PRECEDE

It can help:

• reduce anxiety and depression
• improve sleep quality
• improve strength
• reduce post-op complications
• reduce fatigue
• improve cardiorespiratory fitness
• improve confidence
• improve balance.

Pre-operatively increasing your physical activity can have multiple benefits including reducing the risk of post-operative complications and aiding a quicker recovery.

If you have any history of metastatic bone disease, breathing disorders, heart or joint problems please speak to your GP or Consultant prior to commencing any physical activity. If you experience any adverse effects that do not resolve whilst increasing your activity, please contact the appropriate emergency services

Moderate aerobic activity

Any activity that gets your heart beating faster such as swimming, walking, running, going to the gym, dancing, cycling and sport.

Strengthening exercises 

Any activity or exercise that focuses on making your muscles work harder such as carrying bags, weightlifting, the gym, climbing, boxing and aerobics.

It is recommended to start slowly and build up to the recommended physical activity levels at a pace that is comfortable for you during your treatments.

There are lots of ways to increase your physical activity, it is important to do something that you enjoy but also fits into your daily life. This can include increasing your day to day activities or making lifestyle changes. For example: taking a walk instead of using transport, sitting less or exercising in TV breaks and joining local exercise classes.

1. Complete five 30 minute walks within a week

2. Walk to the shops once a week for the next 4 weeks

3. Practice 15 minutes of relaxation and mindfulness a day for the next month

4. Join 1 x exercise class per week

Complete sat upright, placing your hands on your tummy to feel your lungs expanding.

• Take 3-5 long, slow, deep breaths in through your nose – pushing your tummy out as you do
• Try to hold your breath at the top for a count of 2-3 seconds
• Breathe out slowly
• Complete a cough to clear and phlegm (You can use a towel to support your wound post operatively).

If you experience any dizziness or feel light-headed, discontinue. Complete 2 - 4 x daily for about 10 minutes a time. This can also be completed with other forms of treatment such as chemotherapy to help prevent any chest complications.

Eating well before and after surgery will help you recover faster. It is important that you eat well prior to surgery to help with your post-operative recovery.

Consuming a healthy diet before and after your surgery can really help with wound healing and reduce the risk of infection. Being well nourished reduces risks of post-op complications and your length of stay in hospital. Healthy eating is about having a balance of different foods and nutrients in the diet for good health and wellbeing.

Healthy eating is about enjoying your food, at the same time as being mindful about what you eat. The eat-well guide shows the ideal proportion of each of the different food groups to include in your diet. Having a variety of foods in the recommended proportions and (portion sizes), can help you to be and to stay healthy.

• Carbohydrates are our main energy (fuel) source.
Try to get most of your calories from starchy carbohydrate rich foods. These include bread, potatoes, rice, and pasta. Wholegrain options are healthier choices.

• Fruits and vegetables are rich in vitamins and minerals.
Try to eat at least five portions of fruit and veg in your diet. Dried, frozen, tinned as well as fresh fruit and veg are all included.

• Protein is vital as the body’s main building block.
Meat, fish, eggs and dairy are good sources of dietary protein. Pulses, nuts and seeds are also high in protein as a meat alternative. Try to avoid processed meats such as salami, bacon, hot dogs and ham.

Dairy (and calcium fortified alternatives) are the body’s main source of calcium, necessary for healthy bones and teeth. Milk, cheese, cream, yoghurts, and other dairy products are also a source of protein.

• Like carbohydrates, fat provides us with energy (fuel).
Fats should be consumed in small quantities. Limit saturated fats, salt, and sugar. These are found especially in processed foods, so look at food labels.

• Fatty and sugary snacks are usually full of calories and don’t usually offer much other nutrition.

• Unless you have a specific deficiency, a balanced diet of the above food groups should provide all the necessary vitamins and minerals that your body needs.

