Speaker 1: Welcome to brain Stuff, a production of I Heart Radio,
Speaker 1: Hey brain Stuff Lauren Vogle bomb here. Surgery can be
Speaker 1: the best solution to a medical issue, but it puts
Speaker 1: enormous stress on the body, and it puts patients at
Speaker 1: risk for complications which can slow recovery. But it turns
Speaker 1: out that there's a way to help. Prehabilitation or prehab,
Speaker 1: and taking the time and effort to get into shape
Speaker 1: before elective surgery can vastly improve a patient's chances for
Speaker 1: a speedy recovery. Because the healthier person is before a surgery,
Speaker 1: the better equipped their body is to overcome the stress
Speaker 1: responses produced during the surgery. Rehabilitation is better known it's
Speaker 1: the medical specialty that helps people regain lost functionality after
Speaker 1: a medical event or injury. For example, people who have
Speaker 1: undergone hip replacement surgery usually require extensive rehab to help
Speaker 1: them rebuild muscle strength and regain function and mobility. Prehab
Speaker 1: is like rehab before surgery. It strives to get the
Speaker 1: body to its maximum health potential through exercise and nutritional
Speaker 1: training so that the patient can more quickly heal and
Speaker 1: return to normal activities after their surgery. Like rehab, though
Speaker 1: prehab takes time. Cardiovascular improvements can be seen in as
Speaker 1: little as three weeks, but four to eight weeks of
Speaker 1: prehab before surgery is necessary for patients to see strength gain.
Speaker 1: A prehab is sort of a buzz word right now,
Speaker 1: but the idea has been in the works for at
Speaker 1: least a couple of decades. In an effort to improve
Speaker 1: postoperative outcomes of patients, a group of general physicians from
Speaker 1: Europe developed a method called Enhanced Recovery after Surgery. It
Speaker 1: employs practices designed to reduce a patient's hospital stay, complication rates,
Speaker 1: recovery period, and economic costs. Through the years, the protocol
Speaker 1: has evolved to include practices such as patient and family education,
Speaker 1: pain management, and nutrition recommendations for the article this episode
Speaker 1: is based on how Stuff Work. Spoke with Katie Starr
Speaker 1: v VO, chief Scientific Officer with a v A Perioperative
Speaker 1: Optimization of Senior Health at the Durham v A Medical
Speaker 1: Center in Durham, North Carolina. She said, what we want
Speaker 1: to do with prehab is bump somebody's baseline from where
Speaker 1: they started so that we can delay and reduce the
Speaker 1: loss and impact caused by surgery, so they'll be able
Speaker 1: to recover sooner. The type of surgery and the patient's
Speaker 1: needs dictate the type of prehab needed. For example, prehab
Speaker 1: is often used in patients undergoing joint replacement surgery to
Speaker 1: build muscle mass in order to better support the body
Speaker 1: and provide mobility as the affected area recovers. So before
Speaker 1: knee replacement surgery, prehab might be used to strengthen the
Speaker 1: patient's upper body. It may focus on their arm strength
Speaker 1: so the patient can lift themselves in and out of
Speaker 1: chairs in their bed until it's safe to apply pressure
Speaker 1: to the rebuilt knee. There's also cardio respiratory prehab. A
Speaker 1: Star explained cardio respiratory muscles are extremely important when it
Speaker 1: comes to intubation during anesthesia, the impact on the lungs
Speaker 1: is very big. Strength training for those muscles and building
Speaker 1: aerobic capacity can help improve cardio respiratory fitness, which helps
Speaker 1: lessen the risk of infection, pneumonia, or aspiration after surgery,
Speaker 1: all of which can cause long term complications. Meanwhile, nutrition
Speaker 1: impacts how quickly the body heals from the stress of surgery,
Speaker 1: which is why being nutritionally fit before undergoing surgery is
Speaker 1: imperative to a good recovery. STAR set many conditions can
Speaker 1: adversely impact nutrition. As we age, our bodies go through
Speaker 1: physiological and metabolic changes that result in a loss of
Speaker 1: muscle mass and renal function, which can affect hydration and
Speaker 1: fluid status. Surgical stress also boosts blood sugar levels in
Speaker 1: the body, opposing risks for patients who have diabetes, including
Speaker 1: wound site infections and longer recovery. Cancer and cancer treatments
Speaker 1: can also affect the person's ability to eat food or
Speaker 1: absorb nutrients, which can lead to malnutrition. A Star said,
Speaker 1: just like with function and cardio respiratory and physical function,
Speaker 1: we know that nutritional status is going to decline in
Speaker 1: the hospital setting. We want to make sure we do
Speaker 1: everything we can on the front end to help mitigate
Speaker 1: that on the back end. While anyone would benefit from
Speaker 1: getting in optimal health before elective surgery, prehab is intended
Speaker 1: for patient populations who are more vulnerable to surgical stress response,
Speaker 1: including elderly people, anyone with pre existing conditions like diabetes
Speaker 1: or autoimmune disorders, and patients with cancer, particularly those who
Speaker 1: have undergone chemotherapy or radiation treatment. Star said, we're trying
Speaker 1: to reduce the insult caused by surgery and get patients
Speaker 1: home and back active and back to their baseline as
Speaker 1: soon as possible. A prehab isn't a magic wand surgery
Speaker 1: is always hard on the body and you have to
Speaker 1: put in the work. But studies have shown enough evidence
Speaker 1: to support the benefits of prehabilitation that the American College
Speaker 1: of Surgeons has launched a program called it Strong for Surgery,
Speaker 1: focused on identifying and evaluating evidence based practices aimed at
Speaker 1: optimizing the health of patients before they go under the knife.
Speaker 1: As always, I'm not a medical expert, so if you
Speaker 1: are someone you love is preparing for surgery and is
Speaker 1: curious about prehab, talked to an actual medical expert like
Speaker 1: your doctor. Today's episode is based on the article prehab
Speaker 1: could make your recovery from surgery a bit Easier on
Speaker 1: how staff works dot com, written by Jennifer Walker. Journey
Speaker 1: Brainstuff is production of I Heart Radio in partnership with
Speaker 1: how stuff Works dot Com, and it's produced by Tyler Klang.
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