What does "better getting out of bed" mean?
Better getting out of bed is a quality programme aimed at reducing the physical impact after surgery. The programme is always tailored to the surgery. The concept focuses on a smooth return to your regular eating and exercise patterns. This ensures a better recovery and a lower risk of complications, resulting in a shorter stay in hospital.
Your involvement in your own recovery
During your admission, you will have an important, active role in your own recovery. For example, you will be encouraged to start eating, drinking and exercising fairly soon after surgery. Your recovery will be actively encouraged and your general fitness supported. In this way, we can prevent complications and loss of muscle strength. The doctors, nurses and support staff will help you with this both before and after surgery.
Better getting out of bed in practice
See what better getting out of bed means in practice. In this video (in Dutch with French subtitles), a patient talks about her colorectal surgery. A few doctors explain the part played by the concept of better getting out of bed.
Characteristics of better getting out of bed
Before surgery
Explanation and screening
After it has been decided how your treatment will proceed, you will be given information about the course of your admission. You may receive this information in a group or individually. You may receive the information immediately or a separate time will be scheduled later. It all depends on the specific procedure or ward. The aim is to inform you better about your admission so that you can better prepare for the procedure.
We expect you to spend less time in hospital and have fewer complications thanks to the programme Better getting out of bed. It is therefore important that we also prepare you as well as possible for your discharge. As such, during the consultation, we will take a short questionnaire to see if it is necessary for us to refer you to a social worker or dietician, for example. They can help you even before the operation to prepare for your return home.
Anaesthesia consultation before your operation
Before your operation, you will come for a consultation with an anaesthetist. In preparation for this appointment, you will fill in a questionnaire. This will include possible allergies and other conditions, your lifestyle habits and past operations.
You will also prepare a summary of the medication you are taking. If you recently underwent blood, heart or lung tests, bring the results. Finally, please also bring your blood group card, if you have such a card.
During the consultation, your questionnaire will be gone over with you. In addition, your health condition will be checked and the type of anaesthesia and pain control will be discussed with you, including any risks. Arrangements will also be made about the medication you can and cannot take before the procedure.
Stopping smoking
If you smoke, it is important for your recovery that you stop as soon as possible. The longer you are smoke-free before the operation, the less likely you are to have breathing problems after the operation. Even in the short term, quitting smoking has only advantages. The first effects can be felt after just one to two weeks.
Quitting smoking will improve your blood circulation, so your body will recover faster. Moreover, smoking causes more mucus formation. These prevent your lungs from clearing, making it harder for you to breathe and slower to recover. Stopping smoking reduces the formation of abundant mucus after the procedure.
Discuss with your (family) doctor what resources are available to help with smoking cessation or ask for a referral to a tobaccologist. Also consult the UZ Leuven brochure "Stop smoking? It's possible!" (in Dutch).
Daily exercise
Your recovery benefits when you exercise daily (moderately intense) even before the operation. How much and how long you can move every day depends on your condition before surgery and how you feel during any pre-treatment. By exercising enough every day, you will feel fitter before surgery and your recovery after surgery will be smoother and faster.
A simple guideline for sufficient exercise is:
- At least 10 000 steps a day
- At least thirty minutes a day of moderate-intensity exercise
- At least half an hour of very intensive exercise three times a week
You can divide the moderate-intensity activities into intervals of at least ten minutes. Intervals shorter than ten minutes are too short to be beneficial for your health. For best results, supplement moderate-intensity activities with muscle-strengthening activities at least twice a week. Examples include taking the stairs or walking uphill.
Are you over 65 years old? Then it is best to supplement your daily exercise three times a week with activities to train balance, muscles and agility.
Some examples of daily activities that stimulate your heart, lungs and muscles and lower your risk of chronic disease are:
- Walking (e.g. thirty minutes daily or three good ten-minute walks)
- Going up or down stairs
- Cycling (e.g. cycling for thirty minutes twice a week)
- Dancing
- Car washing
- Gardening
A good way to know if the intensity of your exercises is right for you is to listen to your breathing. When you start breathing faster and deeper, but are not completely out of breath, you are at an ideal intensity level. Be careful not to provoke (additional) symptoms while exercising.
Breathing exercises before your operation
Breathing exercises will help the lungs open up properly and cough up any mucus afterwards. It is best to start these breathing exercises before surgery. This way, you will already be familiar with them and will be able to perform the exercises more easily after surgery.
During surgery
Night's rest
Besides sufficient exercise, adequate rest remains of great importance for your recovery. A good night's sleep will help you recover faster. By moving sufficiently during the day, you will sleep better at night.
If certain discomforts, such as noise, prevent you from sleeping, speak to a nurse on the ward.
Pain
During your admission, we ask you to indicate when you are in pain or when pain symptoms persist despite the painkillers you have been given.
Pain relief is very important for your recovery. When you are in pain, you will find it much more difficult to breathe, cough or move comfortably. This can lead to breathing problems or pneumonia, which can significantly prolong your hospital stay. Good pain management reduces the risk of complications and ensures a smoother recovery.
Exercise and eating
It is important for your recovery that you get enough exercise. This helps prevent possible loss of muscle strength and gets your bowel function and appetite going.
Some wards have established exercise routes that offer an appropriate programme. If an exercise route is available, we strongly recommend you make use of it. The exercise route consists of several panels with exercises spread around the ward. You can also ask the nurses on your ward for tips on how to exercise more.
Specific diets adapted to your operation exist for the different wards. Possible individual needs, such as swallowing problems, are also taken into account. If you have any questions about this or if you need support, please speak to the nurses about it.
After surgery
You will notice that you are not completely fit after the operation. You will tire easily and your leg will feel stiff. This will slowly improve.
It is important to keep moving, even after your discharge. Intensive exercise is not always advisable, but you can slowly build up your fitness again to a healthy exercise pattern, for example by walking or swimming. If you need help rebuilding your fitness, contact a physiotherapist.
A healthy lifestyle is important. This means absolutely no smoking, adequate exercise and not being overweight.
ERAS or ERP
The Better getting out of bed principle is part of an international movement based on the latest scientific research. The principle is also called ERAS (Enhanced Recovery After Surgery) or ERP (Enhanced Recovery Programmes).