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What to avoid for fast recovery surgery

Once we have successfully gone through a surgical procedure, we are told to follow specific recommendations for a faster recovery. Despite being tired or in pain, most of us are eager to go back home and get back to our usual routine, but many people don’t like the wait time it requires. The truth is that to be efficient, you need to focus on healing first or there might be unwanted consequences.

 

Keep the Balance with Physical Activity

Some folks have a hard time finding a balance between rest and physical activity after surgery. While many patients are able to find a good equilibrium, there are others who behave at opposite ends of the spectrum.

For example, Wing RR (2010), as cited by King and Bond (2013) in their research study “The importance of pre and postoperative physical activity counseling in bariatric surgery”, maintains that “Surgical patients will likely gain noticeable benefits from performing many types of activities. Emphasis should be placed on aerobic exercise, which yields the greatest health benefits, such as improving heart function and preventing cardiovascular disease, increasing endurance, and regulating body weight.”1

 

Some post-op patients cannot help but walk around every few minutes, while others stay in bed all day long. Of course, it also depends on the type of surgery each person goes through, but the key is to find a proper balance. Regardless, make sure to follow your physician’s recommendations. If they advise you to stay in bed and refrain from physical exertion, then you should do exactly that.

However, if your doctor says that your type of surgery allows you to be active for an ‘X’ amount of time, you should take advantage of it. If you start exercising before the appropriate time, there are chances you might get hurt and your wounds could open. You might be able to do simple things such as walking and getting up to go to the bathroom. Other procedures simply require more time for you to get on your feet.

Regarding mobility and exercise, Ticker, J. B., & Egan, J. J. (2008) suggest that it is important to remind the patient that each person is different: “Insure the patient understands that the gains post-operatively do not always follow a smooth and steady progression, and that the course can fluctuate with the addition of new exercises and advancing to each new stage, as well as with added activities of daily living. If the patient can look back week by week and appreciate his or her progress, this can be an encouraging perspective. A diligent home exercise program is of equal importance to the physical therapy visits. There are specific exercises at each stage that complement the supervised program to maintain the gains achieved thus far and to build upon these gains.”2

 

Many patients are afraid to even move after surgery, but this extreme mentality is also not good. Staying in bed for too long might bring about many health problems, such as bedsores, embolisms, blood clots, and myasthenia. You may feel undisposed and tired, but an excellent way to end this lethargy is by moving around. This is why physical activity is recommended, it will help you feel much better.

 

Medical Appointments and Medication

It is true that some medications can cause side effects such as dizziness, constipation or nausea, but specific medication like painkillers and antibiotics are prescribed for a reason. Interfering with your medication or neglecting to attend to you doctor’s or appointments is a mistake that may cost you more than you think.

According to Chou, R., Gordon, D. B., de Leon-Casasola, O. A., Rosenberg, J. M., Bickler, S., Brennan, T., … & Griffith, S. (2016), in a publication for The American Pain Society, titled “Management of Postoperative Pain”, the authors reveal studies that show a tendency of strong pain after surgery. “More than 80% of patients who undergo surgical procedures experience acute postoperative pain and approximately 75% of those with postoperative pain report the severity as moderate, severe, or extreme. Evidence suggests that less than half of patients who undergo surgery report adequate postoperative pain relief. Inadequately controlled pain negatively affects quality of life, function, and functional recovery, the risk of post-surgical complications, and the risk of persistent postsurgical pain. Many preoperative, intraoperative, and postoperative interventions and management strategies are available and continue to evolve for reducing and managing postoperative pain.”3

 

Also, cutting back medication is not a smart choice. Infections may threaten your life and exacerbate pain, causing unwanted consequences such as problems with sleep, lack of appetite, and reduced mobility. Avoiding or changing medical treatment interrupts the healing process and your condition can get worse.

As for medication cutback, Heisler, Wagner and Piette (2005) in a publication titled: “Patient strategies to cope with high prescription medication costs: who is cutting back on necessities, increasing debt, or underusing medications?” indicate “Underuse of medications, however, constitutes just one possible strategy patients might adopt to cope with the burden imposed by high medications costs. Other strategies also may adversely affect patients’ health and well-being. Yet, with the exception of one recent study that found that 21% of Medicare recipients without prescription drug coverage had cut back on essentials such as food or clothing to pay for medications, few other studies have examined the range of strategies patients may use to cope with medication cost pressures. Moreover, we know little about how patient characteristics may differ among those who choose one strategy versus another.”4

 

Therapy is also a vital part of rehabilitation. Many patients think they will be okay just relying on their strength and vitality. Even so, this is not enough to fully recover from some surgeries.

