Prehabilitation – preparing patients for surgery

Date: 06 March 2019

Prehabilitation

Going through major surgery can be a traumatic experience both physically and psychologically. Medway’s new prehabilitation service aims to get patients to their optimal health before their operation, helping them cope with the challenges of surgery as well as recover faster.

In the same way that rehabilitation helps people recover following an illness or injury, prehabilitation helps patients build their strength and fitness before surgery. This means that their recovery time is often shorter, and they are able to return to the quality of life they enjoyed before their operation sooner. This new service at Medway is the first of its kind in the south east and patients are already feeling the benefits.

Rainham resident Jim Gillies (73) was diagnosed with kidney cancer in February this year. “The only way my cancer could be treated was through surgery”, says Jim.“Medication wasn’t an option. However my fitness at that time meant that was a much greater risk that I would experience serious complications during surgery.”

Jim was referred to the prehabilitation service for a tailored programme of exercise, nutrition and psychotherapy to help prepare him for the challenge ahead.

“Before I started the programme, my peak flow test was 300 litres per minute. It had to get up to 450 litres a minute, just for me to be able to cope with the anaesthetic.”

A peak flow test measures how fast you are able to breathe out, and a low score can indicate that airways are narrowed or restricted. Just six weeks after starting the programme, Jim’s lung capacity had increased by 50 per cent and his fitness had increased to the point that he was able to have the surgery he needed. His surgery took place in July. 

“The programme was hard work”, says Jim, “but I definitely felt the benefits. The biggest benefit was that I felt fit enough to get back to work after about six weeks. It can often take six months and more to recover from major surgery.”

The service was developed, and is led by, Consultant Anaesthetist Dr Tarannum Rampal, with the support of the team – Consultant Anaesthetist Dr Manisha Shah and Exercise Physiologist Mr Roberto Laza-Cagigas. “Patients who go through this programme report decreased anxiety levels and better post-operative recovery,” says Dr Rampal.

“Prehabilitation – preparing yourself both physically and mentally before surgery – just makes sense. You wouldn’t run a marathon without training and preparation, so why wouldn’t you do the same for major surgery!”

John Williams (83) also went through the programme after being diagnosed with bladder cancer in 2014. “I was shocked to hear that I wasn’t fit enough to have surgery and recover well as I thought that I was very fit,” says John. “I lost three kilogrammes and three inches off my waist after three weeks on the programme. After a lot of hard work, I was finally strong enough to consider surgery.

“On behalf of all the patients who will go through this programme, I would like to thank everyone involved in setting it up, as well as my wife who has been with me every step of the way. I am still hoping to treat my cancer with medication, but going through this programme has given me options that I didn’t have before.”

  • Summary:

    Medway’s new prehabilitation service aims to get patients to their optimal health before their operation, helping them cope with the challenges of surgery as well as recover faster.