Preparing for Major Surgeries: Essential Tips & Insights

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Preparing for major surgeries is a crucial step in ensuring the best possible outcomes and smoother recovery. Whether you're facing liver surgery, liver cancer surgery, or a liver transplant, understanding what to expect can make a significant difference in your journey.

I was inspired to share my experiences and insights to help others navigate this challenging process. My own journey through major surgeries, particularly in treating rectal cancer that metastasized to my liver, provided me with valuable lessons that I hope can offer support and guidance to those in similar situations.

Initial Treatment and Preparing for Surgery

My initial treatment plan involved a combination of chemotherapy and radiation therapy aimed at shrinking the tumor and controlling the spread of cancer cells. This approach was essential in preparing my body for the upcoming liver surgery. Some of its impact on the body include:

Fatigue and Weakness: Chemotherapy and radiation left me feeling extremely tired and weak.

Nausea and Appetite Loss: These and other treatments often cause nausea, making it difficult to maintain a healthy diet.

Skin and Hair Changes: I experienced changes in my skin and hair, common side effects of cancer treatment and cancer drugs.

Immune System Suppression: My immune system was weakened, making me more susceptible to infections.

The First Major Surgery: Liver Radiofrequency Ablation

Liver radiofrequency ablation (RFA) is one of the minimally invasive procedures used to treat liver tumors, including those from primary liver cancer or secondary liver cancer. It involves using imaging guidance, such as ultrasound or CT scans, to insert a thin needle-like probe into the liver tumor. Once in place, high-frequency electrical currents are passed through the probe, generating heat that destroys the cancer cells.

This technique is beneficial for patients who are not candidates for surgery due to underlying liver disease or other medical conditions. Liver RFA offers a less invasive option with a shorter recovery time, making it a compelling treatment approach for managing small liver cancers and metastases.

Deciding to undergo liver radiofrequency ablation was a crucial step in my treatment journey. My healthcare provider and I weighed the benefits and risks, considering this minimally invasive procedure to target small liver cancers. The lead-up to the liver cancer surgery involved extensive discussions with liver surgeons and interventional radiologists to ensure we had a solid plan.

Preparing physically and mentally for liver cancer surgery requires a multifaceted approach. Physically, I focused on maintaining my health through a balanced diet and gentle exercise, as recommended by my care team. Mentally, I practiced relaxation techniques, such as deep breathing and visualization, to manage anxiety. Support from family members and joining a support group were also vital in helping me stay positive and determined.

Post-Surgery Recovery and Continuing Treatment

The recovery period after the liver surgery presented several challenges. Initially, I experienced significant fatigue and some discomfort at the surgery site. The first few weeks were critical, requiring close monitoring and rest to allow my body to heal properly. Despite these challenges, the support from my care team and loved ones was invaluable in navigating this challenging period.

To continue chemotherapy, my healthcare provider adjusted the schedule to align with my recovery needs, ensuring I had enough time to regain strength. The main tracking item after the surgery is whether the liver function returns to normal because ALT and AST will rise sharply after the surgery and remain at a high peak for a while.

Strategies were implemented to manage side effects such as nausea and fatigue more effectively. Frequent blood tests and follow-ups helped monitor my liver function and overall health, ensuring the chemotherapy remained effective without overburdening my recovering body.

Managing to continue chemotherapy during recovery required a delicate balance. I had to listen to my body, rest when needed, and stay in close communication with my healthcare provider to adjust treatment as necessary. The ongoing support from my family and support groups also played a critical role in helping me through this phase.

Preparing for Subsequent Surgeries

After my initial surgery, it became clear that further procedures were necessary to continue my treatment. Each surgery required careful preparation, both physically and emotionally, to ensure the best possible outcomes.

Transanal Total Mesorectal Excision (TaTME)

Transanal Total Mesorectal Excision (TaTME) is an advanced surgical technique used to treat rectal cancer. This is also one of the minimally invasive procedures I underwent that involves removing the rectum and surrounding lymph nodes through the anus rather than traditional abdominal incisions. By using specialized instruments and a high-definition camera, surgeons can precisely excise the tumor while preserving healthy tissue.

TaTME offers several benefits, including reduced post-operative pain, faster recovery times, and lower risk of complications such as infections and hernias. This approach is particularly beneficial for patients with low rectal tumors, providing a practical option for achieving clear surgical margins and improving long-term outcomes.

Preparing for this rectal tumor surgery involved meticulous planning and coordination with my healthcare team. The goal was to remove the cancerous tumor with precision while preserving as much healthy tissue as possible. I underwent a series of preoperative tests, including imaging scans and blood tests, to ensure I was in optimal condition for the procedure.

Physically, I maintained a healthy diet and engaged in gentle exercise to keep my body strong. Emotionally, I focused on stress management techniques and sought support from family and friends. Joining a support group for cancer patients also provided me with valuable insights and emotional resilience, helping me face the upcoming surgery with confidence.

