Overview

Mr Jonathan Olsburgh (consultant surgeon): In this video we're going to talk about what you can expect during your care with us before, during and after an operation and what steps you can take to assist your recovery and help you to get home as quickly as possible.

This is often referred to as the enhanced recovery programme.

These principles apply to any kind of operation. Evidence shows that being prepared for your operation both mentally and physically will help your recovery. You will know what to expect, what you can do to make yourself feel better. This is a key element of enhanced recovery.

Applying enhanced recovery principles before your operation helps ensure you're better prepared by looking at exercise and diet; if appropriate stopping smoking or reducing alcohol; thinking about your home circumstances and having information on what to expect at each stage.

Ian Wicks (kidney transplant patient): I spoke to my doctor when I turned out for my regular appointments about what to expect and things like that helped. I'm someone who likes to know information in advance it helps me process it a bit better. Back in the education sessions it was, don't smoke if you smoke, don't drink if you drink.

Start to manage your diet a little bit differently, which we did, and in terms of the diet I think that was the thing that probably helped the most given guidance on what things would be good for me to eat the things that wouldn't be so good for me to eat. I think having that information and also listening to it is really important.

Kathryn Chatterton (clinical nurse specialist): When I first meet you I'll be introduced to you by my consultant and then we'll be able to go through before and after what's going to be happening to you during your surgery. You'll also be given the opportunity to ask me any questions and also I'll make sure that you have the appropriate literature for you to have with regards to your surgery.

Before your surgery you'll attend a pre-assessment clinic or a seminar which will be with a group of patients that are all undergoing the same surgery. Depending on the type of surgery and length of surgery there are a few members of the health care professional team that you may meet.

You may meet the clinical nurse specialists who will be able to go through any additional questions that you're unsure about regarding your surgery. You will also meet a physiotherapist. They may be able to help you with any exercise to help you for pre and post-surgery and also, perhaps depending on the surgery, a pharmacist.

Our dietitians can give guidance on nutrition before your surgery and how to look after yourself nutritionally when you're discharged. Some patients may be asked to drink a special carbohydrate drink which will help prepare your body for the operation and will help you with your recovery.

Anna Mae Salvador (ward manager): The nurses will prepare you for surgery and when you're ready you'll be taken to an anaesthetic room and from there you're going to the operating room. After an operation most patient will wake up in the recovery room where you will be monitored until you're ready to go back to the ward.

If you have had complex surgery or have complex medical needs you may move to a more specialist unit to be monitored through the initial recovery before being moved to the ward.

It is important to get up and get moving as soon as you can after your operation. Most patients can start gentle exercises in bed and maybe sit out in a chair with assistance from the nurse on the same day of the operation. Movement will really help your recovery.

The team looking after you will make sure you start eating and drinking at the right time after your operation, building this up gradually. We will also ask you if you have any pain or nausea and will help you manage this.

Ian Wicks: I think it was on day one after the operation I should be getting out of bed and sitting up for a little while and I think that gave me the kind of the kick to get up and do it, thinking with that's what I've been told to do that's got to be the right thing to do even if it hurts. So get up, get out of bed and just try and do what the little booklet told me to do.

I think having like a plan laid out, almost like a diary of what to expect, was really helpful, and I think in some ways you almost want to psychologically to try and beat it a little bit because I think it ran for five or six days, the programme. It was nice to know that I could sit in a chair longer than they expected me to sit in a chair for example. So that was a bit of a challenge almost to try and do better than it was laying out for you.

Mr Jonathan Olsburgh: The important thing to remember is that every patient we see gets personalised care and is based around giving you the best possible experience and fastest possible recovery. The experience of Ian is an example of enhanced recovery to best support a transplant patient, many of the principles apply regardless of the type of operation you require.

Ian Wicks: I went home three and a half days after the operation and I felt ready to go.

Mr Jonathan Olsburgh: We're always happy to answer your questions so please do ask a member of your care team.