NZNO nurses, healthcare assistants and some midwives plan to strike from 9am on Wednesday 30 July to 9am on Thursday 31 July. Patient safety is our priority and our hospitals will remain open. Continue to attend all appointments unless we have contacted you directly to reschedule.
Having surgery puts extra demands on your body. Making changes to improve your hauora (health and wellbeing) in the lead up to your operation can make surgery and anaesthesia safer for you. Areas you can focus on are managing your medical conditions, lifestyle factors and getting fit for surgery.
If your doctor or surgeon has recommended you have surgery or a procedure, they will discuss with you and your whānau why it may be necessary. They will explain the procedure and the risks, and if there are any other options for helping treat or manage your health condition.
When you have agreed with your doctor or surgeon to go ahead with surgery, there are things you can do to be as well prepared as possible.
Some medical conditions can affect recovery from surgery. If you have some known conditions, it is important they are under control ahead of your surgery.
As part of your pre-operative assessment at the anaesthetic assessment clinic you will be asked about your health. The team may also test for new medical conditions that could affect your surgery.
If the surgeon or anaesthetist is very worried about your medical conditions, it might sometimes be necessary to delay surgery. This gives you more time to work with your healthcare provider or specialist medical team.
Good control of your blood sugar (glucose) level is really important for reducing your risk of infections after surgery. If you need to get better control of your diabetes for surgery, you can do this by making changes to your diet or your diabetes medicines.
If you have type 2 diabetes, increasing how much you exercise can help. Your healthcare provider or diabetes team can help you make these changes.
Controlling your blood pressure to safe levels reduces your risk of heart disease or stroke. If you have had high blood pressure before or you are currently taking medicines to manage your blood pressure, your healthcare provider can check your blood pressure. They can help you make sure it is well controlled before your surgery.
High blood pressure (hypertension)
Chronic lung disease includes long term breathing conditions like:
Chronic obstructive pulmonary disease (COPD)
If you have chronic lung disease you might feel short of breath with gentle activity, cough up phlegm or mucus even when you are well and might often be unwell with chest infections. In Aotearoa New Zealand, one of the most common causes of chronic lung disease is smoking.
Having chronic lung disease brings a higher risk of breathing complications during and after surgery. There are several ways you can reduce this risk.
Quitting smoking | Te whakamutu i te momi paipa
Things to watch out for that are signs of chest infection include:
It is important to get checked out early and be on the right treatment plan to be as well as possible before your procedure.
Obstructive sleep apnoea (OSA) is a condition that can cause you to stop breathing for short periods of time while you are asleep.
If you have OSA, you might:
If you have OSA, you might not remember these night-time episodes but you may notice other effects instead. These include:
If OSA is not treated, it can lead to other problems like high blood pressure and heart disease.
There are ways to treat or manage OSA. If you think you might have OSA, see your healthcare provider.
If you have untreated OSA you more likely to have complications after surgery. Getting diagnosed and started on treatment helps reduce your chance of complications.
If you have already been diagnosed with OSA and you use a mask to help your breathing at night, bring this with you to hospital when you have surgery so it can be used during your hospital stay.
As part of your assessment for surgery, you will be asked to have a blood test. If this shows you have anaemia (a low red blood cell count) or low iron levels, you will be referred to the hospital blood management service.
The hospital will contact you to organise treatment to boost your iron levels with oral iron or an iron infusion either at the hospital or at your healthcare provider. Treatment helps to get your iron levels closer to normal before your surgery or procedure.
Treating your anaemia before surgery:
Iron deficiency anaemia is the most common type of anaemia. It happens when your body's level of iron mineral is too low. You use iron to:
If you have anaemia your symptoms can include:
Your healthcare team can explain transfusion risks, benefits and any alternatives that are available to you.
Before your surgical or medical treatments, you may wish to ask some questions.
Patient blood management focuses on 3 areas.
Optimise your blood before surgery or treatment — identifying and treating anaemia before your planned surgery or medical treatment. .
