Dr. Kristen Mitteness
How I Prepared for Surgery (and what I wish I would have done)
Updated: Nov 3, 2021
Disclaimer: This is not medical advice. I'm most certainly not an expert on surgery. This is simply my story and personal feedback. Please work with your trusted healthcare provider to determine what is best for you.
Many people are familiar with rehabilitation but not many know of pre-habilitation. Once my tumor was discovered, I knew surgery was imminent. And it was going to be invasive. I'm in good shape to begin with. I eat well. I exercise regularly. But, I wanted to ensure I would have the best possible outcome regardless. I was by no means perfect and that wasn't my goal. Here are a few things I was able to focus on to improve my recovery and a few things I wish I would have done.
Diet: When my tumor was discovered, I was in the middle of a January Whole 30. Thank god. This meant I couldn't drown my feelings in wine and sugar, like I probably would have otherwise. During January, I found that coffee triggered pelvic pain so I had to cut that out even before I knew I had the tumor. It went better than I expected. After the Whole 30, I planned on sticking to a pretty tight paleo diet with some added paleo treats. This was fine until I started having food aversions. I tried my best to eat as much protein as I could, knowing it would help me maintain muscle mass and improve my surgical outcomes and decrease my weight loss. I usually felt the best and was hungriest early in the day so I ate eggs, steak, bacon, sausage, etc. My breakfast was carnivore-esque and I ate as much as I could tolerate. As the day went on, I was less hungry and all I wanted was sugar and sometimes lunch meat. However, I learned that paleo treats made with almond flour killed me. I ended up with extreme stomach pain, nausea and anorexia for up to two days afterward. I also had an aversion to sparkling water, but could tolerate and enjoy ginger kombucha. I did my best to at least make my sweet treats, less sweet. My go-tos were crepes, dairy free decaf mochas, sweet potato brownies, peanut butter cups and chocolate cupcakes.
I didn't drink at all during this time. I was too scared to. My sleep was already hit and miss and my inflammatory response was swift. I also didn't want to do anything to put my mental health at risk. Although I tried to incorporate bone broth, I could have been better with this one. I was also lazy about taking my vitamins. I wish I would have been diligent with fish oils, Vitamin D and my multivitamin, at the very least.
Exercise: I had been doing my #NoExcuses workouts most mornings since last March so I already had a good routine in place. I did have to start modifying it quite a bit after straining my back for the third time. My movements had to be very strict and deliberate. No more burpees or snatches. More mornings were spent stretching rather than strengthening since my range of motion was quickly diminishing in my low back and pelvis as my tumor grew. I had fully intended on spending more time doing intervals utilizing the elliptical and sled at work. But, most days I was too spent (mostly mentally) to spend any extra time there. Or at least that's what I told myself. In hindsight, I wish I would have made a better effort at increasing my cardiovascular capacity. I knew going into surgery I was weaker in that area than I typically am and that it would help with recovery.
I did a lot of posterior chain strengthening (bent over rows and deadlifts) which ended up being much more helpful than I anticipated. Post surgery I could barely stand or sit up straight and I'm confident that my strong spinal muscles helped prevent me from having a constantly sore back.
Chiropractic, massage therapy, acupuncture and physiotherapy: I can't iterate enough how thankful I am to have access to the resources that I do. Acupuncture was the first treatment I sought after finding out I had the tumor. It's my go to for stress management. It was also the first place I full out cried in public about my situation. My pain was instantly reduced after my first session with Tatiana. There were a few weeks that my back pain was so tender that I couldn't even stomach the thought of having any manual therapy and had acupuncture instead.
Once I was ready for hands on therapy, massage and chiropractic were incredibly helpful. I couldn't lay on my stomach so I utilized my pregnancy pillows (the ones I use with my patients) which allowed me to continue with treatment comfortably. My physiotherapist suggested I see a pelvic floor physio before I go in for surgery. DUH! I can't believe I didn't think of this. I suggest it to my pregnant patients all of the time. It was more helpful than I could have even imagined. She gave me wonderful tips for pre and post operative care and now we have a baseline to work with in the future. Worth every penny.
Meditation: I've been meditating fairly regularly for over a year and a half now. I'm not good at it, but I do it anyway because I know the benefits. I prefer Ziva meditation. It has a ton of benefits including improving surgical outcomes.
Sleep: I was stupid tired leading up to my surgery. It was probably a combination of getting up 2-5 times every night to pee and the physical and mental stress of what was going on. I could easily sleep 11 hours a night. On days I could, I would allow myself to sleep as much as I needed. On days I didn't have much to do, I often napped. One thing I'm typically good at is sleeping. I let my body lead the way on this one. Honesty and vulnerability: I'm generally a cup half full type of person. I try to share mostly good or positive things. But, during this time I felt a few more openings that allowed me to be a bit more honest about how I was really feeling. After we found out about the tumor, I kept the news to myself (and Quinn) for the first few days. I was afraid of people "feeling sorry" for me. I had to flip the script and think of how I would feel if one of my friends, co-workers or sisters were going through this. Once I started sharing more, I immediately felt the weight being lifted. It also opened the doors to others sharing their stories which helped me feel a lot less alone, scared and frustrated. People naturally want to help other people. Once I stopped resisting help, it came pouring in. The cards, food and encouragement was incredible. I felt (and still feel) so, so loved. Other things I wish I would have done:
Cold showers: I've done these in the past. My tolerance for stress seemed to plummet after I found out I had a tumor. Anything that ramped up my stress immediately sent me spinning. I couldn't get myself to take cold showers anymore. I think if I could have, it would have mitigated some of the spiraling I experienced and improved my resiliency to every day stressors.
Nature: Good ol Vitamin N. I was not very good at getting outside if the weather was too cold or windy. And at times, it was very cold and windy. Similarly to the cold showers, I couldn't find it in me to muster up the effort to do something that I knew would be uncomfortable. I wish I would have made more of an effort of getting outside even when the conditions weren't favorable. I always felt better after being outside. Nature is an incredible healer. *Take time off work: I chose to work until 7:00 pm the night before my surgery. I was busy and I wanted to ensure I had enough time to wrap everything up before I left. The last week leading up to my surgery was chaotic. And while I was able to get everything done and I'm not sure I would have done it differently considering I felt pretty good, it might have been worthwhile to have a bit of breathing room. That being said, at the time I preferred to be working then sitting at home stressing about what was to come, which is why I added the asterisk.
As I mentioned previously, I wasn't trying to be perfect going into surgery. I think perfection is a waste of stress and energy. However, I did want to give myself a really good shot at a good recovery, and I did. There is always room for improvement and I enjoy reflecting on them. And while I hope I never have to deal with a situation like this again, many it can help someone else in a similar scenario.