Getting Fit for Surgery

Having an operation and the recovery afterwards have been compared to exercise because they place a strain on the heart, lungs and muscles. Physical activity and training help prepare your body for exercise and the same is true before an operation. Improved fitness levels allow your body to cope better with the physical stress of surgery and will reduce your chances of complications.

The benefits of improved fitness before surgery include:

• A better recovery
• Leaving hospital sooner
• Returning to a normal quality of life more quickly
• Reducing your risk of heart disease, stroke and diabetes
• Improving blood pressure control and cholesterol levels
• Helping with weight control
• Reducing anxiety and stress

What to do

If you are normally an active person, we would encourage you to continue doing the activities

that you enjoy before your operation. If you are normally less active, the good news is that it’s never too late to start seeing benefits from regular exercise. The even better news is that you don’t need to do much and every little helps. You should increase what you do gradually, but as little as 30 minutes, 5 days per week is enough to improve your fitness.

You should be exerting yourself hard enough so that your heart rate goes up and your body feels warm. So why not find something that you enjoy and make a start today? Get your friends and family involved, or join a group, to make it even more enjoyable and help you stay motivated. It is important to increase the amount of exercise you do gradually. If you have a heart or lung condition, or have any concerns, speak to your GP, surgeon or pre-assessment nurse before starting an exercise program. For more information see the NHS Inform Keeping Active webpage.

In order for your body to recover from surgery, it needs the right energy and nutrients. A healthy balanced diet is important to help prepare your body for surgery.

You should aim to eat three regular meals with a good balance of the food groups – protein, carbohydrates and healthy fats. Try to avoid adding any extra sugar or salt to your diet. For more information see the NHS Inform Eatwell Guide: How to eat a healthy balanced diet page.

Vitamins and minerals are crucial to recovery after surgery, for example iron, folate, zinc and vitamins A, C and K. Try to get as many different types as possible by eating a healthy balanced diet with a good intake of fruit and vegetables. Aim to eat 5 different portions each day.

Depending on why you’re having surgery, some people may actually lose weight without trying before their operation. It is important your body has good energy stores to recover after surgery. If you have lost weight without trying to, or have a reduced appetite, try these simple changes to stop any more weight loss:

• Eat little and often – try 5-6 small snacks or meals per day
• Take drinks after meals and not before
• Use full fat milk and full fat dairy products
• Add margarine or butter to mashed potatoes
• Add grated cheese and/or cream to soups and sauces

More information

If you want more information about a healthy balanced diet, and would like some delicious meal suggestions, then you can find more information on the NHS Eat Well website and British Dietetic Association website.

If you are a smoker, stopping, or even cutting down, before your surgery is one of the best changes you can make to improve your health. Smoking puts an additional strain on your heart and lungs and increases the risk of complications during and after surgery. Smoking increases the risk of problems during or after your operation.

Heart

• reduced oxygen supply to heart and body
• heart attack

Lungs

• difficulty breathing during or after surgery
• chest infection or pneumonia
• collapsed lung

Blood clots

• blood clots in your veins or lungs

Bones, skin and wounds

impaired healing and scaring

wound infection

Immune system

• increased risk of infection

Vaping

Vaping, or using an e-cigarette, is not as harmful as smoking cigarettes. However, we don’t yet know the long-term health consequences. Vape liquid still contains nicotine, which increases your heart rate and blood pressure and puts a strain on your heart. We would also advise avoiding vaping before your operation.

What you can do… The important thing is that stopping smoking before surgery reduces your risk of these complications. The longer before your operation you can stop, the better. However, even avoiding cigarettes in the last few days can help. An operation provides a great opportunity to improve your long-term health by stopping smoking. Perhaps it could be an opportunity to quit smoking for good?

Support to stop

Quitting smoking is not easy, but we are here to support you. Maybe you could also get your friends and family to help by stopping at the same time?

If stopping is something you are motivated to do, speak to your surgeon or pre-assessment nurse who can refer you to our smoking cessation service. They offer individual and group support, as well as a range of nicotine replacement options. For more information see the NHS Inform stopping smoking website.

Alcohol, like all things, should be enjoyed in moderation. You don’t need to totally avoid alcohol before your operation, but we would advise that you stay below the recommended maximum amounts.

For both men and women this is less than 14 units per week, with no more than 3-4 units on any single day.

This would be around one and a half pints of beer, or two small glasses of wine.

You should avoid alcohol in the 24 hours before your operation.

Medical conditions can affect your recovery from surgery. It is important to make sure any conditions you have are controlled as well as possible before your surgery.

Diabetes

Good blood sugar control is really important to reduce your risk of infections. Talk to your diabetes nurse early to see if they need to make any changes to your treatment.

Blood Pressure

Blood pressure should be controlled to reduce your risk of stroke. Have your blood pressure checked at your GP surgery in good time before your operation. Your GP can then change your medication if needed.

Heart, lung, and other medical problems

If you have any other long-term medical problems, consider asking your GP or nurse for a review, especially if you think your health is not as good as it could be.

Most people feel some anxiety about having surgery. If you are very anxious or upset, it may be helpful to talk about your concerns with your GP. Techniques including mindfulness, relaxation and breathing exercises or yoga could help you relax before and after your surgery.

If you have loose teeth or crowns, a visit to the dentist may reduce the risk of damage to your teeth during an operation.

Are you going to prepare your body as best as possible and get fit for surgery? Although it may seem daunting, it is possible to make a few small changes that will make a big difference.

We are here to support you through this challenging time. If you have any questions about what you’ve just read then ask your pre-assessment nurse, surgeon or anaesthetist who will be able to guide you further.

Up to 1 in 7 people get complications after surgery. This can include issues relating to their wound, heart problems, lung infections and confusion. They can also lose independence if they are in hospital for longer than needed. People who have heart and lung problems, have two or more long-term conditions, and those who are living with frailty are particularly at risk of complications.

Increased activity and improved lifestyle choices ahead of surgery helps reduce these complications. This means patients recover quicker after surgery and get home sooner.

You can use these 10 minute workout videos to help prepare for surgery.