Ask an expert about fitness for surgery 

We know that patients in good health recover better after an operation and have fewer complications. By taking care of yourself beforehand, you can reduce the risk of complications (such as Increased risk of blood clots; lower oxygen levels during surgery; increased risk of wound infection; and increased breathing problems) and help you heal as quickly as possible.

Harms caused by smoking and obesity are potentially preventable and referral to support services prior to surgery offers an opportunity for you to improve your health and reduce the risks of surgical complications. There are other lifestyle behaviours which are good for your health like being active and reducing your alcohol intake.

Our expert is consultant anaesthetist Dr Sam Bampoe whose special interests include obstetric anaesthesia, anaesthesia for major surgery, anaesthesia for head and neck surgery and enhanced recovery.

Dr Bampoe will be here to answer any question you may have about getting fit for surgery. The conversation will cover what you should avoid ahead of surgery and what you should be proactive in doing to optimise your health before an operation. A reminder for the web chat can be set in the box below, or questions can be sent to webmaster@uclh.nhs.uk in advance.

Below is a transcript of the web chat.


1:46 UCLH: 
The webchat will start in 15 minutes. Stay tuned!
 
2:00 Dr Sam Bampoe: 
Hello Everyone!

I'm Dr. Sam Bampoe and I'm a Consultant in Anaesthesia and Perioperative Medicine at University College Hospital in London. Perioperative medicine is the care of patients before, during and after surgery. Today, we're going to focus on preparation for surgery. Please send me your questions and I'll do my best to give you some answers!
 
2:02 [Comment From Raj: ] 
Hi Dr. Bampoe
 
2:03 Dr Sam Bampoe: 
Hi Raj. What would you like to know?
 
2:03 [Comment From Raj: ] 
I have never had an operation before and have been asked to go to a preassessment appointment. What should I expect?
 
2:05 Dr Sam Bampoe: 
Thanks for your question, Raj.
 
2:06 Dr Sam Bampoe: 
Pre-assessment clinics are designed to allow us to assess your general health ahead of surgery. Appointments are generally a few weeks before your operation date so that if we identify any health issues, we have time to address them before your surgery.
 
2:07 Dr Sam Bampoe: 
Most clinics are nurse-led. You will be asked some detailed questions about your general health and will likely have your pulse, blood pressure, height and weight measured. You may have some blood tests and also a reading of your heart known as an ECG. If these are all reasonably normal, then it is likely that your surgery will go ahead.
 
2:07 [Comment From Raj: ] 
Will I speak to a Doctor too?
 
2:09 Dr Sam Bampoe: 
You may also be seen by a specialist doctor known as an anaesthetist who will be an expert in preparing you for surgery. If you have got medical problems, as many people do, your team will advise you on how best to prepare for your operation. This may include further tests, or appointments with other specialists.
 
2:09 Dr Sam Bampoe: 
The pre-assessment appointment is designed to make the process of having an operation as safe as possible for you.
 
2:10 [Comment From Raj: ] 
Thanks!
 
2:10 [Comment From Anon: ] 
Is there any special medication that I should ask my doctor for in the lead up to my operation?
 
2:13 Dr Sam Bampoe: 
Hello there. If you are well with no medical problems, there are no specific medicines that we would advise you to take to prepare for surgery in general. Some operations require you to take some medicines in advance, for example, we give some patients having bowel surgery special medicine in advance to help empty the bowels
 
2:16 Dr Sam Bampoe: 
Ahead of some operations, we may ask you to drink a special carbohydrate drink designed to give you plenty of energy for the operation, despite a short starvation time ahead of of surgery. However, there is nothing specific that you need to ask for before your operation.
 
2:16 [Comment From Helen: ] 
Hi Dr Bampoe, is there anything that I can do to mentally prepare myself for surgery?
 
2:16 Dr Sam Bampoe: 
Hello, Helen.
 
2:20 Dr Sam Bampoe: 
Having an operation can be terribly stressful for some people. Anxiety and fear may cause quite severe emotional distress. I think it is really important to talk to those around you about your anxieties. A good support network is important, and you can always talk to your GP for advice.
 
2:20 [Comment From Gary: ] 
With patients with a pacemaker and defib - is it turned off during the operation?
 
2:22 Dr Sam Bampoe: 
Being mentally prepared for your operation and importantly, being informed about what to expect before, during and after your surgery will help smooth your whole experience and hopefully lead to a better recovery.
 
2:22 [Comment From Fiona: ] 
I don't do any exercise except walking up and down the stairs in my building twice a day. I am not over weight, but should I still try and do a bit more exercise before my surgery?
 
2:23 [Comment From Helen: ] 
Thanks, I've heard people mention mindfulness?
 
2:23 Dr Sam Bampoe: 
Hi Gary and Fiona - I'll get to your questions in just a moment.
 
2:24 Dr Sam Bampoe: 
Helen - There are many ways to help you prepare psychologically. If mindfulness works for you, then definitely give it a go!
 
2:26 Dr Sam Bampoe: 
Gary - Thanks for your question about pacemakers and implanted defibrillators.
 
