Outpatient Surgery Magazine

Going Green for the Greater Good - March 2020 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://outpatientsurgery.uberflip.com/i/1218927

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Page 75 of 124

are at increased risk of being hyperglycemic and experiencing insulin resistance brought about by the trauma of surgery, according to Elizabeth Goldenberg, MPH, RD, CDN, a registered dietician at Weill Cornell Medicine in New York, N.Y. "They're also more likely to have more GI symptoms and experience PONV," says Dr. Goldenberg. She points out optimizing pre-op nutrition puts patients in an anabolic state, during which the body builds lean muscle mass, instead of a catabolic state, which involves the loss of body mass. As soon as possible after cases are scheduled (ideally 6 to 12 weeks before surgery), Ms. Yoder spends an hour with patients to review their medical histories, the medications and supplements they're tak- ing, the average amount of sleep they get on a nightly basis. She asks about their cooking habits, stress levels and home life. She then cre- ates interventions specific to their needs to help promote weight loss and manage existing comorbidities. "It's important to set realistic goals for patients, so they feel motivated to change their health sta- tus," says Ms. Yoder. She prioritizes the care of patients with BMIs over 40 who are at higher risk for complications during and after surgery. Her goal is to help patients lose weight and build lean muscle mass, which helps support the body's structure. Lowering a patient's BMI also reduces pressure on joints and decreases the body's inflammatory response to surgery. Patients who lead healthier lifestyles and lose weight before surgery are better prepared to complete rehab exercises and often require lower dosages of prescribed medications that could increase risks of surgical complications. Some might even be able to stop tak- 7 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 2 0 We find the right amount of fuel for their bodies. Melinda Yoder, RDN, CDN

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