Having Surgery? Then Do Your Homework

When I discuss surgery with my patients, I tell them they have important assignments to complete before the morning we meet in the OR.

I assure them I will be ready for the surgery, but I also tell them that they must prepare as well. And I don’t mean Googling medical websites to read about the operation or setting their alarm so they arrive in time. No, what I ask is that they take responsibility for a successful surgery.

Here’s what I mean. You, the patient, are about to enter one of the most important athletic contests of your life: your operation. It is a competition between pain and comfort, disease and wellness, happiness and sadness.

Think about it. There are many parallels between surgery and athletic contests. Your surgeon will enter a locker room, put on a uniform, scout out the opponent (your disease as demonstrated by your CT and MRI scans), enter a hallowed ground to perform difficult technical tasks, and, with the help of a skilled team of professionals, do battle against your nemesis (the disease that has brought you to the operating room).

So that’s what the surgeon does. You must be equally prepared, doing all you can to stack the deck in your favor. The most successful technical operation means nothing without the proper patient preparation and attitude.

There are a number of concrete, quantifiable steps patients can take to ensure that they are ready for Game Day. Most people are fortunate and know in advance that surgery is required. Unlike patients facing emergency surgery, most have time to prepare physically. Don’t squander this opportunity to do all you can to make the surgery successful.

• Eat right. Good nutrition is paramount in keeping your immune system healthy. By eating a balanced diet with vitamin supplements in the weeks before your surgery, you will have a higher chance of healthy wound healing and decreased chances of infection. While all agree that the best form of nutrition is a healthy, balanced diet from the four food groups, there are some encouraging results from studies looking at various dietary supplements and their effects on health and nutrition.
• Watch the weight. If you are overweight, it is a good idea to slim down before your surgery. This should be done gradually with safe and proven dietary modifications. If you are considering a significant weight loss program (greater than 25 pound weight loss), you should work with a licensed professional nutritionist or physician. A carefully planned weight reduction program can optimize surgical results. Also, by making a lifestyle change prior to surgery, a patient is more likely to continue better eating habits in the post-operative period, leading to better long-term health.
• Be kind to your spine. Particularly with spine surgery, unnecessary weight is baggage that the spine must accommodate. Think about the spine as a flagpole stabilized by guide wires of the back musculature behind you and abdominal muscles in front. It follows that any additional weight in front will put unnecessary strain on the spine which can inhibit the healing process and increase post-operative pain.
• Get in shape. The weaker your muscles and cardiovascular endurance are entering surgery, the harder it will be recover. Consider professional athletes who undergo major operations and return to the playing field one or two months later. It is because they are in such excellent condition that their recovery time can be quite short. Maybe their knee is not functioning well, but they compensate with other exercises like swimming and upper body weight lifting.
• Age is no excuse. You can improve your health at any point in your life by engaging in a sensible exercise regimen. And you can improve your chances for surgical success no matter how old you are if you enter the OR in your peak physical condition. This may require physician or professional trainer supervision if you are just starting out. There is strong evidence to suggest that light weight, high repetition exercises with a focus on cardiovascular endurance will improve pulmonary function in the elderly. This could translate into less dependence on oxygen in the hospital and quicker recovery time. Walking is another excellent exercise to prepare for surgery if your pain does not limit your activity. Remember, too, that exercise boosts your immune system, and it can counteract depression, a common emotion prior to surgery.
• Stop smoking. This sole lifestyle change is one of the most important actions you can perform in your life. If you have planned to quit smoking in the past, consider your surgery a golden opportunity to embark on that mission. The ill effects of smoking on lung function during and after anesthesia are multiple. A smoker has a much higher chance of developing pneumonia after surgery than a non-smoker. Also, smoking is well known to advance the arthritic processes on the spine. Smoking also significantly increases the chances of failed spinal fusion. Ideally, you should stop at least one month before your surgery. This will allow some of your pulmonary function to improve, decrease the amount of secretions your lungs produce, and clear your body of all remaining nicotine and carbon monoxide.

Never feel helpless as you face an upcoming surgery. Know that to an extent, you can help increase the chances for positive outcomes. Although it may not be possible to stop smoking, lose weight, or get in shape if in severe pain, it is important to understand that you do have some control when it comes to elective surgery. By following the above suggestions, you will optimize your chances for recovery and know that you have done all you can to improve your health, now and well into the future.