Waiting Well

While you wait for treatment it is important to try to achieve and maintain a healthy weight. This can help you obtain improved outcomes of your treatment and reduce complications after surgery. Having a healthy weight can have a positive impact in your quality of life as well as helping you avoid blood pressure and heart problems.

The best way to achieve a healthy weight is through a healthy and balanced diet.

These are our top recommendations to reach your goal:

Check your Body Mass Index (BMI)

BMI is a measure that considers your height and weight to work out if your current weight is healthy. It divides your weight in kilograms by your height in metres squared and has different ranges for children and adults. You can use our BMI calculator to check your BMI. If your BMI is in a high-risk category or your waist measurement is more than half your height losing weight could be beneficial for your health. Even a small amount of weight loss or preventing extra weight gain can help reduce the risk of complications and improve healing after surgery or intervention.

Some useful resources to lose weight can be found here:

• Tips to help you lose weight
• Losing Weight – Better Health

Keep Hydrated.

You should aim to drink six to eight cups or glasses of fluid a day. Water, milk, milkshakes and soft drinks, including tea and coffee all count. Find out more about keeping hydrated from It All Counts.

Keeping an eye on Vitamin D

Vitamin D is important for musculoskeletal health, bone and soft tissue healing. Most of our vitamin D does not come from food. It is made by our bodies when we expose our skin to Ultraviolet B (UVb) rays from sunlight.

It is not enough to get enough vitamin D by sitting next to a sunny window. Aim to go outside and expose your bare face and forearms to direct sunlight at least 2-3 times each week for around 10-15 times at a time. People with darker skin may need longer periods of exposure to produce the same amount of vitamin D.

The government recommends that all adults and children over 4 years should consider taking a daily multivitamin or vitamin D tablet or capsule that contains a small vitamin D dose of 10 micrograms (400IU), particularly in autumn and winter (October to March). Supplements can be bought at low cost from any pharmacy or supermarket for less than £10 per year.

People who do not have much sun exposure in the summer, or at higher risk of deficiency are recommended to take a vitamin D supplement all year round.

If you are pregnant or breastfeeding, you may be eligible for vitamins via the Healthy Start Scheme or ask at your local Health Centre or Children’s Centre.

Eat a varied and nutritious diet.

You should eat a variety of foods from the main food groups including plenty of fruit and vegetables; plenty of starchy foods such as bread, rice, potatoes, pasta; some milk and dairy foods or non-dairy alternatives; some sources or protein such as meat, fish, eggs, and beans. The Eatwell Guide has more information about the types of food you should include in your diet and how to get the right balance.

Are you getting the right nourishment?

Malnutrition is a condition where your diet does not have the right nutrition for your needs. Maintaining a healthy body weight and not becoming too thin is important, particularly in older adults. Being thinner increases the risk of falls, fractures and it takes you longer to heal and recover after an illness.

If you are over 65 years old or have a chronic health condition it is recommended to keep your BMI to 20kg/m2 or above to prevent malnutrition.

As we get older, our health needs change and can increase the risk of malnutrition.

The messaging we often hear is focused on weight loss, eating low fat products, eating more fruits and vegetables and avoiding sugar and treats. But this style of eating may not be right for someone who has a small appetite, who has unintentionally lost weight or is finding it difficult or tiring to eat. It is always better to eat something, even if only managing small snacks throughout the day instead of 3 main meals.

If you are concerned about being underweight (slimmer than recommended), losing weight unintentionally or your appetite is reducing, you can use the Patients Association Nutrition Checklist to check for signs that you may need some nutritional help or extra nourishment.

Eating healthy but nutrient dense food will be helpful in keeping your weight in the healthy range or to re-gain some weight if you have noticed it dip. You can find some recipes and tips here:

• Eating well with dementia  
• Eating well with Dysphagia  
• Food as treatment 
• Eating well in later life  

Vegans and Strict Vegetarians

Many vegans and vegetarians are getting all their nutrition needs directly from food but some vitamins and minerals (calcium, iodine, vitamin B12) are harder to get enough of from plant sources.

