ReMemBr Group Team

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The ReMemBr Group is made up of a diverse group of researchers and clinicians.

Dr Elizabeth Coulthard, Consultant Senior Lecturer in Dementia Neurology

 

Elizabeth Coulthard

I trained in Oxford, London and Newcastle before settling in Bristol as a consultant senior lecturer in dementia neurology. I divide my time between clinical neurology and research into dementia and cognition. As a clinician, I see people with neurological illness and run specialist clinics in dementia, cognition and Huntington's disease. As a researcher, with the support of BRACE charity, I established the ReMemBr group where clinicians and researchers work side by side aiming to improve treatments for people with dementia and understanding brain systems that underpin cognition.

We are a flourishing clinical research community with weekly research meetings and regular attendance at national and international conferences. Current projects include clinical trials aimed at slowing dementia progression, a programme of work to better understand how dopamine in the brain contributes to memory formation and trials of medications that might enhance thinking and memory. We also have an active programme of work in Huntington's Disease. Please see the research tab for details of our different projects.

More broadly, I am co-lead director of the dementia Health Integration Team spanning 2 universities, local authorities, acute medical trusts and mental health trusts and I sit on the Bristol Neuroscience Steering group. 

Email: elizabeth.coulthard@bristol.ac.uk

For details about my publications and other activities visit www.bristol.ac.uk/clinical-sciences/people/liz-j-coulthard/publications

Dr Margaret Newson, Clinical Neuropsychologist and Dementia Research Neuropsychologist

Dr Margaret Newson is a Senior Clinical Neuropsychologist at North Bristol NHS Trust, and an Honorary Senior Lecturer in the Department of Experimental Psychology at the University of Bristol.  She has both clinical and research duties within the ReMemBr group.  She obtained a PhD in Clinical Neuropsychology from the University of Windsor (Canada) in 1999 and has been working in Bristol ever since.  She has been part of the clinical research team since its beginning in June 2011.  In her clinical role she is involved in designing the test batteries used in Cognitive Neurology and Dementia Clinic, training and supervising the assistant psychologists who administer the tests, and interpreting the test results so they may be used by the Neurologists to facilitate diagnosis.  She also meets with patients to discuss their test results when a medical cause for their difficulties has not been found. 

Her research interests include developing ways to predict high versus low risk of developing dementia using cognitive and psychological tests.  Her work is supported by BRACE.  One recent project has looked at how many people diagnosed with Mild Cognitive Impairment fail measures of test performance validity (failure on these measures could mean that the cognitive test results are not valid and therefore should not be used as a marker of brain dysfunction), and examine non-neurological factors that might be related to failing these measures.  BRACE recently awarded Dr Newson and Dr Coulthard a PhD Studentship to look at the impact of interventions for people with subjective cognitive decline.

Email: m.newson@bristol.ac.uk

Elena Bellavia, Research Administrator

I have been working with the ReMemBr Group as a Research Administrator since April 2017. My main duties include assisting the team with all of the administrative elements of the day to day running of research studies. I also help with document management, diary management, patient appointments, data entry telephone queries, coordinating site visits, liaising with Research and Development and external sponsors.

Dr Hilary Archer, Academic Clinical Lecturer in Dementia Neurology

 

Dr Hilary Archer

I trained in Oxford and London and am now a NIHR clinical lecturer in Dementia at the University of Bristol.  My main research interests are in biomarkers for early Alzheimer's disease, but I also work closely with the Brains for Dementia Research Project.

Publications

Coulthard EJ, Archer HA, Smailagic N, John C,Giannakou A, Holmes RB, Cullum Sarah. rCBF SPECT for detection of frontotemporal dementia in people with suspected dementia.  Cochrane Database of Systematic Reviews 2013 (12).  http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010896

Archer HA, Panopoulou A, Bhatt N, Edey AJ, Giffin NJ.  Mesothelioma and anti-Ma paraneoplastic syndrome; heterogeneity in immunogenic tumours increases.  Pract Neurol. 2014 Feb;14(1):33-5

Kennedy J, Lehmann M, Sokolska MJ, Archer H, Warrington EK, Fox NC, Crutch SJ.  Visualising the emergence of posterior cortical atrophy.  Neurocase. 2012 Jun;18(3):248-57

Archer HA, Faldon ME, Davies R, Bronstein A.  Accessing escalators: a central vestibular disorder after posterior fossa tumour removal.  J Child Neurol. 2012 Aug;27(8):1067-71.

