Want a Better Surgical Outcome? ‘Train’ Like an Athlete

March 09, 2017 7:00 AM

Simple prep steps can help some surgery patients recover more quickly. A Michigan Medicine-developed plan mirrors how athletes ready for competition.

When it comes to surgery, your medical team is prepared. For optimal results and recovery, your body should be, too.

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Michigan Medicine transplant surgeon Michael Englesbe, M.D., likens the concept to athletic training.

“If you’re going to do a 5K race, you would train,” says Englesbe. “Surgery is a lot more taxing and stressful, but we don’t train our patients in the way that any of us would train for an athletic endeavor.”

Which is why he and his colleague Stewart Wang, M.D., Ph.D., FACS, have spent nearly a decade studying how small lifestyle adjustments before a procedure — typically over just 15 to 30 days — can have big effects.

Their ongoing effort, the Michigan Surgical and Health Optimization Program (MSHOP), helps patients target and lessen their weaknesses before surgery. The program has been implemented at 20 hospitals and 30 practices in Michigan.

A recent study indicates Englesbe and Wang’s longtime theory is correct: MSHOP patients who adhered to moderate changes in fitness, diet and mental health before surgery spent, on average, two fewer days in the hospital than those who hadn’t prepared at all. And, the study also found, medical costs for the former group fell 28 percent.

Beyond these tangible benefits, such measures can supply emotional comfort.

“It’s a way to feel empowered during a scary time,” says Englesbe, who explained some of the elements of presurgical “training” (the tips are beneficial after surgery, too):

4 ways to 'train' for surgery

Get moving: The pillar of the program: exercise. “You don’t get stronger right after surgery,” Englesbe says. “But the more you can do to manage your functional status preoperatively, the quicker you’ll be able to bounce back.”

In MSHOP training, patients are given a pedometer and receive daily text messages to remind them to pick up their steps. The effort, which advises logging 12 miles per week, adds up to about an hour of walking per day, Englesbe says.  

Eat right: Would a star player binge on junk food before the big game? Probably not. Protein is key to building lean muscle mass, so a healthful high-protein diet can help ensure your body is at its strongest. People with diabetes also should have their blood sugar under control first.

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To what extent food plays a role in surgical recovery isn’t certain, Englesbe says. Still, he stresses that improving diet — no matter how late in life — is “a great way to feel like you’re doing something positive.” Of course, it’s vital for staying healthy in the long term.

Quit smoking: Kicking the habit is crucial. Smoking “increases all kinds of complications” during surgery, Englesbe says. “We encourage all smokers to quit.” MSHOP provides tobacco cessation literature to help.

Some discretionary surgeries, he adds, are often withheld until an individual quits for good. And, just as with changing one’s diet, permanent abstinence from smoking can help head off other future problems.   

Plan ahead: Patients can unnecessarily stress themselves with worries of burdening others during their hospitalization and recovery. It can be challenging to ask for, or accept, help, but having a plan benefits everyone. Pro athletes, after all, need coaches and trainers.  

Says Englesbe: “We talk a lot about developing a care team … people who understand the journey could take weeks or months.” Knowing who might, say, help with pet care or provide rides to follow-up appointments can be a relief. Most family and friends are eager to step up.