How to Prepare for & Recover From Surgery | Dr. Andrew Huberman

Kidney Donation Recovery Question

00:00Hello, my name's Kelly and I had a question about recovering from a kidney donation surgery and what you can do following the surgery to retain as much muscle mass as possible during that recovery time. Um, also if there's anything you would do beforehand to increase the odds of less loss in that post-surgical time period.

00:26Thank you very much. Well, thank you for your question, Kelly, and really thank you for uh the incredible um act that you're uh that you're asking about a kidney donation. I mean, these things save lives. Gosh, there aren't even words for it.

00:46I mean, to give a kidney to save somebody's life, what a wonderful and remarkable thing. So, thank you so much for that. What a beautiful example of uh humans helping humans. how to best go into and recover from any surgery and in particular this one.

01:01The

Pre-Surgery Fitness Preparation

01:05short answer is go into it as fit and rested as you possibly can. Now, life constraints will determine what that means for you, but it's very clear and in particular if you're thinking about maintaining muscle and maintaining general fitness and speed of recovery, that having your strength and your cardiovascular health as good as it can be heading into the procedure.

01:28And that also means not exhausting yourself or injuring yourself by overtraining is going to be immensely beneficial. And I can say this because I have several friends who are surgeons that will say to me always, you know, that the athletes that come in, even if they're dealing with major surgeries, even if they're not proathletes, they're just sort of, you know, recreational athletes always recover faster.

01:51Why? Well, their metabolic health is better, their circulation is better, and yes, they probably also are used to pushing into challenge and coming out of surgery um can be challenging. I've had surgeries before and I can tell you that it's always striking to me how absolutely dreadful I would feel coming out of it.

02:11You know, 2 3 days I was like, "Oh my god, I don't know how I'm ever." And then 5 days later like, "Wow, I can't believe how quickly I've healed." And I don't consider myself a, you know, any kind of serious athlete. I mean, I'm athletic. I exercise and so forth.

02:24Um, those surgeries were when I was younger from broken bones and things like that. So, they weren't nearly as intense and invasive as as what you're asking about here. But have your cardiovascular fitness um in place if you have time before this surgery.

02:39So great time to do and I imagine you might be doing any number of things that I'm about to describe but perhaps more as well but as we talked about earlier at least one long slow distance you know of about 45 minutes to an hour zone two three-ish cardio per week um some highintensity interval training at least once per week maybe maybe twice and something more moderate in the middle kind of moderate intensity of about 30 minutes or so and some strength training for both the lower body and the upper body pro most probably on days other than the cardiovascular training, two to three

03:13days per week. And again, not overtraining, right? Not pushing yourself to try and get so fit that you're exhausted because you don't want to go into a surgery exhausted. But you do want to go in getting adequate sleep. It's normal the night before a big surgery to perhaps not get as great sleep as you normally do.

03:31That's normal. I think most surgeons will attest to the fact that while not ideal, that doesn't uh, you know, prohibit a really great recovery either. It's just normal kind of pre-surgery anxiety is is is common. But in the days and weeks before the surgery, being as rested as possible, and here's the big one, both going into and out of surgery.

03:51And I know some of you are going to go, "Ah, here he is again with the sunlight thing." I will tell you based on a lot of experience visiting people in the hospital which was just adjacent to my lab at Stanford. These are people who are dealing with everything from cancer to surgery patients of different ages.

04:04I actually

Hospital Recovery & Sleep

04:06was uh I sat in on I didn't participate of course I'm not a surgeon uh on a brain surgery recently up at UCSF and I'll tell you in talking with the brain surgeons that when patients get and stay on a as normal as possible circadian rhythm coming out of surgery it helps immensely.

04:26There are even data showing that recovery from surgery and other illness in the hospital is significantly improved if the patient is next to a window where they get some natural light. If you can't do that, really think about eye mask at night so that you can get it as dark as possible.

04:39It's really hard in some hospitals to get it really dark because there's and quiet because there's a lot of noise from the equipment and people are coming in for the checks all night and you know you have the night staff. Great eye mask for sleeping at night.

04:53Great earplugs to keep it as quiet as possible so you can sleep on as normal as is possible for you schedule. If you can be positioned next to a window. I think if you're giving a kidney, they should put you next to a window and they should put you next to an east facing window.

05:07I don't know what hospital you're at. This person is giving a kidney. They deserve to be near a east facing window. Uh darn it, uh for their recovery and that will allow you to get on and stay on a normal circadian schedule or even west facing as we talked about earlier, get some ambient light in the early part of the day and get that outdoor time, some fresh air.

05:28This is going to massively help your overall state. It's going to tremendously help your sleep, which is going to tremendously help reduce the inflammation postsurgically. It's going to accelerate your healing and on and on. This circadian rhythm stuff, folks, is real.

05:45It is absolutely real and it is foundational to our health. Then in terms of what you can do to just get back the muscle that you had or maintain it through this period, if you have been

Regaining Muscle & Memory

05:59exercising and doing strength training and perhaps hypertrophy and strength training for some period of time going into this, you will be amazed at how quickly an atrophied limb or an overall reduction in muscle and strength comes back. A lot of the quote unquote muscle memory that we talk about is skill-based muscle memory.

06:16I haven't write ridden a bike in years, but I can still do it. Muscle memory. But there's the other kind of muscle memory, which is the nerve to muscle, the motor neuron to muscle, which controls muscular contractions, quote unquote memory, which is the reestablishment of strength, the reestablishment of hypertrophy when you had it prior.

06:36So, regaining strength and and muscle size is far easier than gaining it for the first time. with the one exception being that when you're young, if like you're in your late teens, early 20s, it's pretty easy to gain muscle fast when you first start uh exercising, but that tapers off pretty quickly after about a year or so.

06:57And then you have to fight for every bit of it. And as you get older, it's harder to to get stronger and to build muscle, but you can do it. Now, that's the conventional stuff. And even that doesn't sound that conventional. I'm guessing that a lot of doctors probably are not talking about this, but that's not because they don't talk about it.

07:12It's just it's hard to prescribe to a lot of patients. And in particular, and here I'm calling out the hospitals, not Stanford Hospital, but other hospitals. They treat people, they want them to heal, they want to free up beds, they want to send them home, but the environment in the hospital is not circadian friendly to the patients or the staff.

07:33It's just not. It's not the nature of how hospitals work. And I'm not just talking about the emergency rooms. It's just not. you know, the bright lights, the noises in the middle of the night and the lack of, you know, uh, natural daylight coming through and it has a negative impact.

07:46It really does, uh, at multiple levels. So, you have to kind of push back on on the system in order to try and, uh, get the best possible circadian environment, if you will. Once again, Kelly, thank you ever so much. You're a godsend for somebody out there, and we need more people like you.

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