Edison P, Hinz R, Ramlackhansingh A, Thomas J, Gelosa G, Archer HA, Turkheimer FE, Brooks DJ.  Neuroimage. Can target-to-pons ratio be used as a reliable method for the analysis of [11C]PIB brain scans?  2012 Apr 15;60(3):1716-23.

S A Bazir-Ahmad, Archer HA, Rice, CM, Gerhand S, Bradley M, Wilkins A.  Seronegative limbic encephalitis: case report, literature review and proposed treatment algorithm.    Pract Neurol. 2011 Dec;11(6):355-61.

Archer HA, Kennedy J, Barnes J, Pepple T, Boyes R, Randlesome K, Clegg S, Leung KK, Ourselin S, Frost C, Rossor MN, Fox NC. Memory complaints and increased rates of brain atrophy: risk factors for mild cognitive impairment and Alzheimer’s disease.    Int J Geriatr Psychiatry. 2010 Nov;25(11):1119-26.

Edison P, Brooks DJ, Turkheimer FE, Archer HA, Hinz R.  Strategies for the generation of parametric images of [(11)C]PIB with plasma input functions considering discriminations and reproducibility.  Neuroimage. 2009 Nov 1;48(2):329-38.

Okello A, Koivunen J, Edison P, Archer HA, Turkheimer FE, Nagren K, Bullock R, Walker Z, Kennedy A, Fox NC, Rossor MN, Rinne JO, Brooks DJ.  Conversion of amyloid positive and negative MCI to AD over 3 years.  An 11C-PIB PET study.  Neurology. 2009 Sep 8;73(10):754-60.

Okello A, Edison P, Archer HA, Turkheimer FE, Kennedy J, Bullock R, Walker Z, Kennedy A, Fox N, Rossor M, Brooks DJ.  Microglial activation and amyloid deposition in mild cognitive impairment: a PET study.  Neurology. 2009 Jan 6;72(1):56-62.

Edison P, Archer HA,Gerhard A,  Hinz R, Pavese N, Turkheimer FE, Hammers A,Tai YF,Fox N, Kennedy A, Rossor M, Brooks DJ.  Microglia, amyloid, and cognition in Alzheimer disease: An [11C](R)PK11195 and [11C]PIB PET study.  Neurobiol Dis. 2008 Dec;32(3):412-9.

Archer HA, McFarlane F, Frost C, Cutler D, Fox NC, Rossor MN.  Symptoms of memory loss as predictors of cognitive impairment?: the use and reliability of memory ratings in a clinic population.  Alzheimer Dis Assoc Disord. 2007 Apr-Jun;21(2):101-6.

Edison P, Archer HA, Hinz R, Hammers A, Pavese N, Tai YF, Hotton G, Cutler D, Fox N, Kennedy A, Rossor M, Brooks DJ.  Amyloid, hypometabolism, and cognition in Alzheimer disease. An [11C]PIB and [18F]FDG PET study. Neurology. 2007 Feb 13;68(7):501-8.

Archer HA, MacFarlane F, Price S, Moore EK, Pepple T, Cutler D, Frost C, Fox NC, Rossor MN.  Do symptoms of memory impairment correspond to cognitive impairment: a cross sectional study of a clinical cohort.
Int J Geriatr Psychiatry. 2006 Dec; 21(12):1206-12.

Archer HA, Edison P, Brooks DJ, Barnes J, Frost C, Yeatman T, Fox NC, Rossor MN.  Amyloid load and cerebral atrophy in Alzheimer's disease: An (11)C-PIB positron emission tomography study.  Ann Neurol. 2006 Jul;60(1):145-147.

