Maggie McKay (Host): You've heard of rehabilitation for after surgery, but what about before surgery? Kathryn Harada, Orthopedic Patient Care Navigator joins us to discuss your surgery journey with the community Memorial Prehabilitation Advantage. Welcome to Wise and Well presented by Community Memorial Healthcare.

I'm Maggie McKay. Thank you so much for being here today, Kathryn.

Kathryn Harada, BSN, RN, ONC, CNOR: Hi, Maggie. Thank you so much for having me.

Host: I'm excited to learn more about this. According to a 2023 study published by the National Institute of Health, joint and spine surgery patients who participated in a prehabilitation or prehab program often experienced a smoother, faster recovery from their procedures. So what exactly is prehabilitation and how does it help patients prepare for joint and spine surgery?

Kathryn Harada, BSN, RN, ONC, CNOR: Prehabilitation is the ability of a patient to come to our gym and get stronger before surgery. They have the opportunity to work out with a personal trainer, whether it's upper body or lower body strengthening, to aid them with a faster recovery after surgery.

Host: And what went into developing the prehabilitation program at Community Memorial?

Kathryn Harada, BSN, RN, ONC, CNOR: It was really a collaborative effort between our Wellness and Fitness Center staff and leadership and our surgeons and the leadership here at Community Memorial Hospital knowing that we want to give our patients the best outcome and nowhere in this county is this being done currently. So we're excited to be able to offer our joint and spine patients this opportunity.

Host: And it's like a way for patients to expect more from their surgical experience?

Kathryn Harada, BSN, RN, ONC, CNOR: Absolutely. It allows them to start strong before surgery so that they can have a great outcome after surgery.

Host: That makes so much sense. I've never heard of anything like this, but how can participants expect to benefit from the prehabilitation program?

Kathryn Harada, BSN, RN, ONC, CNOR: Patients can expect a benefit from this program by working one on one with a personal trainer or with the assistance of a gym attendee, that is an employee there; that show them step by step the specific exercises to strengthen the muscles that are needed, whether it's to push on a walker to stand up and begin using their new hip or knee, or whether it's core strengthening for someone who may be having a spine surgery.

Host: And what about increased upper body strength? Like if they have to use a walker maybe after surgery.

Kathryn Harada, BSN, RN, ONC, CNOR: Yeah, and they're able to either do some free weights, we have ergometers, we've even created an exercise page for patients to refer to if they're not familiar with a gym setting or really not sure how to do upper body strengthening; our occupational therapists have put together some exercises that those patients can do when they're there at the gym with us.

Host: And you also address not just their physical, but their emotional challenges as well, like with spine or joint surgery, you prep them for that.

Kathryn Harada, BSN, RN, ONC, CNOR: You know, for patients who are choosing to have a joint or spine surgery, chances are they've experienced some long term or what we call chronic pain, whether it's bone on bone pain for our hip or our knee patients, or a pinched disc or a pinched nerve even for our spine patients. Being able to manage that pain before surgery safely and effectively by strengthening our supporting muscles can help them after surgery as well.

Host: And Kathryn, when do you recommend patients start the prehabilitation program? How soon before surgery should they begin? And what's the frequency of exercise?

Kathryn Harada, BSN, RN, ONC, CNOR: Our patients are welcome to join up to eight weeks prior to their surgery. So they get eight weeks to come in and work on strengthening of their choice, whether it's upper body, lower body, or core exercises. And for that eight weeks, they are free to work with a personal trainer or a gym attendant that will, again, really show them the important exercises for their specific surgery.

Host: Where does the program take place?

Kathryn Harada, BSN, RN, ONC, CNOR: The program takes place here at Community Memorial Hospital at our Wellness and Fitness Center. It's a separate building from the hospital, it's actually a public gym, but it's a really quiet gym, so there's not a whole lot of, you know, outside traffic that comes in and out of the gym.

It's very specific. Our staff, physicians, nurses, any of the Community Memorial staff also have an opportunity to be members in that gym. So it's always nice to see familiar faces there.

