Dr. Nikolas Antoniou Gives Ten Suggestions on Recovering Well After Surgery

A patient walks into Dr. Nikolas Antoniou's office, and mentions an upcoming surgery. The patient inquires regarding steps to take to optimize the chance of a successful surgery, and recovery. Dr. Nikolas Antoniou MD, who has practiced medicine in the Chicagoland area for three decades, has had a version of this conversation countless times.

"Preparing for a successful surgery and recovery begins weeks in advance of the procedure", says Dr. Antoniou. Here, he outlines ten suggestions that may be helpful.

"Always discuss your unique situation and medical needs with your own personal health care provider", says Dr. Antoniou.

1. Understand the Procedure, the Risks Involved, the Recovery Expectations, Including Postoperative Restrictions and Follow Up

Understanding a surgical procedure is essential for safe and successful outcomes. Patients who are well informed about the nature of the operation, its goals, and alternatives are better able to participate in shared decision-making and provide true informed consent. Equally important is a clear discussion of potential risks and complications, which allows patients to weigh benefits realistically and prepare for possible outcomes. Preoperative education has been shown to reduce anxiety and improve satisfaction and recovery. "Engage your surgeon in the conversation early", says Dr. Antoniou.

Setting accurate expectations for recovery is critical. Patients should understand the anticipated course, including pain, functional limitations, and timelines for return to normal activities. Clear guidance on postoperative restrictions — such as activity level, wound care, and medication use — improves adherence and reduces complications. Finally, emphasizing the importance of follow-up ensures appropriate monitoring, early identification of issues, and adjustment of care plans. Overall, comprehensive understanding promotes safer care, better outcomes, and a more engaged patient.

2. Bring and Review the Surgeon's Preoperative Request Form With Your Primary Care Provider

"Bringing the surgeon's preoperative form to your primary care provider (PCP) during your preoperative visit is a critical step in preparing safely for surgery", says Dr. Nikolas Antoniou MD. This form communicates the surgeon's specific requests, including required evaluations, testing, and medical clearance, ensuring that nothing essential is overlooked. Reviewing it with your PCP allows for accurate interpretation and coordination of care, particularly for patients with chronic conditions or complex medical histories.

Your PCP can identify and optimize underlying health issues — such as blood pressure, diabetes, or medication management — before surgery, which helps reduce the risk of complications. This collaborative approach also prevents unnecessary or duplicate testing and ensures that all requested information is completed correctly and on time.

Additionally, discussing the form provides an opportunity to clarify instructions, address concerns, and align expectations across providers. Overall, bringing and reviewing the preoperative form with your PCP promotes safer surgery, better communication, and a smoother perioperative experience.

3. Ensure the Preoperative Evaluation Is Completed, Including History, Physical Exam, and Any Required Testing

A complete preoperative evaluation is essential to ensure patient safety and optimize surgical outcomes. This process includes a thorough history, physical examination, and appropriate, targeted testing. The history identifies comorbid conditions, prior surgical or anesthesia complications, medication use, and functional status, all of which influence perioperative risk. The physical exam helps detect clinical findings — such as cardiopulmonary conditions — that may require further evaluation or stabilization before surgery. Together, these steps form the foundation for risk stratification and perioperative planning.

A comprehensive evaluation allows clinicians to identify modifiable risk factors, optimize chronic conditions, and coordinate care among surgical and anesthesia teams. Ultimately, completing the preoperative assessment reduces complications, prevents unnecessary delays or cancellations, and supports informed decision-making for both the clinician and patient.

4. Optimize Chronic Medical Conditions Prior to Your Procedure

Optimizing chronic medical conditions prior to surgery is a critical component of perioperative care that directly impacts patient outcomes. Many surgical patients have comorbidities such as diabetes, hypertension, chronic obstructive pulmonary disease, or heart disease, which can increase the risk of postoperative complications. Effective preoperative optimization involves stabilizing these conditions through medication adjustments, improving glycemic and blood pressure control, and addressing lifestyle factors such as smoking cessation and nutrition. For example, improved diabetic control reduces infection risk, while treating anemia and optimizing cardiovascular status can decrease perioperative morbidity.

A targeted, multidisciplinary approach allows clinicians to identify modifiable risk factors and intervene before surgery. This may include coordinating care with specialists, adjusting chronic medications, and ensuring adherence to treatment plans. Evidence shows that addressing comorbidities preoperatively is associated with fewer complications and improved recovery. Ultimately, optimizing chronic conditions enhances physiologic reserve, reduces surgical risk, and promotes safer, more efficient postoperative outcomes.

5. Review and Adjust Medications

A thorough medication review prior to surgery is essential to minimize perioperative risks and prevent adverse events. "This is often overlooked", says Dr. Antoniou MD.

This process involves reconciling all prescription medications, over-the-counter agents, and supplements, then determining which should be continued, held, or adjusted based on pharmacology and surgical risk. Anticoagulants and antiplatelet agents require careful timing of interruption and resumption to balance thrombotic and bleeding risks. Herbal supplements and nonessential medications should be discontinued. Collaboration between the surgical, anesthesia, and primary teams ensures individualized plans that optimize patient safety while maintaining therapeutic goals for chronic conditions.

