Undergoing surgery? You’re not alone. As the population ages, so do the number of surgeries. In fact, an estimated 40 to 50 million surgeries are done every year in the United States, according to the statistics, with hip replacement, knee replacement and heart bypass surgeries among the most frequent procedures.
“Surgeries have become one of the most common, safest and more reliable treatments across medicine,” says Dr. Stavros Memtsoudis, an anesthesiologist with the Hospital for Special Surgery in New York City. “We recognize that surgery can be an unsettling experience for some patients, so it’s important to be transparent from the very beginning about what to expect.”
While a certain level of preoperative anxiety is normal, knowing what to expect and how to prepare can help calm the nerves.
Here’s how to physically — and mentally — prepare for your upcoming surgery based on expert recommendations.
[READ: Types of Surgery for Colon Cancer: How to Prep and What to Expect After Surgery.]
How to Prepare for Surgery
Surgery isn’t a sprint, so it’s important to shift your mindset to prepare for the different stages of the process.
“Think of the surgical experience as running a marathon,” says Dr. Charla Fischer, an orthopedic surgeon at NYU Langone Spine Center in New York City. “Preparing for the surgery itself is just the first leg of the race.”
[READ: These Are the Types of Doctors Women Should See.]
Ask questions
Each patient prepares for surgery in different ways — both physically and emotionally. Make sure your concerns are being addressed by your medical team so you feel prepared throughout the entire surgical journey. Bring a loved one to your doctor’s appointments to serve as another set of ears to absorb the information and ask questions that you wouldn’t have thought to bring up.
“Before surgery patients worry about length of recovery, how bad the pain will be and potential complications, particularly infections,” explains Dr. Andrew Wickline, a board-certified orthopedic surgeon in Utica, New York. “Patients want to know what they can do before surgery to improve their outcomes.”
Educate yourself
Most hospitals and surgery centers provide brochures, either print or online, about the surgery itself. Whether it’s a knee replacement, transplant or heart surgery, there are plenty of resources available through your doctor’s office or on the web.
Eat healthy
Studies show that preoperative malnutrition is often associated with higher rates of surgical infection, poorer wound healing and longer hospital stays. Therefore, you’ll want your body to be well-nourished to handle the stress of surgery. A balanced, nutritious diet will maintain a strong immune system, maintain higher energy levels and help avoid experiencing significant fatigue after surgery. Drink plenty of water to stay well-hydrated, especially a few days leading up to the surgery. A registered dietitian or nutritionist with the hospital or surgical facility can help tailor food selections to address any possible needs for increased protein or other specific nutrients.
Exercise
Talk to your surgeon about which type of exercise is recommended or contraindicated as you gear up for surgery. Many hospitals offer prehabilitation programs designed to guide you through a customized exercise plan to help the body withstand the physical toll of surgery, as well as reduce the risk of post-surgery pulmonary complications, such as pneumonia and bronchitis. Some people are in pain and cannot exercise before surgery, but continuing activity like walking can help your heart and lungs stay strong for the operation.
Stop smoking
It’s always a good idea to quit smoking cigarettes or vaping, but it’s particularly important to kick the habit when you’re preparing for surgery. Smoking increases the risk of blood clots, reduces the ability of blood to carry oxygen to the tissue cells and increases stress on the heart. Quitting smoking four to six weeks before an operation and staying smoke-free four weeks after can decrease your rate of wound complications by 50%, according to the American College of Surgeons (ACS).
Talk to other patients
If you still have concerns about the procedure after speaking with your doctor, then consider talking with other patients who have undergone the surgery. The doctor’s office may be able to connect you with someone, or you can reach out to family members, friends or neighbors who had the surgery and can share their experiences.
Lose excess weight
Working with a registered dietitian can help patients meet weight loss goals that can reduce post-surgery risk. If you’re overweight or have obesity, losing just 5% to 10% of your total body weight can significantly improve health outcomes and decrease perioperative risk.
Day-Of Surgery Preparation
Pre-operative jitters and fear of the operation are common feelings, but that can often be kept to a minimum with proper planning and preparation. Many hospitals and surgical offices help patients feel at ease and answer any last-minute questions.
