Jul 1, 2014


Interviewer: Being in good shape before you go into surgery can make all of the difference afterwards. We're going to learn about that next on The Scope.

Announcer: Medical news and research from University of Utah physicians and specialist you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: What are some of the things you can do to get in shape before you go in for surgery? We're with Dr. Jeffery Campsen. He's a surgeon at the University of Utah Hospital. I've heard it referred to as prehab, which I like, as opposed to rehab things you can do before the surgery to ensure that you have a good outcome afterwards. What are some of those things?

Dr. Jeffery Campsen: It's such an interesting concept because most people think if I'm going into surgery, one, it's not planned, or two, I feel bad and so I don't want to get into shape going into surgery because the surgery's actually going to help me get into shape afterwards. If there's anything that you can do beforehand that makes your recovery better than you might as well do it. I'm one of the transplant surgeons here at the University of Utah, and we do, say, kidney transplants. Patients know that they're going to have these surgeries going into the future. They want to know how they can get out of the hospital quicker and what they can. I tell them it really comes down to lung rehab, or lung prehab, as you had said, which is anything that you can do to make your lungs stronger going into surgery. Most of our abdominal surgeries patients are going to be on the breathing machine, the ventilator. How do they come off the ventilator, and how do they improve from the insult that mechanical ventilation does to them even if it's just for a few hours.

Interviewer: That's interesting. Mechanical ventilation actually does harm?

Dr. Jeffery Campsen: Right, it's not good. We're breathing for you. Maybe not harm, but it definitely, just like any kind of surgery, makes you lose a couple of steps. The better that you come in the less you're going to lose, probably, and the faster you're going to recover from that.

Interviewer: That's fascinating. I just never would have guessed that before. It's like not working out. Because your lungs aren't doing the work anymore they get weaker, or what's happening there?

Dr. Jeffery Campsen: That's exactly right. We're doing the work for you, and you lose a little bit.

Interviewer: Even in the short amount of time that you might be in surgery and recovery? How long is somebody on a ventilator?

Dr. Jeffery Campsen: It depends on the type of surgery. It can be hours, or just an hour. Some people don't come off the ventilator for a day or two because the surgery is a large surgery for whatever reason. The better shape that you're in coming in the less that you'll need that later. The types of things that you can do for this end up helping you across your body. It really comes in to moderate physical activity. Even if you feel poorly if you can do something that gets your heart rate up, gets your breathing up and allows your lungs to expand then you're going to improve it. It's basically working a muscle. Your lung is not a muscle, but you think about it in that way. If you're able to go for walks around the block, a mile a day, something every day leading up to the surgery, it will then allow your lungs to be used to sort of getting up to that rapid heart rate, expanding and really moving the blood along for the body. If it happens to make your legs stronger and your arms stronger and other things then you're going to recover from that better. What you can imagine is you come out of surgery and you're either on or off the ventilator. Then you come off the ventilator, meaning that you're breathing on your own. Then your physician and the team members that are taking care of you are going to ask you to get up out of bed and walk around. They want you to walk as soon as possible. Again, that keeps you from getting pneumonia and keeps you from getting blood clots. If you've already prepared for this coming into surgery when you get up your lungs are going to be stronger, they're going to allow to recover quicker and your legs are going to be stronger which will allow you to walk. If you can just get over that hump of getting used to walking again and basically breathing again then you're just going to recover much faster.

Interviewer: Is there a threshold? I go on daily walks of about a half hour or 45 minutes a day. I work out moderately. Do I need to do more above and beyond that?

Dr. Jeffery Campsen: I think a little bit of both. If you can do more that's going to be great because the better shape you're in the better you're going to do. If you do nothing just walking around the block once a day is going to be a ton more. That's going to help you. It's tough because we're being very vague at the type of surgery that you're going to have. If you're having inter-abdominal surgery of any sort if you're able to do something, even if it's a stationary bike or a walk around the block, something that allows you to increase your heart rate, increase your breathing rate and really move the blood around through the body and help the muscles in your legs and arms, I think you're going to do better afterwards.

Interviewer: It doesn't sound like you have to go in to the gym and be a super star, just do something.

Dr. Jeffery Campsen: That's exactly right. Most people are going to say, "Look, I feel terrible. That's why I'm having the surgery.", but a little bit up front is going to help a lot on the back end.

Announcer: We're your daily dose of science, conversation and medicine. This is The Scope University of Utah Health Sciences Radio.

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