Most people know by now not to eat or drink right before going “under the knife.” But how many have attended a day-long class in order to prepare for surgery?
Mercy Spine Center of Excellence, together with Mercy Physical Therapy and Mercy Integrative Care Services, has nudged patient participation in their own surgery to a new level. The results have been overwhelmingly positive.
“It’s a partnership and a marriage,” says Dr. Douglas Orndorff, fellowship-trained, board-certified orthopedic surgeon with Durango-based Spine Colorado since 2009. “Surgery is a commitment both from the surgeon and the patient.”
In other words, you don’t expect your spouse to do all the work around the house (at least you shouldn’t!), so don’t expect the surgeon to do all the work. A good outcome depends a great deal on the patient, and Dr. Orndorff goes to great lengths to emphasize this. Your health, and his reputation, depends on the patient’s recovery.
“The technical part of the surgery is our responsibility,” Dr. Orndorff says. “But the aftercare is really something the patient has to own and commit to.”
Pre-Surgery
Orndorff askes patients to focus on several things:
- Stay fit, stay active, and work on weight loss if necessary. Each patient is different, but the more you can keep your muscles toned and your weight down, the better the outcome.
- Don’t smoke. They’ll actually cancel your surgery if you test positive for nicotine. They have found that smoking decreases outcomes and increases the complication rate
- Participate in their education system, run by the Spine Center of Excellence (a collaboration between Spine Colorado and Mercy Regional Medical Center) and Mercy’s Integrative Care Services that emphasizes holistic patient care. Every patient receives a comprehensive educational manual that explains the pathology of your condition and the nuts-and-bolts of your procedure. Patients participate in an education day where they attend a class with fellow patients, are fitted for a brace, visit again with the surgeon and a physician assistant, and more. Orndorff will emphasize managing expectations. He’ll talk about the physical therapy you’ll be doing post-surgery, pain control that’s available, and answer questions.
Post-Surgery
You’ll have time for reading and watching TV, but don’t expect to recline 24 hours a day after your spine surgery. Basically, from about the moment the anesthetic wears off, you’ll be expected to get up and walk around. The goal is a mile per day.
“We really believe in an active recovery,” Dr. Orndorff says. “The more mobile you are, the more active you are. That has led to a decreased length of stay in our hospital and I definitely think it’s helped us achieve those very good outcomes that we have.”
Activity provides multiple recovery benefits. It increases lung capacity and decreases risk of pneumonia. It also decreases chance of blood clots and other possible complications. Being active often makes patients feel better, and many find they actually like to walk and move.
In contrast with 10 or 20 years ago, where back surgery was usually fusion and meant a huge scar, today’s cutting-edge techniques involve screws and rods that stabilize the spine, and a small incision. Thus, it’s possible for a patient to get up and about much more quickly.
Orndorff sees over and over how the more invested patients are in surgery — the more they learn, get fit, prepare mentally and physically — the better their outcome. Whether you’re having gall bladder, ACL, or spine surgery, mindset and expectations are crucial. “It makes a huge difference,” he says. At Mercy Spine Center of Excellence, patients respond to that realization that surgery is a partnership, that they have a huge role in their outcome. “We want our patients to feel like people, not like a number,” Dr. Orndorff says. “That’s super important.”