These vitamins and minerals are very important for bone health, immunity and in nerve tissue/red blood cell function. It is sensible to buy supplements for those who struggle to meet their requirements through food alone.

Visit these websites for support on healthy vegan and vegetarian lifestyles:

• Vegan Living | How to be healthy on a vegan diet 
• Vitamin B12 food fact sheet  
• Calcium | British Dietetic Association (BDA)

If you're feeling worry and/or anxiety while waiting, there’s local help available: 

• Keep Your Head: Cambridgeshire & Peterborough’s flagship mental health signposting and support website providing reliable advice and signposting to mental health support available both locally and across the country. 
• How Are You (H.A.Y.) How Are You (H.A.Y.) Cambridgeshire & Peterborough is a family of websites that bring together everything in the local community that boosts wellbeing. H.A.Y. is all about helping you look after you. From yoga to singing, sports clubs to arts groups, or perhaps somewhere to talk or get a cup of tea, H.A.Y. tells you all about local things to do to get a wellbeing boost. Plus a wide range of local professional support. 
• Lifeline –  Free, confidential helpline that you can call anonymously to talk to a trained volunteer. Lifeline is available daily 11am-11pm, 365 days a year and can be reached by calling 0808 808 2121. 
• Mind - CPSLMind, www.cpslmind.org.uk  - A mental health charity providing a range of services and support for people suffering with mental health problems and promote positive mental health across Cambridgeshire and Peterborough.  
• Qwell and Kooth - Free online wellbeing services offering chat-based counselling, peer support and self-help.  Qwell is for ages 18+ Kooth.com is for ages 11-25. 
• Crisis support – If you feel you are in a mental health crisis, urgent support is available in our area 24/7 through 111. Simply dial 111 and select the mental health option. You will be put through to a trained advisor who will speak to you and discuss your current mental health needs. Alternatively text SHOUT to 85258 for crisis support via text messages. 
• NHS Talking Therapies - The NHS Talking Therapies, for anxiety and depression programme (formerly known as Improving Access to Psychological Therapies, IAPT) provides access to, evidence-based, NICE recommended, psychological therapies for people aged 17 and over who are experiencing common mental health problems such as low mood, depression, anxiety disorders and loneliness. NHS Peterborough and Cambridgeshire Talking Therapies commission a variety of providers to deliver this service across the region, please click on the links below to find out more
  • NHS Cambridgeshire & Peterborough Talking Therapies - NHS Talking Therapies
  • Everyturn - Talking Therapies in Peterborough and Cambridgeshire | Everyturn
  • Group Therapy Centre - Group Therapy Centre
  • Peterborough Counselling Ltd - Counselling | Peterborough Counselling | Peterborough (peterboroughcounsellingltd.co.uk)
• Every Mind Matters - Get expert advice and practical tips to help you look after your mental wellbeing and make them part of your daily routine. 
• SignHealth – with a referral from your care provider this service provides psychological therapy support and counselling in British Sign Language (BSL). SignHealth have also developed a large collection of health information in BSL ranging from eating disorders to cancer, all of which can be accessed here - Mental health self-help - SignHealth

Why Stop Smoking ?  

Quitting smoking improves your physical health and boosts your mental health and wellbeing after as little as 6 weeks of being smokefree. The earlier you quit smoking, the more you’re likely to benefit but it is never too late. Stopping smoking will improve your health whatever your age and no matter how long you have smoked. 

Better Physical Health  

Every time you smoke a cigarette, your body is flooded with thousands of chemicals, many of which are poisonous. The day you stop, your body starts clearing itself of all those nasty toxins and the repair process begins. You’ll notice some benefits within days or weeks: 

• Your senses of taste and smell improve. 
• You’ll start to breathe more easily.  
• You’ll have more energy. 

