6 tricks to a quick surgical recovery

What you do before surgery can be as important as what you do after it

Published: March 12, 2015 06:00 AM

Many people enter rehab programs after surgery to help them recover more easily. But improving your physical and emotional health beforehand may get you out of the hospital faster, lower complication risks, and speed healing. “The idea is you build up your reserves, like an athlete training for a marathon,” says Francesco Carli, M.D., professor of anesthesia at Montreal’s McGill University Health Centre.

Prehabilitation—or prehab—has been used for years by orthopedic surgeons. Now it’s catching on in heart surgery and cancer treatment. For example, Carli found that 84 percent of colorectal cancer patients who did a month of aerobic, resistance, and relaxa­tion exercises and nutritional coun­seling prior to surgery recovered faster. A British study found that cycling for six weeks helped those who underwent chemo better with­stand surgery afterward.

If you’re scheduled for surgery, ask your doctor about prehab programs or useful referrals such as physical ther­-apy or nutritional counseling. Or run the steps we’ve compiled past your doctor—experts say the strategies may boost your chances for better recovery. (If you're considering surgery, use our hospitals Ratings to compare hospitals in complication rates and other measures for several kinds of surgery, including hip and knee replacement, back surgery, and heart surgery.)

1. Do breathing exercises

Respiratory muscle-strengthening exer­cises after surgery lower pneumonia and fever risks. Doing them in advance gives you a head start. Massachusetts physiatrist Julie Silver, M.D., who developed the STAR Program Prehab, suggests doing this: Inhale through your nose for 3 seconds, mouth closed. Hold the breath for 3 seconds, then exhale through pursed lips for 3 seconds. Do that five times. Repeat the exercise three to four times daily.

2. Reduce stress

A 2012 study in the journal Brain, Behavior and Immunity found that relaxation exercises and guided imagery for three days before and seven days after surgery helped people heal faster. “Reducing stress can also help you manage pain, and improve sleep and mood,” Silver says. Try gentle yoga stretches; taking slow, deep breaths; or meditation. Get free meditations from the UCLA Mindful Awareness Research Center. Read more about the benefits of managing stress.

3. Pay attention to protein

A well-balanced diet promotes healing and helps fight infection, says Thomas K. Varghese, M.D., med­ical director of the Strong for Surgery program. Protein may be key before cancer surgery: For example, studies have found that bladder cancer patients who are protein-deficient have twice the risk of a postop complication. It's best to get protein from protein-rich foods, like fish and beans, not protein drinks.

4. Stop smoking

If you can’t quit smoking, scale back two weeks before surgery. Smoking slows wound healing and “puts you at higher risk for infection,” says Rick Greene, M.D., surgical oncologist at the Levine Cancer Institute in Charlotte, N.C. Read more of our advice on how to quit smoking for good.

5. Check your meds

Ask your doctor whether and when to stop taking drugs such as aspirin and ibuprofen, which can increase bleeding risks. Ask about supplements such as vitamin E as well. Strong for Surgery advises people to stop echinacea, garlic, ginkgo, ginseng, kava, saw palmetto, St. John’s wort, and valerian at least two weeks before surgery. Read more of our coverage on supplements and drugs.

6. Up your exercise

Aerobic exercise strengthens lungs and improves circulation—a plus for wound healing. “Any amount before surgery, provided it’s more than usual, helps,” Varghese says. (Just get your doctor’s approval.) Ask about surgery-specific moves, such as shoulder stretches to improve shoulder range of motion for women having breast cancer surgery. If you want to get started on an exercise program, see our reviews of treadmills, ellipticals, spin bikes, and rowing machines.

Get a 'pre-hab' advantage

Presurgical health programs are now widely available across the country for people about to undergo joint replacement surgery. "Prehabs” for other kinds of surgery are also emerging. Here are two programs to note:

The STAR Program Prehab offers strategies to improve physical and emotional health before cancer treatments and surgeries. Participants learn exercises to build strength and endurance, and receive nutrition counseling and help with stress reduction. There are about 200 STAR programs nationwide, and they are available in almost every state.

Strong for Surgery, designed to optimize health before all kinds of surgery, focuses on nutrition, smoking cessation, blood sugar control, and safe medication use. The program is currently available in Oregon and Washington states. The American College of Surgeons is expected to launch it nationally this summer.



Editor's Note:

This article also appeared in the March 2015 issue of Consumer Reports on Health.

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