Preparing our patients for surgery

Would you run a marathon without training for it? Didn’t think so. So why do we expect our patients to undergo major surgery with just a bit of pre-assessment and a pat on the back?

St Mary’s is one of London’s centres for upper GI surgery – meaning we operate on oesophageal and stomach cancers.  These are big operations with a high rate of post operative complications like pneumonia.  Our patients generally undergo chemotherapy for three months before their operation and usually they lose physical fitness during this time.  

This three month period is also a wonderful opportunity for training. We always told our patients to stop smoking, do more exercise and ensure they ate well during their chemo, but they were essentially on their own.

For the last two years with grants from the Imperial charity and CLARHC we have been taking this further and providing our patients with a training programme cantering not only on physical exercise, but also nutrition and psychological support.  Our patients are more prepared on their day of surgery, they are motivated, fit, better nourished and have a glint in their eye and a determination to get through the operation. Our complication rates have improved (particularly pneumonia) and our patients mobilise earlier after surgery. Our patients are in control and are able to influence their cancer therapy.

This programme is charity funded at the moment for our NHS patients (interestingly several private medical insurers have refused to fund their insured patients to go through it), and somehow my colleagues have persuaded me to join them on the three peaks challenge in June to fundraise for it. For those who don’t know, the challenge is to climb the three highest peaks in Scotland, England and Wales all in 24 hours. I asked if we couldn’t just do a 10km race or half marathon or something like that, but no – apparently it has to be something more crazy. 

So here I am with my begging bowl – the prepare for surgery programme isn’t a shiny gadget, it’s a simple concept that makes sense, and has made a big difference to our patients.  We’re planning on rolling it out to other specialties and hospitals, we’ve developed an app for our patients and for all this to work we need funds.  

The fundraising link is here https://www.justgiving.com/fundraising/PREPAREforsurgery