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Consumer Reports helps you become surgery savvy with tips to lower your risk

Thursday, October 24, 2013 - 12:01 am

If you're facing surgery, you no doubt want to do all you can to prepare. But according to Consumer Reports on Health, many of the things that patients are told to do, including some their doctor may recommend, aren't necessary and can even cause harm.

For example, many doctors routinely order a battery of preoperative tests, including blood analyses, chest X-rays and cardiac stress tests. But when they are done just to “clear” you for surgery, with little regard to the type of surgery, the kind of anesthesia that will be used or your overall health, they're more likely to cause potentially harmful false alarms than keep you safe, current research shows.

Similarly, patients are still often told to avoid food and drink for 12 hours or more before surgery. But revised guidelines are more flexible; they take into account the fact that fasting too long can stress the body and slow recovery.

Consumer Reports on Health recommends the following steps to help speed your recovery from surgery:

•Don't get overtested. Ordering preoperative tests when they aren't necessary can lead to trouble. For example, some doctors order cardiac stress tests even for low-risk patients before minor surgery. But abnormal results can lead to angiography, a test that exposes people to radiation. And if that test detects a blockage in an artery, doctors might treat it with a stent, even though the artery wasn't causing symptoms. The stent procedure must be followed by the prolonged use of a blood-thinning drug, which can make surgery riskier or delay it for up to a year. If your doctor can't give a clear reason for a preoperative test, say you want to skip it.

•Eat well. Doctors have long advised patients not to eat or drink anything after midnight before morning surgery because of the risk of regurgitating stomach contents into the lungs. But such fasting impairs the body's ability to recover from complications. The American Society of Anesthesiologists says healthy people can have clear liquids up to two hours before most surgeries and a light meal up to six hours beforehand.

•Keep moving. Boosting your activity level, if only for a week or so before surgery, can help you get out of bed and walk around sooner afterward. That can prevent such complications as blood clots and pneumonia. In a 2013 review in the British Journal of Anaesthesia, people who were in an exercise program before heart surgery had shorter hospital stays.

•Strengthen your lungs. People who are recovering from surgery are often told to take long, deep breaths using a device called an incentive spirometer. That helps prevent pneumonia and deliver more oxygen to the surgical site to speed the repair of wounds. But doing those exercises before you get to the hospital also leads to shorter hospital stays, according to a 2011 review in Clinical Rehabilitation. So ask for a spirometer before your operation and practice using it.

•Relax. Psychological stress triggers chemical changes in the body that impair the immune system. So it's no surprise that anxiety has been linked to slower healing, more pain and longer hospital stays. If you have concerns about your operation, talk about them with your doctor. Other stress-busters include deep breathing, meditation, yoga, exercise and listening to music.

•Control diabetes. Blood sugar levels can spike after surgery, which can compromise your immune system and multiply the risk of pneumonia and wound or bloodstream infections. Talk with the doctor who treats your diabetes about things you should do before and after your surgery to control your blood sugar level.

•Stop smoking. Smokers are more likely to need a ventilator to help them breathe after surgery. They also heal more slowly and are prone to infection. Quitting before surgery can reduce those complications. It's best to kick the habit well before surgery, but it helps to stop even temporarily.