• Traffic light food labels can be useful as a guide to identify the calorie (energy), fat (and saturated fat), sugars and salt within foods. Green is low in a particular nutrient, amber means medium, and red is high in a nutrient.

If you are currently ‘underweight’, have lost weight or have a poor appetite, you may need more calories (energy) and protein in your food to put weight back on prior to surgery.

Your specialist nurse or doctor may be able to provide you with information or refer you to a dietitian to support you.

If you are ‘overweight’, losing weight can help improve your health outcomes. Losing weight prior to surgery can also help to;

• improve your blood sugar levels

• reduce your risk of blood clots after surgery

• reduce your risk of wound infections after surgery

• reduce the risks associated with having an anaesthetic.

Your specialist nurse or doctor may be able to refer you to a dietitian for information and support to lose weight

Ensuring that you ask any questions about your surgery or treatment can help you to feel more prepared. It can also be helpful to write down any questions that you have and go through them with your medical team.

It is natural to feel worried after a cancer diagnosis and when preparing for surgery or treatment. Other feelings you may experience include sadness, anger and even loneliness at times.

Stay connected to others; talking about these feelings with loved ones and people who support you can be helpful and a much-needed outlet. Try to let them know what sort of support you may need, both now and after your surgery. This may be practical or emotional. You can also contact the Macmillan Information and Support Service for support on 01253 955710.

It may be helpful to practice some daily breathing techniques. This can help us to manage some of the above emotions by reducing their intensity and helping you to find some calm. Try to find a quiet spot and a comfortable position.

For a few minutes, try some slow breaths, simply breathing in through the nose for a count of around five seconds and out through the mouth for five seconds also. Do this whenever you notice difficult thoughts or feelings but also if you notice physical symptoms that may have been triggered by feeling worried. For some guided tracks please visit www.macmillan.org.uk and search ‘relax and breathe’. Follow the ‘relax and breathe’ audiobook where you will find a number of tracks. You may find tracks 5 to 8 most helpful.

Guided imagery can also be a useful tool that can work well alongside the breathing techniques. Guided imagery can work as a relaxation strategy which focuses the mind on images that you find relaxing, this can help reduce feelings of pain and stress. It can be helpful to close your eyes and practice imagining a favourite location where you feel some calm. It can be a real or imagined place, e.g. a beach or in nature. Try to engage all of your senses to really get connected with the image and feel the relaxing sensations.

Before and after medical procedures there can sometimes be a reluctance to continue engaging in activities and hobbies that you enjoy. You may not always feel motivated or have the energy to do things and it can be easy to compare ourselves to others or to our previous ability to do things. This is natural but not always helpful.

Where possible try and continue doing things that you enjoy. It may be at a reduced pace and level dependent on your energy levels and stage of recovery but it will help you to feel engaged with the people around you and to improve your sense of wellbeing.

1. Create an area to recover: identify a good height chair ideally with two arms to make it easier to get up from, with a side table nearby, have it stocked with some blankets, phone charger set up.

2. Identify hazards: To reduce the risk of falls prior to and following surgery, consider the removal of rugs to prevent trips and slips, electrical cables, add lighting to poorly lit areas consider a night light, clear walkways throughout the property and how you would get help in the event of fall.

3. Meal preparation: Stock up your fridge, consider preparing meals into individual portions to store in the freezer making it easy to heat up following your recovery. Have plastic containers with lids, flask style cup which food can be transported in a bag if you require a walking aid following surgery.

4. Support: Give your family and friends plenty of notice so that they can take time if needed from work to support you. Plan: they may be able to help with tasks like collecting the post, shopping , changing the bed, feeding/ walking the dog, taking out the rubbish. It can be difficult to ask for help but you may be surprised how much they are willing to help.

5. Consider making the environment safer: how is the access to the toilet and bathroom? Identify additional equipment that you could need to make recovery easier.