2:26 [Comment From Helen: ] 
Ok thanks Dr Bampoe, I'll ask my doctor if he can refer me to someone to try mindfulness techniques.
 
2:29 Dr Sam Bampoe: 
What we do with pacemakers and implanted defibrillators depends on a number of factors. Firstly it depends on what the device is doing. We will need to identify the device so that we can know how it might behave during the operation. Sometimes, if they are likely to behave unpredictably then we may turn them off.
 
2:31 Dr Sam Bampoe: 
We would only do this after consulting with a specialist pacemaker technician, or cardiologist - and would be sure to do this in a safe way. Some devices have a back-up mode that we can put them in so that they are safe. In a lot of cases, if the operation is not going to be anywhere near the pacemaker, we can leave it alone and it will be safe.
 
2:31 [Comment From Avi: ] 
I've read that I should have a higher intake of protein in my diet, leading up to my surgery. Is this true? Thanks!
 
2:32 Dr Sam Bampoe: 
Fiona, thank you for your question.
 
2:34 Dr Sam Bampoe
It sounds like you are reasonably fit already. We know that the fitter you are, the less likely you are to suffer any complications of surgery. This is particularly relevant if you are not particularly fit and are having a big operation.
 
2:36 Dr Sam Bampoe: 
I would advise you to continue to try to get as much exercise as possible into your daily routine. Using the stairs is a good start, perhaps try adding a brisk walk a few times a week. Any improvement in you level of fitness may help you get through your operation with fewer potential problems.
 
2:36 [Comment From Fiona: ] 
I do get slightly out of breath though, when climbing the stairs....
 
2:37 Dr Sam Bampoe: 
Hi Avi - I'll get to your question in a moment.
 
2:39 Dr Sam Bampoe: 
Fiona - Don't worry, so do I! As you do more exercise and your fitness levels increase, you'll soon find yourself bounding up those stairs without a care in the world.
 
2:40 Dr Sam Bampoe: 
Avi - Having a big operation can put a lot of demand on your body.
 
2:43 Dr Sam Bampoe: 
After major surgery, your body will need to heal and repair itself. Protein is essential to this process. However, eating too much protein in your diet can cause some problems such as excessive strain on your kidneys. I would advise you to eat a well balanced diet of protein, carbohydrates and healthy fats in the run-up to your operation, and stay well hydrated.
 
2:43 [Comment From Sallie: ] 
Hi, I am due to have an operation when my menstrual cycle is due - it's not a women's health operation - does this matter?
 
2:44 Dr Sam Bampoe: 
Hello, Sallie.
 
2:47 Dr Sam Bampoe: 
Don't worry. For the vast majority of surgery, it doesn't matter where you are in your menstrual cycle. Menstruation around the time of your operation will not affect your surgery, or your recovery. The only exception to this may be fertility surgery when it is important to know where you are in your cycle.
 
2:47 [Comment From Jayne: ] 
I'm worried about telling my kids about my operation as I think it will scare them - any tips?
 
2:49 [Comment From Sallie: ] 
Thanks that's useful to know.
 
2:49 Dr Sam Bampoe: 
Hello, Jayne. Thanks for your question. I think you are describing a dilemma that many people face when preparing for an operation.
 
2:52 Dr Sam Bampoe: 
It's difficult to advise you on what you should do because people react in different ways to emotional stresses. I think it's only natural to be anxious about surgery and I think my kids would probably also be scared.
 
2:55 Dr Sam Bampoe: 
Perhaps you can take some advice from someone who knows you and your children well, and might be able to support you through the process. We often underestimate the effect of having an operation on our loved-ones who may sometimes be just as anxious about it as we are!
 
2:56 [Comment From Anon: ] 
I am due to have an operation next week. I was advised to stop smoking a couple of months ago but haven't been able to quit - is it too late to bother stopping now?
 
2:57 Dr Sam Bampoe: 
Thank you for your question. It's really never too late to quit smoking. We generally advise people who are booked to have an operation to try to stop smoking at least two months before the date of surgery. After two months of not smoking, the ability of the lungs to clear sputum (the stuff we all occasionally cough up) is much improved and as a result, your recovery after surgery is less likely to be complicated by problems like a chest infection.
 
2:59 Dr Sam Bampoe: 
We know how hard it can be to quit, so don't worry, there are many patients in your situation who have not been able to cut down their smoking as much as they would have liked to. I always advise people to stop, even if it is just a few days before the operation. Within 20 minutes of stopping smoking, your pulse rate will start to go back to normal, and within a few hours your blood pressure will start to reduce as the effects of nicotine wear off. Also within a few hours, the levels of carbon monoxide, which is a toxic chemical found in cigarettes, starts to reduce back to normal. This means that there is more oxygen in your blood as a result, which is always beneficial if you are having surgery. So the answer to your question is a resounding no - it's definitely not too late to stop smoking.
 
3:02 Dr Sam Bampoe: 
Thank you for all of your interesting questions. I hope that I have been able to shed some light on your queries. Please join us again soon for the next 'fitness for surgery' web chat, and I wish you all a speedy recovery after your operations!
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