How to work with your doctor to prepare for a successful postoperative recovery
Undergoing surgery naturally increases anxiety for many people. No one likes the idea of an invasive procedure, but sometimes they are necessary to treat an array of conditions.
Likewise, recovering from surgery can be challenging. Depending on the nature of the procedure, recovering from surgery can take weeks to months.
Fortunately, patients can work closely with their health care providers to prepare for a smooth postsurgery recovery.
Here are 10 tips health care experts recommend for a successful recovery after surgery:
1. Make sure you’re at a healthy presurgery weight
Patients who are at a healthy weight tend to have better surgical outcomes, including less postoperative complications.
A 2018 meta-analysis published in the Annals of Gastroenterological Surgery showed that obesity prolongs operative time and is a risk factor for certain short?term postoperative outcomes, depending on the surgery.
“The risk of wound infection decreases and the ability to move around and speed up your recovery is so much better when the patient is closer to an ideal body weight,” says board-certified general and colorectal surgeon Dr. Tracey Childs, vice chair of surgery at Providence Saint John’s Health Center in Santa Monica, California.
A body mass index of 18.5 to 24.9 is considered to be in the healthy weight range, while a BMI of 30 or greater is considered to be obese, according to the Centers for Disease Control and Prevention.
On the flip side, being underweight — a BMI of less than 18.5 — can also be a risk factor for surgical complications.
“Many patients are coming for cancer surgery and have just completed chemotherapy (or radiation) that has left them underweight. It’s very difficult to heal from surgery and maintain healthy immune status when malnourished,” says Dr. Joyce A. Wahr, a professor emeritus in the department of anesthesiology at the University of Minnesota.
Patients who need more nutrition before surgery should consume nutrient-rich, calorie-dense drinks, such as breakfast drinks, two to three times a day. For example, blending peanut butter with an Ensure chocolate shake creates a delicious and nutrient-packed, high-calorie drink.
To make sure you’re getting enough nutrients prior to your surgical procedure, consider consulting with a registered dietitian to develop a healthy eating plan that provides the nutrition and calories you need.
2. Drink clear carbohydrate-containing liquids up to two hours before your surgery
Drinking clear liquids with more than 10 grams per milliliter of simple or complex carbohydrates prior to surgery has been shown to reduce hunger, nausea and thirst, as well as ease anxiety.
In its 2023 Practice Guidelines for Pre-Operative Fasting, the American Society of Anesthesiologists recommends that all healthy patients drink carbohydrate-containing clear liquids up until two hours before surgery requiring general or regional anesthesia or procedural sedation.
Clear carbohydrate-containing liquids that are good to drink before surgery include:
— Clear fruit juice without pulp, such as apple juice or white grape juice
— Water with glucose or fructose added
— Sports drinks without added dyes
— Specially formulated presurgery drinks, such as Ensure Pre-Surgery
“Thirst is an incredibly powerful drive,” Wahr says. “When we are thirsty and not permitted to drink, it can be really miserable. That’s especially true for children, who don’t understand why they aren’t allowed to drink anything.”
3. Consume the protein your body needs
Eating enough protein prior to your operation helps support your immunity, promotes wound healing and assists in maintaining muscle mass — all of which can help you get back on your feet sooner.
“Protein is a fuel source for the body,” says Lauren Sullivan, clinical nutrition manager of Inpatient Nutrition Therapy at Cleveland Clinic’s Center for Human Nutrition. “It supports tissue, muscles, organs, your immune system, hair, skin, nails and a lot of other things. Higher protein intake is needed prior to surgery to provide the body with the building blocks needed to heal and repair itself during recovery.”
Generally, someone anticipating surgery should eat at least 1.2 grams of protein per kilogram of body weight per day for at least two to four weeks ahead of their procedure. For example, a 150-pound patient would need to eat at least 82 grams of protein daily. Your doctor or a registered dietitian can provide personalized advice based on your specific needs and the type of surgery.
Good sources of protein include:
— Dairy products, such as Greek yogurt and cottage cheese
— Eggs
— Fish, such as salmon, tuna and cod
— Lean meat, such as chicken breast, turkey and top sirloin steak
— Legumes, including lentils and chickpeas
— Nuts
4. Eat plenty of plant-based foods before and after surgery
In the days and weeks before your procedure, it’s a good idea to eat plenty of plant-based foods. In addition to providing dietary fiber, vegetables and fruits contain lots of healthy nutrients, including phytochemicals, which are plant compounds that have been shown to reduce the risk for inflammation and that can help your body heal from surgery.
Healthy plant-based foods include:
— Whole grains, such as barley, brown rice, oats and quinoa
— Vegetables, such as spinach, kale, broccoli, carrots and cauliflower
— Fruits, including berries, apples, pears and bananas
— Nuts
While it’s important to eat a plant-based diet prior to surgery, it’s equally important to eat plenty of plant-based foods after your procedure as well to reap the benefits of fiber.
The combination of pain medications and reduced physical activity postsurgery can often cause constipation. Consuming enough fiber and avoiding narcotic pain medications, which are associated with constipation, can help you maintain regularity after surgery. Additionally, eating a high-fiber diet may help fight inflammation, according to research published in May 2020 in the journal Nutrition Reviews.
However, the nature of your surgery can impact dietary recommendations. For example, if you’re having a gastrointestinal procedure, your doctor may recommend a low-fiber diet to reduce discomfort, bloating and gas during your recovery. Additionally, if you weren’t following a high-fiber diet prior to your surgery, you may need to introduce high-fiber foods gradually to avoid gastrointestinal distress.
