January 18, 2025 · Written by Dr. Gina Bernal
January 18, 2025 · Written by Dr. Gina Bernal
Before I worked as a physical therapist in a hospital, I was under the impression that I was relegated to wearing hospital gowns and eating whatever was brought to me. I didn’t know how to prepare for surgery or what to even expect. My surgery prior to becoming a PT was a bit of a crash course on this, but I still came away from the whole experience lacking information. After I worked for a few years as an inpatient PT with weekly post-op floor coverage, I had a whole new understanding and perspective of not only how to prepare myself for any future surgery, but how to help others through this whole process. This post is my guide for how to navigate surgery prior to the procedure. Be sure to talk about your specific situation and needs with your PT or surgeon prior to surgery in case this guide doesn’t cover those details.
The following text is a bit lengthy, however I have found it all to be very valuable to my patients over the years.
Physical Therapy Appointments
First, get your physical therapy appointments scheduled now. I think we’ve all noticed how backlogged PT clinics are, and with so many people needing post-op PT, it’s impossible to push post-ops to the head of the line when 50 others are in the same boat. Even if it’s six months from now before you’ll have surgery, make those appointments. You’ll want to schedule at least a month’s worth if possible, and it will probably be twice a week for that time. You should also request scheduling a pre-op appointment so that you can go over any exercises and assistive equipment with your PT so you are familiar with this. Each clinic and practitioner has their own scheduling policy, so this may vary, but they will all thank you for planning ahead. Go ahead and do that now before continuing with this article.
Equipment
Ok, now that you’re all scheduled, let’s talk about equipment you might need. This varies depending on what kind of surgery you’re having, but the common concerns are: mobility support, toileting needs, bathing needs, and sleeping needs. Mobility support includes walkers, canes, wheelchairs, knee scooters, and crutches. Your PT or surgeon will help you determine what you will need based on your current mobility and how your mobility will be impacted by the surgery. Be sure to get the equipment needed before surgery so you can go home with it.
Toileting needs include providing additional height and support to your toilet. This is common for knees, hips, and back surgeries due to mobility limitations and precautions. If you have a tall toilet and grab bars around it, then you’re all set. Chances are decent though that you have one or none of these. A standalone raised toilet seat with grab bars is ideal. They are adjustable, sturdy, and stable. I would caution against raised toilet seats that fit into the toilet itself as these can pop out and don’t provide the same flexibility of use as a standalone model. I would also caution against using any suction cup grab bars as they don’t adhere to drywall well and can also pop off. Nobody wants to have to make the call to EMS from between the toilet and wall.
Bathing needs revolve around preventing water from coming near the surgical site and shower safety. There are some amazing shower sleeves out there to choose from that can help keep water out. They are not meant to be submerged and you don’t want the gasket part to be overwhelmed by the stream from a shower head. I used a shower sleeve for two weeks with great success after a wrist surgery and didn’t get any water inside. I was impressed with how well it kept the water out despite being in a tight shower stall with little room to avoid the water.
Shower safety includes shower seats and grab bars. Even if you aren’t getting surgery on your leg, you will likely want a seat to rest on. It is not uncommon to suddenly need to sit due to fatigue post-op, and this can last for weeks, so a shower chair with grab bars is a good investment. Again, suction grab bars are not recommended as they can come unstuck at the most inconvenient times.
Sleeping needs include bolsters and pillows. Elevation is key after a surgery, and so you might benefit from a wedge pillow to raise your legs or to raise your head and chest. Small pillows to keep your arm elevated are also helpful in this case. Again, each surgery is different, so be sure to talk with your PT or surgeon about the details.
Where do you buy all this equipment? Won’t this cost a lot? Sure, you can buy all this online or from a drug store easily, but you don’t have to. Many thrift stores sell this equipment in good condition at a fraction of the cost. I once bought a $200 pair of forearm crutches for six dollars. You can’t beat that. Many senior resource centers also carry equipment that you can borrow for free. Something else I’ve known people to do is to buy an expensive piece of equipment as a group. If you and your group of friends are all thinking you’ll have surgery in the next few years, I would suggest pooling your money and buying what you need. Then, you know you’ll have it and it’s yours to keep without having to take the financial hit alone. An example of this was when a group of my patients went in together on an ice therapy machine. They were still passing it around two years later and grateful for their proactive decision.
Conditioning Your Body
So, you’ve scheduled your appointments and you are familiar with what equipment to buy, now what? Now is the time to focus on what you are putting into your body. Eating high inflammatory foods, such as sugar, puts a strain on the body. Smoking also does this. When we expose our body to inflammatory things, we are using up valuable resources and going into surgery at a deficit. This does not set us up for success. Staying hydrated is also key as it helps flush out any inflammation.
Sleep prior to surgery is also important as it plays a major part in healing. When we are sleep deprived, our cortisol levels go up. This in turn causes a cascade of events, including limited tissue healing and increased inflammation. Going into surgery with elevated cortisol will impact your recovery. If possible, for a month leading up to your procedure, limit your consumption of inflammatory foods, eliminate smoking, and get as much sleep as possible. Naps are also helpful, so try not to resist them if you can.
Something else I want to discuss is stress. Our cortisol levels go up when we are experiencing stress and anxiety, and as stated before, this impacts recovery. You might be thinking “How can I not be stressed before surgery?” or “My life is hectic, there’s no way I can avoid stress”. Whatever you might be thinking, your concerns are valid. Me telling you not to be stressed is like telling water not to be wet. What you do to manage the stress in your life makes a difference. This opens the door to an entirely separate blog post (or few), but the bottom line is: explore ways to reduce or release stress. Your adrenal glands will thank you. You don’t have to be perfect at it either, even spending 30 seconds doing breath work before bed will make a positive impact.
I have shared these things with many patients, and they have all come back saying “Thank you”. I believe you will do well with your surgery as you are, and adding some or all of what we have discussed today will only elevate your experience. Stay tuned for my blog post about how to navigate life after surgery.
Be well,
Gina