Enhanced Recovery After Surgery

Conveniently located to serve the areas of Denver, CO

Like many of the country’s leading surgeons, Dr. Lisa Hunsicker now employs enhanced recovery after surgery (ERAS) protocols to elevate not only her quality of care, but also her patients’ comfort, outcomes, and satisfaction. (1)

Dr. Hunsicker and the Revalla team believe in helping each patient feel comfortable and confident, but we strive to achieve that in a safe, effective manner with as little downtime as possible. Rather than forcing a risky, too-soon return to your routines, these enhanced recovery after surgery protocols can help you recover faster, stronger, and with less discomfort.

If you are ready to explore how Dr. Hunsicker can help you achieve your goals, please reach out today to schedule a consultation. If you have any further questions about preparation, surgery, recovery, or anything else, please call our Littleton office at (720) 283-2500.

About Enhanced Recovery After Surgery

Enhanced recovery after surgery (ERAS) is an increasingly-adopted protocol in all surgical fields. (1) It comprehensively optimizes recovery, from pre-procedure preparations to full resumption of routines, with evidence-backed techniques, innovative prescriptions, light movement, recovery positions, and groundbreaking technologies. ERAS has shown to improve patient mobility, reduce complications, decrease hospital stays and medical costs, and enhance patient outcomes. (1)

Preparation as Recovery Optimization

The best way to ensure a smooth, swift recovery is to effectively prepare for your procedure. Preparation takes many forms, and Dr. Hunsicker provides each patient with comprehensive instructions specific to their medical history, procedure details, and ideal outcomes. In general, she advises that patients:

  • Adjust medication intake: Under the proper guidance, halt the intake of any medications (or supplements) that have blood-thinning or antiplatelet effects. Dr. Hunsicker will also recommend certain probiotics or other medications to enhance comfort and kickstart healing. Speak with your primary care physician before discontinuing or starting any medications.
  • Arrange transportation: Have a trusted friend or family member take you home and stay with you during your initial recovery.
  • Take time away: Dedicate time to your recovery by taking time off from work and other commitments.
  • Optimize diet: Consume healthy, nutritious foods to flood your cells with the nutrients they need to rebuild, and stay hydrated before and throughout your recovery.
  • Cease substance use: Quit smoking (or other forms of nicotine) several months ahead of your procedure, and avoid alcohol, caffeine, and cannabis for a few weeks in advance. Continue your abstinence throughout your recovery.
  • Run errands: Before your recovery limits your mobility, make sure to pick up your prescriptions, stock up on snacks and meals, gather pillows and blankets, and clear your schedule of any tasks that might wear on your mind.

At a pre-operative appointment, Dr. Hunsicker will review your preparation requirements and provide several beneficial items. She frequently recommends a green smoothie recipe, protein drinks, scar creams, probiotics, and Hibiclens Surgical Scrub, a skin wash solution that will kill bacteria to reduce the risk of infections or complications. (2)

During Surgery + Medications

Another effective way to enhance recovery is to use precise and advanced surgical techniques. Dr. Hunsicker’s more than three decades of experience have given her accuracy over each movement and a deep understanding of the nuances of tissue. She carefully manipulates, severs, repositions, and tightens with judicial control and an understanding of how the body will respond. She also does not perform surgeries with opiate anesthetics, which avoids complications such as breathing difficulties, post-op nausea, and constipation. (3) Aside from these complications, 3% to 10% of patients develop opioid use disorders after taking these pain medication post-surgery. (4) Avoiding these minimizes the risk of substance reliance or long-term narcotic use. Instead, her and her team employ the following during and after surgery:

  • Journavx: a non-opioid medication that selectively blocks sodium gates to reduce moderate-to-severe acute pain.
  • Celebrex: (celecoxib) a prescription non-steroidal anti-inflammatory drug (NSAID) that blocks the COX-2 enzyme, reducing the spread of chemicals that cause pain and swelling.
  • Tylenol: (acetaminophen) a widely common non-NSAID that reduces pain and swelling. Dr. Hunsicker can prescribe stronger doses than what is available over-the-counter.
  • GABA: (gamma-aminobutyric acid) our body’s main inhibiting neurotransmitter. GABA supplements will halt the chemical messengers that signal pain.
  • Flexoril: (cyclobenzaprine) a muscle relaxant that helps to reduce stiffness and soreness in healing tissues.
  • Bactroban: (mupirocin): a topical antibiotic that keeps incision sites clean and helps to prevent MRSA infections.