Archer HA, Schott JM, Barnes J, Fox NC, Holton JL, Revesz T, Cipolotti L, Rossor MN.  Knight’s move thinking?  Mild cognitive impairment in a chess player.  Neurocase Volume 11 (1) Feb 2005.

Email: hilary.archer@bristol.ac.uk

For more details visit www.bristol.ac.uk/clinical-sciences/people/person/hilary-a-archer/overview.html

Ms Hanna Isotalus, PhD Student

Ms Hanna Isotalus, PhD Student

I completed a MA(hons) in Psychology (1st) at the University of Glasgow and a MSc in Neuroimaging at King’s College London before starting my PhD here in Bristol in October 2014. I have a particular interest in memory, healthy ageing, dementia, epilepsy and Parkinson's Disease. To study these processes I use a variety of different techniques, such as behavioural testing of cognitive ability, pharmacological alterations of neurotransmitter activity, and neuroimaging - including magnetic resonance imaging of the hippocampus, diffusion tensor imaging, electroencephalography of sleep, and I look forward to getting involved in some intracranial recordings of humans too.

Funding

My work is jointly funded by the Medical Research Council and BRACE.

Contact Details

Email: hanna.isotalus@bristol.ac.uk

Ms Louise Gethin, Research Nurse

 

Louise Gethin

Louise Gethin qualified as a Registered General Nurse in  1988.  She has spent time working in the UK and New Zealand and has NHS and Charity Sector experience.  Within the Dementia field she has worked with people in Elderly Care settings.  Two years were spent working with people with AIDS-related brain impairment within a  palliative care home.  For the last 18 months, she has been working as a research nurse on studies for people with Huntington’s Disease and Parkinson’s.

Useful links related to her work are:

For Huntington’s Disease: Huntington's Disease Association and Euro-HD

For Parkinson’s Disease: Parkinson's UK

Contact Details

Email: louise.gethin@nbt.nhs.uk

Telephone: 0117 4148270

Ms Natalie Rosewell, Research Nurse

Ms Natalie Rosewell, Research Nurse

I trained as a nurse at the University of the West of England, graduating in 2009 with a first class honours degree.  I have a broad clinical background including experience as a staff nurse on a busy stroke ward.

I started working as a research nurse for dementia studies in September 2014. I work full time on dementia research as part of the ReMemBr group, based at Southmead Hospital in the newly opened Brain Centre.

The studies I work on include, the RADAR trial, TOMMORROW and ELAD. 

 

 

Email: natalie.rosewell@nbt.nhs.uk

Dr Gary Christopher, Senior Lecturer in Cognition and Ageing

 

 

Dr Gary Christopher is a Senior Lecturer in Cognition and Ageing.  He is co-founding member of the new Psychological Science Research Group (PSRG launch scheduled soon).  He is a recognised expert in cognitive function and emotion regulation, with a particular focus on ageing and mental health.  He has published widely in the field.  In addition to this, Dr Christopher has published a range of papers on the psychopharmacological and behavioural effects of caffeine.  These papers systematically address a number of key methodological issues associated with the impact of caffeine on performance.  His journal articles include a highly-cited paper on the impact of depression on working memory.  He has published an authoritative single-authored text on the psychology of ageing (The Psychology of Ageing: From Mind to Society, Palgrave).  He is currently Series Editor for Routledge for a new range of clinical texts, and he is in the process of writing two titles in this series, one on dementia, the other on depression.  His current research is funded by the Alzheimer’s Society and BRACE (a Bristol-based charity that funds dementia research).  In the past, his research has been funded by substantial grants from the Economic and Social Research Council (ESRC; caffeine) and the Department of Health (mental health), as well as industry-funded projects by the likes of Nestlé and Wrigleys.  Dr Christopher is a member of the Bristol Health Partners Health Integration Team for Dementia Research, ReMemBr Group (University of Bristol, North Bristol NHS Trust), the British Society of Gerontology, and the British Psychological Society.

