Beyond
Walking

By Ronda Gates, MS

Ronda Gates, MS, is a pharmacy grad who traded her white coat for a pair of athletic shoes and never looked back. Her health promotion business, LIFESTYLES, provides motivational speaking, program development, and fitness assessment services to support people making a lifestyle change. She has developed health promotion programs for many organizations nationwide.
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An early-morning walk is a blessing for the whole day.

— Henry David
Thoreau

When Your RX Is Surgery

Many walking enthusiasts I’ve met also devote time to cycling, swimming, tennis, and other activities to ensure a more balanced fitness regimen and prevent overuse injuries. But any sport can set the stage for an injury which may require surgical repair.

More than 50 million surgeries are performed in the United States each year. About 30 million of these are elective, meaning people have time to prepare. Many elective surgeries are described as “outpatient” when they occur in a hospital with no overnight stay.

Like anyone who is active, I’ve experienced the inevitable aches and pains following a long hike, a bike ride, or logging more miles than usual in a walking fundraiser. I’ve torn ligaments in my ankle, broken a wrist, and needed stitches after a bicycle crash. However, none of my injuries required surgery — until this past May when a tennis injury didn’t respond to some first-choice measures.

The injury itself wasn’t dramatic. I ran hard to return a well-placed ball, and when my right foot struck the ground, I felt and heard a “pop” in my knee. I knew immediately this was not good news. My orthopedic physician delivered the inevitable message: rest, ice, compression, and elevation — RICE — the first line of defense against progressive damage in most injuries.

X-rays and an MRI suggested knee damage we hoped would respond to the RICE approach, and, subsequently, a cortisone injection. However, six weeks later my knee was still swollen and painful, and I became a candidate for elective outpatient arthroscopic surgery.

Outpatient surgery requires preparation on many levels. The hospital needs contact information (including who will drive you home), registration data, and payment arrangements. You may require pre-surgery lab tests or X-rays. Your doctor will undoubtedly provide specific instructions to set the stage for the surgery.

Beyond these logistics, there are other things you can do to be prepared, reduce stress, and promote healing long before an incision is made. Now that my career and life experience have made me more savvy about how to manage this mini-crisis, here are my suggestions for making your (potential) surgery tolerable.

1. Prepare a written list of questions to ask your doctor about what to expect during post-surgery recovery. Most outpatient surgeries require that someone drive you home, but find out if you need someone to stay with you and, if so, for how long.

2. Give your doctor a list of the medications you take regularly. Include over-the-counter products that relieve pain, allergy symptoms, heartburn, or other ailments. Remember to list vitamins and herbal products since these may also interact with anesthetics or interfere with post-surgical clotting.

3. Without exception, don’t ignore the list of medications your doctor will tell you to avoid using for up to two weeks before surgery. If the list includes, for example, “aspirin-like products,” “anti-inflammatories,” or lists some anti-depressants or anti-anxiety drugs, ask your pharmacist for more specific information. If a prescription (especially one prescribed by another doctor) is on the list, work with all your physicians to find a substitute. If you need a pain reliever, ask your doctor if you can take a non-aspirin substitute, like acetaminophen. If you smoke, stop at least two weeks before surgery to increase oxygen circulation needed for healing.

4. If you can exercise without further injury before surgery, strive to be in tip-top shape; this will help your body heal. Strong, flexible muscles will be a valued asset to your recovery.

5. Before surgery, eat as healthfully as possible. Avoid alcohol and foods with added sugar and fats. Take a multi-vitamin supplement to assure adequate nutrition intake. Some physicians encourage additional vitamin C to promote tissue healing. Although you will receive instructions to avoid food and liquid (including water) after midnight the day of surgery, stricter dietary restrictions can eliminate a post-surgery upset stomach. Consider a soft foods diet for 48 hours before surgery and a mostly liquid diet for 24 hours afterwards.

6. Develop a positive attitude and practice stress-reducing strategies including meditation, massage, acupuncture, music, or breathing exercises to relax you in the weeks before surgery. After checking into the hospital, my Pachelbel-packed iPod provided a calming environment that, coupled with yoga breathing, took me to the operating room with a pulse rate of under 50 beats per minute.

7. On surgery day, leave your pride, your pocketbook, and your jewelry at home. Shower with bland soap and don’t use lotion or other toiletries, including makeup. Some hospitals ask that you remove nail polish. Dress for comfort, not style.

As I write this, I’m in the post-operative state I describe as limbo: I am mentally, but not physically, up to par. My incisions may be small, but the microsurgery required to repair my knee left fragile tissues vulnerable to further injury. When I asked how soon I can resume my active lifestyle, my surgeon said, “Take it easy.” I’m learning patience and the value of life in the slow lane. By the time you read this, I expect to be walking, cycling, and dancing again.