Smorgasbord Health Column – New statistics on #surgery recovery that are shocking and preparing for an operation.


I have known about the risks of surgery for many years and have experienced them first hand with my mother. Her original hip replacement at 72 failed in her late 80s requiring a replacement. It was painful from the time she came home and after six months it dislocated and she was rushed to hospital to have a new and larger ball put into the socket.

This was one of the headlines this week that makes for shocking reading, but to be honest it is not all that surprising. Yes there are botched operations, mainly in the seemingly unregulated cosmetic industry, but many surgeries are emergency interventions in life-threatening circumstances.

This means that people are already ill, are likely to have compromised immune systems, are suffering from loss of blood after injuries or are very young or very elderly and therefore vulnerable. That makes life-saving surgery all the more risky.

Surgery kills more than HIV, TB and malaria COMBINED: Operations are the ‘neglected stepchild of global health’ after too much money has been pumped into infectious diseases

Summary

  • Every year, 4.2million people die worldwide within 30 days of surgery
    This is a staggering 1.23million more deaths than HIV, TB and malaria combined
    Makes up 7.7% of all fatalities – with only heart disease and stroke killing more
  • An analysis of data from 29 countries by the University of Birmingham revealed a staggering 1.23million more die after going under the knife than from HIV, TB and malaria combined.
  • Overall, 7.7 per cent of all fatalities worldwide occur within 30 days of the deceased going under the knife – with only heart disease and stroke being bigger killers.
  • ‘Postoperative complications’ – such as bleeding and infections – are thought to be behind most of these deaths.
  • The researchers claim surgery is the ‘neglected stepchild of global health’ after too much money has been pumped into treating infectious diseases.

You can read the rest of the article Surgery more people than HIV TB and Malaria combined.

I think it is fair to say that most of us are not happy to be told we need an operation, but since the average waiting list in the UK for an elective surgery is around 18 weeks, we have time to help make a difference to both the risk to our body during surgery and our recovery afterwards.

One of my roles over the years is to prepare some of my clients for surgery.  There are risks to any procedure, but you can make a difference to the level of these risks if you are a healthy weight, have normal blood pressure and boost your immune system.

With the best will in the world, and the best efforts of the NHS, it is still likely that you will be added to a lengthy waiting list for a non-urgent procedure. For most of us this can be a worrying time and the longer you have to wait the more stressful it can become. However, you could look at this period as a positive opportunity, to not only improve your general health, but also reduce the small but nevertheless normal risks of both anaesthesia and post- operative infection.

There are three areas that you can focus on for the weeks or even months before your operation and it is as easy as changing foods in your diet and improving some of your lifestyle choices. It is important to give up smoking and to reduce your alcohol intake. In the two weeks prior to the operation you should stop drinking alcohol completely.

1. Weightloss

The nearer you are to your optimum weight the less risk there will be from anaesthesia. There are some practical issues to address. You are going to require more anaesthesia the heavier that you are, and this can affect your recovery immediately following the procedure. If you are very overweight and going to be on your back on the operating table for some hours, the pressure of fat in the chest area will compromise your breathing. The need for intubation is dramatically increased for obese patients as is the pre-operative work up which has to include far more tests than those undertaken for less overweight patients.

If you are scheduled for joint replacement, particularly hip or knee joints, losing weight ahead of your operation will improve your recovery time. For many patients it is the additional stress on the joints from being overweight which has caused the wear and tear in the first place.

2. Boosting the Immune System

In the last two or three years there has been a steady decline in recorded numbers of MRSA and other post- operative infections. In many cases the patients concerned have been high risk having suffered long term ill health, being elderly and malnourished, or very young. If you have a number of weeks notice before a stay in hospital then you can take steps to boost your immune system giving your body every chance to not only speed recovery but also avoid contracting an infection. The body requires a very broad spectrum of nutrients to fuel the thousands of chemical reactions going on in the body at any moment in time but there is a specific range of nutrients that are essential for a healthy immune system and I give you an example of some of the foods to include later in the post.

3. Reduce high blood pressure and unhealthy low density lipoprotein cholesterol.

Modern anaesthesia practices are very sophisticated and if a patient has high blood pressure it will be monitored throughout the operation to ensure the safety of the patient. There are millions of middle aged patients who are currently on blood pressure medication and you should always continue taking that medication right up to the time of the operation and you will be advised of any changes to the dosage when you are admitted to your ward.

Having said that one of the desirable side effects of losing weight before your surgery will be a probable reduction in your blood pressure. The more stable and nearer to normal levels that your blood pressure is, the less risk of complications during and after the procedure. You are also likely to be taking pain medication following your operation and there is always drug interactions to be considered. You must however, not take yourself off any medication without the support and advice of your doctor and you can discuss this with him after losing weight and improving other lifestyle related risk factors affecting your BP.

