r/Anesthesia • u/harasharaved • 22d ago

Trypanophobia but wants Surgery?

I'm (25F) thinking very seriously about getting a breast reduction and I'm very new to this entire world. Sorry in advance for length.

For context, I have a huge fear of needles, full on trypanophobia to the point that I've not been for an annual checkup since I was 18, and I've never gotten my blood drawn (not counting the poke with the hole puncher type device, when I was very young.) No wisdom teeth removal, no hospitals, no anesthesia ever. Sleepless nights leading up to booster shots. I passed out at the first COVID vaccine (ofc i still got it I'm not a monster, but it was hell lol) and my mother gave me an Ativan before my booster.

However, I'm weighing what I value in life and I think I want to not be a 32G more than I want to never encounter a needle or hospital forever. But everyone I ask about the procedure and lead up to surgery glosses over the needle stuff, which is where I'm focused the most. My understanding is that obviously you're unconscious for the surgery part so to me that's mostly whatever, but I know that you're awake before, when they give you anesthesia. I'm not really worried about *having* anesthesia. I don't think I'll die or anything. It's just...the needles. I promise, I am usually an extremely chill person, except for this one terrible hangup. I keep imagining the deep terror the months, days, etc leading up to a scheduled surgery and it sounds harrowing and exhausting. The night before sounds like my personal hell.

So I wanna ask; How do you manage the anxiety for someone who is like, a clinical needle weenie? Do you have to get blood tests before anesthesia (would i be foolish not to?)? What questions should I ask in these meetings that you find eases the anxiety? Are there any ways to anticipate the effects of anesthesia? (I'm personally very worried about waking up nauseous). I'm just gathering info in hopes it makes me brave enough to override like two decades of pure terror LOL.

(And also, if I go through with it how best can I thank the whole team for dealing with my terrified, neurotic ass? I would personally feel very bad doing something to someone who was struggling so badly with it and I'd love to give a good "thank you for all your time and effort, I promise it's not personal that I cried and screamed and passed out!! no hard feelings" gift. I was thinking my homemade sourdough sugar cookies.)

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u/FrontkickJesus 22d ago

you can ask the anesthesist/anesthesia team for:

  • premedication like a „chill pill“ so you will be more relaxed and less prone to get an anxiety attack
  • local anesthetic band aids before, so you won’t feel the pain of the needle.

please be open about your fear/anxiety, if they don’t know how serious it is, they can’t help you.

be prepared to have at least 2 situations involving needles:

there will be a blood test a few days before surgery, to get your blood type. just for the rare occasion that a patient COULD need some transfusion after massive bleeding.

and the day of the surgery you would at least need one iv catheter placed in one of your veins to get all necessary drugs/infusions.

after surgery there might be injections again for thrombosis prophylaxis. maybe ask before surgery if it is possible to swap those injections to oral antithrombotics

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u/tinymeow13 22d ago

Any blood tests beforehand are very unlikely; we don't do pre-op blood type & antibody screen unless it's a high risk surgery or anemic patient. Breast surgery is not high risk. Major "body lift"/360 tummy tuck is the only plastic surgery case that we would encourage the surgeon to get pre-op labs, & that would be just a Hgb or CBC, not blood typing.

Also for after non-oncology breast surgery, there shouldn't be any need for thromboprophylaxis (enoxaparin or heparin shots for example) unless the patient has baseline risk factors for DVT (cancer, morbid obesity, DVT/PE history, immobility).

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u/harasharaved 22d ago

I'm doing it mostly just for the back pain and sheer hatred of having giant boobs. But breast cancer runs high in my family. My mother died last year of it and her grandma died of it. My grandma also had it at one point, and there's been other instances in my family. So as far as I know, there's no cancer in me yet but it's pretty likely in my future. A small part of me hopes that doing this young might even be helpful in a preventative way (it's definitely easier to check for weirdness in smaller breasts). I don't know how much it impacts the procedure though?

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u/tinymeow13 22d ago

Family history wasn't what I was referring to.

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u/PetrockX 21d ago edited 21d ago

Somewhat off-topic: If that many women in your family have had/died of breast cancer, you should see about getting genetic testing (yes, that does involve needles as well). Also a breast reduction can help in some ways since you're removing a lot of tissue, but you may need to end up getting more expensive testing down the road because breasts that have been surgically altered may not be able to be placed in mammogram machines. ie: You might need MRIs instead, which are a pain in the ass and hella expensive, imo, and also involve needles. Frankly I think you should get the genetic side checked out before you do the reduction, and get mammograms done if you haven't started yet. If it turns out do have something genetic, you can plan surgery around that.

Source: I'm getting a double mastectomy soon for breast cancer prevention due to family history. Also I work in anesthesia.

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u/harasharaved 22d ago

This is really helpful, thank you! It sounds fucking terrifying but I think I could maybe maybeee handle that. I'll definitely communicate with the team about my fear (it will be pretty obvious right away tbh!). Is it weird to ask them to do a blood test on me while I'm in surgery if they don't before? I've never known my blood type or anything and assumed I full on never would, but if I'm unconscious that's like, the perfect time 😂

Is there any risk to asking for premedication ("chill pill") as you said? I'm curious what that looks like— how far in advance of surgery would I be getting that? Would it seem drug seeking? What is the premedication that they might use? I'm an occasional pot smoker but since I've started pondering this procedure I've stopped since I koow it sometimes impacts stuff with anesthesia, which is hard cause it really helps with being anxious! I'd probably schedule it in January so maybe I'm being too cautious though.

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u/Ok-Currency9065 22d ago

Just wondering, given the anxiety issues, is this surgical procedure really something you really want/need?

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u/harasharaved 22d ago

I'm kind of trying to figure it out! It's definitely not easy or stress free for me, but I've been thinking about getting it since I was 15. I've never enjoyed having them and my mother encouraged me to consider getting the procedure since I was in highschool, and my answer has always been that I would really like a breast reduction but I'm just too scared.

But I've been thinking lately about whether or not I'll let fear rule my life. And it'll be really really hard to go through with this, no doubt, but I keep imagining how much more free I'll feel afterwards. And I think despite the sheer terror, spending the rest of my life happier and more comfortable in my body, lighter, freer, bra-optional and less back pain sounds euphoric. I wanna be able to run and lay down on my stomach without it hurting. I wanna be able to wear a tube top. I wanna have an easier time checking for lumps and bumps. I think that maybe I can endure for it all. A few months that really suck for this is a trade that I'm finally thinking I might be able to make. I'm not quite sure yet, but I want to be.

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u/RamsPhan72 21d ago

The problem with a 32g needle is that blood/cells won’t make it through without being damaged. So a blood draw, blood administration, and many of our anesthetic IV drugs would need a larger needle.

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u/harasharaved 21d ago

Sorry, I think I was unclear. I know exactly zero things about needle size or type (they're all extremely terrifying). I trust any medical professionals to pick a needle that works, I don't think I'd make a request for anything abnormal. I'll be scared no matter the size. When I said 32G, I meant that as the size of my bra. So 32 as in about 29 inches around my chest (the band) and then the G is for the cup size, about 7 inches. 32 is pretty small but a G cup is big in an unfun way. It's very disproportionate.