Preparing for surgery

Exercise is good for your body and for your well-being. Research has found that patients who are more fit and active before surgery develop fewer complications. You should try to increase your fitness before surgery to help you recover afterwards. You can choose from a many kinds of exercise but you should aim to get mildly short of breath during the activity. Exercise may include walking, swimming, exercise classes or cycling. We advise at least 20 minutes of exercise every day, the amount of exercise possible will differ from person to person. You should also climb the stairs, instead of using escalators and lifts. You may be referred to exercise and education classes to prepare you for surgery. We have a DVD for our patients available from our nurses and doctors. The exehttps://www.thoracicsurgery.co.uk/exercise-videos/rcises can also be accessed on this website.

If you smoke it is very important to stop as soon as possible. This will increase your ability to heal and your ability to recover from the anaesthetic. Stopping smoking will also reduce your risk of complications and increase your survival. Help to stop is available from your local NHS stop smoking service. Talk to your doctor or nurse about which service is best for you, or visit http://www.nhs.uk/smokefree. If you really cannot stop completely try to reduce the amount you smoke as much as possible.

Aim to be a healthy weight and have good nutrition before surgery. This helps you  recover and reduces complications. Your appetite may be low straight after the operation but should improve with time. Drink plenty of fluids and have a balanced diet. If you are underweight, ask to see a dietitian before your surgery, as you may need supplements.

Each day try to eat:

• Fruit and vegetables – at least five portions a day (a portion is about the same size as your own fist)
• Bread, rice, potatoes, pasta and other starchy foods. Choose wholegrain varieties whenever you can.
• Some milk and dairy foods.
• Some meat, fish (two portions a week), eggs, beans and other non-dairy sources of protein.

Limit the amount of alcohol you drink and do not exceed 14 units per week. Alcohol may interact with medications so check the label and with your doctor.

More advice from the NHS about healthy eating and alcohol can be found at www.nhs.uk/Change4Life/Pages/healthy-eating.aspx

More advice from Macmillan about healthy eating and lifestyle can be found at www.macmillan.org.uk/information-and-support/coping/maintaining-a-healthy-lifestyle

You will get an appointment for the pre op assessment clinic before surgery. This is to assess your overall health before surgery and find any issues before coming to hospital. The appointment and tests will take a few hours.  At this clinic you will be asked questions about your health, allergies and any medications you are taking. Your nurse will usually need to listen to your heart and lungs.  Please bring all your usual medications, we will advise you which medications to take on the day of surgery and if any need to be changed before surgery.

You will have the following tests:

• ECG (heart tracing)
• Blood samples
• Blood pressure, pulse, temperature and oxygen levels
• Height and weight
• Swabs for MRSA
• Many people also need a chest X ray

You will be given advice about not eating and drinking for a certain length of time before your surgery, it is important to follow these instructions.

Almost everyone is admitted on the day of surgery. Sometimes you may need to be admitted sooner to make sure you are ready for surgery. For example, if you take warfarin for a replacement heart valve and need to have blood thinning medication (heparin) when the warfarin is stopped.

Most people are invited to take part in research. You do not have to do this, it is voluntary. Taking part may help others in the future and many of our patients who have taken part in research feel good about it.

If you are being admitted for an emergency operation your pre op assessment will be done on the ward. We will ask about health, medications and allergies. We will examine your chest and chest drain, if you have one. You will have a blood test and heart tracing. We will check your previous X rays and scans.

The treatment options will be explained, please ask us any questions you may have and check anything you do not understand. Sometimes it may take a few days to see if an operation is the best treatment and which operation would be best. Once you are happy you understand what is being offered and want to go ahead, you will be asked to sign a consent form for the operation to take place.

It will help reduce stress to have your home ready to go back to. You may find the following checklist helpful.

• Stock up on food that will not go off. Such as tea, coffee, sugar, tins, dried food, frozen food
• Cook extra portions and freeze them for later
• If you live alone, arrange for a relative or friend to stay with you, or stay with them until you feel strong enough to be on your own
• Arrange for a relative or friend to call during the day to check if you need anything
• Make sure you have a good supply of your regular medications
• If you have young children, arrange help to care for them for at least the first week after discharge, or until you feel strong enough
• Arrange for a friend or relative to care for your pets e.g. feeding the cat
• Make sure you have cleaned comfortable clothes and bedding

 

Please bring the following items in a small bag with you when you come into hospital:

• All tablets that you are taking, in the correct containers
• Night wear/dressing gown/slippers. You may prefer to wear clothes such as a jogging suit
• Tissues
• Washbag and toiletries
• Squash to drink, nothing fizzy
• Walking aids – frames/sticks/crutches, false limbs, these should be labelled with your name, address and hospital number
• Hearing aids/glasses labelled with your name, address and hospital number
• Something to occupy your time – magazines, books, music
• A small amount of money to buy newspapers or use the telephone

• Do not bring in large amounts of money or valuables
• Remove all nail varnish on fingers and toes
• Remove all body piercings and leave at home

It is normal to feel anxious before an operation, we are happy to discuss anything that is concerning you. If surgery is recommended it is always your choice to go ahead, you can change your mind at any time. Please contact us if you are unsure, need further time or wish to choose another treatment.