Host: Assuming prehabilitation exercises can be done anywhere, why is it important that patients have access to that gym, the Community Memorial Wellness and Fitness Center? What benefits does this environment provide? Because you said it's open to the public, right? But they call it not your typical gym.

Kathryn Harada, BSN, RN, ONC, CNOR: Correct. Yeah. So when you come to the Wellness and Fitness Center, you're greeted, by our gym attendant. we have the personal trainers who are able to work one on one with our patients. So I know for me, it can be a challenge to get that motivation at home, but once I'm at the gym, I feel that support.

I'm able to kind of drive my fitness, and really work towards those goals that I have. So that's why it's important for patients to come to the Wellness and Fitness Center to participate in prehab rather than doing exercises at home that they may not know which exercise is best for their type of surgery.

Host: True, it's kind of like accountability, right. If you know that someone's waiting for you, you've got to show up. You mentioned that the public can come to this gym. Is there a fee to participate in the program and how does somebody get started?

Kathryn Harada, BSN, RN, ONC, CNOR: Well, for prehab, the patient starts off in their physician office, whether it's their orthopedic or spine doctor's office, there's a form letter that their doctor is able to sign and hand to the patient. They bring that to the wellness and fitness center as kind of their ticket in, if you will. There is a fee of $20, to have those eight weeks that they can come and, and work out.

And then after their surgery, they have two free months of gym access and access to a visit for with the personal trainer. So at no cost to them post operatively to keep up that healthy active lifestyle.

Host: That's amazing. So, do you encourage patients to call the nurse navigator, you, to get started or to find out more?

Kathryn Harada, BSN, RN, ONC, CNOR: Absolutely. I'm excited for this opportunity for our patients to participate in this. Our surgeons are absolutely engaged and they are happy to refer their patients to the Wellness and Fitness Center for this opportunity.

Host: How important is exercise after surgery, and how can Community Memorial help patients live a more active lifestyle post surgery?

Kathryn Harada, BSN, RN, ONC, CNOR: After surgery, healing is actually improved with circulation. So first and foremost, we always explain to our patients the importance of movement. It's going to circulate blood, it's going to prevent DVTs or deep vein thrombosis, blood clots, it's going to prevent pneumonia. And really, circulating blood to that incision site is what's going to help patients heal.

So not only is the active lifestyle important, but maintaining that good circulation, in addition to muscle strengthening around a new implant, if it's a hip or a knee. So there is a lot of benefit to patients continuing that active lifestyle, working out, strengthening muscle, strengthening core after surgery.

Host: And then you're already in the habit. It's kind of like something you do and you don't have to think about it. You mentioned earlier personal training and health and wellness coaching. That's available as well at the center?

Kathryn Harada, BSN, RN, ONC, CNOR: It absolutely is available. We have health and wellness coaches. We have personal trainers who are available to work with our patients there. Yeah, that's all I got.

Host: Okay. Kathryn, what else would you like your listeners to know about the Community Memorial Prehabilitation Program?

Kathryn Harada, BSN, RN, ONC, CNOR: The prehabilitation program here is such a benefit for our patients to be able to get stronger, get in shape before their surgery. Starting strong really will help them to recover after surgery and really encourages patients to be engaged in their health care, in their health and wellness journey, and in the recovery after their surgery.

So we are here to support them on that journey and to let them know it doesn't end once surgery is over, that we can continue that process in encouraging their health.

Host: That's awesome. Thank you so much for this useful information, Kathryn. I'm sure it will be very helpful to people looking at having surgery in the future. We so appreciate your time.

Kathryn Harada, BSN, RN, ONC, CNOR: Thank you for having me. We're really excited about this and for the opportunity for our patients as well.

Maggie McKay (Host): It sounds amazing. Again, that's Kathryn Harada. If you or a loved one is planning a joint or spine surgery at Community Memorial, ask your surgeon if you're a candidate for the prehabilitation program. Or you can call 805-948-2874. That's 805-948-2874 for more information. If you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. I'm Maggie McKay. Thanks for listening to Wise and Well presented by Community Memorial Healthcare.