5 years ago | Post surgery

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By Joy Stephenson-Laws, JD, Founder

We train for so many things in life. 

As kids, we were “potty trained.” We also had training wheels put on our bikes. 

Now, we may train at the gym or undergo training for a new job. Some expectant mothers train for birth by taking Lamaze classes. We do all of this training in order to prepare and achieve the best outcome possible.

So it makes perfect sense that if you have to undergo surgery, you would train for it - right? 

Well, it turns out that there is credible support to suggest that we should indeed be training for our surgeries. A recent study, backed by the Journal of the American College of Surgeons, found evidence which suggested that older adults who train for major surgeries by exercising, eating healthily and practicing techniques to reduce stress before going under the knife “...have shorter hospital stays and are more likely to return to their own homes afterward rather than another facility, compared with similar patients who do not participate in preoperative rehabilitation...,” according to one report discussing the study.

We tend to think of rehabilitation as something that we do after an event, but this study shows how important it is to do beforehand. In the case before surgery, it is called “prehabilitation” or “prehab.”

"We believe every patient [so not just older patients] should train for a major operation. It's like running a 5K race: You have to prepare," said one of the doctors and coauthors of the study.

Undergoing a major operation is stressful to the body. It is traumatic, and there are risks of having complications (especially in older adults) after surgery such as pneumonia, urinary retention and surgical site infections.

According to yet another recent study, surgical site infections affect as many as 300,000 patients per year in the United States. 

This study reported that surgical site infections (SSIs):

• Are the most common and costly of all hospital-acquired infections (accounts for 20 percent of all hospital-acquired infections).
• Occur in an estimated two to five percent of patients that have inpatient surgery.
• Cost an estimated $3.5 billion to $10 billion every year in the U.S.

“Although most infections are treatable with antibiotics, SSIs remain a significant cause of morbidity and mortality after surgery. They are the leading cause of readmissions to the hospital following surgery, and approximately 3% of patients who contract an SSI will die as a consequence,” according to one source.

But according to the study report discussing prehab, “Past studies show that prehabilitation lowers the rate of postoperative complications [which may include SSIs] and speeds the patient's return to their normal functioning, among other advantages.”

In order to test the effects of training before surgery, researchers recruited patients from 21 hospitals in Michigan who had to have chest/heart or abdominal operations. Patients were selected if they were considered to be at a high risk of having postoperative complications.

How the patients trained for surgery.

• They followed a home-based walking program in which patients had to track their steps using a pedometer. They also received daily reminders through phone and text messages and email. (This shows that having someone or a device to hold you accountable can be key in your training).
• The patients received education on nutrition, relaxation techniques and how to quit smoking. (Smoking is definitely a great way to make your immune system weaker and lungs less healthy, making you more prone to infection and complications after surgery).
• Practiced using an incentive spirometer (a device that helps your lungs recover after surgery or battling a lung illness).

The study included more than 500 Medicare patients who participated in this prehab program for at least one week (but participation times ranged from 11 to 33 days) before undergoing inpatient surgery.

“For comparison, the researchers used Medicare claims data during the same period to identify 1,046 matched controls: patients with similar demographic characteristics and coexisting illnesses who had the same operation at the same hospital but did not take part in prehabilitation.”

Average age of the patients and controls was 70.

Overall, participation in the prehab program shortened the length of the hospital stay after surgery by one day (six days versus seven days). This may not sound like a big difference. But if you’ve ever had a lengthy hospital stay, you know that each day feels like your longest. And the less time you are in a hospital (even if it is a difference of one day) the less time you have to be susceptible to hospital-acquired infections. 

In addition to this, the patients who trained for their operations were more likely to go home after surgery as opposed to another facility for additional care (65.6 percent versus 57 percent of controls).

Furthermore, insurance payments were significantly lower in the patients who trained.

“Every patient scheduled for a major operation—not just those at high risk—should ask their surgeon for a prehabilitation program," said one of the doctors involved in the study.

How can you be proactive and train for surgery?

First, seek the advice of a competent healthcare professional. He or she can construct a safe plan that is catered to you. Some of the suggestions for training will likely include:

• Eating a nutrient-rich diet and avoiding a pro-inflammatory diet. Before surgery, you want to make sure that your immune system is in top shape. Your white blood cells play a critical role in fighting infections that may cause complications after having surgery. Think of your white blood cells as being “immune system cells.” You want to have the optimal number of these cells to ensure you are in the best position to combat viruses and infections. A great way to be proactive about making sure you have plenty of these white blood cells is by making sure you get an adequate intake of nutrients such as zinc, selenium and vitamins B9, B12, C and E. To learn more about these nutrients and healthy food sources where you can get them, read here.
• Practicing stress relieving activities such as meditation and yoga. Surgery is stressful. The less stressed you are before an operation, the better the outcome may be. Stress also wreak havoc on our immune system.
• Making sure you get plenty of good quality sleep. Good sleep helps combat stress and strengthens the immune system.
• Getting adequate exercise. Talk to your doctor about which exercises are best for you. For some it may be walking, and for others it may be strength training with weights. Read here to learn about how to properly fuel your body for workouts.
• Quitting smoking if you do. I think this one is pretty self-explanatory!

Additional things to keep in mind:

• Make sure you are getting enough vitamin C. This nutrient helps with wound healing after surgery. Consider taking advantage of IV vitamin drips or injections. I take advantage of these drips at the pH Drip Lab on a monthly basis to boost my immune system and address my inevitable nutrient absorption issues with vitamin C. At the pH Drip Lab, we offer all sorts of vitamin “cocktails.” My go-to is the “Pick Me Up Buttercup,” which is an injection of 1,000 mg of vitamin C. I believe this has successfully boosted my immunity, energy and good health. 
• Get routine nutrient tests. Schedule these tests in order to identify any nutrient imbalances or deficiencies you may have. If the test reveals you have too much or too little of a certain nutrient, a competent healthcare professional can work with you on making the necessary dietary changes and recommend quality supplements if necessary.
• Consider cryotherapy. You will want to seek the advice of your doctor, however, the benefits of cryotherapy include better sleep, a stronger immune system and less inflammation throughout the body - all things you want prior to surgery.

Enjoy your healthy life!

The pH professional health care team includes recognized experts from a variety of health care and related disciplines, including physicians, attorneys, nutritionists, nurses and certified fitness instructors. This team also includes the members of the pH Medical Advisory Board, which constantly monitors all pH programs, products and services. To learn more about the pH Medical Advisory Board, click here.