Are you Strong for Surgery?

During surgical residency - a long, sometimes arduous five year apprenticeship in the art and science of surgery - we would often remind ourselves that "its a marathon, not a sprint." The long hours, the deluge of information, the pressures: if you weren't focused and prepared, you were not going to thrive.

Being a surgical patient is similar in some ways (but thankfully, very different in other ways!) A patient who will need an operation also needs to be focused and prepared for the operation ahead. This is where the "Strong for Surgery" idea comes into play. The "Strong for Surgery" program was developed as a public health initiative in Washington state in 2012. The idea was to identify modifiable risk factors to prepare ​patients for their operation so they may have the best possible outcomes. Modifiable risk factors are the things one can change. You can't really change your gender, your race, your family history, or your diagnosis, but you can change whether you're a smoker and you can improve your nutritional status, among other things. The "Strong for Surgery" program gives surgeons and their patients checklists and tools to work on these modifiable risk factors, and just like training for a marathon, get focused and prepared for the challenges ahead.

The four items outlined in the "Strong for Surgery"plan are:

1. Eat Well

2. Quit Smoking

3. Blood Sugar

4. Medicines

Eat Well

  • Eat foods that will help your body heal. Good choices are protein-rich foods, whole grains, fruits,

vegetables, and dairy products.

  • Eat at least three times a day. Don’t skip meals.

  • Include protein-rich foods with each meal. Some healthy choices are lean meat, fish, poultry, beans, eggs, cheese, nuts, tofu, milk, cottage cheese, yogurt, and protein drinks.

  • Drink at least 6 to 8 eight-ounce cups of fluid each day to stay well hydrated.

  • Add a daily protein drink if you cannot eat enough food. (https://www.facs.org/~/media/files/quality%20programs/s4s/nutrition_before_surgery.ashx)

Quit Smoking

Smoking increases the risk for many problems after your operation. It can:

  • Make it hard for you to breathe

  • Make an infection in your wound (incision) more likely

  • Increase your chance of having a heart attack (https://www.facs.org/quality-programs/strong-for-surgery/patients/quit-smoking)

Blood Sugar Control

If you have diabetes, you know how important good blood sugar control is. Your surgeon needs to know what your recent blood sugar test results have been. On the day of your operation, your surgeon should check your blood sugar before your operation.

Having surgery puts stress on your body and stress can affect your blood sugar level. Blood sugar that is too high or too low can cause serious problems. Keeping blood sugar in control before, during, and after your operation will reduce your risk of infection in your incision and will help you heal better.

Even if you haven’t been told you have diabetes, your surgeon may want to check your blood sugar. Many people have high blood sugar and don’t know it. (https://www.facs.org/quality-programs/strong-for-surgery/patients/blood-sugar)

Medicines

Anticoagulants, antiplatelet agents, aspirin, beta-blockers and other heart or blood pressure medicines, and even herbal supplements: all of these can make a difference on a patient's surgical outcomes. Some of these medicines should be continued, others should be stopped, and only by having all of the information, can the correct plan be formulated. (https://www.facs.org/~/media/files/quality%20programs/s4s/medication_checklist.ashx)

Bottom Line:

There are some simple ways to get prepared and focused for running a long race, whether it is an operation, or 26 miles of pounding the pavement. Let your surgeon be your coach and get Strong.

To learn more, check out www.strongforsurgery.org

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