After you have taken care of enough people, you start to notice patterns in how some people bounce back quite quickly after a repair/reconstruction, and others have a very difficult time. As someone who is trying to improve outcomes and happiness among patients, I try to figure out what the differences are among these people, and how those differences may tie into how they recover. If I perform a couple hundred arthroscopic shoulder repairs in a year, there are usually enough people I see with a very similar problem and it becomes easier to then compare amongst them.
One of the factors that has stood out for me is gratitude. Time and again I see patients who are generally appreciative of the world around them and the opportunity to interact with people. These are people who are thankful for what they have, and tend not to rue what they are missing or wanting. They discuss issues in terms of where they are heading, not where they are stuck at. It seems obvious that a “happy” person would feel better, but it seems to be more than just a smile on a face. It is the attitude of really knowing that things will go well; if they don’t go well for a time, then there must be a reason for the bump in the road and it will be bypassed soon enough. It reminds me of actualization. That is to say, visualizing positive outcomes and general appreciation of those around you, and then the realization of that positivity becoming real in future experiences.
I’m not just bringing this up because happy people are easier to be around. I actually see them recover more quickly from surgeries in terms of strength, pain control and independence. It can be quite remarkable. They ask for less (or no) analgesic/NSAID medications. They look for reasons to avoid narcotics. Instead of spending time explaining what they are unable to do during rehab, they want to know when they can return to certain specific activities that bring them joy.
We do know from studies that people with depression or anxiety take more pain medications compared to those without these issues for the same surgeries. Why is that? I think it ties into what we’re talking about here. It has been shown that meditation is as effective at treating mild to moderate depression as anti-depressant medications. It makes sense, as meditation can create a connection for a person that they may lack in everyday living. Connection is part of what makes us whole, and the grateful/positive person tends to feel connection to the world around them. Drug use may be a method to fill in the hole of lack of connection. If we can find that connection in our lives, we can empower ourselves to get through adversities (such as surgery!) more smoothly. In my own life I continue to look for a feeling of gratitude in each day and seek those that help keep a positive forward motion in life. That has certainly been a key for my ability to get through difficult times.
Rest assured that your outcome after surgery can be tied to how responsible you feel for your own recovery. Those who expect the medications and Physical Therapist to take care of the rehab for them will not achieve the best results. Those who see the surgery and rehab team as an adjunct to facilitate their own progression to independence as an active participant are more successful.