email: gary.christopher@uwe.ac.uk

Dr Marta Swirski, PhD, Postdoctoral Research Associate

Dr Marta Swirski, PhD, Postdoctoral Research Associate

Marta completed her first degree at King’s College London in Pharmacology. She continued her studies at Imperial College London achieving an MRes in Translational Medicine. The research project conducted at the Neuropathology unit, under the supervision of Dr Stephen Gentleman and Dr Michael Kalaitzakis, focused on nucleus basalis pathology in Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB). Marta continued her studies at the University of Bristol and completed her PhD at the Dementia Research Group. Marta’s research explored the relationship between amyloid-beta and alpha-synuclein in Parkinson’s disease, DLB and PDD. Her project was sponsored by the charity Bristol Research into Alzheimer’s disease (BRACE). Marta joined the ReMemBr group in 2016 and is involved in the cognitive clinic and various research studies, including the genetics of Alzheimer’s disease, the effect of exercise on sleep and cognition and the European Prevention of Alzheimer's Dementia (EPAD).

 

 

Contact Details

Email: marta.swirski@bristol.ac.uk

For more details visit:

http://www.bristol.ac.uk/clinical-sciences/people/marta-swirski/index.html

Selected Publications:

Swirski, M, Miners, JS, Silva, Rd, Lashley, T, Ling, H, Holton, J, Revesz, T & Love, S, 2014, ‘Evaluating the relationship between amyloid-β and α-synuclein phosphorylated at Ser129 in dementia with Lewy bodies and Parkinson's disease’. Alzheimer's Research and Therapy, vol 6., pp. 77


Miners, J, Renfrew, R, Swirski, M & Love, S, 2014, ‘Accumulation of α-synuclein in dementia with Lewy bodies is associated with decline in the α-synuclein-degrading enzymes kallikrein-6 and calpain-1’. Acta Neuropathologica Communications, vol 2., pp. 164

Dr James Selwood, Clinical Research Fellow

Dr James Selwood, Clinical Research Fellow

I joined the ReMemBr Group as a Clinical Research Fellow in September 2017. I graduated in medicine from the University of Liverpool in 2010 and have previously completed core psychiatry training. I have over three years of experience working in mental health services across the North West. I obtained Membership of the Royal College of Psychiatrists (MRCPsych) in 2015.


I am passionate about research and improving the lives of those affected by dementia. Bristol has an excellent reputation for neuroscience. I therefore made the decision to move here and completed an MSc degree in molecular neuroscience at the University of Bristol. I was involved in the DOPAMIND trial for my research project. This study aims to test whether dopamine medications can improve memory.

My current role includes seeing patients in our cognitive clinics and I am involved in several research projects. One study involves using home sensor technology to assess the behaviour of people living with dementia. Another study will look at sleep patterns and how they relate to biomarkers of Alzheimer’s disease. The work I do for these projects will form the basis of my PhD. I am also involved in the European Prevention of Alzheimer’s Dementia (EPAD) study and the Reducing pathology in Alzheimer’s Disease through Angiotensin taRgeting (RADAR) trial.

 

Saba Meky, Research Assistant, Assistant Psychologist

I currently work as a Research Assistant and Assistant Psychologist within the ReMemBr Group team. Recently I worked on the SleepQuest study looking at the effect of the COVID19 lockdown on sleep and mental health in individuals with or without dementia. My role in the Mild Cognitive Impairment (MCI) clinic includes completing Neuropsychological assessments with patients, and generating reports based on assessment scores.

Memories of Memory Study

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Memories of Memory: Investigating how functional cognitive disorder affects personal judgements of memory and visual ability

We all make judgements about how good or bad our memory is. Some people may misjudge their memory - experiencing memory symptoms despite doing well on memory tests.  ​

This may be due to a condition called Functional Cognitive Disorder.

We are investigating how personal judgements of memory are affected by different conditions.

Who can take part?

We are looking for:

  • people with a diagnosis of Functional Cognitive Disorder (also called Functional Memory Disorder)
  • adults without memory problems.

What does the study involve?

