1 00:00:01,800 --> 00:00:04,320 Speaker 1: Welcome to brain Stuff, a production of I Heart Radio, 2 00:00:06,600 --> 00:00:11,119 Speaker 1: Hey brain Stuff Lauren Vogle bomb here. Surgery can be 3 00:00:11,240 --> 00:00:14,000 Speaker 1: the best solution to a medical issue, but it puts 4 00:00:14,160 --> 00:00:17,200 Speaker 1: enormous stress on the body, and it puts patients at 5 00:00:17,280 --> 00:00:21,080 Speaker 1: risk for complications which can slow recovery. But it turns 6 00:00:21,120 --> 00:00:25,040 Speaker 1: out that there's a way to help. Prehabilitation or prehab, 7 00:00:25,800 --> 00:00:27,920 Speaker 1: and taking the time and effort to get into shape 8 00:00:27,920 --> 00:00:31,600 Speaker 1: before elective surgery can vastly improve a patient's chances for 9 00:00:31,640 --> 00:00:35,519 Speaker 1: a speedy recovery. Because the healthier person is before a surgery, 10 00:00:35,800 --> 00:00:38,280 Speaker 1: the better equipped their body is to overcome the stress 11 00:00:38,320 --> 00:00:44,080 Speaker 1: responses produced during the surgery. Rehabilitation is better known it's 12 00:00:44,120 --> 00:00:47,760 Speaker 1: the medical specialty that helps people regain lost functionality after 13 00:00:47,800 --> 00:00:51,120 Speaker 1: a medical event or injury. For example, people who have 14 00:00:51,200 --> 00:00:55,240 Speaker 1: undergone hip replacement surgery usually require extensive rehab to help 15 00:00:55,320 --> 00:00:59,960 Speaker 1: them rebuild muscle strength and regain function and mobility. Prehab 16 00:01:00,200 --> 00:01:03,200 Speaker 1: is like rehab before surgery. It strives to get the 17 00:01:03,200 --> 00:01:06,640 Speaker 1: body to its maximum health potential through exercise and nutritional 18 00:01:06,680 --> 00:01:09,280 Speaker 1: training so that the patient can more quickly heal and 19 00:01:09,319 --> 00:01:13,360 Speaker 1: return to normal activities after their surgery. Like rehab, though 20 00:01:13,680 --> 00:01:17,840 Speaker 1: prehab takes time. Cardiovascular improvements can be seen in as 21 00:01:17,880 --> 00:01:20,600 Speaker 1: little as three weeks, but four to eight weeks of 22 00:01:20,640 --> 00:01:24,680 Speaker 1: prehab before surgery is necessary for patients to see strength gain. 23 00:01:26,120 --> 00:01:28,559 Speaker 1: A prehab is sort of a buzz word right now, 24 00:01:28,959 --> 00:01:30,640 Speaker 1: but the idea has been in the works for at 25 00:01:30,720 --> 00:01:34,920 Speaker 1: least a couple of decades. In an effort to improve 26 00:01:35,000 --> 00:01:38,800 Speaker 1: postoperative outcomes of patients, a group of general physicians from 27 00:01:38,840 --> 00:01:43,000 Speaker 1: Europe developed a method called Enhanced Recovery after Surgery. It 28 00:01:43,080 --> 00:01:47,360 Speaker 1: employs practices designed to reduce a patient's hospital stay, complication rates, 29 00:01:47,360 --> 00:01:52,040 Speaker 1: recovery period, and economic costs. Through the years, the protocol 30 00:01:52,080 --> 00:01:55,560 Speaker 1: has evolved to include practices such as patient and family education, 31 00:01:55,800 --> 00:02:01,000 Speaker 1: pain management, and nutrition recommendations for the article this episode 32 00:02:01,080 --> 00:02:03,520 Speaker 1: is based on how Stuff Work. Spoke with Katie Starr 33 00:02:03,880 --> 00:02:06,760 Speaker 1: v VO, chief Scientific Officer with a v A Perioperative 34 00:02:06,800 --> 00:02:09,519 Speaker 1: Optimization of Senior Health at the Durham v A Medical 35 00:02:09,560 --> 00:02:13,200 Speaker 1: Center in Durham, North Carolina. She said, what we want 36 00:02:13,240 --> 00:02:16,240 Speaker 1: to do with prehab is bump somebody's baseline from where 37 00:02:16,280 --> 00:02:19,280 Speaker 1: they started so that we can delay and reduce the 38 00:02:19,400 --> 00:02:22,359 Speaker 1: loss and impact caused by surgery, so they'll be able 39 00:02:22,400 --> 00:02:26,800 Speaker 1: to recover sooner. The type of surgery and the patient's 40 00:02:26,840 --> 00:02:30,919 Speaker 1: needs dictate the type of prehab needed. For example, prehab 41 00:02:31,000 --> 00:02:34,000 Speaker 1: is often used in patients undergoing joint replacement surgery to 42 00:02:34,120 --> 00:02:36,640 Speaker 1: build muscle mass in order to better support the body 43 00:02:36,720 --> 00:02:41,040 Speaker 1: and provide mobility as the affected area recovers. So before 44 00:02:41,080 --> 00:02:44,480 Speaker 1: knee replacement surgery, prehab might be used to strengthen the 45 00:02:44,520 --> 00:02:47,760 Speaker 1: patient's upper body. It may focus on their arm strength 46 00:02:47,840 --> 00:02:49,840 Speaker 1: so the patient can lift themselves in and out of 47 00:02:49,919 --> 00:02:52,640 Speaker 1: chairs in their bed until it's safe to apply pressure 48 00:02:52,680 --> 00:02:57,720 Speaker 1: to the rebuilt knee. There's also