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Should You Try ‘Prehab’ Before Surgery?

Just as you would get in shape for a marathon—eating right, exercising more—it makes sense to prepare before heading into elective surgery. Our primary care doctors in Delray Beach are proponents of this kind of pre-surgery preparation and for good reason.

The concept is called “prehabilitation,” as opposed to the typical rehabilitation that takes place following surgery. Numerous studies have shown it can help you recover faster from an operation. In some cases, prehab can help postpone the need for surgery or even help you avoid it altogether.

Prehab gaining more attention

What began several years ago as an effort to help candidates for orthopedic surgery soon spread to other types of non-emergency surgeries such as those for cancer. Doctors recommend it for individuals undergoing chemotherapy or radiation.

“Prehab could be a relatively cheap way to get people ready for cancer treatment and surgery, both of them stressors,” Francesco Carli, a professor of anesthesiology at McGill University in Montreal, told NPR radio.

He co-authored a study that found that 84 percent of prehab patients returned to normal functioning in six weeks. This opposes just 62 percent of patients who got the only rehab after the fact.

The American College of Surgeons says, “Generally, the more fit and active you are going into a surgical procedure, the more likely you are to retain a higher level of function after.”

The Royal College of Physicians says, “Prehabilitation prepares individuals to ‘weather the storm’ of their operation and to avoid or overcome complications.”

Benefits of prehab

A study published last year in the American College of Surgeons’ journal found that 523 patients with prehab care across the state of Michigan left the hospital one day earlier than those who didn’t participate, and were more likely to go straight home rather than to a skilled nursing facility.

With the right kind of prehabilitation program, research shows you may be able to:

  • go home sooner after your operation
  • better manage any postoperative pain or side effects
  • have fewer side effects
  • recover faster

In addition, prehab can give you more of a feeling of control over your health, helping you better cope with the physical and mental stress of surgery, and recover sooner afterward.

What is involved?

The type of prehab you undertake largely connects to the type of surgery you’re facing. In general, it involves improving your physical stamina and mental outlook.

The typical approach may involve:

  • improving your diet to focus on healthier foods
  • lifestyle changes such as stopping smoking and reducing alcohol consumption
  • increasing your physical activity to improve muscle tone and cardiovascular health
  • performing specific training exercises
  • increasing your mental wellbeing

Other parts of prehab that may apply include the types of interventions that typically occur after surgery.

Depending on the type of operation you’re contemplating, this could mean you might receive coaching in how to use such devices as a wheelchair, walker, or crutches. Or you could practice the types of exercises you’ll need to do during your recovery. This time before surgery can even be used to prepare the home for your return. This includes installing handrails, ramps, or grab bars.

One well-known key to the success of the surgery and rapid recovery afterward is a positive mental outlook. Doctors encourage patients to practice relaxation techniques such as mindfulness meditation. This can help reduce any preoperative anxiety and depression.

Unexpected benefits

These types of improvements to your overall health might even allow you to postpone your surgery if they result in improvement in your condition.

For example, significant weight loss could relieve the pressure on joints enough that you might be able to go longer without a knee or hip replacement, or even ultimately decide it’s not necessary.

On the other hand, some patients are not deemed good candidates for certain types of surgery. This is because of their poor physical condition. A good prehab program may be able to improve heart or lung function enough to make a person eligible for life improvement or even life-saving surgery such as an organ transplant.

How to get prehab care

The concept of prehabilitation is still relatively new, so not all hospitals offer it, nor does all insurance cover it.

“Insurance can be one of the most difficult obstacles for prehab patients,” physical therapist Steve Sylvester, Ph.D., told the Arthritis Foundation (AF). Sylvester is an assistant professor of health and human performance at Palm Beach Atlantic University in West Palm Beach, Florida.

“Physical therapy coverage often is limited to six weeks total—including prehab and rehab—or prehab may not be covered [at all].”

AF recommends checking with your hospital prior to your scheduled surgery to find out whether they offer prehab. Sometimes it is a free part of their pre-surgery education course.

Or you may be able to schedule a few appointments with a physical therapist. They can help develop a regimen that you can do on your own.

Whether or not you can obtain formal prehab care, talk to us before any elective surgery you’re facing. We may be able to suggest ways to help you “weather the storm” of pending surgery.

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