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Recovery

Having an operation can be both physically and emotionally stressful. Enhanced recovery programmes try to get you back to full health as quickly as possible.

This section provides an outline of:

  • Programmes to aid recovery.

  • Information on how long recovery may take.

  • Guidance on helping you to recovery as quickly as possible.

Early Recovery after Surgery (ERAS) Programme

Research has shown the earlier a person gets out of bed and starts walking after having an operation, the shorter their recovery time will be.

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Enhanced recovery is a modern, evidence-based approach that helps people recover more quickly after having major surgery. Many hospitals have an enhanced recovery programme in place, and it's now seen as standard practice following surgery.

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The Oxford University Hospitals (OUH) project started in October 2011 with funding from NHS South Central to introduce an Upper Gastrointestinal Enhanced Recovery after Surgery (ERAS) Programme to enhance the quality of care delivered to patients undergoing oesophagogastric cancer surgery.

 

Oxfordshire Oesophageal and Stomach Organisation (OOSO) helped to set up the programme and will continue to support it.

 

This ERAS programme aims to:

  • introduce into routine practice the principles of enhanced recovery to the pre-operative, peri-operative and post-operative periods.

  • establish appropriate protocols for enhanced recovery, including patient information and documentation.

  • optimise patient preparation for surgery, through patient education and partnership, stabilisation of nutritional state and inspiratory muscle training.

  • reduce post-surgery complications, including a reduced incidence and severity of pulmonary complications.

  • reduce re-admission rates to the intensive care unit and also reduce the length of hospital stay.

  • enhance patient expectation and satisfaction with care.

  • enhance an improvement in the use of hospital resources and therefore cost-savings to the Trust.

  • Ensure that patients:

    • are as healthy as possible before receiving treatment.

    • receive the best possible care during their operation.

    • Receive the best possible care while recovering.

 

As part of the enhanced recovery programme, you’ll be able to play an active role in your care. You’ll be able to choose what's best for you throughout your treatment with help and advice from your GP and healthcare team.

 

Your overall experience should be improved due to high-quality care and, where possible, high-quality services, such as keyhole surgery.

 

Following surgery, you'll also have access to rehabilitation services such as physiotherapy. This will help speed up your recovery and enable you to be discharged from hospital as soon as possible so that you can return to normal life.

 

Depending on your operation, you may be able to go home sooner than usually expected. It's therefore important to plan and prepare for your return home before you go into hospital.

Recovery times

Recovery times very much depend on the individual. Typically, discounting other health conditions, everyone takes around 3 months to recover sufficiently well to return to a relatively normal daily routine. This means being able to eat small but normal meals, drive, shop, work, travel, and do most normal things around the house. In reality however, a full recovery can take up to a year or more, while for a few people it might be 2 years before they feel ‘truly normal’ again. This is because some of the side effects of surgery are life changing and it takes longer for some people to adapt to doing certain things differently.

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For example, some patients after surgery need to be on a liquid or soft food diet for longer than others because their digestive system simply takes longer to adapt to the changes. For these patients, in the short term, it is harder to maintain or gain weight. This has knock-on consequences affecting energy levels and how they feel. While recovery is not the same for everyone it will happen, and in time all patients return to a good quality of life. 

How to recovery to aid after surgery

As soon as you get home plan a daily routine of things to remember and do. Write it down as a list or on a calendar. This should include a meal plan of eating six small meals a day ticking them off as you go, so you don’t forget to eat. Add to the daily list two or three short exercise sessions which might be as simple as walking around the house; going up and down stairs; leg lift exercises while sitting down and so on. As the days move on, try to be more ambitious with your exercise. After 4 weeks at home, I was proud to be walking nearly 2 miles a day. Recovery might feel painfully slow, but if you make notes on your progress, you will surprise yourself by how well you are doing. Don’t forget to add in a daily rest period. I found that 1-2 hours of rest during the mid-afternoon, helped a lot during the first 3 months.

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Minimising post-operative side effects

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Knowing about side effects is half the battle. Being aware of minor complications (e.g. aches and pains, diarrhoea) means you can be better prepared for them and be better prepared to act to reduce the effects.

 

Eating small portions of foods that break down or can be chewed easily is a good start. Not eating too late is also an important general tip to help avoid acid reflux whilst sleeping. The section on surgical side effects deals with solutions and tips on now to ameliorate some of the main side effects.

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