, so cancelled and it will probably be late October or November before the next available date.

    When I first saw the Consultant, he explained everything and said that he is always willing to give nervous patients something to help them relax, perhaps you can speak with your surgeon and ask if this is possible for you.  Take care x

    • Posted

      You are absolutely right, It was traumatic enough getting to the point of action.   Your Consultant sounded much more understanding than the man I saw.   It's  supposedly such a 'routine' procedure, that to the surgeon one is just another body.   I will see if I can arrange for a sedative injection this time although I have the feeling that I would be 'making a fuss'     Incidentally,  I am in the UK.   Thanks for your empathetic reply.

  • Posted

    Hi so sorry for way this was handled.  I live in Canada and for cases like this you can have an IV (conscious sedation).  I myself took a strong 2mg of Ativan to help my anxiety.  Not sure where you live but there are options .  Procedure is much quicker than 30 mins.  Took 10 to prep when I got into OR area and 8 to 10 mins for actual procedure.  
    • Posted

      Hello Sue.An,

      Thank you for your reply.   I live in the UK and options such as conscious sedation are not suggested, although I feel sure it must be available.    Maybe  this is because of cost, or time.   The op. is free under our NHS but I would be quite happy to pay for the op. plus conscious sedation injection.    The speed of the procedure that you told me about is a comfort.   'Still have to face it though. x 

    • Posted

      I can relate - had first eye done July and 2nd eye was done a week ago.  So memory of it all still fresh.

      Canada is much like UK.  We have national health coverage so procedure done in a hospital .  All covered by Medicare .  If we want a lens not covered (which is the monofocal lens) we pay the hospital difference between that lens and premium lens.  Our eye surgeons get same amount of money regardless of the lens selected.   My surgeon knew I would be anxious so he prescribed Ativan.  I filled prescription prior to surgery on my own and brought pill with me and nurse told me when to take it.  

    • Posted

      Interesting about the Ativan prescribed by the surgeon.   I thought that was something you were already taking and were pointing out that it helped on the day.   Also, interesting about the different lens types.    This hasn't been mentioned at all by the Consultant or surgeon.   I guess in the UK it's a 'one fits all'  unless it is queried.    Thank you.

    • Posted

      My cataract operation was coveted by my private medical insurance and I then paid a top up fee to upgrade to a premium lens which cirrrcted my vision so I would no longer have to wear glasses . This option is not available on NHS
    • Posted

      Yes surgeon prescribed the Ativan when I told him I would be anxious.  This was at my consult with him and he prescribed the drops I would need for the eye.  Prescription was for 2 Ativan only.  My sister took that for awhile but her prescription is 0.5 mg whereasine was 2.0 mg. it was strong.

      Yes I know UK national health only fo monofocal lenses.  If you know and want to get another lens it has to be done private and when you do that neither surgery or lens is covered.  Here in Canada surgery covered no matter which lens is selected - you pay only for difference in cost between monofocal and premium lens and that fee paid to hospital not surgeon.  Not sure about all the surgeons here but the surgeon I selected didn't discuss premium lenses until I asked at pre-op if there were different lenses.  That is when I started to research them. One province here in Canada just started covering g under their healthcare plan premtlenses.  I imagine others will follow soon.  Just not in time for me.

    • Posted

      Very useful  information.   Thank you.
    • Posted

      I think I am going to have to speak up about the anxiety and the lens options.   This is all useful information and at least I feel that I have a couple of suggestions to put forward.   Thanks again.
    • Posted

      You are welcome.  If you get nowhere you could also go to your family physician and see if you could get Ativan prescribed to use for procedure. I am sure it is also in the surgeon's best interested that you are relaxed too.  Could be that the NHS won't cover it in the expense (I have read on these forums they don't prescribe pre-op eye drops (I had these to put in my eyes 2 days prior to surgery to help prevent infection. ).  If it is a matter of expense covered tell them you'll pay out of pocket.  Will save you much aggravation. afterwards than to suffer through a preventable complication.

      Best wishes for a successful procedure. You'll be amazed at colours and clear vision afterwards.   It is just getting through it that's difficult.  Keep reaching out here.  I know I got lots of comfort in hearing others stories knowing I wasn't alone on this.

  • Posted

    I live im hk I was so scared I asked for full anaesthesia but doctor didnt give me that he just gave me a sedating tablet. I was extremely anxious when I waited outside the op room. I waited for 30 mins. Then they told me to go in. The doctor started the operation. I didnt feel any pain and it was not as scary as I thought. I felt immediately relieved after his first incision. Then after 15 mins the surgery is done.

    I was so happy I didnt have shaking or serious heart beat .

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