PREPARING FOR SURGERY

Once you and your doctor decide that surgery will help you, you will need to learn what to expect from the surgery and how to actively participate in the treatment plan for the best results afterward. Preparing mentally and physically for surgery is an important step toward a successful result. Understanding the process, and your role in it, will help you recover more quickly and have fewer problems.

YOU have to own your recovery. The surgery part is relatively easy, the recovery is the hard part. Your part includes being ready for surgery and also being ready to recover after surgery. To do this you need to be optimized for surgery.

More in depth information here (PDF).

PRE-SURGICAL OPTIMIZATION – “LIVING WELL”

Surgery is a large physiological hit to the body and it should not be taken lightly. You are in a unique position to directly impact your outcome, we encourage you be a very active part in your pre and postoperative care.

  • Smoking: Nicotine (pouch, cigarette, chew, gum, patch, lozenge) is 100% forbidden for 3 months preoperatively and 6 months postoperatively. It chokes off the blood vessels that deliver healing nutrients to your limb and will lead to poor outcomes, infection, and more surgery. If you cannot quit on your own please seek help of a professional. If you use marijuana, then switch to edible forms.

  • Infections: Have any tooth, gum, bladder or bowel problems treated before surgery to reduce the risk of infection later. Something as innocuous as a toothache can cause your surgery site to become infected. Report any infections immediately. Surgery cannot be performed until all infections have cleared up.

  • BMI (Body Mass Index): If you are overweight, losing weight before surgery will help decrease the stress you place on your body and decrease risk of complication. While it is not a perfect measure, a BMI should be between 20 and 25. Too low or too high and it puts you at risk for problems.

  • Diet: Eat a well-balanced diet, the Mediterranean diet is recommended. See below for more information.

  • Heart and Lung health: If you have had a heart attack, heart surgery, stents, a pacemaker, or a cardiologist you need to see your cardiologist to be cleared for surgery. Sleep apnea and COPD (emphysema or asthma) must be under control prior to surgery.

  • Mental Health: anxiety and depression lead to worse outcomes (some studies show more than 6 times more dissatisfaction), you MUST be treated BEFORE surgery

Mediterranean Diet – Focus on Whole Foods and Avoid Things that Come Pre-Packaged:

General rules to follow for at the minimum 6 weeks preoperatively to 3 months postoperatively. If you are on a special diet or have kidney problems, discuss with your primary care physician or nephrologist.

  • Stay Hydrated – Water, unsweetened tea or coffee. No sugar in your drinks. No alcohol. 

  • No Fried or Processed Foods – fries, burgers, chicken nuggets, chips, mac and cheese, salami

  • No Added Sugars – Look at the nutrition facts, most things in boxes have added sugars

  • DO EAT:

    • Beans (chickpeas, lentils, pintos, black, kidney, etc.)

    • Cruciferous vegetables (broccoli, Brussel sprouts, bok choy, kale, collard greens)

    • Other vegetables (artichokes, asparagus, mushrooms, okra, onions, sweet potatoes, tomatoes, garlic)

    • Nuts (walnuts, brazil nuts, cashews, chia, hazelnuts, macadamia, pecans, seeds)

    • Protein (aim for 100g daily, can supplement with whey or soy if needed)

    • Meat (tuna, salmon (white meats); avoid red meats and pork)

    • Whole grains (oatmeal, barley, quinoa, wild rice, buckwheat, brown rice)

    • Berries (acai, blackberries, raspberries, blueberries, cherries, strawberries, etc.)

    • Fruits (apples, apricots, avocado, melon, oranges, mangos, plums, pomegranates, etc.)

WORKING WITH YOUR DOCTOR

Before surgery, you will be checked to make sure you don’t have any conditions that could interfere with the surgery or the outcomes.

  • Routine tests, such as blood tests and X-rays, are usually performed a week before any major surgery.

  • Discuss any medications you are taking with your doctor and your family physician to see which ones you should stop taking before surgery.

  • If you are taking aspirin or anti-inflammatory medications or any drugs that increase the risk of bleeding, you will need to stop taking them one week before surgery to minimize bleeding.

PREPARING YOUR HOUSE AND COACH FOR YOUR PROCEDURE

You will need help in your recovery after surgery. This comes in the form of preparing your house and also recruiting a coach. This should be arranged well before surgery and is essential in your recovery.

  • Home Preparation: You will be going home after surgery. Install grab bars and handrails where needed (stairs, bathroom, etc.). Remove throw rugs and other tripping hazards that are on the floor. Make a plan for pets that live with you.

    • Ambulatory Aids: Everyone will need crutches or a walker after surgery. An iWalk or a knee scooter are also helpful if non-weightbearing, but are not covered by insurance.

    • Equipment: Everyone will benefit from having a shower chair, a 3-in-1 commode that can be used as an elevated toilet seat with arms, and if you are having foot/ankle surgery a cast cover. These can all be purchased off Amazon. Make sure you have a stable chair with a firm seat cushion, a firm back and two arms.

    • Preoperative PT: There is an option to send you to have a preoperative therapy evaluation that can help ease your mind and help be prepared for after surgery.

  • Coach: 1 or 2 people close to you that will be designated to help after surgery for the first few weeks in a decreasing fashion. The most help is needed in the first few days. The coach could be a spouse, a relative, a trusted caregiver, or a trusted friend/neighbor. They will get you to and from surgery, help with getting around the house safely, and assist in meals.

  • Social Preparation: If people depend on you for daily things and they cannot pick up the slack (making dinner, car rides, etc.) a plan needs to be made for them as well, since you will not be able to do this and should not be doing this as it will negatively impact your recovery.

PREPARING FOR YOUR PROCEDURE

You are having same-day surgery, remember the following:

  • Have someone available to take you home, you will not be able to drive for at least 24 hours.

  • Do not drink or eat anything in the car on the trip back home.

  • The combination of anesthesia, food, and car motion can quite often cause nausea or vomiting. After arriving home, wait until you are hungry before trying to eat. Begin with a light meal and progress as tolerated.

  • If you had surgery on an extremity (leg, knee, hand or elbow), keep that extremity elevated and use ice as directed. This will help decrease swelling and pain.

  • Take your pain medicine as directed. Begin the pain medicine as you start getting uncomfortable, but before you are in severe pain. If you wait to take your pain medication until the pain is severe, you will have more difficulty in controlling the pain.