Facing surgery? Be prepared.

Fortunately, most running injuries heal completely with rest and the proper care. But sometimes things just don't turn out the way we'd like them to and surgery may be your best option. Surgery has come a long way in recent years. Many more procedures are done on an outpatient basis with local anesthesia, and when hospital stays are necessary they are shorter. New tools enable surgeons to make smaller incisions and cause less trauma. Less blood is lost, healing time is shorter, and there are fewer surgical complications. Once you've made the decision for surgery and you're confident in your doctor's expertise, you've done half the work. But there are many things you can do to optimize the process.

Get Educated

Information is strong medicine and the more of it you have the better off you are. Understand your injury, what it is and how it will be repaired. What are the risks? What should you expect during recuperation? Will you need help to get around? How much is it likely to hurt? What medications will you have available to deal with pain? Can you get your prescription filled in advance? Do a trial run at the hospital. Hospitals can be huge, overwhelming labyrinths if you don't know where you're going. You are likely to be more nervous than you expect to be and anything you can do to relieve anxiety will contribute to a better outcome and faster recovery. Knowing what to expect on every level is the best antidote for anxiety

Going Under

Most of us have had little or no experience with anesthesia and it can add a big dose of fear and anxiety to the prospect of surgery. Despite the fact that anesthesia is very safe (probably much safer than your drive to the hospital) you may worry about waking up during surgery, or not waking up at all. The truth leaves little to worry about. Deaths from anesthesia occur only one in 250,000 cases and those are almost completely limited to patients who are not healthy before surgery. If you are healthy and fit as most runners are, the risk is not zero, to be sure, but very close. As to waking up while under the knife, medications can wear off during surgery. But your body will give lots of signals via heart and respiration rates, blood pressure, eye movements, etc. so that the whole operating room staff would have to leave for a meeting in order to miss the clues and fail to make the proper adjustments.

The other problem with anesthesia is its after-effects, but this too has had the benefit of new developments in medical practice. Newer medications wear off faster and leave you feeling better than medications available ten years ago. Although you won't be running any races right away, the miserable headachy, nauseating fog suffered in the past by nearly all surgical patients is much less with the better drugs available now. There are many variations on sedation and postoperative medications you can discuss with your doctor.

Postoperative Expectations

Most surgical procedures for sports-related injuries will be done as an outpatient--you won't have to spend the night. But even if you need to stay overnight, you will be scooted out of the hospital in a bigger hurry today than in the past. Although that trend is mostly the result of economic forces, it can actually be a good thing for your progress after surgery. Hospitals don't sleep and you'll need yours. The 'round the clock activity in a hospital can be disorienting and depressing. You'll need rest, good food, and the attention of your friends and family to optimize your recovery and under most circumstances you can tend to those needs better at home.

Don't underestimate how tired you will be. The trauma of surgery calls on your body for deep energy resources for healing and it will leave you feeling drained for longer than you think. Take advantage of the rare excuse to totally pamper yourself.

Get Moving

On the other hand, your doctor is likely to want you to be up and moving quicker than you might expect. You may be asked to move around soon after your anesthesia wears off. Risk of dangerous blood clots go way down if you are up and moving. While you're in the hospital, you will be given instructions, but ask how much and what kind of movement you can do at home in the first two weeks before you return for a postoperative checkup. Find out what you can and can't do during rehabilitation. Ask about cross-training options and physical therapy, which can be an enormous help to get you running again. A physical therapist can also help to make sure the problems that led to your injury in the first place have been corrected. Last but not least, ask when you can expect to run again, which is, after all, the whole point.