As with any medication, please take these as Dr. Hunsicker and/or your primary care physician instructs.

After Surgery

Dr. Hunsicker will provide you with detailed recovery instructions. Once you return home after your surgery, the most important thing is to rest. Dr. Hunsicker will provide Exparel, a long-lasting non-opioid anesthetic, that will keep you comfortable up to 3 days after your procedure. You should elevate your healing areas, stay hydrated, and eat meals as soon as you are able to. ERAS encourages early mobilization; you should engage in light, gentle movements, such as short walks, as soon as possible. (1) This will help promote proper circulation.

It is also vital that you abide by the instructions you receive carefully. Follow all guidelines regarding rest, movement, nutrition, medication intake, bathing, incision cleaning, and drainage. Dr. Hunsicker will monitor your progress at regular follow-up appointments.

Continued Healing

Dr. Hunsicker and the Revalla team will remain available to you at any time. Within the weeks and months after your procedure, you will return for regular follow-up appointments. Here, we will monitor your progress and evaluate your developing results, ensuring that everything is healing properly and on track. Scars usually continue to fade into being barely visible, and Dr. Hunsicker can also recommend scar treatments. With our advanced ERAS protocols, you will be able to return to your full, active routines much faster and with more comfort. (1) As you enjoy your new appearance, you will also enjoy more confidence.

FAQ

Is all ERAS the same?

Not necessarily. Although each ERAS protocol shares similar elements, each patient’s recovery journey is unique. ERAS is not a checklist, rather, it is an innovative approach to healing.

How can ERAS benefit me?

ERAS brings several benefits to all patients. It promotes a smoother, swifter recovery with less discomfort. Many patients report little to no nausea, an increased appetite, more energy, and more strength. Patients are able to resume movement and activity sooner with less soreness, stiffness, and discomfort. This translates to a faster return to routines and the ability to enjoy full surgical outcomes sooner.

Does ERAS have any risks?

As a recovery concept rather than a surgery, ERAS itself does not have any risks. However, you will still be susceptible to the risks or complications that come with your procedure as well as possible allergies to new medications.

How will I know when I can resume my normal routines?

Dr. Hunsicker will give you clearance to resume full activity when the time is right. During your recovery, you can engage in light movement to assist your recovery. However, ERAS promotes a faster return to full activity.

Will I need to take opiate pain medications during my recovery?

Usually not, Dr. Hunsicker avoids prescribing opiates. Patients receive effective, non-opiate alternatives.

References

  1. Altman AD, Helpman L, McGee J, et al. Enhanced recovery after surgery: implementing a new standard of surgical care. CMAJ : Canadian Medical Association Journal. 2019;191(17):E469-E475. doi:https://doi.org/10.1503/cmaj.180635
  2. Aly R, Malbach HI. Comparative antibacterial efficacy of a 2-minute surgical scrub with chlorhexidine gluconate, povidone-iodine, and chloroxylenol sponge-brushes. American Journal of Infection Control. 1988;16(4):173-177. doi:https://doi.org/10.1016/0196-6553(88)90029-6
  3. Stephan BC, Parsa FD. Avoiding Opioids and Their Harmful Side Effects in the Postoperative Patient: Exogenous Opioids, Endogenous Endorphins, Wellness, Mood, and Their Relation to Postoperative Pain. Hawai’i Journal of Medicine & Public Health. 2016;75(3):63. https://pmc.ncbi.nlm.nih.gov/articles/PMC4795331/