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August 4, 2003

Ten Things You Absolutely Need to Know Prior to Surgery
Neil F. Neimark, MD

1. Be prepared--physically, mentally and emotionally--for your surgery. Extensive research tells us that the more prepared you are (in terms of knowing what to expect before, during and after the operation) the more smoothly and rapidly you will recover. By preparing yourself physically, mentally and emotionally you will minimize the potential complications you face, and most likely be able to speed your recovery, shorten your hospital stay, minimize your need for pain medications and reduce your anxiety before and after surgery. How do you prepare physically? Eat healthy, wholesome foods prior to the surgery. Consider taking a multivitamin and additional Vitamin C (1000mg a day) and Zinc (50mg a day). With your doctors' approval, get light exercise on a regular basis like a brisk walk or light calisthenics. How do you prepare mentally? Adopt the right mindset about why your participation is critical to a healthy outcome. You will read more about this in item 8 below. How do you prepare yourself emotionally? Get the support of friends and family. Read inspirational literature, pray or meditate. You can read more about this in item 7 and 9 below.

2. Learn as much as you can about your surgery beforehand. Ask your surgeon questions about what to expect in terms of recovery, potential complications and things you can do to prepare yourself. The more you know what to expect, the greater your ability to prepare for potential complications, pain and recovery. There is no question and the research clearly confirms that the more you know about your surgery, the greater opportunity there is for a speedy and healthy recovery. Talk to friends who've had the same operation. Seek information from the internet and learn all that you can.

3. Work closely with your surgical team. Communicate your needs, questions and concerns assertively but with respect. Don't be afraid to discuss all aspects of your treatment. The research clearly shows that the more prepared you are for surgery, the better your recovery will be. You may feel overwhelmed and out of control at the prospect of having surgery, but it is essential that you communicate your needs and fears honestly and openly to your surgeon and/or their nursing staff or educational staff. This is no time to take a back seat. Though you will be turning over your care to the skills of your surgeon, you are in charge of your state of mind prior to entering surgery.

4. Don't hesitate to get a second opinion before any major elective surgery. Many insurance companies require this. It is essential to your preparedness and ability to recover from surgery to know everything you can about your operation. There are often many different approaches and surgical techniques that can be done, so if you have any concerns at all, please get a second opinion. It is more than worth the extra time and expense.

5. Choose a surgeon you trust. If you are uncomfortable with something your surgeon says or does, ask questions and express your concerns. Most surgeons are happy to discuss things with you before the operation and their nursing staff is usually well prepared to answer all your questions. But you must be proactive and ask. This is no time to be shy or passive. All research shows that the more actively you participate in your surgery, the healthier your recovery will be. If you address your concerns with your surgeon and you are still uncomfortable with their answers, then seek a second opinion or consider choosing a different surgeon. Your health, your recover and your very life may depend upon it.

6. Ask your surgeon ahead of time if you're likely to need a transfusion. If you are, inquire about autologous blood donation, wehre you donate your own blood several weeks before the surgery.

7. Enlist the support of friends, family and loved ones to help reassure you emotionally and put you in a healthier frame of mind. Medical research shows clearly that social support is a key factor in activating our healing system, which is essential to healing post-operatively. If you are really frightened at the prospect of surgery, it is advisable to meet with a therapist or psychologist prior to surgery to discuss any irrational fears or anxieties you may have.

8. Prepare yourself mentally for surgery by having the right mindset. The best approach to preparing for surgery is described by psychologist Henry Bennett Ph.D., who says, ". . . think of yourself as an athlete training for a major event, rather than as a passive body being handed over to the surgical team." This participation in your own healing activates your healing system and better prepares you to reduce the difficulties and maximize the benefits of your upcoming surgical procedure.

9. Take 15 minutes every day for the week prior to your surgery to nurture yourself and have some quiet time for reflection. Stop being super-Mom, super-Dad, super-Kid, super-Friend or super-Lover and just take some time to relax and get in a quiet frame of mind. Meditate, pray or take a walk in nature. Take at least 15 minutes every day for the week prior to your surgery just to take care of yourself. Though the prospect of surgery is frightening, it can become an opportunity for quiet reflection and reassessing your goals and priorities in life.

10. Use a guided imagery tape prior to surgery, after surgery and--if possible--during the surgery itself. Recent studies verify that listening to a properly prepared guided imagery cassette tape prior to surgery can help bring about positive post-surgical outcomes in patients, including:
1) decreased blood loss during surgery
2) a shorter hospital stay
3) less anxiety
4) faster wound healing
5) decreased need for post-operative pain medication.

It is critical to know that not all guided imagery tapes are alike. Research has shown that simple relaxation tapes can actually make things worse. Your guided imagery tape must use what is called specific physiologic instructions, which give your body specific information it needs to help augment the healing process.

If you are interested in a state of the art guided imagery relaxation tape utilizing the latest information in behavioral anesthesia and utilizing state of the art specific physiologic instructions for healing, then please continue reading on

So that's it. These are the ten things you absolutely need to know prior to having surgery. Now put them into action. Read over the list again and this time, take out a piece of paper and make a list of:

all the things you need to do to be prepare yourself physically for your surgery (e.g. eating well, taking your vitamins, getting fresh air, walking and exercise)

all the things you need to do to be prepare yourself mentally for your surgery (e.g. making this list is one thing you can do to give yourself a mental edge by being prepared, think positive thoughts, read a positive quote everyday about health and healing, read anything by Norman Cousins, Bernie Siegel, M.D. or Herbert Benson, M.D., take care of bills to be paid in advance so you don't worry about them after the surgery when you need your energy to recover, etc.)

all the things you need to do to be prepare yourself emotionally and spiritually for your surgery (e.g. talk to family and friends, listen to a guided imagery relaxation tape, read inspirational material or a passage from psalms or anything that bolsters your faith, pray or meditate, etc.)

all the questions you need to ask your surgical team (e.g. make sure you ask about what happens before surgery, during surgery and after surgery, i.e. like what kind of anesthesia you will have, how long the operation takes, how long you will be in recovery, how long you have to rest at home, what medication you will be on after the surgery, what medication you have to stop prior to the surgery, etc. . By the way, if you can meet with the anesthesiologist prior to surgery, it can be very reassuring to know your anesthesiologist as well as your surgeon. Having a realistic expectation for recovery is critical to healing well.)

all the information you need to gather to really understand your operation (e.g. if you need to get a second opinion, now's the time, go to different websites for information on your operation, learn about the different possible surgical approaches if it is relevant to your outcome. There are often many alternative choices when it comes to surgical procedures and each carries with it a different set of complications and expectations regarding recovery.)

all the things you are going to do to nurture yourself prior to and after surgery. (e.g. take a bath, get a massage, get your nails done or take a sauna or steam, etc.)

After you complete your list, start doing those things and then cross them off our list. As you take an active role in preparing for your surgery, you will begin to feel a greater sense of control and mastery regarding your upcoming operation. You will transform yourself from a passive patient into an active participant in the surgical process, thereby activating your healing system and optimizing your chances for a healthy and speedy recovery. This type of participation strengthens your entire body, mind and spirit. You will feel better just making the list, to say nothing of how great you will feel when you start crossing things off your list, knowing that you are an active part of the team that is working so hard to restore your health and well-being.

Neil F. Neimark, M.D.

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