Getting Optimized for Surgery: Preparing Your "Vehicle"

By Dr. Kourtney Kemp MD, FACS


Seniors (patients over the age of 65) are at increased risk for surgical complications. I recently wrote on making the decision to have surgery, now I will discuss how to prepare for surgery. As your body ages, it is more sensitive to medicines, anesthesia, and procedures. Even straightforward surgery can have debilitating effects, particularly on the brain, heart, and kidneys. Just like preparing your vehicle for a long road trip, preparation and planning for surgery are essential to a smooth journey.



Step 1: Clean out your vehicle.


Get your body in the best shape possible!

Smoking is damaging to every organ system and can delay or interfere with recovery due to reduced blood flow carrying essential nutrients to the body. Smoking increases your risk of wound infection, blood clots, pneumonia, heart attack, and other complications. Refrain from alcohol/tobacco/drugs and prepare your body with good nutrition.


Ensure your bowels are regular.


Constipation can worsen with anesthesia and pain medications. As our body/colon ages, the colon may be slower to recover. Fiber/stool softeners may help clean out old stool, toxins, and residues. It will also help to maintain good colon health in recovery. Discuss with your doctor which bowel regimen is best for you.

Step 2: Maintenance check


It is essential to have an evaluation by your primary doctor before a surgical procedure. Optimization of your medical issues will reduce complications. If you have diabetes, uncontrolled blood sugars may have devastating infectious complications. Medications related to diabetes, hypertension, heart disease, or other vascular diseases may need to be improved before surgery. If you suffer from depression, please discuss this with your doctor or psychiatrist. Depression can increase your risk of post-surgical delirium and other post-surgical memory and functional problems. See the GeriAcademy blog on delirium for more information.


Step 3: Start on a full tank.


Ensure your nutrition is adequate. Being overweight or underweight both have nutritional effects on healing. Maintaining muscle mass with activity and proper nutrition, including adequate protein intake, will speed up the healing process. Always talk to your doctor about your ideal weight and how much protein is safe with your current medical issues. Discuss current medications, vitamins, and minerals. It is crucial to revisit medications, discuss which ones you no longer need and which medications to continue. See the GeriAcademy blog on vitamins/minerals/herbs for more information.


Step 4: Packing the vehicle efficiently


Packing efficiently for your journey is crucial. As our brain ages, it can be more affected by medications and anesthesia. Pack familiar things such as pictures, mementos, prayers, or cards/words of encouragement. I recommend bringing a journal to write about your experience and jot down your thoughts and questions with your healthcare team. Bring puzzles, crosswords, or other games that will keep your mind occupied by something other than the pain/discomfort you may experience. Games/activities have been shown to reduce the need for mind-altering pain medications. Don't forget essentials such as glasses, hearing aids, dentures, or essential toiletries. Although hospitals/facilities tend to have toiletries, blankets, gowns, it may be more comforting to have familiar items that make you more comfortable.

Step 5: Make room for your passengers


Family involvement is probably the most important step. Discuss plans with your family members and update them on health care discussions and decisions. Designate a health care proxy or a decision-maker in the event you are incapacitated.


It's best to have one family member that your healthcare team can regularly update. Designate that family member to update other family/friends to prevent the healthcare team from spending too much time on the phone instead of providing care for you.


Family/friends want to be helpful and feel essential to your journey; finding ways for them to be helpful is vital to your recovery. Examples of how your loved ones can help include: feeding your dog/cat, sending a card or words of encouragement, bringing your favorite meal, and driving you to/from the hospital.


Preparation for surgery will improve post-surgical outcomes and bring you a little peace of mind knowing you have done your part.

Remember, you are not alone; your trusted healthcare team will do their very best to prevent complications and address any obstacles along the way. In addition to your health care team, your family/friends will be by your side to support and encourage you to reach your ideal destination.





Dr. Kourtney Kemp is a board-certified general surgeon and medical director for Twin Cities Heartburn Center at Specialists in General Surgery in Minneapolis, Minnesota. Dr. Kemp has a special interest in hernia surgery, robotic-minimally invasive surgery and reflux/esophageal diseases. Since 2017, she has held several hospital leadership positions on the Medical Executive Committee, Chief of Surgery and most recently, Chair of Peer Review. Dr. Kemp is dedicated to supporting both patients and physicians in providing the best quality of life for patients in our communities.

Summary


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