Active Wait programme

Week 9 – Making Positive Lifestyle Changes

A healthy lifestyle

Waiting for a hip or knee replacement and living with pain and fatigue is going to impact on your everyday life and it is understandable that it may be more difficult to live a healthy lifestyle. But it is essential that your health does not decline while you are waiting for surgery as you need to be fit and strong for a successful recovery from surgery. Making some lifestyle changes prior to surgery can have a positive impact on how well the operation goes as well as your recovery time. The great news is you have already taken big steps towards this by joining the active wait programme. Looking after yourself in a healthy way may include:

• Making sure you keep active and engage with strength exercises.
• Ensuring you are eating a well-balanced diet and keeping an eye on your weight, and if required making changes to your diet and losing some weight.
• Avoid smoking or using tobacco products.
• Limiting or avoiding alcohol.
• Getting the right amount of sleep.

Smoking

If you do smoke, stopping smoking is one of the most beneficial things to do in preparation for your surgery. Not only is smoking bad for your heart and lungs, but it is also bad for your joints and your healing ability for your upcoming hip or knee replacement surgery. You should stop smoking because:

1. Smoking prevents healing

Toxins in cigarette smoke negatively affects the body’s ability to heal. Active cigarette smokers are 3 times more at risk of wound-related complications following a joint replacement surgery. The toxins in cigarette smoke also negatively affect the body’s immune system. Active cigarette smokers are 2 times more at risk of developing an infection from surgery. Infection after joint replacement surgery can be a devastating complication, and every effort should be made to prevent these complications.

2. Smoking causes longer recovery times

Active smokers have 3 times longer hospital stays and longer recovery times from surgery than non-smokers. This is because active smokers have slower wound healing and are more likely to develop chest infections, pneumonia, and blood clots after an operation. Complications from surgery concerning the heart and kidneys, including heart attacks are more likely with active smokers. Active smokers have been found to have increased pain following a hip or knee replacement compared to non-smokers and require significantly greater doses of strong painkillers. Active smokers are also more likely to be readmitted to the hospital for complications following surgery.

Prepare to stop

Although smoking can have these devastating complications, the good news is that stopping smoking reduces the risks of having complications from surgery. We recognise it isn’t easy, but it is never too late to stop smoking as you gain a benefit from stopping quickly. However, you should stop smoking completely as soon as possible because the longer you stay away from smoking, the greater the benefit.

To successfully stop smoking, you must prepare. Good preparation includes:

• Finding help from a service like Yorkshire Smokefree. People are 4 times more likely to stop using a service than trying to quit on their own.
• Telling friends and family about stopping smoking and asking for their support. They will be understanding that your journey to stopping smoking will be difficult and they will want to help you.
• Getting rid of all the cigarettes and ashtrays in your home, car, and place of work. Knowing cigarettes are around or having visual cues of smoking can increase urges.
• Asking family and friends who still smoke not to smoke around you or leave cigarettes out where you can see them.
• Practising saying, “No thank you, I don’t smoke.”
• Thinking back to your past attempts to stop smoking and figuring out what works best for you to help stop smoking and what does not work for you.
• Avoiding situations where the urge to smoke is strong.
• Reducing or avoiding alcohol as this can cause stronger urges to smoke.

Alcohol

Drinking too much alcohol is bad for your health and negatively impacts your liver, heart and immune system. Drinking too much alcohol in the lead up to surgery increases the chance of:

• Infections from surgery.
• Prolonged wound healing and complications.
• Complications with other organs, such as chest infections and heart attacks.
• Excessive bleeding requiring longer operation times. 

Adults should drink no more than 14 units of alcohol per week. 1 unit of alcohol is about a pint of beer or 1 small glass of wine. If you are over this limit, you should reduce the amount of alcohol you drink for your health. To reduce the risks of alcohol on your surgery, at least 4 weeks leading up to surgery you should reduce your alcohol below the weekly recommendation of 14 units and you should not drink alcohol at least 2 weeks before surgery, longer if possible.

If you regularly drink a lot of alcohol, it’s important to seek help to cut down. For advice on how to cut down, visit the NHS website on alcohol support.

Sleep

Sleeping well and getting the right amount of quality sleep is important for our health and wellbeing. Quality sleep helps us recharge the body and mind and prepare us for the next day ahead. It helps with our concentration, pain, immune function, mental wellbeing and weight. Regular poor sleep leads to exhaustion and affects your energy, mood, and pain. Struggling with poor sleep can have a negative impact on all aspects of your life. For the best chance of regular quality sleep, it’s important to:

1. Have a regular sleep routine

Getting into good habits can help you sleep better. Having a routine and getting up and going to bed at regular times helps your sleep. Avoiding naps in the day can help you sleep better at night. Taking time to relax before bed can help get you off to sleep.

2. Exercise regularly

Doing regular exercise can really improve sleep. This is any exercise that gets you at least a bit out of breath. This can help you unwind by the end of the day and lead to more refreshing sleep. It’s best to avoid doing any exercise close to bedtime as this tends to stimulate our brain, making us less likely to want to sleep.

3. Cut out caffeine

If you are feeling tired, it is recommended that you cut out caffeine. Try to stay off caffeine completely for a month to see if you feel less tired without it. If you drink a lot of caffeine, you might find that not having caffeine gives you headaches. If this happens, cut down more slowly on the amount of caffeine that you drink. If you cannot stop drinking caffeine, it is best to avoid any drinks containing caffeine after lunchtime.

4. Avoid alcohol

Although alcohol in the evening can help you fall asleep, you sleep less deeply after drinking alcohol. Even if you sleep a full 8 hours if you drank alcohol the night before, you still wake up feeling tired. Avoiding alcohol greatly improves the quality of sleep a person can get.

5. Avoid screens

Phones, tablets, laptops and other electrical devices can make getting to sleep harder. They give off light that can stimulate the brain and make it think it’s daytime and therefore not time to be sleeping. Putting screens away a few hours before bedtime can help you fall asleep faster.

Your weekly exercises

Click the links below to see this week’s exercises. You only need to select one level. Start on the foundation level, and if you find it easy click on the intermediate and advanced exercises for a more difficult version next time.

• Foundation – bed and chair exercises
• Intermediate – chair and standing exercises
• Advanced – standing exercises