Complete paperwork
There will be many forms to fill out and sign, including patient information, medical history, consent forms, insurance and billing information. Oftentimes, these forms can be completed online before the surgery to reduce wait time.
In the pre-operating room area, you will meet your anesthesiologist, if your surgery involves anesthesia. At this time, you may be required to complete an anesthesia consent form. The skin area will be cleansed and marked and prepared for incision.
Take medications as prescribed
To ensure a safe and successful surgical outcome, doctors prescribe medications through intravenous administration. Some common medications administered include:
— Antibiotics: Antibiotics are given to prevent infections especially for people at risk of major infection or those undergoing implants or transplants.
— Antacids: These help to neutralize stomach acid and reduce the risk of aspiration during surgery.
— Antiemetics: Help prevent nausea and vomiting during the procedure.
— Pain medications: Analgesics will help patients feel as comfortable and pain-free as possible during and after the surgery.
— Sedatives: These medications are given to minimize anxiety and encourage a more relaxed state of mind.
— Steroids: In some cases, steroids may be used to reduce inflammation or prevent allergic reactions.
[See: Top Medications That Can Make You Tired.]
Post-Surgery Recovery
Much of the expert advice offered before surgery also applies during the recovery process. Eating well, staying active and managing pain are all components of post-surgery rehabilitation.
“After surgery, patients want the smoothest and fastest recovery possible,” says Wickline, who has developed a detailed patient guide to help answer common questions around joint-replacement surgeries.
U.S. hospitals are increasingly adopting updated guidelines on enhanced recovery after surgery (ERAS) protocols, which focus on optimizing nutrition, early mobilization and pain management.
“We found that with older guidelines, physicians were overtreating a lot of patients and causing rather than alleviating problems with recovery,” says Dr. Michael McGee, a colorectal surgeon at Northwestern Medicine who also serves as the chair of Northwestern’s enhanced recovery programs and co-director of the Illinois Surgical Quality Improvement Collaborative (ISQIC). “Now, we are going to feed you right after surgery and get you walking the night following surgery. The sooner you can get back to everyday life the better your body will heal.”
Adopt digital solutions
New mobile services and telehealth options are being offered to support patients after surgery. While some medical centers have their own digital tools, a new perioperative platform, called Upgraid, is expanding into several hospitals nationwide. The system offers call support to patients from a clinical team who can coach, support, guide and monitor a patient’s status, including clinical nutrition. The remote monitoring triages critical questions to help minimize the number of patient calls going to the hospital and frees up staff time for more patient care.
Eat healthy
Maximize protein-rich foods, vegetables and fruits and minimize processed, sugary foods. Drink plenty of fluids to stay well-hydrated, aiming for five 12-ounce servings of liquids each day and completely avoid alcohol. A dietitian or nutritionist with the hospital or surgical facility can help tailor food selections to address any possible needs for increased protein or other specific nutrients.
Exercise
Post-surgery exercise and rehabilitation will look different for each type of surgery and the patient’s health status. Many programs involve deep-breathing exercises to strengthen the lungs and prevent respiratory complications, gentle walking to aid in blood circulation, build stamina and quicken the healing process and gentle range of motion exercises to maintain joint flexibility and avoid stiffness.
Track your health
Tracking post-surgical progress is key to your recovery. The tracker may include information about your diet, sleep quality, symptoms, pain levels, daily activities, medications and hydration. For example, the information the care team collects from symptom tracking will help inform any interventions that need to be made to the post-surgical care plan. You may experience more pain on a certain day, but it might be due to a more active day. Tracking information can be captured in a notebook or mobile apps like Bearable and Symple.
Supplement with nutritional products
Essential nutrients can help repair tissue and wound healing. Essential amino acid powders, specifically Mend Joint Replacement, have been shown to improve healing, reduce muscle loss and lead to fewer complications, according to a study published in the Journal of Bone and Joint Surgery. For those who have low protein levels, essential amino acid powders can be started one week prior to surgery and then taken for two weeks afterwards.