The study involves pen and paper and computer tests of memory and vision, and questionnaires.
If you wish to take part in the study, please contact us
Telephone: 0117 414 8238
Email: research.volunteer@nbt.nhs.uk

SMTN Policies

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Severn Major Trauma Network Policies 

Severn Trauma Adult Guideline Manual 2022 (STAG Manual 2022) 

 

 

Severn Major Trauma Network 

- Major Trauma Automatic Acceptance Policy

 

- Mass Casualty and Major Incident

 

- Network Repatriation 

 

Pre-Hospital 

- Inter-Hospital Transfer of Major Trauma Patients 

- Pre-Hospital Blood  

- Pre-Hospital Handover

- Registration of Patients with Uncertain Details

 

The Emergency Department 

-The Trauma Team

- Emergency Department and Critical Care Drug Bags

- Death and Breaking Bad News in the Emergency Department

 

Airway and Anaesthesia

- Emergency Anaesthesia for Major Trauma

- Emergency Surgical Airway

- Oral and Maxillofacial Injuries

 

 

Thoracic Injuries

- Chest Injuries in Major Trauma 

- Management of Fractured Ribs and Flail Chest

- Management of Cardiac Injuries

- Overview of Chest Drain Insertion and Management

- Resuscitative Thoracotomy

- Traumatic Cardiac Arrest

 

 

Major Haemorrhage & Vascular Injuries 

- Major Haemorrhage

- TXA Use in Trauma Patients

- Traumatic Vascular Injury

 

 

Traumatic Brain Injury & Spinal Injury 

- Traumatic Brain Injury 

- Spinal Injury

 

 

Abdomen & Pelvis

- Assessment and Management of Major Abdominal Trauma

- AAST Organ Injury Grades

- Pelvic and Acetabular Fracture Management

 

 

Extremities

- Open Fractures

- Compartment Syndrome

- Tertiary Survey

 

 

Radiology

- Whole Body CT Imaging Protocol

- Interventional Radiology

- Southmead Radiology Department

 

 

Rehabilitation

- Specialist Dietetic Management and Nutritional Support

- Amputee Referral Pathway

- Referral Guidelines To Rehabilitation Services

 

 

 

 

 

Step Inside Brunel

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This tour allows you take take a virtual walk through the Atrium of the Brunel, see where you can check in for your outpatient appointment and find where the gates are located throughout the building. 

We know that coming to hospital can be a stressful experience, so we hope that being able to familiarise yourself with the building before you arrive for an appointment will demystify the experience and help you to feel more relaxed.  

Brunel building
Southmead Hospital Bristol
Southmead Road
Westbury-on-Trym, BS10 5NB
United States

Role of Imaging in Soft Tissue Sarcoma

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Imaging plays an important role in the diagnosis of soft tissue sarcomas. 

Ultrasound:

  • Identify the lesion
  • Solid or Cystic
  • Well circumscribed or irregular
  • Uniform echogenicity or heterogeneous Size
  • Superficial or deep to the fascia

MRI:

  • Location, adjacent anatomy – vessels, muscle and bone involvement
  • Size
  • Tissue type

MRI Protocol Axial T1, Axial PDFS, Coronal T1, Coronal STIR (Sagittal T1, Sagittal STIR – depended on location.)

For patients who have under gone an excision of a lesion and have obtained a diagnosis of sarcoma as an addition we perform pre and post sequence with gadolinium. (Axial T1FS Pre and Post).

Ultrasound screening of soft tissue masses in the trunk and extremity

Ultrasound screening of soft tissue masses in the trunk and extremity (This document is located on REMEDY  BNSSG referral pathways and Joint Formulary).

SWAG region lipomatous tumour Pathway This document is located on REMEDY BNSSG referral pathways and Joint Formulary).

Breast Reconstruction Enhanced Recovery Surgery

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The aim of Breast Reconstruction Enhanced Recovery Surgery is to get you back to full health as quickly as possible after your operation. There may be circumstances where the programme will not be appropriate for some patients and if this is the case, you will be fully informed.

Research indicates that after surgery your recovery will be quicker with fewer complications the earlier we get you out of bed, exercising, eating and drinking. In order to achieve this we need to work together to enhance your recovery.

Before surgery

The specialist breast care nurse will have already discussed appropriate lifestyle behaviour. It is important that you understand what you need to do in order to ensure you are fit and safely prepared for surgery. It is important to keep as active as you can before your operation. The nurse will discuss diet and exercise with you and returning to normal activities.

