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7 Unusual Things That Affect How Well Your Surgery Will Go

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April 14, 2016

By ARIADNE WEINBERG, Featured Columnist



Going into surgery is one of the most nervewracking, vulnerable experiences. You try to prepare for it psychologically, but sometimes the littlest of things make you nervous.

And then you start to Google search what could possibly go wrong, and find that maybe, just maybe, something you have could cause complications.

There are many things that can affect operations, but of course it depends completely on your procedure. The best thing to do is just ask your doctor and relax, of course. But in the meantime, read up on some of the things that you might not expect would be problematic. You may find something interesting you can actively prevent.

  1. Muscle Mass

So, your bulk matters? Well, it partially depends on your biological sex, but having a little more strength generally makes things easier.. In a 2013 study by A. DiMartini from the University of Pittsburgh Medical Center in Pennsylavia, they looked at pretransplant computed tomography data for 338 liver transplant candidates.

In both men and women, those with a greater muscle mass had a shorter length of stay both in the intensive care unit and overall, as well as fewer days of intubation.

While in men, a higher muscle mass was a predictor of survival, in women it was not. They concluded that improving or sustaining muscle mass before surgery was a positive pretransplant intervention.









2. Anemia

Anemia (low levels of iron in the blood), is common to find in the preoperative patient; in fact, it is the most common hematological problem. Blood transfusions are one solution.

In 2010, S. Patel Manish from the Robert Wood Johnson Medical School in New Jersey examined what happened when blood transfusions were not accepted. He studied 1,958 consecutive surgical patients who refused transfusions based on religion.


The overall risk of death increased when preoperative hemoglobin levels decreased. Below 6 g/dL was a risk factor. Between 5-6 g/Dl of hemoglobin, patients experienced a sharp rise in mortality, whereas between 7-8 g/Dl, they were generally safe. So, get your levels checked before surgery. And don't forget to eat those black beans.

3. Hyponatremia

Huh? If this is a new one on you, don't worry. But do put some salt on whatever you're eating.

Hyponatremia is defined as an abnormal level of sodium in the blood. It's not just iron you have to worry about.

For all the diet tips about leaving salt out of the picture, you do need some. It is also relatively common, and linked to morbidity and mortality in various medical conditions.

Dr. Ada  from the Division of General Medicine and Primary Care in the Brigham and Women's hospital in Boston, Massachusetts looked at the effects of hyponatremia at the time of the surgery processes.

A total of 964, 263 adults from more than 200 hospitals (from January 1st, 2005 to December 31st, 2010) were observed for 30-day perioperative outcomes. Some 75, 423 patients with hyponatremia were compared with 888, 840 patients with normal baseline sodium levels.

The researchers found that a higher risk of mortality within 30 days was consistent with hyponatremia patients.

Other side effects included perioperative major coronary events, wound infections, and pneumonia, as well as prolonged median lengths of hospital stay by one day.

This is another one you can control, people. Just have a few potato chips, and put a touch of salt on your dinner.

4. Diabetes Mellitus

There's a theme here. Your blood has to have just the right amount of certain substances. The hyperglycemia (and in some cases, accompanying hypoglycemia) that goes along with diabetes, causes complications.

The fact is, the morbidity and mortality rate is higher in diabetic patients than it is in non-diabetic patients.

But interestingly enough, according to A. Zambouri from the Hippokrato Hospital in Greece, diabetics are more likely to be harmed by neglect of long-term complications than they are by the short-term control of blood glucose.

In his 2007 study, the doctor found that there was a higher incidence of death after myocardial ischemia in those with diabetes than there was in those without diabetes.

From 8 to 31% of people with diabetes reported having asymptomatic coronary artery disease. This means that it is important for patients to be checked for symptoms of peripheral vascular, cerebrovascular, and coronary disease before surgery.

Diabetics, if you are going to be operated on soon, take especially good care of yourselves.

5. Exercise Tolerance

Yeah, hate to be the bearer of bad news, but that extra jog around the park could come in handy.

Your heart needs to be able to handle cardio stress during surgery.

A 2013 study by Dr. P.G. Supino from the University of New York Downstate Medical Center in Brooklyn, New York aimed to predict survival and symptom persistence after surgery for chronic non-ischemic mital regurgitation.

They tested this by looking at exercise duration on a treadmill. Some 45 patients (45% men) were prospectively followed (for an average of 9 years).

Within two years of the operation, 11 patients died, 8 of them with persistent symptoms.

It's worth it to do at least a little bit of exercise each day, especially if you're a person who routinely has surgeries or will be operated on in the near future.

6. Smoking

This one isn't just bad for you on a day-to-day basis. Smoking can actually cause serious issues in surgery outcomes.

In one 2013 study conducted by A. Sharma and researchers at the University of Rochester Medical Center, they looked at the impacts of smoking on post-surgery results after colorectal resection in both malignant and benign processes.

A total of 47, 574 patients were tested: 26, 333 for colorectal cancer, 14,019 for diverticular disease, and 7,222 for inflammatory bowel disease.

Of those patients, 60% never smoked, 20.4% were current smokers, and 19.2% were ex-smokers.

The study discovered that current smokers had an increased risk of postoperative morbidity and mortality after colorectal surgery.

This connection between smoking and bad surgical outcomes held true for both malignant and benign diseases, and had a dose-dependent effect, being stronger if they had smoked a larger quantity of cigarettes for more time.

So, if you were looking for another motivation to give up the smokes, being safe after surgery is a pretty good one.

7. Medications

The medication you take before surgery can have a significant effect on how you feel after your operation.

It is common to take narcotics (especially opioid products) after surgery to manage pain.

However, a study by Robert Westermann from the department of orthopedics at the University of Iowa, conducted in 2016, found significant danger in taking this medication before surgery.


He looked at 112, 569 patients undergoing knee anthroplasty between 2007 and 2014.

Those who filled an opioid prescription in the 3 months before the surgery were more likely than non-users to have complications, such as kidney diabetes or coronary artery disease. And then, of course, there's always the risk of addiction.

According to Westermann, the U.S consumes 99% of all hydrocone and 83% of all oxycodone that exists in the world.

In other places, people pop a tylenol 3 or maybe some ibuprofen.

So, if you are from the United States, don't just take narcotics because you have the access. Be careful to take a moderate dosage, and avoid them before surgery, if possible. (Read more about oxycodone overdose symptoms and remedies.)




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