Ticker, J. B., & Egan, J. J. (2008) also insist that following a postoperative rehabilitation programs is crucial: “The primary goal of a post-operative rehabilitation program is to control pain, protect repaired tissue during the healing process, restore function and avoid recurrence of symptoms.”5

 

Eating Properly

A proper diet gives our bodies the nutrients and strength to fight possible complications, according to Shepherd, A. (2009) in his publication “Wound Management”. The author also states that: “An individual’s nutritional intake consists of both macronutrients, which include carbohydrates, fats and proteins, and micronutrients, which include minerals and vitamins. All of these substances have been shown to play a vital role in the wound healing process. In addition, it is important to note that fluid status is an essential part of nutrition, as this maintains adequate perfusion to the wound site, which is critical for transportation of both oxygen and nutrients.”6

 

As a post-surgery patient, you might have a special diet assigned. Usually, it is a very light and healthy diet, but many people refuse to drink or eat anything after surgery. Surgical procedures may cause a lack of appetite; it is normal that you do not feel like eating.

On the other side of the coin, some people are quite the opposite after surgery. They feel famished and will ravish any meal that comes their way. This, however, is also counterproductive because the body has gone through an invasive procedure and it might not be ready to take in large amounts of food.

One of the most delicate diets is for patients who had gastric bypass surgery. Judy Dowd, RD & LND (2005), in “Nutrition Management After Gastric Bypass Surgery”, points out that “Early postoperative food capacity is usually about one-half cup or less. Patients must learn to eat frequent, small meals consisting of healthful foods. Failure to modify this habit will result in poor nutrition and an inadequate calorie intake. Consuming too few calories can result in the “starvation mode” of metabolism, which will interfere with weight loss. Patients are encouraged to eat breakfast and to eat at least four to five small meals daily.”7

 

During the first days, you can only eat light foods such as juices, broths, and purees. As the days go by, you will be able to incorporate more solid foods that will help you gain strength and energy. However, you should be very careful with what you eat because some foods may not sit well with your body. Ideally, go with foods rich in fiber such as fruits, vegetables, and whole grain products.

Follow your doctor’s directions and do not abuse or lie to your doctor about your dietary habits after surgery.

 

Going Back to Work Too Soon After Surgery

Being in a rush about going back to work could actually delay your recovery. Some people try to work while still in the hospital, using smartphones, tablets or laptops. They do not have any idea of how work-related stress can wreak havoc on healing. You need to plan your days off from work in advance because you definitely shouldn’t work during your recovery period.

As for the surgical wound, Jean-Philippe Gouin and Janice K. Kiecolt-Glaser (2011) in a research study titled “The impact of psychological stress on wound healing: methods and mechanisms” insist that: “Wound healing is a critical process involved in the recovery from injury and surgical procedures. Poor healing increases the risk for wound infections or complications, lengthens hospital stays, magnifies patient discomfort, and slows return to activities of daily living. Converging evidence from different research paradigms suggest that psychological stress and other behavioral factors can affect wound healing.”8

 

Also, many patients take the risk of driving to their office right after surgery, which is an unforgivable error. If your doctor has told you not to drive, you must not drive. It may be for a few weeks, but it is important you stick to the recommendation. You might react slower than usual, and this can cause accidents. Besides, your wound could rip open.

Driving and going to work may increasE your stress levels, which may contribute to acquiring unhealthy and dangerous habits, particularly after surgery. Moreover, Jean-Philippe Gouin and Janice K. Kiecolt-Glaser (2011), once again, infer that: “Individuals who experience greater levels of stress are more likely to increase their alcohol and tobacco use, decrease their participation in physical activity, experience sleep disturbances, and make poorer diet choices, compared to individuals reporting less distress. These negative health behavior practices can then compound the detrimental impact of stress on physiological healing processes”9

 

Other recommendations after surgery:

