PrEPPing for better health in recovery
Recovery from major surgery can be long and difficult, but a program at Nepean Hospital is empowering patients to get in the best possible shape before and after their procedure, to reduce the risks of complication, spend less time in hospital and improve the patient experience.
When Les needed complex abdominal surgery to remove a rare form of cancer, he knew the stakes were high.
“I was told that my life would change a lot”, says Les, who underwent what’s known as a Whipple procedure to remove parts of his pancreas, small intestine, gall bladder and reconstruct his bile duct.
“I knew the surgery would be long and high risk, which made me anxious – I didn’t know for sure that I would even wake up”.
After celebrating his 70th birthday earlier this month, Les is feeling fit and healthy again, in part thanks to his participation with the PrEPP clinic at Nepean Hospital.
PrEPP stands for Pre-operative Education and Prehabilitation Program and is available to select abdominal and thoracic surgical patients in the Nepean Blue Mountains Local Health District, and in some cases beyond.
By attending the clinic, Les was able to prepare for his procedure with personalised care from a dedicated multidisciplinary team.
Depending on the patient’s needs, this team can include a geriatrician, dietician, pain specialist, pharmacist, physiotherapist and social worker.
“Because of the length of the operation I essentially needed to learn how to breathe again, so a lot of the exercises were to do with training my lungs to recover”, says Les.
“I also needed to do weights, squats and chair exercises to strengthen my legs”.
William Lai, resident physiotherapist with the PrePP program at Nepean Hospital, explains how “prehabilitation” aims to enhance patients’ physical and psychological functionality in the period before surgery to support them to deal with surgical intervention.
“We provide a comprehensive initial assessment which is typically face-to-face but also offered via telehealth, as some patients come to Nepean Hospital from as far West as Orange”, says William.
“We then provide education about how to prepare for surgery and offer appropriate multidisciplinary support. For my part this includes exercise classes, here in our hospital-based gym but also through a home-based, personalised exercise program”.
Research published recently by the PrePP team at Nepean Hospital demonstrates some of the benefits of the program, including significant reductions in the need for prolonged ventilation of patients and a reduction in their average length of their stay in hospital.
Patient feedback about the program also emphasises the social aspect of the clinic as beneficial to their overall experience.
“Being here at the gym helped me to feel more confident”, says Les.
“William introduced me to other guys who’d had the operation, helping me to understand what life would be like on the other end”.
“Patients attend across the surgical continuum and there is freedom to talk amongst themselves and share their experiences and thoughts”, says William Lai.
Following prehabilitation and surgery, patients like Leslie continue to participate in home and hospital-based rehabilitation services.
Without the gym I wouldn’t have recovered so well, and I think that with all these people looking after you, it gives you confidence”, says Les.
“I’m feeling good now, and I always try to I make the most of things”.