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BODY WATCH : Get Well Soon : What You Know Before Surgery Can Hasten Recovery


Before the Big Day

The better prepared you are for surgery, the more quickly and completely you will recover. It is important to learn all you can about the procedure and prepare yourself, your home, your family and your employer for it.

Here are some tips.

* The better your physical condition before surgery, the quicker you'll recover.

"Go into your surgery well-nourished," says Kathy Carder, a registered nurse who works with critical-care patients at Santa Monica Hospital. "Protein is necessary for the antibodies and cells that fight infection. Calories, vitamins and minerals are also very important. Before and after surgery is not the time to diet."

Carder also suggests that patients who smoke try to stop at least two weeks before surgery.

* "Bathrooms can be dangerous for all but the most physically fit patients," says Dr. Hilary Siebens, assistant medical director for the Department of Physical Medicine and Rehabilitation at Cedars-Sinai Medical Center.

"Remove all throw rugs, and find out if you'll need a stool in the tub or shower. Consider moving your bedroom to the first floor during recovery," she says. "Find out if you'll need help with self-care while recuperating."

* Siebens suggests that patients and families discuss how their roles will change after surgery. Delegating who will manage finances, household chores and children should be discussed before surgery.

"Families also need to consider what will happen if full recovery is not possible or your surgery uncovers a more serious problem or terminal illness," Siebens says.

* Let your employer know how much time you anticipate being gone. Tie up loose ends and find out who will take over your work duties. Arrange for your wages to be picked up or deposited directly to your bank account. Ask how much your insurance company will cover of your procedure and post-operative care, especially if special help or equipment becomes necessary during recovery.

* Find out if you will need a blood transfusion. Ask what your options are.

* Find out what your post-surgical medications will be and see if you can purchase them ahead of time.

* Stock up on groceries, toiletries, pet food, stationery and stamps. Get enough to last six weeks.

* Cook extra food and freeze meal-size portions.

* Have lists of household instructions posted for any helpers coming to your home.

* Arrange transportation for incoming helpers and post-operative trips to the doctor.

* Alert your postal carrier if you'll be confined to the house. Ask if he or she will pick up outgoing mail.

* Take care of banking and bills ahead of time or arrange to do it by telephone.

* Get some of those back-burner projects that you've been waiting to do organized and ready to tackle.

* Purchase reading materials.

After It's Over

Ever wonder why patients who have just been through surgery are forced to sit up, stand up or walk as early as the day after surgery?

Although exercise of any kind in the few days after surgery may feel like torture, "Movement is extremely important after surgery," Santa Monica Hospital's Carder says. "Early walking is most effective in preventing skin breakdown, blood clots, pneumonia and constipation."

Movement is so important that patients who cannot walk are generally turned side to side by a nurse.

"While bed rest is very important, the body loses muscle strength, flexibility and cardiopulmonary stamina, which is reversible through exercise," Siebens of Cedars-Sinai says.

Once you are at home, alternate periods of rest and activity, and don't worry if you're sleeping more, Carder says.

"Tissues heal faster during sleep," she says. "Some days you may feel great; others, worse."

Carder warns that pain can prevent necessary deep breathing, movement and sleep.

"Don't be afraid to ask for sufficient pain medication," she says. "Drug addiction almost never happens because of surgery and you must move."

Attitude plays a big part in the recovery process.

"For some patients, coping with recovery is straightforward; others deal with many mood swings," Siebens says. "Find someone to talk to about your feelings. If depression persists, seek some help."

More ways to a speedy recovery include:

* Psyche yourself up and remember the big picture.

* Learn what signs of infection look like.

* Know the side effects of your medicines.

* Have telephone numbers handy for medical personnel who can answer your questions. A good number to have is that of the nurses station of the hospital floor you stayed on. Someone who may be familiar with your case is there 24 hours.

* Keep post-operative instructions handy for you and anyone assisting you.

* Watch your fatigue level.

* If you're walking with crutches or a cane, use a carpenter's apron with many pockets to help carry things. A patient using a walker can attach a basket.

* Stick to your doctor's recommendations regarding exercise. Overdoing it can hurt you.

* Encourage non-stressful visitors. Talk to people who will make you laugh. When someone asks what they can do to help, tell them.

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