Navigating surgery with ADHD and autism
BMJ 2024; 387 doi: https://doi.org/10.1136/bmj.q1834 (Published 08 October 2024) Cite this as: BMJ 2024;387:q1834
- Kirsty Brown
- krb700{at}alumni.bham.ac.uk
I have always felt different from others, but these differences became more apparent while I was at university and during the pandemic. As my anxiety and obsessive-compulsive disorder became worse, I received a diagnosis of ADHD at the age of 22. For me, ADHD feels like constant restlessness, racing thoughts and overthinking, and a rollercoaster of energy and emotions. I constantly feel that I am racing to keep up with life, yet I’m always behind.
About 18 months after the ADHD diagnosis, I also received a diagnosis of autism. My experiences have been affected by both ADHD and autism all my life.
How can we help you?
I often find it difficult to ask for help and support. A year after my diagnosis of ADHD, I had to have laparoscopic surgery, and during a pre-op call I was asked how ADHD affected me. I was totally stumped, as it affects me in so many ways. I ended up calling the ward to ask for my own room for before and after the operation. I knew that being away from lots of people would help my anxiety. Fortunately, I was given a private room which helped immensely because it removed some of the environmental stimulation and reduced sensory sensitivities that contribute to my anxiety.
While in hospital, some of the staff tried as best they could to help me through the procedure and the experience of being in hospital. I explained some of my concerns and how my conditions affected me. They didn’t rush and made me feel understood. It meant that when I woke up after surgery and completely panicked, my health team weren’t surprised, and knew how to help.
Clear communication
After surgery I developed a high temperature and was told I would need to stay in overnight for monitoring. The next day the healthcare team came round, and I could tell they were in a rush. They told me I needed to stay in another night because of my temperature. Having ADHD and autism makes me sensitive to change. I had not anticipated staying in one night, let alone two. Explaining, in a calm way, that I needed to stay in because of the temperature would have helped a lot.
I also like to ask questions to fully understand what is going on and why, as it helps me to feel more in control. This is easiest one to one, and it is harder when I have to see many health professionals at once. With the conditions I have, I also think very literally. All or nothing. Black or white. And I am target driven. At an appointment with the surgeon a year before the surgery, I asked how long it would take to recover. They said I would be back on the hockey pitch after two weeks. I latched onto this and repeated it to friends and family. I wish I hadn’t been told these very clear-cut points in the recovery journey, as I fixated on them. Instead, I wish they had told me to rest and focus on my recovery, rather than timelines or dates.
What you need to know
Having an open conversation about how ADHD and/or autism might affect someone during a hospital stay can help relieve concerns
Giving people with ADHD/autism opportunity to ask questions one to one may help them manage the unpredictability of hospital stays
People with ADHD/autism can take things literally, especially when it comes to meeting goals or targets
Education into practice
How could you help ensure that someone with ADHD/autism feels supported and comfortable when preparing for surgery?
What language could you avoid when discussing recovery with people with ADHD/autism to avoid any misunderstanding?
Additional resources
Additude. Resources for people with ADHD. https://www.additudemag.com/
ADHD UK. Resources and support for people with ADHD.https://adhduk.co.uk/
Footnotes
Competing interests: none.