​​​​​​​​​​​​​​​​​​​​​​​​​If you’re having surgery, you p​robably have some questions. This Patient Guide will help you get ready for your surgery and explains the Enhanced Recovery After Surgery (ERAS) Care Pathway. You will find out what to expect before you go to the hospital, the day of your surgery, and when you go home after surgery. Following the ERAS Care Pathway helps you prepare for surgery, feel better sooner, and recover faster.

The ERAS Care Pathway steps, along with your healthcare team, will help you:

• plan ahead for your recovery
• be as healthy as possible before your surgery by:
  • being active
  • eating healthy and drinking enough fluids
  • managing your medical conditions
  • quitting tobacco
  • not drinking alcohol 24 hours before surgery
• get ready for your surgery by talking with someone from the Pre-Admission Clinic
• know what to do and what to expect the day before and the day of surgery
• recover after your surgery by:
  • being active
  • eating healthy and drinking enough fluids
  • controll​ing pain and nausea (feeling sick to your stomach)
    
• prepare for leaving the hospital (your discharge)
• support your recovery at home

Knowing what to expect will help you prepare for your surgery journey. It’s important to know:

• You have an active part in preparing for your surgery and recovery.
• You and your family are part of the healthcare team.
• The best time to plan for your recovery is before your surgery.

For more information, watch Your Surgery Journey Video Series​. ​

​​​​​​​​​​​​​​​​​​​​​​You have an important part in getting ready for your surgery. Planning ahead and getting your body healthy can make your hospital stay more comfortable. It also gets you home and helps you recover faster.

Plan Ahead

• Plan a ride home. Ask a family member or friend to bring you home after your hospital stay.
  
• Plan for meals. Good nutrition is important for your recovery, but cooking may be harder to do right after you get home. Prepare and freeze meals before your surgery or ask friends and family to help you cook or shop for groceries.
  
• ​Get help with chores. After you get home you may need help. For a short time after your surgery, you may be told to avoid certain physical activities. Plan ahead and arrange to have some help with chores after your surgery.
  
• Buy gum or hard can​dies. Chewing gum and sucking on hard candies may help get your bowels moving after surgery.​
  

Be as healthy as possible

• Be active. Being​ active before surgery will make it easier for you to be active after surgery. If you’re normally active, keep doing your regular activities up to the day of your surgery. If you aren’t used to exercising, start slowly. You can start by going for 15 minute walks.
  
• Eat healthy. Eating healthy foods will give your body the nutrients it needs to prepare for and handle the surgery. Eat healthy foods and drink enough fluids in the weeks before your surgery. Your healthcare team will tell you how long before surgery that you need to stop eating and drinking.
  
• ​Manage y​our medical conditions. If you have other medical conditions, such as anemia or high or low blood sugar, ask your healthcare team what you need to do to prepare for surgery.
  
• Quit tobacco. You can heal faster and prevent lung problems after surgery if you quit tobacco. Aim to quit smoking and using tobacco and tobacco-like products at least 4 weeks before surgery. Talk to your healthcare team about ways to quit or cut back. Visit AlbertaQuits.ca for helpful tips and support.
  
• Don’t drink alcohol 24 hours before surgery. Alcohol, cannabis, and other drugs may interact with medicines you take before and after surgery. Talk to your healthcare team if you need help stopping or cutting back on alcohol, cannabis, or other drugs. ​​
  

For your safety, tell your healthcare team if you use alcohol, cannabis, or other drugs including medicines such as herbal​ or complementary medicines.

The Pre-Admission Clinic

As part of your surgery journey, you will talk with a nurse from the Pre-Admission Clinic (PAC). The PAC is a hospital department that helps you prepare for surgery. You may have this appointment at the hospital or over the phone.

This is an important time to talk about how to be as healthy as possible before surgery and ask any questions you have. Follow all of the instructions that the PAC gives you.

The PAC healthcare team will:

• talk to you about all your medicines (including herbal or complementary medicines) so you know which ones to keep taking and which ones you may need to stop
• let you know if you need tests before surgery
• give you information about eating and drinking before surgery (these are handouts called Eating and Drinking Before Surgery: Patient Instructions).
  
• let you know how to find out about your surgery time
• explain how to do a bowel prep (clean out your bowels) before surgery, if you need to do one

​​​​​​​​​​​​​​​​​​Do the following before your surgery to help you feel better sooner and recover faster.

The day before surgery

• Know the time of your surgery, when you need to be at the hospital, and where you need to go when you get there.
• Follow any instructions the PAC or your surgeon gave you for your medicines (including herbal or complementary medicines).
• Don’t drink alcohol 24 hours before your surgery.
• Mark the times you need to stop eating and drinking on the Eating and Drinking Before Surgery: Patient Instructions handout. This is for your safety. Not having anything to eat or drink before surgery prevents food or fluid going into your lungs (called aspiration) during your surgery. If this happens, it can cause serious health problems (complications). If you don’t follow all of the instructions, your surgery may be cancelled.
• If you were told to carb load, have clear apple or cranberry juice on hand for the day of surgery.
• Pack for the hospital and make sure to bring:
• ​​your photo identification
• ​Alberta Health Care card
• all of your medicines or a list of your medicines (including herbal or complementary medicines)
• your continuous positive airway pressure (CPAP) machine (if you use one)
  
• Do the bowel prep (if you we​re told to do one).
  
