Facing Surgery? Read this Surgeon’s Advice First

You’ve just learned that you need a surgical procedure. It gives you pause to think, or at least it should. “I tell my patients, ‘No marathon runner wakes up and runs a marathon. They train for three months prior.’ It’s the same thing with surgery,” says Jose M. Martinez, M.D., FACS, a general surgeon and chief of the Division of General Surgery at the University of Miami Health System. 

If a runner wants to win, they prepare. 

To achieve the best possible outcome from an elective or planned surgery, you must also prepare. And while no one can plan for an emergency or urgent procedure, improving your overall health improves your chances of a better outcome. 

First things first

People with diabetes, obesity, heart or lung disease, or other chronic conditions should “always improve your disease condition first,” says Dr. Martinez. “If you haven’t seen your doctor in a while, get evaluated to see where you’re at. Is your blood sugar or heart rate too high?”

Consider your medications

When you speak to your doctor, tell them about your upcoming surgery and ask if there are possible risks associated with any medications you might be taking. Blood thinners, platelet therapy, and/or anticoagulants are commonly prescribed and can increase your risk of bleeding during a procedure. That doesn’t necessarily mean you should stop taking them. “The biggest problem occurs when patients stop taking medications without telling anyone,” he says. “If you stop your medication, you may end up with a heart attack or stroke in the middle of surgery. You should weigh the risks versus benefits with your surgeon and/or prescribing doctor before stopping any medicine,” says Dr. Martinez. He warns that immunosuppressants, commonly prescribed for transplants, inflammatory bowel disease, and certain forms of arthritis, can also change your bleeding and healing profile. 

Basically, if you take “anything other than a daily over-the-counter vitamin,” tell your doctor. That includes herbal supplements.

Do your body a favor

“Going into surgery with extra weight increases the risk of complications such as pulmonary embolization (a blood clot in an artery of the lung). There are fewer issues during surgery if you’re fit,” says Dr. Martinez. Many surgeons require patients to lose weight before agreeing to elective surgery. In fact, some people can avoid surgery for obesity-related problems such as joint or back pain by losing enough weight and following a healthy lifestyle. 

Speaking of healthy lifestyles, smoking has no place in your life. 

“Tobacco creates significant negative outcomes, including complications with wound and tissue healing. If you can’t stop smoking, you should reconsider whether you should have the surgery at all.” 

Smokers are also more likely to experience complications if they have a medical device implanted. 

Another way to benefit your body before surgery is to reduce or stop drinking alcohol. Cleaning up your diet also helps. 

Your doctor will provide pre- and post-operative dietary guidelines. Most surgeries require fasting; even if you’re famished after your procedure, stick to clear fluids or ice chips for several hours afterward to reduce nausea. Once you’re cleared for solid foods, ask your nurse or surgeon if it’s okay to eat protein to help your body heal and high-fiber foods to counteract constipation, a common side effect of pain medication. 

You may not be overweight or use tobacco, but if you’re older or elderly, carefully evaluate the pros and cons of any procedure. “Elderly individuals have a higher risk of pneumonia. Age also affects the impact of anesthesia on your body and your recovery,” says Dr. Martinez.

Manage your expectations

You might be so focused on getting through the surgery you haven’t had time to think through what’s involved. Patients need to communicate clearly with their surgeon because, as Dr. Martinez says, “Surgeons aren’t very communicative about post-operative expectations about pain. You are going to be in pain or discomfort. The contour of the skin also changes around wounds or incisions; tissue fibers often take six to nine months to heal fully.”

He also finds that patients often need clear expectations of what the surgery will achieve. 

Downtime is another concept that needs to be understood. 

“One hour of anesthesia makes you weird for about three weeks after surgery. Don’t overbook your days the first week you return to work. Ask your surgeon, ‘How much time should I take off?'” 

That said, each individual is different. You may want to pad your recovery time with a few extra days, just in case, and line up help – from family, friends, neighbors, and/or a home health agency. Simple tasks you take for granted – walking the dog, shopping for groceries, picking up a squirming toddler – could be risky when your body has just had surgery. 

Surgeons must focus on the highly technical task at hand; they can only anticipate or answer some of the questions that may come to mind after you leave their office. 

“Patients should ask their doctor who they can contact if they have any questions or concerns prior to and after a procedure.”

Share your health information

Don’t assume your surgeon has access to all of your medical records. 

“I can’t just call another doctor in another health system because of HIPAA privacy protocols. The patient has to be the messenger,” Dr. Martinez says. 

Tell your primary care provider and other specialists about your upcoming operation and share pertinent health information with the surgeon. He or she needs to know about your medications, drug allergies, previous surgeries, and chronic health conditions. 

The mind-body connection

“The value of Eastern medicine was not at the forefront of surgical education in prior decades but certainly has increased in more recent years. Employing all possible treatment approaches is valuable. Having the mind be in a different state allows us to heal differently,” says Dr. Martinez. 

Meditation, yoga, prayer, positive affirmations, and having a support system help calm the nervous system and counteract the “cascade effect” that stress hormones and a racing heart rate have on the body. 

Figure out the financials

Worrying whether insurance causes many Americans great concern.

“Contact your insurance company and tell them which doctor is going to perform which specific surgery at which facility. The doctor’s practice or office manager can give you the procedure code or number to share with your insurance company.”

In general, if your insurance covers a provider, the procedures should be covered, but every person’s insurance is different, he says.

You could also speak to your human resources department if you are insured through your employer. Uninsured individuals should speak to the hospital or surgical center’s billing office to inquire about available financial aid or payment plans.

With so many moving parts – insurance, medical records, communicating with different doctors, medication management – getting your health where it needs to be before surgery may seem like one more hurdle. 

Dr. Martinez simplifies the process. “You check all the systems in your car before going on a road trip.” It makes sense to be sure all of your body systems are functioning properly before making that trip to the operating room. 

Nancy Moreland is a regular contributor to UMiami Health News. She has written for several major health care systems and the CDC. Her writing also appears in the Chicago Tribune and U.S. News & World Report.

Tags: before surgery, Dr. Jose Martinez, general surgery, surgical procedures