Other benefits will follow, including: 

• Improved lung function, leading to reductions in any cough, wheezing or other breathing problems. 
• Better blood circulation to your heart and muscles, which will make moving easier. 
• Your longer-term risks of cancer, lung disease, heart disease and stroke will be significantly reduced. 

Better Mental Health   

You may think that smoking supports your mental wellbeing and helps you to relax, deal with stress and anxiety and cope with life’s difficulties. However, the opposite is true. Stopping smoking boosts mental health and wellbeing.  

Evidence shows that after the withdrawal stage of quitting, people have reduced anxiety, depression, and stress. People who have quit also have increased positive mood compared with people who continue to smoke.  

It can take as little as 6 weeks to start feeling the mental health benefits of stopping smoking. 

Better for your family and friends  

For some people, a big reason for stopping smoking is to be there for their family and friends. If you have stopped smoking and are physically and mentally healthy, you're more likely to be able to support your loved ones – and be a part of their life in the future. 

Quitting also means you'll protect your loved ones from the potential health harms of second-hand smoke (sometimes called passive smoking). Second-hand smoke is dangerous for anyone exposed to it, especially for children. Also, becoming a smoke-free role model means your children are much less likely to take up smoking.  

Ways to Quit  

Many people try to quit smoking with willpower alone, but it’s much easier to go smoke free with the right help. There are lots of support options available, try a combination that works for you. 

• Local Stop Smoking Service 

Local stop smoking services provide free expert advice, support and encouragement to help you stop smoking for good. The trained advisers are on hand to offer you support, either one to one or in a group, along with stop smoking medicines. 

The sessions usually start before you quit and can be done via phone or video call if you cannot attend in person. Sessions are usually held once a week or fortnightly for up to 12 weeks.  

If you live in Cambridgeshire or Peterborough, Healthy You can provide stop smoking support. Visit Find Your Local Stop Smoking Service (LSSS) - Better Health - NHS (www.nhs.uk) it you live outside these areas.

• Stop Smoking Aids 

Willpower is important when you're stopping smoking, but it's easier when combined with some extra support. 

Stop smoking treatments really help with managing nicotine cravings and other tobacco withdrawal symptoms. They also boost your chances of successfully quitting, especially if you get expert support from your local stop smoking service. 

If you have tried stop smoking aids before, it's worth trying again because you may need to try a few to find what's right for you. 

Visit the Better Health website to find out more information about the different types of stop smoking aids and how they can support you to stop smoking for good. 

• Download the free NHS Quit Smoking App 

Use the NHS Quit Smoking app to help you quit smoking and start breathing easier.  

The app allows you to: 

• Track your progress 
• See how much you’re saving 
• Get daily support 

NHS Quit Smoking app NHS Quit Smoking on the App Store (apple.com) or NHS Quit Smoking – Apps on Google Play  

• Personal Quit Plan  

Quitting smoking is easier with the right support. Give up for 28 days, and you’re 5 times more likely to quit for good.  

Visit Better Health and answer 3 questions to find the combination of support that’s right for you. 

Quitting Tips 

• Choose a quit date and remember to add it to your calendar 
• List your reasons to quit 
• Tell people you’re quitting 
• If you have tried to quit before, remember what worked 
• Use stop smoking aids 
• Have a plan if you are tempted to smoke 
• List your smoking triggers and how to avoid them 
• Keep cravings at bay by keeping busy 
• Keep active to reduce cravings 
• Throw away all your cigarettes before you start 
• Remember, there is never “just 1 cigarette” 

It is very important to safely reduce the amount of alcohol you drink before your operation. Alcohol can weaken your immune system, putting you at risk of developing complications and prolonging your recovery. 

Reducing how much you drink can improve your health, boost your energy, help you lose weight and save money. Get help to drink less Drink Aware.

Further advice on reducing the amount of alcohol you drink can be found on the NHS website. Healthy You Alcohol Health Trainers can provide local one-to-one support.

You should aim to be alcohol free for at least 24 hours before your operation.

Diabetes is a lifelong condition that causes a person’s blood glucose (sugar) level to become too high.