cardio respiratory prehab. A 49 00:02:57,800 --> 00:03:01,880 Speaker 1: Star explained cardio respiratory muscles are extremely important when it 50 00:03:01,919 --> 00:03:05,800 Speaker 1: comes to intubation during anesthesia, the impact on the lungs 51 00:03:05,880 --> 00:03:10,240 Speaker 1: is very big. Strength training for those muscles and building 52 00:03:10,240 --> 00:03:14,560 Speaker 1: aerobic capacity can help improve cardio respiratory fitness, which helps 53 00:03:14,639 --> 00:03:18,240 Speaker 1: lessen the risk of infection, pneumonia, or aspiration after surgery, 54 00:03:18,600 --> 00:03:24,280 Speaker 1: all of which can cause long term complications. Meanwhile, nutrition 55 00:03:24,440 --> 00:03:27,440 Speaker 1: impacts how quickly the body heals from the stress of surgery, 56 00:03:27,720 --> 00:03:31,200 Speaker 1: which is why being nutritionally fit before undergoing surgery is 57 00:03:31,240 --> 00:03:35,440 Speaker 1: imperative to a good recovery. STAR set many conditions can 58 00:03:35,480 --> 00:03:39,400 Speaker 1: adversely impact nutrition. As we age, our bodies go through 59 00:03:39,400 --> 00:03:42,760 Speaker 1: physiological and metabolic changes that result in a loss of 60 00:03:42,800 --> 00:03:45,960 Speaker 1: muscle mass and renal function, which can affect hydration and 61 00:03:46,000 --> 00:03:50,080 Speaker 1: fluid status. Surgical stress also boosts blood sugar levels in 62 00:03:50,120 --> 00:03:53,800 Speaker 1: the body, opposing risks for patients who have diabetes, including 63 00:03:53,800 --> 00:03:59,720 Speaker 1: wound site infections and longer recovery. Cancer and cancer treatments 64 00:03:59,760 --> 00:04:02,520 Speaker 1: can also affect the person's ability to eat food or 65 00:04:02,560 --> 00:04:06,880 Speaker 1: absorb nutrients, which can lead to malnutrition. A Star said, 66 00:04:07,520 --> 00:04:11,040 Speaker 1: just like with function and cardio respiratory and physical function, 67 00:04:11,480 --> 00:04:14,520 Speaker 1: we know that nutritional status is going to decline in 68 00:04:14,560 --> 00:04:17,320 Speaker 1: the hospital setting. We want to make sure we do 69 00:04:17,400 --> 00:04:20,080 Speaker 1: everything we can on the front end to help mitigate 70 00:04:20,120 --> 00:04:24,880 Speaker 1: that on the back end. While anyone would benefit from 71 00:04:24,920 --> 00:04:28,839 Speaker 1: getting in optimal health before elective surgery, prehab is intended 72 00:04:28,880 --> 00:04:32,800 Speaker 1: for patient populations who are more vulnerable to surgical stress response, 73 00:04:33,240 --> 00:04:37,360 Speaker 1: including elderly people, anyone with pre existing conditions like diabetes 74 00:04:37,440 --> 00:04:41,440 Speaker 1: or autoimmune disorders, and patients with cancer, particularly those who 75 00:04:41,480 --> 00:04:46,680 Speaker 1: have undergone chemotherapy or radiation treatment. Star said, we're trying 76 00:04:46,720 --> 00:04:50,280 Speaker 1: to reduce the insult caused by surgery and get patients 77 00:04:50,360 --> 00:04:53,240 Speaker 1: home and back active and back to their baseline as 78 00:04:53,240 --> 00:04:58,560 Speaker 1: soon as possible. A prehab isn't a magic wand surgery 79 00:04:58,720 --> 00:05:00,599 Speaker 1: is always hard on the body and you have to 80 00:05:00,600 --> 00:05:03,560 Speaker 1: put in the work. But studies have shown enough evidence 81 00:05:03,560 --> 00:05:06,760 Speaker 1: to support the benefits of prehabilitation that the American College 82 00:05:06,760 --> 00:05:10,000 Speaker 1: of Surgeons has launched a program called it Strong for Surgery, 83 00:05:10,480 --> 00:05:14,480 Speaker 1: focused on identifying and evaluating evidence based practices aimed at 84 00:05:14,480 --> 00:05:17,320 Speaker 1: optimizing the health of patients before they go under the knife. 85 00:05:18,680 --> 00:05:21,880 Speaker 1: As always, I'm not a medical expert, so if you 86 00:05:22,000 --> 00:05:24,520 Speaker 1: are someone you love is preparing for surgery and is 87 00:05:24,600 --> 00:05:28,359 Speaker 1: curious about prehab, talked to an actual medical expert like 88 00:05:28,440 --> 00:05:36,840 Speaker 1: your doctor. Today's episode is based on the article prehab 89 00:05:36,839 --> 00:05:39,440 Speaker 1: could make your recovery from surgery a bit Easier on 90 00:05:39,440 --> 00:05:42,120 Speaker 1: how staff works dot com, written by Jennifer Walker. Journey 91 00:05:42,640 --> 00:05:45,040 Speaker 1: Brainstuff is production of I Heart Radio in partnership with 92 00:05:45,040 --> 00:05:47,560 Speaker 1: how stuff Works dot Com, and it's produced by Tyler Klang. 93 00:05:48,120 --> 00:05:50,400 Speaker 1: Four more podcasts from my Heart Radio, visit the I 94 00:05:50,480 --> 00:05:53,280 Speaker 1: heart Radio app, Apple Podcasts, or wherever you listen to 95 00:05:53,360 --> 00:05:54,200 Speaker 1: your favorite shows.