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Physical Activity

How to build your abdominal muscles after surgery

Your treatment team will usually show you the first exercises that you can perform.

The following exercises will help you get started, however, you should discuss all exercises with your treatment team before beginning training.

Abdominal muscle training

The abdominal muscles are important for supporting the body. Together with the back muscles, they stabilise you and are involved in almost every movement that you make.

Exercise 1: Isometric tension

Isometric exercises do not involve any movement. Just holding a position in place for some time can strengthen your muscles. Lie on your back with your legs bent and raise your pelvis. Pull your tummy in and press your lower back, the lumbar spine, into the support. There should be no space between the lumbar spine and the support. Keep the spine pressed to the floor. Your abdomen will become tense by holding this position. Hold the tension for 20 seconds and repeat ten times.

Exercise 2: Getting out of bed

It is important to avoid stretching the scar after recent surgery. Therefore, when getting out of bed, you should get up from a lying position to a sitting position in a certain way. Lie on your back and bend your legs. Then turn to one side. While doing this, support your scar by applying light pressure with the hand that is furthest from the bed during the rotation. With the elbow you are lying on, push yourself up from the bed into a sitting position and at the same time push both legs out of the bed. Continue to stabilise the wound with the other hand. Finally, place both feet firmly on the floor.

Exercise 3: Stabilising the upper body

Sit upright. Both feet are on the floor. Your knees should be above your feet. Tilt your straight upper body forward, remain in this position for a few seconds and then return to the starting position. Repeat this exercise slowly ten times. Make sure that your back remains straight at all times.

Ask your doctor for a prescription for a physiotherapist. Your physiotherapy team can show you other exercises that will help.

Author: Susanne  Schwengler, B.Sc | Reviewer: Dr. Christian Keinki

Sources:

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Physical Activity

Three exercises for bladder weakness after prostate surgery

The following exercises will help you to start your training.

Exercise 1: Getting to know your pelvic floor muscles

To become more familiar with your pelvic floor muscles and what they do, you can try stopping your urine stream for a moment while you’re peeing. But don’t do this repeatedly because it can cause damage if you do it too much.

Another way to become more aware of these muscles is to lie on your back with your legs bent and hip-width apart. Place one hand on your pubic bone and press both feet flat on the floor. Hold this position for 10 seconds while breathing normally. Repeat this exercise 10 times.

Exercise 2: Tense the muscles

Once you know where your pelvic floor muscles are, you can start to tense and relax them. First, locate your ischial tuberosities, which are the bones you sit on. Sit on a stool with your back straight and your hands under your bottom. Then, push these two bones together and imagine holding in your pee as if you have a full bladder. Repeat this exercise 10 times.

Exercise 3: Strengthening the pelvic floor muscles

Lie on your back with your legs bent and hip-width apart. Push your feet into the floor and tighten your pelvic floor muscles. Raise your bottom in the air by lifting the lower part of your spine, all while keeping your pelvic floor muscle tight. Press your arms that are lying next to you, into the floor. Hold this position for a few breaths, then slowly relax by lowering your body from your head to your toes. Repeat this exercise 10 times.

Your physiotherapy team can show you other exercises and treatment methods. You can even ask your doctor for a prescription!

Author: Susanne  Schwengler, B.Sc.| Reviewer: Dr. Christian Keinki

Sources:

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Physical Activity

How to stay active every day

One way you can make exercise a part of your life is to set the right goals. Goals have a great influence on your actions and your motivation.

For most people, increasing physical activity is a big challenge. That’s why it can be difficult to succeed right away. If you feel the same way, setting specific, measurable goals can help you steer your behavior in a more positive direction.

Be as specific as possible about your goals

Set more specific goals. This will help you actually achieve them. General goals such as “I want to exercise more in my daily life” are too vague. Try setting more specific, measurable goals. For example, one of your goals could be: “I want to go for a 30-minute walk every day for the next week. No matter the weather!” Ideally, you should also set an exact time of day and an alarm to encourage you to go.

Set yourself goals that are not too easy but not too hard

It’s very important that you set appropriate goals for yourself. They should not be too strenuous but not too easy either.

Check the goals you have set carefully. Ask yourself if they are suitable and feasible for you. If they are, great! Knowing you can achieve them with your own skills and motivation will make it easier to begin!

Plan for obstacles

Life has its surprises. Although it’s hard to plan for them in advance, you should be aware that there will be breaks in training. Maybe because of an unplanned stay in the hospital or because you are temporarily unwell. It’s important to have a plan B for these situations. You can try a less strenuous training programme during times like these.

Author: Susanne  Schwengler, B.Sc.| Reviewer: Dr. Christian Keinki

Sources:

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Recipes

Creamy mushroom risotto

Risotto is easy to eat and doesn’t require a lot of chewing. Moreover, it is quick to prepare and doesn’t take much effort.

This recipe is ideal if you suffer from loss of appetite, nausea, vomiting, chewing and swallowing difficulties, fatigue and inflammation of the mucous membranes.

