Wellness
Wellness/Patient Care

1.  Preparing for Surgery

Thank you for choosing to have surgery with Dr. Wittig. 
Please read below in order to best prepare yourself for your upcoming procedure.   

During the weeks before your surgery, begin exercising under a physician’s supervision:  It is important to be in the best possible physical condition for your surgery. If you are undergoing lower extremity surgery, special exercises to increase your upper body strength will help you use a walker or crutches in the early days after surgery. No matter how safely surgery is performed, it involves trauma to the body.   People who have healthy habits are often better able to handle it.   People, who prepare both physically and mentally for surgery, have quicker recoveries, less pain, and fewer complications.
Remember to:
1. Exercise and Be Active
2. Limit alcohol
3. Stop smoking:  This is a good idea at any time, but particularly before major surgery in order to help reduce the risk of postoperative lung problems and improve healing.
4. Maintain a healthy weight and choose healthy foods.  Foods that are rich in protein will help your body heal after surgery.

More resources to help you prepare:
PDF – PreOp Checklist
PDF – Surgery Manual
Links:
http://www.webmd.com/healthy-aging/ss/slideshow-surgery-prep-10

2. Recuperating from Surgery

Be aware, recovery takes time. Expect to feel a bit more tired than usual for a few weeks. Your surgery is a major event. Give yourself time to regain your strength and self-confidence. Stay active – just don’t overdo it! You will notice a gradual improvement over time in your strength and endurance.

By the time you come home from the hospital or are transferred to a rehabilitation center for further therapy, you should be eating a normal diet, high in protein. Dr. Wittig may recommend that you take iron and vitamin supplements following surgery. Continue to drink plenty of fluids and avoid excessive intake of vitamin K if you are taking the blood-thinning medication Coumadin (warfarin). Foods rich in vitamin K include broccoli, cauliflower, brussel sprouts, liver, green beans, garbanzo beans, lentils, soybeans, soybean oil, spinach, kale, lettuce, turnip greens, cabbage and onions. Try to limit your coffee intake and avoid alcohol altogether. Consider supplementing your diet with nutritional shakes such as Ensure, especially if you are having difficulty eating.

Your nutrition plays a key role in proper healing and can aid in relieving constipation.

3. Constipation/Diet After Surgery

Surgery patients are prone to constipation for multiple reasons.  If you are more prone to constipation, Dr. Wittig may ask you to start taking a stool softener (Colace) and a laxative (Senekot) several days prior to your surgery.  You will also be given these medications while the hospital and will be instructed to take them at home if you are continued on pain medication.

The primary reason for constipation after surgery is that the prescription drugs given for pain relief can cause constipation. If you must take large or multiple doses of pain medication or you have taken the pain medication for an extended period of time, you will be at risk for constipation.

Food and Drink After Surgery: As part of your preparation for surgery, you may have been instructed not to eat or drink after midnight. After surgery, you may have been told to drink minimally and perhaps not eat at all for a day or two. The combination of too little fluid and no food intake can work against your body’s normal routine of elimination.

Too little fluid in the body means less fluid in feces, resulting in hard, dry stools. Food works to stimulate the digestive system and keep things moving along. With no food being eaten, the “food in, food out” mechanism doesn’t work.
Your dietary choices, along with your intake level, also may have changed after surgery. Even the food provided in the hospital may be a major change from your normal diet and can cause constipation.

Inactivity: Getting up and walking or being active is one of the triggers for a bowel movement. Suddenly spending most of your time in bed resting can help to trigger a bout of constipation.

Anesthesia: Most patients think of anesthesia as something that puts us to sleep. Anesthesia, though, also paralyzes the muscles: your intestine is paralyzed during surgery along with your arms and legs. This stops the muscle contractions to push food along the intestinal tract. Until your intestines "wake up" there is no movement of feces. (About.com – Surgery)

Links:
Eating Tips

4. Wellness Beyond Surgery

Combined with healthy eating, cross-training exercising is a great approach to get you back to a healthy level after surgery and beyond the cancer treatments.  Exercise can decrease the risk of cancer recurrence as well.

A slow and steady progression are the best ways to start exercising again.  Walking, yoga and weight training are three exercises to consider for your ‘cancer fitness program.'
Walking is a light exercise that can be done at any time and any where.  It offers physical, emotional and social benefits that can help through recovery.
Yoga, considered an alternative medicine practice, is a good way to improve your strength and flexibility after cancer treatment/surgery.  Yoga is a whole body exercise that focuses on the mind, body and spirit.  Improved mood, circulation and sleep as well as increased flexibility and balance keep you in the optimum space for wellness.  Meditation, a component and aspect of yoga, allows your body to be still and absorb the stillness to ease your mind.
Weight Training - Often, muscle mass is lost during traditional chemotherapy and radiation therapies.  Building it back up will strengthen your body and increase your energy level.  
Swimming is also a great form of exercise while recuperating from surgery.  Dr. Wittig may recommend formal aquatherapy or general swimming if you have access to a pool.

Links
Exercise

5. Hackensack Fitness and Wellness Center – Information coming soon.



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