Connective Issues Spring 2022

PREPPING FOR SURGERY MENTALLY AND PHYSICALLY

on walking for 30 minutes and build up from there as tolerated. Similarly, walking up and down a few fl ights of stairs in the weeks leading up to surgery can help. Commonly we fi nd that the more active someone is before surgery, the sooner they will return to full activity afterward. u What is your best advice for preparing mentally for surgery? Mental preparation for surgery is di ff erent for each person. An open conversation with the surgeon is the best place to start, particularly for those who feel more comfortable knowing the details of the operation. If possible, connect with others who have had similar operations, which can help provide a sense of what to expect, and most importantly, demonstrate that full recovery is possible. The Marfan Foundation is a great resource for connecting with similar people in the community. u What recommendations do you have post-surgery for recovery, both mentally and physically? The biggest thing I like to emphasize is that recovery from open-heart surgery is a long process and requires patience. Over the 2-3 months (and sometimes longer) of recovery, there are good days and bad days—it is not always a straight line back toward normalcy. Small setbacks are a common and expected part of the recovery process. This is important to understand so that patients and families do not become discouraged and continue to trust that the overall progress remains good. Be con fi dent in your surgeon and his/her team, as they will guide you and help you get back to the fully active person you were before your surgery. u How do you recommend reducing stress about surgery? Having heart surgery is a scary process, and being anxious about it is completely normal. There are two main ways that I think are most helpful to reduce anxiety and worry around this process. One is to talk with others who have had similar operations in the past. The other is to trust the surgeon and team that will be providing your care. The Marfan Foundation is a great resource for helping with both of these measures. The Marfan Foundation o ff ers many resources to connect with others for information and support and to prepare for and learn about the di ff erent types of surgeries. Learn more at Marfan.org, and be sure to check out our Aortic Health & Surgery Series on YouTube.

One of the most di ffi cult situations for someone with Marfan, Loeys-Dietz, or VEDS is when they are facing aortic surgery. We spoke with Clayton A.

Kaiser, MD, thoracic surgeon at Ascension Saint Thomas Hospital in Nashville, TN, to get insights about how to best prepare for surgery. u Do you think people adequately prepare for surgery? Every person prepares for surgery di ff erently. There is no one-size- fi ts-all approach. Some will want to know every detail of their procedure, including watching videos of open-heart surgery online. Others do not want to know any speci fi cs because thinking about the details of their surgery leads to anxiety. I typically recommend that people do not watch any surgical videos before their operation, as the visual can be a lot for a non medical person to process and understand. In general, I think people should have an understanding of what operation they are having and should be able to explain to their family and friends the basics of the operation, e.g., replacement of my ascending aorta, repair of my aortic valve, etc. Becoming familiar with details beyond this can be handled on a case-by-case basis. u Why is it important to prepare physically and mentally for surgery? Open-heart surgery is a signi fi cant operation, and the scope of it should always be well explained to patients and their families by the surgeon and his/ her sta ff . Being in the best shape possible—mentally and physically—heading into surgery optimizes an individual’s chances for the ideal outcome: a smooth recovery from surgery, a shorter stay in the hospital, and return to full activity at home sooner. u What is your best advice for preparing physically for surgery? To prepare physically for surgery, an individual should stay at least as active as he or she was prior to scheduling the surgery. For example, if you were previously active outside with regular walking or jogging, you should continue those activities. This is not a time to begin vigorous exercise for those who were not active before, but implementing a moderate exercise routine can be bene fi cial. For example, work

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Marfan.org