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Thursday, November 21, 2013

An Ounce of Preparation for a Pound of Cure

By Heather Millar

doctor talking to patient

When I look back on my breast cancer surgery, I have to admit that I didn’t do much of anything the “right” way. When doctors told me that a slight delay wouldn’t harm my prognosis, I went ahead with a long-planned, cross-country move and spent two weeks driving across the continent with my family. That move/vacation was fun in many ways, and I am SO glad that I didn’t spend days and days on a bumpy interstate after surgery. (I completely underestimated how tender I’d be and for how long.)

But still, it’s not like I did much of anything to reduce stress, or to enter the OR ready and rested. The whole period between diagnosis and surgery was just a mad dash.

I met with my surgeon the day after we arrived in San Francisco. I had surgery four days later, the same day that my daughter started in a new school.

I did go to a “Prepare for Surgery” appointment, during which I met with the anesthesiologist and had a bunch of “baseline” tests done. But I didn’t even realize there was such a thing as a “Prepare for Surgery” class.

Then, a few weeks ago, I noticed an item for a Prepare for Surgery class in the Cancer Resource Center newsletter from my hospital, UC San Francisco Medical Center. I attended the class earlier this week, and I so wish that I had attended before my first breast surgery.

A quick lap around the web reveals that most major medical centers offer some variation on this “Prepare for Surgery” class. They use these sessions to outline a lot of basic information that doctors and nurses may not have time to share.

You learn about the process of surgery, the different kinds of anesthesia, what’s good to eat before surgery, what sorts of supplements and herbs you should avoid before your procedure, ways to manage post-surgery pain, simple relaxation and stress management techniques You get to see pictures of the various clinics that you’ll probably visit, of the OR door, of the OR itself, of the post-anesthesia care unit.

It’s a chance to ask the “stupid” questions that you may be embarrassed to ask of your medical team. For instance, I got to ask about the big tube that tucks under the blanket of the OR Bed. ORs are cold; the tube delivers heated air to the parts of your body that are not involved in the surgery, keeping you toasty warm.

Who would’ve thought that surgery is cozy in that way?

It reminded me a lot of the childbirth classes that nearly all hospitals offer. How many people do you know who’ve given birth without going to a childbirth class? Not many, I bet. But I suspect that you know lots of people who’ve had surgery but known little or nothing about what to expect and how to prepare.

Science backs this idea: A “meta-analysis,” in Research in Nursing and Health, that is, a study that brings together the results of many studies, pooled the results of 191 studies involving more than 8,600 surgery patients. [Alas, the paper is from 1992 and not available on-line.] Here’s what it found: People who do some preparation for surgery lose less blood and use fewer pain meds. They have fewer complications from surgery and spend less time in the hospital. This seems to be true whether the patients are male or female, young or old, urban, suburban or rural.

I went through the first weeks of cancer treatment in a sort of hysterical haze. A “Prepare for Surgery” class might have taken the edge off all that stress. If you’ve got time before your procedure, find out if your hospital, or a nearby hospital, offers such a class.

Have you attended a “Prepare for Surgery” class? Did it help? Would you recommend it to others? Let us know here.


Posted by: Heather Millar at 1:16 pm


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