5 Things to Know Before Surgery


Many patients who come to us for rehabilitation have undergone surgery. If you or a loved one are one of these people, make sure you know these five little pearls—bits of practical wisdom—that won’t be in that fancy color pamphlet that the surgeon gives you or the packet of papers the nurse places into your hands after surgery. When I had to go into surgery, these five tips helped everything go smoothly, and whenever I have patients going under the knife, I always let them know how to prepare for surgery and what they should expect afterwards.

Stool Softeners and Bowel Movements

I have an idea that won’t make everyone happy. Early in their training we should make every medical and nursing student constipated for three days. They will never again dismiss constipation as “no big deal.” Sometimes, physical therapists will come to me and complain: ”Mrs. Jones is being unreasonable and will not go to therapy today because she feels terrible from her constipation.” (I better add therapists to the list of people who should have to deal with constipation as a part of their training.)

The first thing for anyone who is undergoing surgery is to start taking stool softeners two days prior to their surgery—don’t be squeamish! The medications they give you at the time of surgery, your pain medications and the recovery’s inactivity will all constipate you. Insist on stool softeners immediately after surgery, and if you are in the hospital for a few days, don’t be afraid to ask for a suppository in order to have a bowel movement before you go home. When you are holding your sore belly, head or back as you first try to go to the bathroom post-surgery, you will thank me for this advice. 

Elevated Toilet Seat and Shower Chair

Even if you haven’t had a stroke, you will still appreciate these two items. Just get them and store them in the garage, because you and a family member will need them more than once. It doesn’t matter what type of surgery you are having; your toilet seat is too low. Getting up from a low toilet seat puts a lot of strain on your back and abdominal muscles.  You don’t need the big rig that rolls over your commode. They make a nice seat that clamps onto your current toilet, and everyone will feel comfortable using it.  You can also purchase a nice little stool that fits in the shower or tub. Don’t try to be an acrobat and balance on one foot while you shower. Remember, buy these before your surgery and have your home all set for when you get back from the hospital.

General Anesthesia Will Affect Your Thinking

I find the anesthesia worse than the surgery. I get a headache, low grade fever and feel “foggy” and fatigued for at least two to three days. I always tell my patients that they may notice problems with their thinking for weeks after a general anesthetic. This is well documented in the medical literature and is called Post-Operative Cognitive Dysfunction (POCD).                   

Even if they just “put you to sleep” and don’t perform surgery, you would still have these problems. Many of the drugs that are administered to put you under and then to wake you up have an effect on your brain and cognition. Remember the whole idea is to “knock you out,” so we would expect them to have some effect on your thinking. Don’t be alarmed, but don’t plan on making any important decisions at home or work for at least a week or until you feel clear headed.

It May Take Longer to Recover Than You Think

As a neurologist, many of my patients undergo major surgery on their brain or spine. I always remind them beforehand: “If you wake up after surgery and feel terrible, it doesn’t mean that things went wrong; you just had a big operation.” Most surgeons don’t want to tell their patient, “I am going to operate on you, and you will wake up feeling bad,” but you deserve to know that you may not feel so great. I have always been amazed when I have had surgery that I feel pretty good before they wheel me into the operating room only to awaken a few hours later feeling much worse. So, be prepared to feel worse than expected and don’t worry. If you feel fine, it’s a bonus—enjoy it.

Who is on-call?

One of my friends had surgery on a Wednesday. She went home on the Friday of a holiday weekend. If she had a problem and needed help, whom should she call? Will they know about her case, or will she get the well-worn response, “Go to the ER?” Whenever you are discharged from a hospital, don’t forget to ask the doctor if they will be around the next few days or if someone else is on-call.  What number do you call for help? Would the doctor please let the on-call doctor know about you? If you are medically fragile, you may try asking for their cell phone number. You will be surprised how many doctors will be willing to share it with patients who won’t abuse the privilege.

You always hear that it is the little things in life that count, and guess what? They count for surgical recovery, too. Follow these tips on how to prepare for surgery. You may have had a big operation, but when nature calls, you will be ecstatic that you took your stool softeners and are seated on a comfortable elevated toilet seat. Trust me, I know.