There are two main types of diabetes – Type 1 Diabetes and Type 2 Diabetes.

When you have diabetes, you are entitled to certain checks, tests, and services to help you get the care you need – like your HbA1c blood test. These checks help to prevent serious diabetes complications, so make sure you keep up to date with your yearly tests. 

For all types of diabetes, it is important to keep your blood sugars well checked and keep them in your ideal target range.

The surgical team will ask questions about your diabetes and how it is treated to ensure you are well looked after and appropriately managed during and after your surgery. Depending on the type of surgery the team may manage this may be different to how you normally would, but they will be available to answer questions if you are concerned. 

To prepare for your surgery and minimise complications or post operative infections keep your blood sugars in your ideal target range and avoid hypos or hypers. Make sure you engage well with your diabetes service and follow their instructions on how to take your medication or insulin as recommended. 

Diabetic Eye Screening

Everyone with diabetes aged 12 years old or over should be invited to have their eyes screened regularly.

If you have diabetes, your eyes are at risk from diabetic retinopathy, a condition that can lead to sight loss if it's not treated.

Screening, which includes a 30-minute check to examine the back of the eyes, is a way of diagnosing diabetic retinopathy and detecting the condition early where possible so it can be treated more effectively. In many people, this can stop it affecting their vision or reduce the chance of it getting worse.

It's important to see a doctor if you notice any problems with your eyesight. Do not wait for your next screening appointment.

Read more about diabetic eye screening.

Diabetic Foot Problems

Diabetes can damage the nerves in your feet and cause a loss of feeling. It can also reduce the blood supply to your feet. This means you may not notice if your foot is sore or injured, and foot injuries do not heal as well. This can lead to ulcers and infections, and sometimes amputations can be needed in serious cases.

Adults with diabetes should have their feet checked every year by a healthcare professional.

It's important to see a healthcare professional as soon as possible if you notice any problems with your feet.

You can read more about diabetes and foot problems on the Diabetes UK website.

Self-referral

When you have diabetes, there are huge benefits to losing weight if you're carrying extra weight. You’ll have more energy and you’ll reduce your risk of serious complications like heart disease and stroke. Losing weight can help with your diabetes control too. And if you have type 2 diabetes, losing weight could even mean going into diabetes remission.

Below are some weight management programmes that you can self refer to, as well as some useful websites to support the self-management of your diabetes:

• Healthy You: Local virtual and face to face physical activity programmes, health trainers etc​
• NHS Better Health: Digital weight loss app, Couch to 5K, general healthy lifestyle tips​
• Know Your Risk: Patient self referral.  Provides patients their risk of developing type 2 Diabetes and a self referral pathway to access the National Diabetes Prevention Programme.
•  Roche Carb Counting - Free online healthy eating programme, Patients access the website directly.
• Diabetes UK - Advice and support for self-management 
• BERTIE - Type 1 Diabetes Education programme for young adults and adults

Pre-diabetes

If you’ve recently had a blood test indicating that you are “pre-diabetic”, then you may be eligible to enrol onto the NHS “Healthier You” Diabetes Prevention Programme. This 9-month programme is delivered over 13 sessions, to support with reducing the risk of developing type 2 diabetes. Lifestyle areas discussed include exercise, nutrition, sleep, mind, and alcohol (if applicable). For more information about this NHS initiative, including eligibility criteria, visit www.healthieryou.org.uk

Your GP can refer you into the programme, or you can self-refer. There are a variety of delivery options including face to face group sessions, digital (using your phone, tablet or laptop - https://healthieryou.org.uk/digital-programme/), and tailored remote (online course delivery for specific cohorts of patients).

If you have been told that you have a history of, or recently diagnosed with gestational diabetes (pregnancy related diabetes), you are eligible to self-refer into our tailored programme to support with this. A history of gestational diabetes may lead to an increased risk of developing type 2 diabetes in later life. This programme is designed to support you on several different lifestyle areas. For more information, including self-referral please visit https://healthieryou.org.uk/gdm-programme/