6. Sleep: Following surgery the stairs may be difficult to negotiate, consider how you could facilitate a temporary option of downstairs living. ie: Do you have toilet facilities downstairs, is there space for a bed downstairs if needed. Sleeping pattern: Sleep is an important factor in well- being and recovery. Try to maintain a regular sleeping pattern. Short rest periods in the day will help with your fatigue management following surgery. Have a number of pillows as getting up from lying and being flat can be uncomfortable following surgery.

7. Getting dressed: Bending and reaching down to your lower half can be difficult following surgery, having a long- handled shoehorn and long grabber/ grip stick could be useful for dressing lower half. You may want to choose loose fitting easy to wear clothing. Loose pants and shirts, slippers with rubber grip soles.

8. Sitting: Standing for long periods following surgery may difficult and you may need to conserve energy. Put chairs in places that you often go to avoid standing for long periods. This will help when completing tasks like getting washed and dressed, with cooking and preparing food.

9. Kitchen: Set your kitchen up ready. Reaching and bending down for the first few weeks can be difficult following surgery. Set up an area in your kitchen where you can put all your frequently used items, rearrange items into cupboards between waste and shoulder height.

10. Stock up on essentials, like medications and other essential items in advance.

11. Energy conservation: Break up tasks, allow time to complete an activity without rushing. Prior to and following the surgery it may take you longer to complete tasks. Allow yourself an adequate amount of time to rest before and after the next activity. This will help prevent burnout. Keep frequently used items in easy reach. Sit rather that stand. Listen to your body and rest before you feel exhausted.

St Andrews Church Rough Lea Road, Cleveleys, FY5 1DP (01253 921266)
Line Dancing - Mondays and Thursdays 12:30 - 4.00pm
Taekwondo - Wednesdays 6pm

Christ Church Thornton Meadows Avenue, Thornton, FY5 2TW (01253 272372)
Table Tennis - Thursdays 2.30 - 4.30pm
YMCA Lofthouse Building Fleetwood, FY7 6JL (01253 208442)
Yoga - Tuesdays 1.00 - 2.00pm

Fleetwood Town Community Trust Fleetwood (01253 208442)
Walk and Talk Fleetwood - Meet at the Marine Hall Fleetwood Mondays 10.30 - 11.00am Wednesdays 11.00am - 12.00pm Fridays 11.00am - 12.00pm

Memorial Park Pavilion Off Warrenhurst Road, Fleetwood, FY7 7AN (01995 602125)
Gardening Club - Wednesdays 9.30am – 12.00pm Cleveleys

Park Methodist Church West Drive, Thornton-Cleveleys FY5 2BL (01253 208442)
Gentle Exercise Class - Wednesdays 1.45 - 2.30pm
Rossall Point Beach Clean Group (no need to book) - Thursdays 10.30am - 12.00pm

Wellbeing Walks across the Fylde coast at various places. For more information: (01253 478007):

• Stanley Park
• Blackpool Zoo circular
• Woodlands Gardens
• Bispham Marsh
• Carlton Lodge
• Robins circular
• Heron’s reach
• Marton Mere
• South Shore Promenade
• Anchorsholme / Cleveleys promenade
• North Promenade
• Palatine
• Fairhaven Lake
• Witch Wood

Active Blackpool programme has Gym based exercises, aerobic classes, lifestyle circuits, chair exercise classes and more available for a monthly fee. Based at Moor Park, Blackpool Sports Centre and Palatine Leisure Centre For more information: (01253) 478474.

If you’re looking for a way to enjoy Wyre’s beautiful coast, countryside, parks, and green spaces take a look at what’s on in their Great Outdoors calendar and Great Outdoors activities. For more information visit: www.wyre.gov.uk/greatoutdoors.

YMCA
“Your Move Programme” YMCA provide a free 12 week programme with tailored support for people who are classed as inactive and have at least one health conditions. For more information visit: www.ymca-fyldecoast.org/physical-activity-yactive.

Macmillan Information Centre is a great source of advice for additional and up-to-date activities that are available. For more information: (01253) 955710.