Open Hepatectomy

Open hepatectomy is an open surgery procedure performed to remove a part of the liver, typically to treat liver cancer, liver metastases, or severe liver disease. This surgery involves making a large incision in the abdomen to provide the surgeon with direct access to the liver. Depending on the size and location of the tumor or diseased tissue, the surgeon removes part of your liver, usually a segment, a lobe, or up to 50% of the liver.

The procedure is often chosen when minimally invasive methods are not suitable. Open hepatectomy allows for precise removal of cancerous or damaged liver tissue while preserving as much healthy liver tissue as possible, facilitating effective treatment, avoiding liver failure, and ensuring recovery.

Deciding on and preparing for the 50% open procedure hepatectomy was a significant step in my treatment. This surgery aimed to remove enough liver affected by cancer. My decision was based on extensive discussions with my healthcare provider and liver surgeons, who explained the potential benefits and risks associated with the procedure.

To ensure a successful surgery and recovery, I took several important steps:

Pre-Surgery Conditioning: I followed a regimen of healthy eating and physical activity to prepare my body for the surgery. Whether liver function is normal and healthy is crucial to the success of surgery. Maintaining healthy liver function is a challenge, especially for cancer patients undergoing treatment. It is recommended that cancer patients pay attention to the ALT and AST values during every blood test during the treatment period and do not develop a fatty liver. Healthy eating and exercise are good for maintaining healthy liver function.

Medical Preparations: Underwent thorough medical evaluations, including liver function tests and imaging scans, to assess my readiness for surgery.

Support System: Coordinated with family members to ensure I had the necessary support during and after the procedure.

Mental Readiness: Practiced relaxation and visualization techniques to manage anxiety and maintain a positive outlook.

Post-Surgery - Recovery

After major surgery, such as TaTME or Open Hepatectomy, the most important thing, in addition to rest, is exercise. In the first few days after the operation, you will be in so much pain that you cannot move and can only lie on the hospital bed. After that, slowly restoring the function of my intestines and liver through exercise is very critical. I exercise three times a day, mainly walking, for forty minutes at a time. While in the hospital, I was unable to eat due to the surgery and could only rely on intravenous nutrition drips. I would push the IV and walk back and forth along the corridor of the hospital and get to sweat a little bit.

There is a strong comparison with the patient in the bed next to me who underwent the same surgery as me. He did not exercise at all. On the day the doctor informed me that I could be discharged from the hospital, the doctor told him that his recovery was not going well, that he had a little fever, and he would have to stay in the hospital for a while longer. Lightweight exercise is essential for body repair, but at the same time, you must also consider your physical condition and not cause too much fatigue.

Managing Pain and Side Effects

Navigating the aftermath of major surgeries involved managing pain and dealing with various side effects.

Effective pain management was crucial to my recovery. I utilized several strategies to manage post-surgery pain:

Medications: I took prescribed pain medications as directed by my healthcare provider to keep the pain under control.

Non-Pharmacological Methods: Ice packs, heat pads, and gentle massage alleviated discomfort.

Relaxation Techniques: Practiced deep breathing, meditation, and other relaxation methods to reduce pain perception.

Dealing with Side Effects

Experiencing side effects after major surgeries was inevitable, but I found ways to cope effectively. Common side effects included fatigue, managed by resting frequently and conserving energy; nausea, controlled with medications and dietary adjustments; appetite loss, addressed by eating small, nutrient-dense meals; swelling, reduced with compression garments and elevating limbs; sleep disturbances, tackled by establishing a consistent sleep routine; and mood changes, monitored with counseling.

Coping methods involved staying well-hydrated, engaging in light physical activity, leaning on family, friends, and support groups for emotional support, consulting with a dietitian for nutritional supplements, and practicing mindfulness and meditation to stay present and reduce stress. These strategies helped me manage the pain and side effects associated with major surgeries, enabling me to focus on recovery and continue my fight against cancer.

Nutritional and Physical Preparation

Proper nutrition and physical readiness play crucial roles in preparing for major surgeries. They ensure the body is in the best possible condition to handle the stress and promote recovery.

Maintaining Weight and Nutrition

Maintaining good nutrition and a healthy weight before and after surgery is vital for a successful outcome. Ensuring my body had the necessary nutrients to help heal and fight infections.

Specific dietary adjustments and supplements:

Balanced Diet: Focused on a balanced diet rich in fruits, vegetables, high-quality protein and fat, and a small amount of whole grains.

Protein Supplements: Incorporated protein shakes to support muscle repair and strength.

Hydration: Drank plenty of water to stay hydrated and support overall health.

Vitamin Supplements: I took vitamins, particularly C and D, to boost immune function and zinc to help with wound healing.

Low-Fiber Diet: I followed a low-fiber diet before surgery, as recommended by my healthcare provider, to ease digestion.

Ensuring proper nutrition and maintaining weight involved working closely with a dietitian to tailor a diet plan that met my specific needs before and after surgery.

