Translator: Nika Kotnik Reviewer: Denise RQ
Hello, my name is Ben Witteman, and it's a pleasure to be here.
I'm a medical doctor as you've already heard,
and I especially treat patients with bowel diseases.
I can imagine that you're curious why I am here.
Well, I want to demonstrate to you a new way of patient care
in which you are in the lead.
You play the key role.
To cure patients, it's often necessary to take them to surgery,
and surgery isn't peanuts.
It puts your life upside down. It's a heavy treatment.
Not only in an emotional way but also in a physical way.
And that is the reason why I'm here.
I want to demonstrate to you that the need of energy during an operation
may be the same as that of high level sports.
Typically, when you're admitted to the hospital you put on your pajamas,
you lie in your bed, and you eat less, you lose your independence,
and you play a fully inactive role.
And I think this should change. I think the patient should be in the lead.
More active.
During an operation, a body needs a lot of energy
and this energy, during the operation, the total amount of energy
before, during, and after the operation
may be the same as that of high level sports,
and therefore I think patients should be treated the same way,
should prepare themselves the way as in high level sport.
Just as rowing a race.
This is Inge Janssen.
At the moment, she is one of the most prominent rowing athletes
in the Netherlands, she also went to the Olympics in 2012,
and we are very proud of her.
Do you know how many hours does she have to train to reach this level?
She trains for more than 20 hours
and besides that, she also eats a special diet, rich in protein.
So in other words, an operation might be comparable with high level sports,
and because of the physical similarities between the surgery and high level sports,
I think people should be trained, prepared the same way.
However, in daily practice, this is not the case.
Patients eat less, you can see it here on the slide,
and they also make less exercise, they don't train before the operation.
And I think this should change, this is very important,
it is my wish and my belief that the patient
should be more in the lead to train himself.
Do you know how many operations are performed here in the Netherlands
on a yearly base?
1.5 million.
That's a lot.
That means, as you are sitting here,
the chance that you may need an operation once in your lifetime is quite real.
So, be prepared.
Why is nutrition and exercise during illness and surgery so important?
In normal life, you can lose some weight and it's not a problem.
But during illness, this makes a difference.
Because you don't only lose fat cells, but you also lose body cells.
That means loss of muscle mass and loss of organ function;
and of course, as a result, you can get more complications after the operation.
More complications lead to a longer hospital stay,
and a longer hospital stay leads to more healthcare costs.
I think it is very important to be aware of that.
Protein enriched nutrition is very important,
so you need a diet like that,
but a diet alone will not prevent the decrease in muscle mass.
So to prevent that, we should combine - and that is important -
combine exercise with nutrition.
Therefore, I want to advise you, but also your beloved ones,
when you need an operation or other severe therapy,
please prepare yourself for this operation,
do this with exercise and nutrition.
You can do this yourself, you can do this at home,
it's very easy and otherwise we can help you with it.
Clinical research already showed that when you train for one week
before the operation and eat a good diet, then the post operative cost will improve.
But, there is a problem.
Sorry, this is a wrong slide.
When you are operated upon, you get anesthesia,
and when you get anesthesia, then the stomach has to be empty
otherwise the gastric content can flow into your lungs
and this is not what we want.
You are not allowed to eat for six hours, and that's a long time.
In this fasting state, you can already see
that your hormone insulin is not working properly;
and beware: your hormone insulin is one of the most important hormones
to keep your body in a healthy balance.
So that is depressing,
you did all you could do to get in good condition before the operation
and now you're stuck in the last hours,
very important hours, before the operation.
But luckily, we also found the solution for that,
because you are allowed to drink clear liquids before the operation,
because clear liquids will pass the stomach within two hours.
And this may be the window of opportunity,
because if we add proteins and energy to this drink,
then you can see it as a bonus of energy drink just before the race.
Besides that, it has a positive influence on the insulin levels
and on the postoperative course.
My take home messages for you are:
I think surgery is like top sports for the patient.
Two, as a patient you should prepare yourself the same way as athletes do.
And three: you are the future patient, and I think you should be in the lead.
Thank you.
(Applause)