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