& LIFESTYLE Let’s take a healthier approach to surgery
WHILE EXPERTS WILL TAKE CARE OF THE MAIN EVENT, LOOKS AT HOW WE CAN PREPARE FOR AND RECOVER FROM AN OPERATION
THOUSANDS of people will be waiting for surgery of some sort right now – yet preparing for it is something we seldom talk about. I don’t mean the core basics, like remembering the ‘nil by mouth’ rule before your general anaesthetic, and wriggling into compression stockings. I’m talking about getting operation-fit on a wider level.
After all, we wouldn’t dream of running a marathon without putting considerable thought into our training and recovery regimes, so why not take a similar approach when we’ve got a major health event like surgery on the cards?
Of course, a dedicated team is waiting to take care of you. But before the operating table, you’re in charge – and a proactive approach can be immensely beneficial.
HOW CAN YOU HELP YOURSELF?
“PEOPLE get a lot of benefit from feeling they’re contributing to their health and not just being passive, and there’s evidence it gets them out of hospital quicker,” says Mrs Scarlett McNally, consultant orthopaedic surgeon and Royal College of Surgeons (RCS) Council member who also works with the Centre for Perioperative Care (CPOC, the medical term for pre and postsurgery care).
It’s very important, she stresses, and has a significant impact on patient outcomes. “For example, if people stop smoking for four weeks before surgery, it reduces the complications of the operation by 19%. That’s a significant number,” says Mrs McNally.
Psychological wellbeing is also important. Dr Meg Arroll, a Harley Street psychologist
says there have been a number of studies looking at the impact of stress on healing. “We know chronic stress leads to significantly longer healing periods, so there is a profound physical benefit of taking care of our emotional and psychological health before and after surgery,” says Dr Arroll.
CPOC is producing a series of patient resources which you can find online (cpoc.org.uk/ patients), but there’s a lot to be said for thinking beyond the basics and considering what’s going to work best for you as an individual too.
BODY AND MIND
SURGERY isn’t just a physical ordeal – it’s a mental one too, including coming to terms with a diagnosis, anxiety about the procedure, and coping with the recovery phase. It’s normal to experience these things, and acknowledging them can be immensely beneficial, as it puts you in the driver’s seat for managing them. “Of course it’s an anxietyprovoking time, and planning is very important,” says Dr Arroll.
Mrs McNally agrees physical health and emotional wellbeing go hand in hand when preparing for surgery. “There are several aspects to that,” she says. “But for the patient there are physical and mental things they can work on.”
If you’re experiencing heightened anxiety, there’s lots you can do to help yourself. “Certainly don’t berate yourself for feeling that level of anxiety,” says Dr Arroll, who suggests “treating yourself with compassion while working through those thoughts. Even being aware of those thoughts is helpful.”
If you’re worried about things going wrong, cognitive behavioural therapy-based exercises can help. “One way to deal with that, in terms of CBT,” she continues, “is to look at the evidence you’ll have from your surgeon, as you’ll have to sign a consent form outlining the risks of the procedure. Look at that as objectively as you can.”
This can help keep your thoughts focused on real probabilities, rather than spiralling or catastrophising.
Talking to other people who’ve been through similar procedures can be helpful too – but Dr Arroll notes it’s important to seek positive stories – people are often more likely to share negative experiences than positives ones, especially on the internet.
“Relaxation exercises are also brilliant,” adds Dr Arroll. “And some people find hypnotherapy beneficial.”
A few minutes of mindfulness meditation, breathing exercises and yoga – there’s so much you can try.
KEEP MOVING
HOW active you can be depends on individual health, and it’s crucial to listen to your body and doctor. But generally, having surgery doesn’t mean we should hole up indoors only thinking about bed rest.
“I’ve done a lot of work around exercise, encouraging people to just get up and go for a walk every day and move around, then their hearts and lungs are better to get them through the operation,” says
Mrs McNally.
“That’s a really important thing for people to do – and it’s also important for their own wellbeing. Getting outside for a walk gets your heart rate up, you’ll get endorphins from the exercise and boost serotonin, so you feel better, you feel more in control.”
The same applies during recovery. Your surgeon and physiotherapist will advise on activities to avoid, or exercises to build strength back up – and it helps to focus on what you can do, rather than what you can’t.
“You may not be able to go to the gym, but research suitable, safe activities, you can do – there are so many YouTube videos of things like exercises and stretches you can do in your chair, for example,” says Dr Arroll. “Make sure you’re safe, have a chat with your surgeon. It depends on your procedure, but a lot of the time they want you to be active, but in a safe way.”
GET READY FOR RECOVERY
NUTRITION is fundamental for optimal health, and even more important when our bodies are healing. As well as ensuring you’re eating well before surgery, think about what you’ll be eating during the recovery phase.
You may not be able to get out to the shops or lift pots and pans for a while – so plan ahead.
“You might want to have some healthy microwave meals available for example, so you aren’t going to struggle,” says Mrs McNally.
It’s all about making things as easy and comfortable as possible when you leave hospital.
“You might want to have your fluffy socks handy, that you can get on easily when you can’t really bend down, for example,” says Mrs McNally. “Or your nice fluffy blanket for when you do want to rest.”
Psychologically, lots of people find recovery tougher than waiting for surgery. You might be a lot more isolated than usual, which along with not being as mobile and active as usual, can be a shock to the system.
“Don’t be afraid to reach out and tell people what you need,” says Dr Arroll. “Even if it’s just asking a friend to send you a daily text.
“And have things ready to occupy your mind. Maybe there’s a book you want to read but never had the time, or box-sets you really want to see – now’s your chance,” Dr Arroll adds. “Don’t feel guilty, give yourself full permission to do that.”