 

Fortisip

You will be given a choice of special nourishing supplement drinks called ‘fortijuce’ and ‘fortisip’, in a variety of flavours. These are nutritional supplements containing protein (to aid healing) and vitamins (to support your immune system). Regardless of your weight or appetite, you will be given some of these drinks to take home with you. Take them at the time discussed.

As you are likely to be in hospital for 4-5 days, it is important that you remember to bring a few things in with you, or get a family member to bring them in for you. Things you will need:-

  • Night wear with buttons down the front
  • Slippers/dressing gown
  • Sports bra/support bra
  • Support pants [Large enough to cover abdominal scar]
  • Toiletries [Including dry shampoo]
  • Comfortable clothes to wear in the ward and home
  • IPod, MP3 magazines and books

Support/Sports bra will be fitted once your breast drains have been removed, you need to wear it for 4-6 weeks following surgery. After Diep surgery, whilst in hospital you will need to try and wear support [spanks] pants to help support your abdomen and reduce some of the abdominal swelling, for at least 4 weeks.

 

Pre-op

If you were told to take Preop drinks, take them at the time discussed. These drinks are a clear liquid ‘breakfast’ to ensure your body has fuel to work with whilst you are not eating. If you are diabetic we will not give you these as they can cause your blood sugars to rise.

Once you arrive for surgery

Upon arrival, a member of the surgical team looking after you will check that you are fully aware of your surgery.

In order to help prevent blood clots you will be required to wear special support stockings (TEDS). The nurse will need to measure your legs to obtain the correct size.

After your surgery

You will return to the ward after your operation. You will need to stay in bed for the first 24 hours positioned with your knees bent/flexed to help your abdomen relax. For the first 24-72 hours you will be closely monitored to ensure that your new breast[s] is healing and that you are recovering from the anaesthetic.

Following this progression chart will help improve your recovery. The nurses on the ward will assist you or if you have any questions.

Day of Surgery, after your operationDay 1 after your operationDay 2 after your operationDay 3 after your operationDay 4 after your operationDay 5 after your operation
Drink freely as toleratedEat and drink freely as toleratedEat and drink as toleratedEat and drink normallyEat and drink normallyYou will only be in hospital if your drains have not yet been removed
Drink Fortijuce/FortisipDrink 3 Fortisip/ FortijuceDrink 3 Fortisip/ FortijuceDrink 3 Fortisip/ FortijuceDrink 3 Fortisip/ FortijuceEat and drink normally
Eat a light diet as tolerated as otherwise advisedYou can sit up, between 45 and 60 degrees – a nurse will help you with this after you have seen your doctorTry to get dressed into your day clothesGet dressed into your day clothesGet dressed into your day clothesDrink 3 Fortisip/Fortijuce
Remain on bed restStart breathing exercises (the nurse & Physio will advise you)Aim to sit out and mobilise as soon as you have seen your doctor – the nursing staff can help youMobilise normally – aim for 4 walks a day Maintain a slightly stooped positionMobilise normally – aim for 4 walks a day Maintain a slightly stooped positionContinue to mobilise
  Continue breathing exercisesAsk for laxatives if your bowels have not openedAsk for laxatives if your bowels have not openedPractice stairs with physio
  have you opened your bowels? if not inform your nurseFitting of a sports braEnsure you are wearing your sports bra 
  Start planning for discharge homePlan for going home tomorrowDischarge home today of your drains are out 

You should try and be as mobile as you can once you are home. You will find that you will also need to take regular rests at intervals which may mean you have to go back to bed for a couple of hours each day. This surgery can be very tiring for the first couple of weeks and then improve slowly. The Physiotherapist will give you exercises to do once your are home, it is important to continue with the advice given to ensure you recover quickly and with full movement. We advise
no heavy lifting, washing clothes etc. for at least three to four weeks after surgery. This allows all wounds and scars to heal without any added stress to the area.

For further information:

Urology Enhanced Recovery Surgery

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The aim of Urology Enhanced Recovery Surgery is to get you back to full health as quickly as possible after your operation.

