THE OPTIMIZED PATIENT

“Patient, heal thyself” is the message in this primer on recovering from surgery.

Although screenwriter, film producer, and financial services professional Warren’s (Drop Debt, 2011) advice here is applicable to other types of surgeries, it centers on spinal surgery, and includes specific measures that patients can take to “optimize” their healing. The author underwent several spine operations after a 2010 car crash, and his measures include nonsurgical, alternative treatments for back pain: injections of cortisone or epidural anesthetics, pre-operation physical conditioning to strengthen core muscles to withstand surgical trauma, post-operation physical therapy exercises, and more. The author swears by aquatherapy, which involves walking in a pool, pre-op and post-op. On pain management, he suggests taking opioids to get rest, but to stop as soon as possible to avoid addiction. Post-op home care procedures include using special equipment to negotiate beds, chairs, and the bathing process without bending, lifting, or twisting motions. Warren also devotes much attention to digestion and nutrition; anesthetics, antibiotics, and opioids, he says, can paralyze the gut and wipe out its microbiome, leading to constipation and poor nutrition, necessitating probiotic foods to restore proper function. He further recommends a diet that’s high in fresh fruits, vegetables, and whole grains, and low in meat and sugar, and as much exercise as one’s spine can tolerate. Above all, he emphasizes the patient’s psychological “will to get well” by pursuing every possible measure to hasten recovery. Overall, Warren provides a lot of useful material in this book. However, its disorganization makes it a chore for readers to access. He presents his advice piecemeal and unsystematically, drawing it from anecdotes and lengthy interviews with surgeons, physical therapists, nutritionists, and other spinal surgery patients, including a young violinist whose chronic back pain drove her to consider suicide. There are almost no bullet points, charts, lists, or summaries to orient readers or distill lessons. Long sections from interviews are repeated in meandering chapters with redundant exhortations, such as “Whether you think you can get better or whether you think you can’t get better, you’re right.” Readers will need to take careful notes to extract a clear program from this book.

An encouraging but haphazard self-care guide.