HYANNIS – Recovery from surgery can be difficult and painful – and that’s why many surgeons recommend getting a head-start on the healing process.
“There are definitely benefits to prehabilitation or ‘prehab,’ and I’d like to see more patients do it,” said C. Jeffrey Siegert, MD, FACS, a general surgeon based at Cape Cod Surgeons in Falmouth. “It’s important to be as healthy, fit and mentally prepared as possible before any planned surgery.
“I was just at a meeting of the Massachusetts chapter of American College of Surgeons and one of the main subject matters was the aspect of prehabilitation.”
Giving patients preoperative physical, nutritional, and psychological guidance led to a 31 percent shorter hospital stay and a 28 percent reduction in costs, according to a study performed at the University of Michigan.
A preoperative program wellness program that included nutritional supplements and smoking cessation “dramatically reduced” hospital-acquired infections in surgical patients, according to researchers at the Indiana University Health Center.
Making sure patients have enough information is the first step of prehab, said Dr. Siegert.
“A lot of our patients have never had an operation before, so it’s hard for them to understand what to expect,” he said. “If you take away the unknown, it really puts people at ease.”
One of the key things people need to know, he said, is the amount and duration of pain they may face in the moments and days after surgery.
“Some people have the expectation that when they wake up, they won’t be in any pain,” he said. “The way I explain it to my patients is, ‘It’s like jumping into a cold pool. You know it’s coming, but when you first jump in, it can take your breath away. But then, a second later, it feels okay. You just keep swimming, and it’s not so bad.’
“That’s a lot like post-operative pain, in my experience. If you can have that discussion in advance, it’s much better. We let them know that it’s normal to be in pain after an operation and we have ways to treat it.”
Many patients benefit from having time to make some physical changes before an operation, he said.
“Sometimes, as surgeons, we want to book an operation as soon as possible, but there are plenty of times when it’s better to wait a little,” he said. “It can be like getting ready to run a long race. If the patient has never raced before, well, it’s going to be a long day.”
An operation on the horizon can be good motivation to quit smoking.
“If someone’s smoking, I may show them some of the data. ‘This is the outcome for a smoker compared to a non-smoker.’ If it’s not an emergency surgery, they have time to quit.”
If a patient is able to walk comfortably, Dr. Siegert sets a goal of walking 10,000 steps a day for several weeks before the surgery. He also encourages them to eat well, including getting lots of protein and perhaps gaining a few extra pounds.
“Patients gain a nice sense of control through prehab. They’re not just lying there getting an operation They feel like they’re part of the team.”
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