Usually patients who are suffering from high blood pressure have also elevated LDL cholesterol levels. Reducing your cholesterol to as normal levels as possible will have a knock on effect on your BP.

A pre-operative exercise plan

It is likely that you are not at your most active during the weeks leading up to your operation, but there are armchair exercises and also breathing exercises that can help you lose weight and your doctor’s surgery should be able to advise you on these. I have a breathing programme that is easy to complete a few minutes each morning and night that does not require you to become over energetic and you can adapt for your particular health issue.

This post tells you more about the benefit of breathing efficiently and the exercises that will help you achieve that: https://smorgasbordinvitation.wordpress.com/2017/04/25/lets-walk-a-marathon-internal-fitness-programme-day-two-getting-enough-oxygen-to-walk/

A pre-operative eating plan.

This eating plan is based on 1500 calories per day but if you are male then you will need to add another 300 calories in the form of wholegrain carbohydrates and lean protein. It is better to eat 3 moderate meals with 3 small snacks rather than eat 3 large meals per day. Your body will process the food more efficiently and your metabolism will remain stimulated throughout the day aiding weight loss.

It is very important that during this plan that you restrict your intake of industrialised factory foods completely as most are both salt and sugar laden, even if they say they are fat reduced and healthy. If you find that you have to use prepared food in any way then ensure that it is low salt. Be aware that hams, bacons and other processed meats are very high in salt usually and will elevate blood pressure even further.

Prepare your own foods from scratch and put a level teaspoon of salt in a small dish and this is your cooking and seasoning allowance per day. Try to move away from sugar and sweeteners and if you enjoy honey then try Manuka honey which you only need a very small amount of. Manuka is the subject of ongoing scientific research and has been shown to have anti-bacterial properties.

The foods

This is just an example – any fresh fruit, vegetables, lean protein that you enjoy is fine. Cook from scratch and if you are only eating around 20% of your foods from processed sources you should be fine.

Whole grains containing Biotin, Vitamin E, Co-enzyme Q10, phosphorus and manganese to boost the immune system. Fibre to help reduce blood pressure and cholesterol.

Per day

  • At least one bowl of porridge or muesli once a day. (4 tablespoons)
  • 2 slices of multi-grain bread (4 if you are male)
  • 4 tablespoons of cooked whole grain rice (6 if you are male)

Fresh fruit and vegetables containing Beta-carotene, Vitamin C, Vitamin E, Bioflavonoids, Potassium, manganese and tryptophan to boost the immune system.

Per day

  • I glass of fresh squeezed orange juice
  • 1 bowl of fresh fruit salad made with pineapples, blueberries, kiwi and fresh apricots
  • 1 banana per day.
  • ½ avocado
  • Carrots
  • Broccoli
  • Any dark green vegetables.
  • Walnuts or Brazil nuts
  • Sunflower seeds or pumpkin seeds

 

Protein containing Vitamin A, Biotin, Vitamin D, Vitamin E, Co-enzyme Q10, phosphorus, Potassium, Iron, Selenium, Zinc to boost the immune system

  • Egg
  • ½ pint of fresh milk Cow’s or goats
  • Butter
  • Olive oil
  • Cheese even a small square or used in cooking.

Three times a week. (Spread over breakfast, lunches and dinners)

  • Chicken or Turkey (four times a week if you are male)
  • Salmon or sardines
  • White fish
  • Calves liver
  • Prawns
  • Lamb or beef
  • Pork

Fluids

Start each day with juice of half a lemon and hot water this will help boost the immune system, alkalise the body and get the digestive system kick started.

Apart from fresh juices such as orange, apple and cranberry drink (you can buy some brands that are just juice and you only need a small glass) at least 4 cups of Green Tea per day which boosts the immune system and helps reduce both blood pressure and cholesterol.

Also Red tea with citrus or any other herbal tea that tastes good.

Tap water to make fluids up to 2 litres per day.

I hope that if you are facing an operation at some point in the future that you will look on it as an opportunity and by taking action beforehand you can save yourself weeks and possible months in rehabilitation. Getting fit before an operation may also save your life.

©sally cronin Just Food for Health 1998 – 2019

A little bit about me nutritionally.

I am a qualified nutritional therapist with over twenty years experience working with clients in Ireland and the UK as well as being a health consultant on radio in Spain. Although I write a lot of fiction, I actually wrote my first two books on health, the first one, Size Matters, a weight loss programme 20 years ago, based on my own weight loss of 154lbs. My first clinic was in Ireland, the Cronin Diet Advisory Centre and my second book, Just Food for Health was written as my client’s workbook. Since then I have written a men’s health manual, and anti-aging programme, articles for magazines and posts here on Smorgasbord.

If you would like to browse by health books and fiction you can find them here: https://smorgasbordinvitation.wordpress.com/my-books-and-reviews-2018/

 If you have any questions then please do not hesitate to ask in the comments.. or if you prefer send in an email to sally.cronin@moyhill.com