6. Maintain Good Nutrition, Hydration, and Stay Active if You Can

"Maintaining good nutrition, hydration, and physical activity prior to surgery plays a key role in improving surgical outcomes and recovery", says Dr. Nikolas Antoniou. Adequate nutrition, particularly sufficient protein and caloric intake, helps preserve muscle mass, support immune function, and promote wound healing. Poor nutritional status has been consistently associated with higher rates of complications, infection, and delayed recovery. Staying well hydrated is equally important, as dehydration can increase perioperative risks, including hemodynamic instability and postoperative complications.

Physical activity, even at a moderate level such as walking or light resistance exercise, enhances cardiovascular fitness and functional capacity. Preoperative exercise programs have been shown to reduce postoperative pulmonary complications and shorten hospital stays. Together, these elements form the basis of "prehabilitation," which aims to improve physiologic reserve before surgery. Encouraging patients to eat balanced meals, maintain adequate fluid intake, and remain as active as possible can significantly improve resilience to surgical stress and support a smoother postoperative recovery.

7. Stop Smoking, and Limit Alcohol Intake Prior to Surgery

Stopping smoking and limiting alcohol intake prior to surgery are critical steps in reducing perioperative risk and improving recovery. Smoking is associated with impaired wound healing, increased pulmonary complications, and higher rates of infection due to its effects on tissue oxygenation and immune function. Even short-term cessation is beneficial, with greater reductions in complications seen when patients stop at least four weeks before surgery. Importantly, quitting at any time prior to surgery can still improve outcomes.

Excessive alcohol use similarly increases the risk of postoperative complications, including bleeding, infections, and cardiopulmonary events. Alcohol can impair liver function, coagulation, and the body's stress response to surgery. Reducing or abstaining from alcohol for several weeks before surgery helps restore physiologic balance and lowers complication rates.

Preoperative counseling and support, including behavioral strategies and pharmacologic aids when appropriate, can improve success with cessation. Addressing these modifiable risk factors enhances surgical safety, shortens recovery time, and contributes to better overall outcomes.

8. Arrange Postoperative Support, Including Transportation and Assistance at Home

Arranging postoperative support well in advance of surgery is essential to ensure a safe transition from hospital to home and to reduce complications or readmissions. Many patients experience temporary limitations in mobility, self-care, and daily activities after surgery, making reliable assistance critical. Planning ahead allows patients to secure transportation on the day of discharge and for follow-up appointments, which is a key factor in maintaining continuity of care.

Equally important is arranging help at home, whether from family, friends, or professional caregivers, to assist with tasks such as medication management, wound care, meal preparation, and mobility. Early involvement of caregivers improves preparedness and confidence in managing recovery needs. Assessing the home environment for safety and accessibility can further prevent falls or complications.

Proactive discharge planning that includes social support and transportation has been shown to improve recovery, reduce stress, and support better overall outcomes following surgery.

9. Identify and Choose a Home Health Agency for Postoperative Services

"Identifying and selecting a home health agency well in advance of surgery is an important component of effective postoperative planning", says Dr. Nikolas Antoniou. Early coordination allows for a smoother transition from hospital to home, reducing gaps in care that can increase the risk of complications or readmission. Home health agencies provide essential services such as skilled nursing, wound care, medication management, and physical or occupational therapy, all of which support recovery in the home setting.

Choosing an agency in advance gives patients and clinicians time to evaluate quality, availability, insurance coverage, and specific service offerings. It also allows for better communication between the surgical team and home health providers, ensuring that care plans are clearly understood and implemented. Discharge planning that includes assessment of postacute care needs and coordination of services has been shown to improve outcomes and reduce fragmentation of care.

10. Follow Preoperative Medication Protocols, Preoperative Fasting and Hygiene Instructions

Following preoperative medication protocols, fasting instructions, and hygiene measures is essential to reduce surgical risk and improve outcomes. Medication instructions help ensure that necessary drugs are continued while others are safely held to avoid complications such as bleeding, hypotension, or metabolic disturbances. Clear guidance also prevents medication errors on the day of surgery.

Preoperative fasting is critical to reduce the risk of pulmonary aspiration during anesthesia. Adherence to these instructions minimizes intraoperative and postoperative complications.

Hygiene measures, including preoperative bathing or showering with soap or antiseptic agents, help reduce skin bacterial load and lower the risk of surgical site infections. Together, compliance with medication, fasting, and hygiene protocols ensures optimal surgical conditions, enhances patient safety, and contributes to smoother perioperative care and recovery.

In Summary

Preoperative planning by the patient is a key factor in achieving safe surgery and smooth recovery. Active participation allows patients to optimize their health, follow instructions, and prepare for postoperative needs. This includes managing chronic conditions, adjusting medications, improving nutrition and activity, and arranging support at home. Good preparation reduces the risk of complications, delays, and cancellations, while improving overall surgical outcomes. It also helps patients understand expectations, leading to better adherence to perioperative instructions and reduced anxiety. When patients are engaged in planning and decision-making, care becomes more coordinated and efficient. Overall, thoughtful preoperative preparation empowers patients, enhances safety, and contributes to faster recovery and better long-term results.

"The patients who do best after surgery are the ones who start planning weeks in advance, are methodical, and don't panic", says Dr. Antoniou MD.