Exercise and Physical Readiness

Exercise played a significant role in preparing for surgery and also recovering from surgery by helping to maintain strength, stamina, and overall physical health.

Types of exercises performed as preparation for the surgery:

Walking: Regular walks to improve cardiovascular health and stamina.

Light Weightlifting: I used light weights to maintain muscle strength without overexerting myself.

Stretching: Daily stretching to improve flexibility and reduce muscle tension.

Breathing Exercises: Practiced breathing exercises to enhance lung capacity and reduce anxiety.

Types of exercises performed for recovery:

Walking: Walking helps wounds heal faster, and body functions recover faster.

Breathing Exercises: Practiced breathing exercises to enhance lung capacity and reduce anxiety.

Exercise helped me build the physical resilience needed for surgery and recovery, ensuring my body was as strong as possible.

Emotional and Psychological Preparation

Preparing emotionally and psychologically for major surgeries is as important as physical preparation. Managing anxiety and having a robust support system can significantly impact the overall experience.

Coping with Anxiety and Fear

Strategies for managing anxiety and fear:

Mindfulness Meditation: Practiced mindfulness to stay calm and focused.

Visualization Techniques: Visualized positive outcomes to reduce fear.

Journaling: I kept a journal to express and process my emotions.

Breathing Exercises: Used deep breathing techniques to manage anxiety.

Mental health and emotional support were crucial. Addressing anxiety and fear before surgery helped me maintain a positive outlook and reduced stress.

Support Systems

Family, friends, and support groups were invaluable in my preparation process. Their encouragement and understanding provided emotional stability. Professional psychological support and counseling also played a key role.

I sought help from a counselor to navigate the complex emotions involved, and joining support groups connected me with others facing similar challenges. This comprehensive support network was essential in helping me feel prepared and less isolated.

Practical Tips and Advice

Practical preparation is vital for ensuring a smooth surgical experience and recovery. Based on my journey, here are some tips and advice.

Medical Preparation

Practical tips for medical preparation:

Follow Medical Advice: Adhered strictly to the preoperative guidelines provided by my healthcare provider.

Organize Medical Records: Kept all medical records and documents organized and accessible.

Prepare Questions: I prepared a list of questions to ask my healthcare team during consultations.

Medication Management: I reviewed all medications with my doctor to avoid any complications.

Plan Post-Surgery Care: Coordinated post-surgery care, including transportation and home setup.

Following medical advice and preparing for post-surgery care was crucial. It ensured I was fully informed and ready for recovery, minimizing potential complications.

Personal Preparation

Personal tips and advice:

Educate Yourself: Learned as much as possible about the surgical process and recovery.

Prepare Your Home: Set up a comfortable recovery area at home with essential supplies.

Pack Essentials: Packed a bag with necessary items for the hospital stay, including comfortable clothing and personal items.

Communicate with Your Team: Maintained open communication with my care team and family members.

Being proactive and informed about the surgical process empowered me to make better decisions and feel more in control. It also helped me prepare thoroughly, ensuring a smoother and more confident approach to surgery.

Preparing for Major Surgeries

Reflecting on my preparation for major surgeries, I recognize the importance of thorough preparation in ensuring the best possible outcomes. Key points such as maintaining proper nutrition, regular exercise, keeping healthy liver function, managing pain and side effects, and seeking emotional support were crucial. By staying informed and taking an active role in my surgical preparation, I was able to face each challenge with confidence and resilience.

To anyone preparing for major surgeries, I encourage you to be proactive, educate yourself, and build a strong support network. Remember, your efforts in preparation can significantly impact your recovery and overall well-being.

References

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Charnsangavej, C., Clary, B., Fong, Y., Grothey, A., Pawlik, T. M., & Choti, M. A. (2006). Selection of patients for resection of hepatic colorectal metastases: expert consensus statement. Annals of surgical oncology, 13(10), 1261–1268. https://doi.org/10.1245/s10434-006-9023-y

Irani, J. L., Hedrick, T. L., Miller, T. E., Lee, L., Steinhagen, E., Shogan, B. D., Goldberg, J. E., Feingold, D. L., Lightner, A. L., & Paquette, I. M. (2023). Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery From the American Society of Colon and Rectal Surgeons and the Society of American Gastrointestinal and Endoscopic Surgeons. Diseases of the colon and rectum, 66(1), 15–40. https://doi.org/10.1097/DCR.0000000000002650

Lacy, A. M., Tasende, M. M., Delgado, S., Fernandez-Hevia, M., Jimenez, M., De Lacy, B., Castells, A., Bravo, R., Wexner, S. D., & Heald, R. J. (2015). Transanal Total Mesorectal Excision for Rectal Cancer: Outcomes after 140 Patients. Journal of the American College of Surgeons, 221(2), 415–423. https://doi.org/10.1016/j.jamcollsurg.2015.03.046

Preparing for Major Surgeries: What You Need to Know

Initial Treatment and Preparing for Surgery

The First Major Surgery: Liver Radiofrequency Ablation