Research indicates that after surgery your recovery will be quicker with fewer complcations the earlier we get you out of bed, exercising, eating and drinking. In order to achieve this we need to work together to enhance your recovery.

Before surgery

It is important to keep as active as you can before your operation and if you are a smoker you should stop now. Stopping smoking helps reduce breathing problems after surgery. You can see your GP or pharmacist for advice to help you stop smoking.

Outpatients

Before you come into hospital for your surgery, your Consultant will see you in the outpatients department to explain your operation. Following this you will be sent a date to attend the pre-operative assessment clinic, where we will carry out routine tests to ensure you are fit and safely prepared for surgery. All patients are routinely screened for potential infections at this time.

Fortisip

Pre-operative assessment clinic

The specialist Enhanced Recovery Nurse will see you at the pre-operative assessment clinic and will explain the programme to you.                 

You will be given a choice of special nourishing supplement drinks called ‘fortijuce’ and ‘fortisip’, in a variety of flavours. These are nutrional supplements containing protein (to aid healing) and vitamins (to support your immune system). Regardless of your weight or appetite, you will be given some of these drinks to take home with you. Take them at the time discussed.

You will be provided with written information and given the opportunity to ask questions. If you have concerns about your appetite or diet before coming in for your operation please speak to the nurses at your pre-assessment visit.
If required, you will be referred to the anaesthetist and pharmacist.

Pre-op
If you were told to take Preop drinks, take them at the time discussed. These drinks are a clear liquid ‘breakfast’ to ensure your body has fuel to work with whilst you are not eating. If you are diabetic we will not give you these as they can cause your blood sugars to rise.

After your surgery

Mobilizing and exercising
Following your surgery, when you wake up, it is important that you do deep breathing exercises (as prevention against chest infection). You will need to do 5 deep breathing exercises every hour as follows:

  • Start in a comfortable position, ideally sitting upright in the bed or chair with your shoulders relaxed.
  • Take a long, slow deep breath in, as much as possible. Hold this breath for 3 seconds.
  • Slowly breath out.
  • Take 3 more deep breaths in the same way. Then return to breathing normally.

For further information:

Vascular Enhanced Recovery Surgery

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The aim of Vascular Enhanced Recovery Surgery is to get you back to full health as quickly as possible after your operation.

Research indicates that after surgery your recovery will be quicker with fewer complcations the earlier we get you out of bed, exercising, eating and drinking. In order to achieve this we need to work together to enhance your recovery.

Before surgery

It is important to keep as active as you can before your operation and if you are a smoker you should stop now. Stopping smoking helps reduce breathing problems after surgery. You can see your GP or pharmacist for advice to help you stop smoking.

Outpatients

Before you come into hospital for your surgery, your Consultant will see you in the outpatients department to explain your operation. Following this you will be sent a date to attend the pre-operative assessment clinic, where we will carry out routine tests to ensure you are fit and safely prepared for surgery. All patients are routinely screened for potential infections at this time.

Fortisip
Pre-operative assessment clinic

The specialist Enhanced Recovery Nurse will see you at the pre-operative assessment clinic and will explain the programme to you.                 

What you eat is important, as good nutrition now will help you recover faster from your operation.

You will be given a choice of special nourishing supplement drinks called ‘fortijuce’ and ‘fortisip’, in a variety of flavours. These are nutrional supplements containing protein (to aid healing) and vitamins (to support your immune system ). Regardless of your weight or appetite, you will be given some of these drinks to take home with you. Take them at the time discussed.

You will be provided with written information and given the opportunity to ask questions. If you have concerns about your appetite or diet before coming in for your operation please speak to the nurses at your pre-assessment visit.
If required, you will be referred to the anaesthetist and pharmacist.

Pre-op
If you were told to take Preop drinks, take them at the time discussed. These drinks are a clear liquid ‘breakfast’ to ensure your body has fuel to work with whilst you are not eating. If you are diabetic we will not give you these as they can cause your blood sugars to rise.

