Jan - Feb 2013

Walk It Off

By Ryan Moon, MD

 

Welcome home stranger!  You finally walk through the doors of your home after surgery. Now your months of emotional and physical preparation have culminated in a successful new beginning for you, and you certainly have questions. If you’re wondering at this stage, what you can do to successfully continue your journey, we have a few simple guidelines. Heed this advice to stay safe and healthy:

 

Atelectasis:

Patients, when undergoing general anesthesia, require an endotracheal tube be inserted into their airways to assist with breathing. This tube is ultimately in circuit with a ventilator, a form of “mechanical lungs” that breathes for the patient while asleep. This process is not nearly as effective in expanding your lungs while awake. As a result, the billions of alveoli, or “air sacs” that make up each lung, are not fully expanded immediately upon emergence from anesthesia. This can last for several days after surgery and is the most common cause of a low-grade temperature in postoperative patients. This can also lead to pneumonia (lung infection) in up to 4% of bariatric patients following surgery. Walking after surgery forces patients to take bigger, deeper breaths, re-expanding the alveoli, and lowering the chance of fevers and pneumonia.

 

Blood Clots and Pulmonary Embolism:

Blood clots and pulmonary embolisms occur in roughly 2% of all bariatric patients. “Low-flow” states, or decreased venous flow, can increase the chances of blood clot formation in lower extremities. Left untreated, clots can lead to a pulmonary embolism. This decreased venous flow occurs after surgery for a myriad of reasons ranging from drowsiness due to the anesthetics or pain medicine to postoperative pain itself, or a lack of movement. Walking after surgery flexes the muscles of your lower extremities and activates a natural “pumping mechanism”, effectively creating a moving column of blood returning to your heart. While hospital staff routinely use compression boots and blood thinners postoperatively, walking after surgery dramatically lowers the chance of clot formation.

 

Postoperative Ileus:

Anesthesia, immobility, and post-operative narcotics for pain control can all lead to a postoperative ileus, or a lack of adequate movement or peristalsis of the intestines. This can ultimately lead to uncomfortable bloating and swelling, nausea and vomiting, and can even put unwanted strain on any intestinal procedures. Walking after surgery helps to avoid this and actually encourages the finicky intestines to move air and contents through much more readily.

 

The simple act of walking after bariatric surgery helps to dramatically lower the chances of atelectasis, blood clots, embolisms, and postoperative ileus. So what are you waiting for? Lace up your shoes, start moving, and continue your safe journey to success!