Preparing for an upcoming surgery involves a proactive approach known as prehabilitation, which is designed to build the body’s reserves for the stress of the operation and subsequent recovery. This period of physical and mental conditioning can significantly improve outcomes and accelerate healing. For patients undergoing elective surgery, the weeks leading up to the procedure offer a valuable chance to optimize health. Focusing on nutrition, physical fitness, medication management, and lifestyle adjustments helps individuals take control of their readiness and prepare for a smoother post-operative experience.
Optimizing Nutrition and Physical Health
Improving strength and cardiovascular function before surgery is directly linked to faster recovery times and a lower risk of complications. Engaging in moderate, doctor-approved exercise, such as brisk walking, cycling, or light strength training, can boost cardiorespiratory fitness and maintain muscle mass. Consistent physical activity, even 30 minutes five times a week, conditions the lungs and heart, making the body more resilient to the effects of anesthesia and post-operative immobility.
Nutrition plays an important role in the prehabilitation phase, especially through the adequate intake of protein. Protein serves as the fundamental building block for tissue repair and supports the immune system’s function. While a healthy adult typically requires about 0.83 grams of protein per kilogram of body weight daily, pre-surgical requirements are often higher, sometimes needing at least 1.2 to 1.5 grams per kilogram. Focusing meals on lean meats, fish, eggs, dairy, and legumes ensures a steady supply of amino acids for the healing process that follows surgery.
Certain micronutrients also support the body’s preparation for healing. Vitamins C and D are particularly relevant, with Vitamin D often included in nutritional protocols alongside protein supplementation. These vitamins act as co-factors in metabolic processes and support immune function, which is temporarily suppressed by surgical trauma. Patients must avoid extreme or “crash” diets, as they can deplete energy stores and compromise the nutritional status needed for recovery.
Managing Prescribed Medications and Supplements
Careful management of all current medications and supplements must be supervised by the surgical and anesthesia teams. Certain prescription drugs, particularly blood thinners, must be stopped or modified because they increase the risk of excessive bleeding during the operation. Common anticoagulants like warfarin often need to be paused about five days before a procedure. Newer direct oral anticoagulants might be stopped 24 to 72 hours beforehand, but this timeline is highly individualized.
Patients taking medications for chronic conditions like diabetes or high blood pressure require specific instructions. Diabetes medications, especially insulin and oral agents, often need dosage adjustments before surgery to prevent fluctuations in blood sugar levels during fasting periods. Some heart and blood pressure medications may be continued with a small sip of water on the morning of surgery, while others are temporarily stopped.
Over-the-counter medications and herbal supplements carry potential risks and must be fully disclosed to the medical team. Many supplements, including fish oil, Vitamin E, and herbals like garlic, ginkgo, and ginseng, can interfere with blood clotting or interact negatively with anesthesia. These are typically discontinued one to two weeks before the procedure to allow the body to clear them. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen are also stopped seven days before surgery due to their effect on platelet function.
Addressing High-Risk Lifestyle Factors
Reducing certain lifestyle habits increases the likelihood of avoiding post-operative complications. Smoking cessation offers one of the greatest opportunities for risk reduction, as nicotine constricts blood vessels, impairing oxygen delivery and hindering wound healing. Carbon monoxide from smoke binds to red blood cells, further reducing the body’s capacity to transport oxygen needed for tissue repair and recovery from anesthesia.
The ideal timeline for quitting smoking is at least four to eight weeks before the procedure to allow for meaningful reductions in complications. However, even quitting 24 to 48 hours before surgery can offer benefits by improving oxygen levels in the blood. Excessive alcohol consumption before surgery can complicate the process by thinning the blood, increasing the risk of bleeding. Heavy drinking also affects liver function, which metabolizes anesthetic agents and post-operative medications.
It is recommended to refrain from drinking alcohol for a minimum of 48 hours to seven days before the operation. Controlling pre-existing chronic illnesses is another factor that reduces risk. Conditions such as uncontrolled hypertension or unstable diabetes significantly raise the chances of complications like heart problems or infection after surgery. Ensuring these conditions are well-managed and stable through adherence to treatment plans is an important preparatory step.
The Final 24-Hour Checklist
The final day before surgery involves specific, time-sensitive instructions to ensure the safest possible environment for the procedure. The most important instruction is the mandatory fasting protocol, often referred to as NPO (nil per os, or nothing by mouth), which prevents pulmonary aspiration. Aspiration occurs when stomach contents enter the lungs during anesthesia, a serious and potentially life-threatening complication.
Patients are typically instructed to have no solid food after midnight on the day of surgery, including gum, mints, and hard candies. Clear liquids—such as water, black coffee, or clear electrolyte drinks—are often permitted up to two hours before the scheduled arrival time, though this varies by facility and procedure type. Non-compliance with these fasting rules will lead to the cancellation or delay of the surgery for patient safety.
Other logistical and hygiene steps must also be completed in the final hours. Patients are often instructed to shower the night before and the morning of surgery, sometimes using a specialized antiseptic wash to reduce the risk of surgical site infection. Arrangements must also be confirmed for a responsible adult to drive the patient home and remain with them for the first 24 hours after the procedure, as post-anesthesia effects make supervision necessary.
Removal Checklist
Before the procedure, patients must remove or leave off the following:
- All jewelry, including wedding rings and body piercings.
- Makeup.
- Nail polish.
- Contact lenses.