As non-emergency surgeries resume, co-author of “The Informed Patient” offers tips to improve recovery
Hospitals across America are scheduling elective surgeries postponed by the COVID-19 pandemic. Sara L. Merwin, MPH, co-author of “The Informed Patient: A Complete Guide to a Hospital Stay,” says this pause gives patients an opportunity to improve their surgical experience and enhance recovery.
“As people eagerly await health-preserving surgeries that have been put on hold, they have the power to influence their outcomes. It’s all about being pro-active,” says Merwin, whose book, written with Karen A. Friedman, MD, helps patients navigate the personnel, processes, policies and procedures they’re likely to encounter during a hospital stay.
Merwin advises, “People planning surgery should prepare physically, psychologically and practically. Informed patients who work closely with their care team often get the best results and have the best quality of life afterwards. The American College of Surgeons (ACS) has developed a comprehensive program called Strong for Surgery that outlines preparation actions. Ask your surgeon and office staff about their thoughts on the ACS program and let them know you are willing to do your part.”
“The COVID-19 pandemic and the cancellation of elective surgery has vividly reinforced the imperative to be an informed patient,” says Paul E. Levin, M.D., vice-chairman of orthopaedic surgery at Montefiore Medical Center in New York. Dr. Levin notes that patients who have established realistic expectations of the outcomes with their surgeon are much more likely to be “gratified with the results of the surgery.”
“Educate yourself about what to expect before and after your procedure, so you can speak up if something doesn’t seem right,” says Merwin. “You are your own best advocate in the hospital.” She also encourages patients to ask about the hospital’s visitor policies and COVID-19 infection control practices.
Whether a patient is scheduled for a simple gallbladder removal, a knee replacement or a complex cancer surgery, “Patients should work with their primary care provider and surgeon to create a prehabilitation plan,” Merwin advises. “Lifestyle changes can help you withstand the rigors of anesthesia and surgery, so discuss the steps you can take to get healthier and stronger.”
- Dietary changes. Obesity is a known risk factor for post-surgical complications. It’s also associated with high blood sugar, diabetes and high blood pressure, which carry their own risks. Dietitians can help patients create eating programs to lose weight, control blood sugar, or improve nutrition for malnourished or underweight people.
- Improved fitness. The long lockdown period caused many people to give up their exercise regimens when gyms were closed, and have put on extra weight as a result. Strong muscles, good balance and increased heart and lung function help patients recover faster.
- Healthier lifestyle. Studies indicate that non-smokers recover faster from surgery and have fewer complications than those who use tobacco. Patients should also be honest about their use of street drugs and alcohol when conferring with the surgeon and anesthesiologist.
Certain non-prescription medications and natural supplements interfere with blood clotting or affect how prescription drugs or anesthesia works. When first meeting with their surgeon, and during pre-surgical testing, people should bring a current list of every medication and supplement they take—including prescriptions, over-the-counter products, medical marijuana, CBD, vitamins, and supplements.
Primary care physician Susan C. Hirsch, M.D. agrees that patients should focus on getting as healthy as they can. “Pre-operative health optimization would include improving nutrition, losing weight, controlling blood sugar, quitting smoking. All of these can help speed recovery and wound healing,” says Hirsch, who serves as medical co-director, Division of General Internal Medicine at Northwell Health in New York.
Merwin closes with advice from “The Informed Patient”: “Write everything down, bring someone you trust to your pre-operative appointments and to the hospital, and stay vigilant to protect safety.”