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Prehabilitation – What you can do to improve your health before surgery

The goal of prehabilitation is to help you become as healthy and strong as possible to prepare you for surgery and the recovery period that follows. Patients who are more fit and medically stable have fewer complications after surgery, shorter hospital stays and a smoother recovery.

Prehabilitation is a holistic approach which allows you to become actively involved in your care. Please see attached educational pamphlet outlining the basic goals of prehabilitation (or see below).

The IMPACT-Surgery Team

Before your surgery, your surgeon may ask you to meet with the IMPACT-Surgery Team (Interprofessional Multidisciplinary Prehabilitation Assessment Consultation Team) to talk about Prehabilitation.

Our professional team consists of a Family Physician/Hospitalist, Occupational Therapist, Social Worker, Dietitian, Surgeons and Nurses at the Odette Cancer Centre at Sunnybrook Health Sciences Centre. If you meet with the team, you will be asked questions about your medical history, diet, sleep habits, smoking history, exercise routines and how you are managing your daily activities. The team may provide you with recommendations to help you best prepare for your surgery. Our IMPACT-Surgery Team works closely with the inpatient therapists and nurses who will care for you after your surgery.

Rahul Jain MD, CCFP, MScCH (HPTE) is an academic Family Physician with the Department of Family and Community Medicine and a Surgical Hospitalist with the Division of General Surgery at Sunnybrook Health Sciences Centre (University of Toronto). He provides medical expertise as well as comprehensive, person-centered assessments as part of the prehabilitation program.

Leslie Gibson OT Reg (ON) is an Occupational Therapist at the Odette Cancer Centre. She brings expertise in functional assessments, individualized exercise prescriptions and lifestyle counseling.  Leslie is also a member of the smoking cessation team at the Odette Cancer Centre and can provide smoking cessation strategies to help you quit prior to surgery.

Denise Bilodeau MSW, RSW is a Social Worker at the Odette Cancer Centre. She can help answer questions about possible supports and resources available upon discharge from hospital following your surgery.

Tracey Rapier, B.A.sc, RD is a Registered Dietitian at the Odette Cancer Centre. By conducting nutrition assessments, she can help ensure you are well nourished before surgery to ease recovery and reduce the risk of complications.


Why is Prehab important?

Prehab can help you:

  • Get stronger and healthier before your surgery
  • Lower the risk of problems during and after your surgery
  • Recover faster
  • Leave hospital sooner
  • Become actively involved in your care

Looking at these four areas of Prehab can help you get ready for your surgery.

four areas of prehabilitation

Functional

Exercise: More physical activity can help make you stronger, improve balance and make you more fit for surgery. Medical: improving your health before surgery can decrease your chance of problems during and after surgery.

Nutrition

Eat well before your surgery. This may help you feel better and heal faster. Make sure you have a balanced diet with vegetables, fruits, and foods high in protein. If you have lost weight or feel less hungry, nutritional drinks like Boost, Ensure or Glucerna, may help.

Lifestyle Choices

Quit smoking before surgery. This will help you breathe easier and heal better after surgery. Try to stop drinking any alcohol before surgery. Sleep is important to give you more energy and feel less tired before your surgery.

Stress Management

Use relaxation tools such as deep breathing and meditation. These can help you control the stress and worries you may have about your surgery. Speak with family and friends before your surgery to make sure you have support and help as you heal.


What will happen BEFORE surgery ("Prehab")?

Your surgeon may ask you to meet with the IMPACT-Surgery Team (Interprofessional Multidisciplinary Prehabilitation Assessment Consultation Team) to help you get ready for your surgery. Speak with your family doctor/primary care provider. Let them know that you are having surgery so they can go over your medical history. You will have an appointment at the Pre-Admission Clinic before your surgery to go over your medications and hear what will happen on the day of surgery.

What to expect AFTER surgery?

Bring a pair of good walking or running shoes to the hospital. You will be out of bed for short walks soon after your surgery. You may meet a team of professionals (including nurses, therapists, and dietitians) who will work with you to get better. Your team will help you plan and get ready to leave the hospital.

Top 5 Checklist for Prehab:

  1. healthy coupleExercise, exercise, exercise. Aim for 30-40 min of physical activity each day. Check with your doctor before you start any new exercise program. An Occupational Therapist can meet with you to talk about an exercise prescription.

    Exercise Goals:
    Frequency (how often): every day
    Intensity (how hard): moderate exercise. You can still have a conversation with someone while you exercise.
    Time (how long): 30-40 minutes. This can be broken up into 10-15 minute periods over the day.
    Type (type of exercise): any physical activity that will safely raise your heart rate and breathing (such as brisk walking, stationary cycling)

  2. See your family doctor/primary care provider for a health review. You may also be seen by the IMPACT-Surgery Team so they can help you get ready for surgery.

  3. Eat healthy. A dietitian can meet with you to talk about ways to improve your diet.

  4. Healthy Mind = Healthy Body. Try to get at least 7-8 hours of sleep every night. A social worker can meet with you to talk about how you are feeling and let you know about community supports.

  5. If you smoke cigarettes or drink alcohol, STOP as soon as you can. A Smoking Cessation Counsellor can meet with you to talk about how to quit, including using nicotine replacement therapy.

Please contact the GI site Nursing Team if you have any questions or would like to speak with other members of the health care team. Phone: 416-480-6100 x81061