Reduce blood loss — minimising blood tests and samples before surgery and using modern techniques to help reduce bleeding during your planned surgery.
Manage anaemia — your body can adapt to lower levels of haemoglobin (the molecule that carries oxygen inside red blood cells) caused by blood lost during surgery. A blood transfusion is not always needed. You can be given iron tablets or intravenous iron instead, to help increase your haemoglobin levels.
If you need a blood transfusion, patient blood management means the transfusion is safe and you are only given what you need.
Your doctor can explain the transfusion risks, benefits and any alternatives available to you. Ask if you have any questions or concerns. There are clear processes for people who, for religious or other reasons, refuse blood transfusions. Let your healthcare providers know as soon as possible, so they can discuss options with you.
If you have loose teeth or crowns, it is a good idea to see a dentist to reduce the risk of damage to your teeth during your surgery.
You can take positive actions in the time before your planned surgery to improve your hauora . As well as making your surgery and anaesthesia safer, it will help you recover.
When you have an operation and while you are recovering from surgery your body has to work a little harder than normal. Regular exercise to improve your fitness before an operation can help you get your body ready for this extra work.
You and your whānau can choose any activity that gets you moving, including:
Try to do at least 30 minutes of exercise on 5 or more days a week. You can split the 30 minutes over the day.
If you are aged 65 and over and interested in joining an exercise group, there are local, low cost, community group exercise classes that focus on strength and balance.
Find a class near you — Live Stronger for Longer
In the weeks leading up to your operation, try to choose foods that help make your body strong. These foods include:
For some operations your surgeon might recommend losing weight before surgery, if you have a certain body type. This might be because:
Losing some weight can make things much easier. Your surgical team will explain this during your appointment.
Most of the time, it is more important before surgery to focus on keeping your body moving and eating foods that will help your body heal and recover — rather than trying to lose weight.
Having an operation can be a very big deal. You may feel worried or anxious while you are waiting for surgery, or when you get to hospital. It is important to recognise if you feel this way and, ideally, to work with whānau to find ways to help you relax and keep positive. Some people like to use mindfulness exercises or breathing techniques — your healthcare provider may also be able to offer you useful resources.
You can have a support person stay with you before your surgery. There is cultural and spiritual support through the kaitiaki and chaplain service before and after surgery, if you request it.
If you smoke you are more likely to have complications during and after surgery. These smoking-related complications are things like:
These can mean needing another operation and taking longer to recover and get discharged from hospital.
We strongly recommend you stop smoking before having an operation. The best results happen when you stop at least 6 weeks before surgery. Even stopping just a few days before will still make a difference.
You are more likely to successfully stop smoking if you have support, especially from trained ‘Stop Smoking’ advisors. You and your whānau may have a support network, and you can get help to connect with the services designed to help you quit.
Quitting smoking | Te whakamutu i te momi paipa
You can also call Quitline on freephone 0800 778 778.
Electronic cigarettes or ‘vapes’ have been used to help people quit smoking. The ingredients in vapes are not as harmful as cigarettes but they can still cause complications when they are used before surgery.
The listed ingredients in vapes are unreliable. Even ‘nicotine free’ vape liquids can contain nicotine, and nicotine-containing vape liquids can have much more nicotine than in regular cigarettes.
To have the best results from your surgery, stop vaping in the same way you would stop cigarette smoking — for as long as you can beforehand, and ideally at least 6 weeks before surgery.
Alcohol has many effects on your body, including causing harm to your heart and liver. This can affect how your body processes medicines given during your hospital stay. It can also increase bleeding during surgery.
Make sure you are drinking less than the recommended limits to improve your body’s ability to heal after surgery. It is recommended to drink less than:
An infection in the site of your surgery can slow your recovery. You might also need another operation to help get rid of the infection.
There are things that you can do before and after surgery to lower your chance of getting an infection.
Staying safe before and after surgery — Te Tāhū Hauora Health Quality & Safety Commission (video)