• Remove your jewelry and piercings.
• Shower before bed but don’t shave the area where you will have surgery. Wear clean pajamas to bed. This can lessen your chance of getting an infection.
• Follow all instructions the healthcare team gave you to prepare for your surgery.

• Plan to arrive at the hospital on time.
  
• Follow any instructions the PAC or your surgeon gave you about your medicines (including herbal or complementary medicines).
  
• Read and follow all of the Eating and Drinking Before Surgery: Patient Instructions. (See the day before surgery section above.)
  
• Bring all of the things you packed for your hospital stay. (See the day before surgery section above.)
  
• Follow all other instructions the healthcare team gave you to prepare for surgery.
  

​​​​​​​​​​​​​​​​You and your family are an important part of the healthcare team. You can help yourself to feel better sooner and recover faster by being active, eating healthy, and drinking fluids. It’s also important to stay in control of your pain and nausea and keep your lungs healthy by doing breathing exercises. You can use tools such as whiteboards and handouts from your healthcare team to help you reach daily goals.

Be Active

Get out of bed as soon and as often as possible.

• It may be hard to move around right after surgery but moving will help you heal faster. Moving soon after surgery can also lower the chance of having a complication such as blood clots or an infection in the lung (pneumonia).
• In most cases, your healthcare team will ask you to get out of bed on the same day as your surgery.
• Take short​ walks at least 3 times each day (after the day of your surgery) and try to add more activity each day.
• Sit in a chair to have your meals.

Eating and Drinking

Eating and drinking after surgery can help you heal faster.

• Eat and drink soon after your surgery to keep your energy up. Only eat as much as you feel like.
• Drink oral nutritional supplements (such as Ensure Protein Max) several times a day. Think of these like a medicine that gives you extra protein and energy to help you heal.
• Drink other fluids to make sure your body gets enough water to help you recover from surgery.
• Your IV is removed when you are able to drink enough fluid on your own. It will be easier for you to move without an IV.
• You are weighed every day to check if you are holding on to extra fluid (called fluid retention).
• Chew gum because it may help get your bowels working again after surgery. If you can’t chew gum, you can suck on a hard candy.

Pain and Nausea

Make sure your pain and nausea are controlled so you can feel better sooner and recover faster.

• Some commonly used pain medicines (opioids) have side effects such as drowsiness, nausea, and constipation (trouble having a bowel movement). These side effects can make you feel worse and lead to longer hospital stays.
• Your healthcare team will work with you to keep your pain and nausea under control by offering you regular pain and nausea medicine.
• The ERAS Care Pathway uses a combination of medicines to control your pain. Expect to have some pain after surgery, even when you take pain medicine.
• The nurses will ask you to rate your pain using a pain scale from 0 to 10. Having no pain at all is a 0 and 1​0 is the worst pain you can imagine. Asking you to rate your pain will help your healthcare team know how much pain you are having and how it can be treated.
• Good pain and nausea control helps your recovery so you can move around, eat and drink, feel relaxed, and sleep well. Let your nurse know if your pain or nausea makes it hard to move or eat.

​​​​​​​​​​​​​​​​​​​How long you stay in the hospital depends on your surgery and other things related to your health. In most cases, you are ready to go home from the hospital when you can:

• get out of bed
• eat food and drink enough fluids
• control your pain with medicine
• pass gas and urinate (“pee”)
• manage your new care needs such as getting injections or having a catheter or ostomy

Before you go home:

• get written instructions for your discharge from the hospital
• get prescriptions for all of the medicines you need
• ask your healthcare team questions about what to watch out for and what activities you can do at home
• have your support team ready to help you (if you have one set up)
• talk to your healthcare team if you have concerns about coping at home​
  

​​​​​​​​​​​​​​​​​You may need some help once you are home.​ It may take up to a few months before you fully recover. Talk to your healthcare team if you have any concerns about your recovery.

Your ERAS Care Pathway doesn’t stop when you leave the hospital. To help your recovery at home:

• Slowly get more active.
• Eat healthy and drink fluids as you did before surgery (unless your healthcare team gives you other instructions).
• Drink oral nutritional supplements (like Ensure Protein Max) for the first month after surgery to give you extra protein and help you heal faster.
• Take less pain medicine as your pain gets better.
• Take your blood thinner and other medicines as you were told.​
  

​​​​​​​​​​​​​​​​​Eating and Drinking Before Surgery: Patient Instruction Handouts

For patients without diabetes:

• Non-Diabetic​
• Non-Diabetic, Fasting Only​
• Non-Diabetic, With Bowel Prep
• Non-Diabetic, Wi​th Bowel Prep and Fasting

For patients with diabetes:

• Diabetic
• Diabetic, With Bowel Prep

All Patients - When to Stop Eating and Drinking Before Surgery:

• Easy Reference Timetable

Video​s

• Enhanced Recovery After Surgery (ERAS) Video Series: Your Surgery Journey
• Bowel Resection Surgery
• Colostomy
• Hysterectomy
  

To see more videos about surgery, go to the Before and After Surgery Video Library​.

Surgery Information

• Anesthesia​​​
• Incision Care After Surgery
• Learning about Enhanced Recovery After Surgery
• Surgery: What to Expect​​
  
• Surgery: What to Expect at Home​
• Safe Surgery Checklist​
• Your Journey Through Breast Cancer Surgery​
  

For more information on care before and after surgery, and different types of surgery, go to Patient Care Handouts​, and click on Before and After Surgery and Adult in the list.