Discuss pain management options
From anesthesia to non-opioids and, lastly, narcotics, there are several options to control pain that your doctor may prescribe. Increasingly used is local anesthetics or nerve blocks that numb the nerves in the affected area to decrease the pain. Nerve blocks can be used during surgery and for two to three days after the procedure through a nerve catheter or a long-acting nerve block. After trauma, the body responds with inflammation and swelling. Post-operative swelling can continue upwards for as long as seven days after surgery. Managing post-op swelling is one of the key factors in how long your recovery will take and how much pain you experience.
Seek psychosocial care
When needed, your hospital or surgical center will arrange for psychosocial or emotional support with mental health professionals to assist you with your emotional recovery.
Be patient
Perhaps due to social media, there is a misperception that technology can magically help wounds heal faster. Healing occurs at a set rate, and no amount of extra exercise or purchase of late-night infomercial products will reliably speed Mother Nature’s healing process. Wounds have minimal strength the first week of healing, approximately 30% to 50% in four to six weeks and 60% at around six months. It is important to understand that full healing of a surgical wound takes much longer than most people think.
Post-Surgery Recovery for Older Adults
If you’re 65 or older, you’re more likely to need surgery than others. Older patients have significantly higher rates of both inpatient and outpatient procedures, accounting for about one-third of all surgical cases, according to the American College of Surgeons.
The ACS and American Geriatrics Society jointly developed best practice guidelines for preoperative assessment of geriatric surgical patients. As recommended, your health care team will check your health status in these key areas:
— Complete history and physical exam.
— Depression screening.
— Identifying risk factors for postoperative delirium.
— Screening for alcohol or other substance use or dependence.
— Cardiac evaluation.
— Identifying risk factors for pulmonary complications and planning preventive measures.
— Functional status and history of falls.
— Frailty.
With this information, your medical team can plan a surgical process accordingly and work with you to reduce risks in advance.
Post-Surgery Recovery for Children
Many children’s hospitals and pediatric facilities also have enhanced surgical recovery pathways in place for young patients, says Dr. Mike Chen, a professor and surgeon in chief at Children’s of Alabama Hospital in Birmingham. Some hospitals have taken a kid-friendly approach to the entire experience by giving them children superhero costumes to wear.
“Surgeons, in partnership with anesthesia colleagues, are working with parents to set out clear expectations before surgery to provide them opportunities for earlier discharge,” Chen says, adding that phone follow-up by the surgeon’s team is part of this enhanced process. “With improved communication, patients or parents can reach out for assistance and access care digitally.”
In addition, parents will be provided explicit instructions about eating or drinking prior to surgery. For older children, most will be asked not to eat or drink after midnight. Some are allowed to take medicine the morning of surgery with sips of water. Infants and young children may be allowed to take clear liquids until two to four hours prior to the procedure, Chen adds.
If you have any questions about helping your child recover from surgery, consult with your surgical and anesthesia team.
Key Questions to Ask Your Doctor
Ultimately, preparing for major surgery involves several essential steps to ensure a safe and successful procedure and recovery. While it may be confusing and stressful to navigate at first, asking questions will help you get more familiarized with the process and know what to expect.
Here are some key questions to raise with your doctor:
— Will I need anesthesia? If so, will it be general, regional or local anesthesia?
— How much pain will I experience and how will it be managed?
— Should I do anything in advance to my home before I return, like purchasing a raised toilet seat, leg lifter, extra ice packs, etc.?
— What do I need to look out for in terms of complications?
— What are the best ways to control swelling?
— How long will it take to recover?
— Who should I call in an emergency?
“There are no irrelevant questions about undergoing surgery because it’s a major decision,” Memtsoudis says. “Patients should be encouraged to ask questions at any time.”
More from U.S. News
Questions Doctors Wish Their Patients Would Ask
A Guide to Exercise After Surgery
Preparing for Surgery: How to Improve Your Recovery
How to Recover From Surgery originally appeared on usnews.com
Update 08/03/23: This story was previously published at an earlier date and has been updated with new information.