After your surgery

Mobilizing and exercising
Following your surgery, when you wake up, it is important that you do deep breathing exercises (as prevention against chest infection). You will need to do 5 deep breathing exercises every hour as follows:

  • Start in a comfortable position, ideally sitting upright in the bed or chair with your shoulders relaxed.
  • Take a long, slow deep breath in, as much as possible. Hold this breath for 3 seconds.
  • Slowly breath out.
  • Take 3 more deep breaths in the same way. Then return to breathing normally.

 

For further information:


Colorectal Enhanced Recovery Surgery

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The aim of Colorectal Enhanced Recovery Surgery is to get you back to full health as quickly as possible after your operation.

Research indicates that after surgery your recovery will be quicker with fewer complications the earlier we get you out of bed, exercising, eating and drinking. In order to achieve this we need to work together to enhance your recovery.

If you are having a reversal of ileostomy you may benefit from our 23 hour programme. If you are eligible, you will be given all the relevant information prior to your surgery and will include pelvic floor exercises. 

If you go home with a stoma, and the output increases, please read the patient information leaflet. 

Before surgery

It is important to keep as active as you can before your operation and if you are a smoker you should stop now. Stopping smoking helps reduce breathing problems after surgery. You can see your GP or pharmacist for advice to help you stop smoking.

Outpatients

Before you come into hospital for your surgery, your Consultant will see you in the outpatients department to explain your operation. Following this you will be sent a date to attend the pre-operative assessment clinic, where we will carry out routine tests to ensure you are fit and safely prepared for surgery. All patients are routinely screened for potential infections at this time.

Pre-operative assessment clinic

The specialist Enhanced Recovery Nurse will see you at the pre-operative assessment clinic and will explain the programme to you. 

What you eat is important, as good nutrition now will help you recover faster from your operation.

 

Pre-op

You will be able to eat and drink as normal although It may be suggested that you benefit from a low fibre or ‘low residue’ diet. For examples of a low fibre diet download                   

You will be given a choice of special nourishing supplement drinks called ‘fortijuce’ and ‘fortisip’, in a variety of flavours. These are nutritional supplements containing protein (to aid healing) and vitamins (to support your immune system ). Regardless of your weight or appetite, you will be given some of these drinks to take home with you. Take them at the time discussed.

You will be provided with written information and given the opportunity to ask questions. If you have concerns about your appetite or diet before coming in for your operation please speak to the nurses at your pre-assessment visit.
If required, you will be referred to the anaesthetist, pharmacist and stoma nurse.

If you were told to take Preop drinks, take them at the time discussed. These drinks are a clear liquid ‘breakfast’ to ensure your body has fuel to work with whilst you are not eating. If you are diabetic we will not give you these as they can cause your blood sugars to rise.

You may be required to take medication to clear the contents of your bowel, this will be discussed with you if required.

Once you arrive for surgery

Before your operation you may need 1 – 2 enema(s) to empty you bowel contents. Some patients may be required to take medication the day before in order to achieve this, this will be fully explained to you.

In order to help prevent blood clots you will be required to wear special support stockings (TEDS). The nurse will need to measure your legs to obtain the correct size.

After your surgery

Mobilizing and exercising
Following your surgery, when you wake up, it is important that you do deep breathing exercises (as prevention against chest infection). You will need to do 5 deep breathing exercises every hour as follows:

  • Be in an upright position
  • Take a deep slow breath in (feel your stomach gently rise)
  • Hold the breath for 3 seconds
  • Breathe out slowly

Following this progression chart will help improve your recovery. The nurses on the ward will assist you or if you have any questions.

Day of surgery, after your operation

Day 1, 2, 3 and 4 after your surgery

Drink freely as tolerated

Get dressed in your day clothes

Eat a light diet 6 hours after surgery

Sit out of bed for 6-8 hours

Sit out of bed for at least 1 hour

Eat and drink freely as tolerated

Fortisip or Fortijuce drinks as tolerated

X3 Fortisip or Fortijuce during the day

Complete daily progression diary

Walk approximately  60 metres 4 times a day

 

Complete daily progression diary

 

Do you know your planned discharge date? Plan for discharge (ask your nurse if you are unsure)

For further information: