"Oh, ye of so little faith
Don't doubt it, don't doubt it
Victory is in my veins
I know it, I know it
And I will not negotiate
I’ll fight it, I’ll fight it
I will transform"
These words ring true for Alison Tonks, UK hip patient and aspiring psychologist. She has faith and she fights for a hopeful attitude.
Alison first noticed her hip pain in 2013 when she was running. She went from physio to physio, but never fully recovered. She continued to run, but her hip pain ultimately was not resolved through physiotherapy. In 2016, she was diagnosed with “hip dysplasia, femoroacetabular impingement, labral tears and early arthritis.” Further conservative treatment did not help and she ended up with scopes in May 2017 and May 2018. Right hip healed well, but her left - not so much. Currently she, along with her doctor, is considering a hip replacement or a periacetabular osteotomy (PAO).
Alison has had great challenges in her hip journey just as most of us have, but for Alison, as a marathon runner, being told to stop running was really hard to hear. In 2016, she ran the London Marathon and always found that “running was [her] main form of exercise but also a huge mental health outlet. Running cleared [her] head at the end of a busy day.”
But as hard as that challenge was, Alison, is most proud of her continued fight! She says, “I’m currently in a solid routine of doing strength workouts x4 a week and getting outside for a daily walk. I cycle when the weather is good! I’m sure I can see a correlation between the amount of strength training I do (focusing on glute and core work) with a reduction in pain symptoms.” Alison is also very proud of the fact that, regardless of the outcomes, she gave it her best shot. No regrets!
Even though there have been days of discouragement and frustration, Alison has her favourite strategies to use when she is discouraged and frustrated. She relays the value of a good “cathartic cry” and “seeking support from her partner” who is a great cuddler and is able to go with the flow of her emotions.
She loves “playing happy, uplifting music and going for walks or doing a strength workout. Nothing beats the feelings of accomplishment & endorphins after exercise”.
So, we go from a patient to psychologist perspective. Alison is also in her 2nd year of a three-year Doctorate in Psychology program. This Hopeful Hippie has always been very interested in the psychology of recovery and the impact of a positive outlook on recovery and rehab and I’m super excited to share Alison’s take on the status of a patient’s mental health and recovery.
How does the mental health of a patient impact that recovery?
A study in 2017 reviewed the health information of people who had undergone hip and
knee replacements, hernia repairs and varicose vein operations. The likelihood of
wound complications after surgery was 17% greater for those with moderate anxiety or
depression prior to surgery. If the body is under constant stress and anxiety, the body
can raise blood pressure and inflammation. This is linked to our survival instinct,
getting us ready to fight or run away from danger. Aiming to lower stress and anxiety
during recovery is likely to make the process faster and easier.
Let’s think about mental health as a continuum. The World Health Organisation defines
mental health as "a state of well-being in which the individual realizes his or her own
abilities, can cope with the normal stresses of life, can work productively and fruitfully, and
is able to make a contribution to his or her community."
Across this continuum we could be anywhere from being mentally health or mentally
ill. Our emotional state is able to change quickly depending on a complex array of
external influences (income, housing, social networks, surgery) and internal resources
(e.g. optimism, resilience, self-esteem).
When going through surgery or dealing with any issues of the body, the external
influences are likely to have an impact on mental health. I think it is important to
normalise this, and for people to recognise that they should not feel ashamed or guilty
if they notice a dip in their wellbeing.
Why can mental health be impacted with surgery?
[There is] anxiety leading up to surgery, worries about finances and childcare, stress of
going through a procedure / coping with more pain. Factors of surgery can increase
the risk of depression such as reaction to anaesthesia, antibiotics, the pain.
What are some social-emotional strategies or other supports for recovery from hip surgery?
Know that changes in mental health is normal
Monitor your symptoms and feelings (this is where mindfulness could be particularly helpful)
Express your emotions. Suppressing feelings of sadness and anxiety will not make them go away.
If you have feelings of sadness and anxiety, seek support from friends, family and medical professionals
Understand what to expect before undertaking medical procedures and make a clear plan of any factors that may be impacted
Consider what you can control and focus on these
Sleep as best you can. Follow sleep hygiene guidelines to promote a good night’s sleep
Stick to a routine
Get up each day and aim to get natural sunlight each day
Reach out to friends and family
Set small, achievement goals
Recall what has worked before when faced with a challenging time and replicate those strategies wherever possible. You know what works best for you
Write about optimism and gratitude. E.g. past life successes, who and what you are grateful for. This can help keep a positive outlook.
Focus on rest and patience
How do you feel that mindfulness comes into play with recovery?
Often when recovering, our minds can be preoccupied with thinking about either the
past or the future. Past thinking: Did I do enough physio? Why did this happen to me?
Future thinking: Is this going to work? What if it doesn't? When will I be able to do X
Mindfulness provides an opportunity to bring our attention to the present. It helps us
to notice thoughts coming and going in the mind. Once you begin to notice these
thoughts more easily, you can begin to work on changing how you think.
Changing how we think is important because how we think impacts how we feel and
act. If you spend recovery thinking that it won’t be successful, you are more likely to
feel sad and anxious.
Another way that mindfulness can be useful in recovery is that you can tune in to
signals from the body. It can help you notice if you’re feeling tense, anxious or relaxed.
Studies have shown that mindfulness can help manage depression, anxiety and stress.
It may not work for everyone, but it is something to consider giving a go.
From my hopeful hips to yours, I strongly agree with Alison. Mindfulness is this Hopeful Hippie's strategy and it goes right along with "transforming" discouragement and frustration into hopefulness. Find your road to hopefulness and start riding!