Consuming adequate amounts of fluids also goes hand in hand with a high-fiber diet to help promote regular bowel movements, so make sure to stay hydrated.
5. Think about pain management before your procedure
Depending on the procedure, some patients will have minimal pain and discomfort after their procedure, while others will experience significant pain. Therefore, it’s important to think about pain management before undergoing surgery.
“Pain after surgery is something that a lot of patients fear. Knowing how to make good decisions about your options, especially nonopioid ones, will help you feel better and make the best progress,” says Sterling Elliott, clinical pharmacist lead at Northwestern Medicine and assistant professor of orthopedic surgery at Northwestern University Feinberg School of Medicine in Chicago.
Questions about postoperative pain management to ask your surgeon include:
— What level of pain should I expect?
— How long is the pain likely to last?
— What are the signs that pain is interfering with my functionality?
— Are pain medications necessary, and what non-medication strategies can I use to help manage pain?
— What medications are available for pain relief, including nonopioid or over-the-counter options?
— Are there any serious risks or side effects I should be aware of when taking pain medications?
— What steps should I take if the prescribed medications aren’t relieving my pain?
— When should I contact a health care provider if my pain isn’t well-controlled?
Patients should also become educated on the dangers of using opioids, which are painkillers associated with misuse and dependence.
“There’s power in understanding how and when to use opioids,” Elliott says. “There’s power in knowing when another option is best. Ultimately, thoughtful decision-making will be best for your recovery.”
6. Avoid sugary foods
Excessive sugar intake may lead to insulin resistance or elevated blood glucose levels, which are associated with diabetes. For patients undergoing surgery, elevated blood glucose levels can reduce healing and promote infection.
“There is nothing nutritious about (sugar),” Sullivan says.
You should avoid processed foods with added sugar before and after surgery, including:
— Pastries and baked goods, such as muffins, cookies and cakes
— Ice cream and frozen desserts
— Many condiments and sauces
— Candy, including chocolate
— Sugary beverages, like soda or sweetened fruit juices
Consuming fruits that contain natural sugars, on the other hand, is different because apples, blackberries, blueberries, citrus fruits and an array of other fruits provide plenty of nutrients, including fiber, which is important to your postsurgery recovery.
7. Stop smoking and vaping
People who smoke or vape tobacco or cannabis right before their surgery have a much greater chance of developing a surgical site infection than nonsmokers, research suggests. A 2017 meta-analysis published in the journal Surgical Infections evaluated 26 studies involving more than 67,000 patients and found that smoking increases the risk of surgical site infection after surgery.
Research shows that smoking and vaping impairs blood flow function, which can lead to complications, such as:
— Death
— Impaired wound healing
— Shock
— Stroke
Conversely, individuals who quit smoking have a better chance of a successful surgery. According to research published in 2020, eliminating tobacco for four weeks prior to surgery led to improved blood flow throughout the body to essential organs and improved health outcomes by 19%.
Experts encourage you to talk to your surgeon about ways to quit smoking or vaping as soon as the surgery is scheduled. For additional support, the American College of Surgeons has a program to help their surgery patients and their physicians collaborate to achieve this health goal using various strategies, including nicotine cessation products and mindfulness techniques.
8. Increase your physical activity before your procedure
Getting enough exercise is important to maintaining good health, but moving your body is especially important in the days before you’re scheduled to undergo surgery.
“I’d like all patients to increase their physical activity level in the week before their surgery,” Wahr says.
In the week before your surgery, make a point of walking at least 30 minutes every day, she says. If you have a favorite form of exercise, like swimming or playing tennis, continue your usual exercise regimen.
“Sometimes people think they should become inactive because they’re about to have surgery,” Wahr says. “We encourage patients who are active to continue to be active, and those who have a low level of activity to increase it.”
Keeping your body in shape and accustomed to physical activity can help you bounce back after the operation. Physical inactivity following an operation can make some patients vulnerable to potentially deadly blood clots.
9. Continue taking your prescribed medications
Some patients still believe they must stop taking all medications before a procedure, but this can be extremely dangerous. Abruptly stopping medications, particularly if you’re taking them to manage a chronic condition, like hypertension, can have dire consequences, including:
— Worsening or unmanageable chronic medical conditions
— Increased surgical risks
— Withdrawal symptoms, which can cause potentially dangerous health effects
— Complications during your postoperative recovery
Unless your surgeon or physician advises you otherwise, keep taking your prescribed medications as usual. It’s important to keep in mind that your surgeon needs to be fully aware of all the medications you’re taking and the dosages.
10. Communicate with your surgeon
Typically, before your procedure, your surgeon will provide instructions to help you prepare for your recovery, so it’s important to go over the instructions with your care team to make sure you clearly understand them.
“Remember, not every surgery is the same nor are the postoperative instructions for recovery,” Childs says.
These days, technology can connect patients with their surgeons and other health care providers, allowing them to jointly develop a plan for a successful postoperative recovery.
Before your procedure, make sure to ask your surgeon what’s the best way to get in touch during your recovery if you have any follow-up questions or concerns.
For example, a patient portal may come in handy for getting in touch with your care team and for sending reminders about upcoming appointments. With that, it’s important to make sure you have access to the portal before heading into the procedure, so make sure you download any necessary apps and ensure you can successfully log in beforehand.
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Preparing for Surgery: How to Improve Your Recovery originally appeared on usnews.com
Update 08/07/24: This story was published at an earlier date and has been updated with new information.