  • Wear comfortable and loose clothing. You will notice that any friction, however mild, on the area of the wound can be painful and annoying. You will want to avoid clothing that rasps your wound. The best solution is to wear loose clothing, preferably cotton, which facilitates perspiration and does not press the wound.
  • Breathing exercises are fundamental; they’re specially designed to recuperate from the effects of anesthesia and expand your lungs. Your doctor should explain the proper way to perform them. Evidence found in “The effect of deep and slow breathing on pain perception, autonomic activity, and mood processing—an experimental study” by Busch, V., Magerl, W., Kern, U., Haas, J., Hajak, G., & Eichhammer, P. (2012) points out that: “… relaxation may constitute a biologically and clinically effective component of breathing techniques, additionally influencing mood processing. This aspect seems of utmost importance, considering that breathing management is able to modulate emotional processing in the presence of pain, thereby pointing to the mutual relationship between pain and mood processing.”10 These exercises are essential after surgeries of the stomach, heart, spine, and lungs.
  • Always protect the wound. Regarding this matter, Shepherd, A. (2009), in “Wound Management”, reveals the importance of proper dressing: “There are currently many sophisticated dressings available, made from a variety of materials, which can be used alone or in conjunction with other forms of dressings. There are also several attributes of an ideal surgical wound dressing that surgical technologists should take into consideration prior to using any dressing. (…) The dressings used should be easy to apply, painless on removal, allow earlier discharge from the hospital and require fewer dressing changes.”11
  • During the first few days post-surgery, hospital nurses will clean the surgical wound, but when you are at home it is your responsibility to follow up with the hygiene you learned from your stay at the hospital; just make sure you take precautions to avoid injuring the area.

the feet so that inflammation is reduced mostly around legs and ankles.

 

References:

(1) King, W. C., & Bond, D. S. (2013). The importance of pre and postoperative physical activity counseling in bariatric surgery. Exercise and sport sciences reviews, 41(1), 26. Available online at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3529741/

(2) , (5) Ticker, J. B., & Egan, J. J. (2008). Postoperative Rehabilitation Following Arthroscopic Rotator Cuff Repair. In Arthroscopic Rotator Cuff Surgery (pp. 348-362). Springer, New York, NY. Available online at:

https://shouldersurgeonlongisland.com/wp-content/uploads/2017/09/post-operative-rehabilitation-following-arthroscopic-rotator-cuff-repair.pdf

(3) Chou, R., Gordon, D. B., de Leon-Casasola, O. A., Rosenberg, J. M., Bickler, S., Brennan, T., … & Griffith, S. (2016). Management of Postoperative Pain: a clinical practice guideline from the American pain society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ committee on regional anesthesia, executive committee, and administrative council. The Journal of Pain, 17(2), 131-157. Available online at:

https://www.jpain.org/article/S1526-5900(15)00995-5/pdf

(4) Heisler, M., Wagner, T. H., & Piette, J. D. (2005). Patient strategies to cope with high prescription medication costs: who is cutting back on necessities, increasing debt, or underusing medications? Journal of behavioral medicine, 28(1), 43-51. Available online at:

https://deepblue.lib.umich.edu/bitstream/handle/2027.42/44817/10865_2005_Article_2562.pdf?sequence=1&isAllowed=y

(6) , (11)  Shepherd, A. (2009). Wound Management. Surgical technologist, 256. Available online at:

http://www.ast.org/articles/2009/2009-06-306.pdf

(7) Dowd, J. (2005). Nutrition management after gastric bypass surgery. Diabetes Spectrum, 18(2), 82-84. Available online at:

http://spectrum.diabetesjournals.org/content/18/2/82.full

(8) , (9) Gouin, J. P., & Kiecolt-Glaser, J. K. (2011). The impact of psychological stress on wound healing: methods and mechanisms. Immunology and Allergy Clinics, 31(1), 81-93. Available online at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3052954/

(10) Busch, V., Magerl, W., Kern, U., Haas, J., Hajak, G., & Eichhammer, P. (2012). The effect of deep and slow breathing on pain perception, autonomic activity, and mood processing—an experimental study. Pain Medicine, 13(2), 215-228. Available online at:

https://academic.oup.com/painmedicine/article/13/2/215/1936333

Robert Velasquez
13 October, 2018

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Hello everyone, my name is Robert Velazquez. I am a content marketer currently focused on the medical supply industry. I studied Medicine for 5 years. I have interacted with many patients and learned a lot...read more:

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