@mikeycat I am getting ready for an August RTHR, and I recognize the preop emotional challenge you describe very well. I have gone through periods of “adjustment disorder” (aka situational depression) before, and if chronic pain, insomnia, an unwelcome medical diagnosis, and the prospect of life-altering surgery isn’t a recipe for an adjustment challenge, I don’t know what is. I have started to use all my tried-and-true cognitive coping tools in the preop phase. I think it’s good practice for later. I have to remind myself sternly that nothing is ever as bad as I fear or as good as I hope. That everything, once I have lived through it, becomes an experience that brings some value to me and my loved ones - even if I can’t see what that value will be quite yet. I am using my sleepless times to practice peaceful acceptance - I try to let sleep come to me instead of chasing it. I am tuning in to my preop pain instead of tuning it out, so I stay in touch with my “why” for doing this. I am defining this chapter as a necessary investment in my own health and happiness. But those adjustments did come after weeks of tears and some all-consuming fears about dependency and rejection from those closest to me. I am glad to say those clouds have started to disperse. I hope you will find some time in the last couple of weeks before your surgery to go back to the self-talk tools you developed that worked for you post-partum. I agree with you that psychological and emotional preparation can help us meet the challenges of surgery much more smoothly. I am rooting for you!