Preparation time: 20 minutes

Servings: 2

What you need:

  • 1 shallot
  • 250 g of mushrooms
  • 3 tbsp of butter
  • 200 g of round grain rice
  • Salt & pepper
  • ½ tsp of thyme
  • 600 ml of meat stock
  • 4 tbsp of cream
  • 2 tbsp of parsley (chopped)
  • 2 tbsp of parmesan

This is how it works:

  • Peel the shallot and cut it into fine cubes.
  • Clean the mushrooms and chop them finely.
  • Heat the butter in a saucepan and sauté the shallot cubes. When they are translucent, add the mushrooms.
  • After 3 minutes, add the rice and thyme. Stir until the rice starts to become translucent.
  • Add the stock and bring everything to a boil. Reduce the heat and let the rice expand while covered. Stir from time to time.
  • When the rice is cooked, add the cream, Parmesan cheese and parsley. Taste again.
  • Enjoy your meal!

Tip: For softer rice that is easy to chew, let the rice cook for longer. In this case, add a little liquid.

Author: Christiane  Hübbe| Reviewer: Dr. Christian Keinki

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Recipes

Warm porridge with berries

Just looking at it will make your mouth water! Fresh berries provide important vitamins and oat flakes add high-quality carbohydrates.

If you suffer from a lack of appetite or experience nausea and vomiting you should give this recipe a try! This is also a good meal choice after having stomach resection surgery as it is light on the stomach and is easily digestible.

Preparation time: 10 minutes

Servings: 2

Ingredients:

  • 1 cup fine rolled oats
  • 1 cup milk
  • 1 cup water
  • 1 pinch cinnamon
  • Honey (add to taste)
  • 1 handful raspberries
  • 1 handful blueberries

How to make it:

  • Bring the milk, oat flakes and water to a boil in a saucepan. Stir constantly. Reduce the heat and let the porridge simmer until it is creamy.
  • Add honey and cinnamon to your porridge according to your taste.
  • Wash the berries thoroughly.
  • Add the porridge into glasses or bowls and top it off with a handful of berries.

Tip: Put a portion into your fridge. It also tastes great cold when you get hungry again!

Author: Christiane  Hübbe| Reviewer: Dr. Christian Keinki

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Recipes

Sandwich bites

Small bites invite you to eat them more often. These mini sandwiches contain healthy fats from avocado and protein from chicken. Tomatoes and lettuce add freshness!

This snack is a light food and is particularly easy to digest. It can help you deal with nausea and vomiting and allow you to better handle your loss of appetite.

Preparation time: 10 minutes

Servings: 1

Ingredients:

  • 3 slices of toast
  • 2 tbsp cream cheese
  • ½ avocado
  • 1 pinch of salt
  • 3 cherry tomatoes
  • 4 slices of chicken breast (cold cuts)
  • some iceberg lettuce
  • ¼ cucumber

Instructions:

  • Remove the flesh from the avocado and mash it with a fork. Mix it with the cream cheese and a little salt.
  • Toast the bread. Meanwhile, wash the tomatoes and lettuce. Peel the cucumber and cut it into thin slices and do the same with the tomatoes.
  • Spread the avocado dip on one slice of toast, and put some lettuce and the cucumber slices on top. Add the second slice of toast and spread the dip on it again. Place the sliced chicken breast on top.
  • Spread the last slice of toast with dip and place it on the sandwich with the coated side down.
  • Press your sandwich together and cut it into 4 easy to eat triangles.

Enjoy your meal!

Tip: Modify the sandwich to your own taste! Pickles, cooked ham, hummus: whatever tastes good is allowed.

Author: Christiane  Hübbe| Reviewer: Dr. Christian Keinki

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Recipes

Apple pie

This no-frills apple pie is quick and easy to whip up – and is delicious!

This recipe can help you with:

  • Nausea and vomiting
  • Lack of appetite
  • Flatulence
  • Difficulty chewing and swallowing
  • Constipation
  • Inflammation of the mucous membrane in the mouth
  • Ascites
  • Ileostoma

Preparation time: 1 hour

Serves: 4

What you’ll need

  • 4 apples (preferably tart)
  • 3 eggs
  • 125 g of flour
  • 125 g of sugar
  • 125 g of margarine
  • 1 tsp of baking powder
  • Icing sugar
  • 1 tsp of ground cinnamon
  • 30 g of sultanas

This is how it works

  1. Preheat the oven to 160 °C.
  2. Peel and core the apples, then cut them into wedges.
  3. In a bowl, beat the margarine, eggs and sugar with an electric whisk until fluffy. Then add the flour, baking powder, sultanas and cinnamon. Mix until you have a homogeneous dough.
  4. Grease a springform baking tin (26 cm) with a little butter and spread the dough in it.
  5. Arrange the apples on top of the dough.
  6. Bake for 45 minutes, let the pie cool on a rack and sift some icing sugar over the top before serving.

Tip: this pie is ideal for home freezing – and defrosting is also a breeze if you pop it into a warm oven or in the microwave on defrost for a few minutes.

This recipe can be good for

  • Nausea and vomiting: Eat whatever you can stomach! If the baking aroma is too much for you, try opening a window or asking someone to bake it for you.
  • Lack of appetite: the heavenly aroma of a freshly baked pie can get your mouth watering – so why not give in to temptation and treat yourself? You can freeze whatever you can’t finish in one go and tuck in again whenever you like.
  • Bloating: if bloating bothers you, simply leave out the sultanas so the pie won’t contain anything that could promote wind. Without the sultanas, this pie is the one for you.
  • Difficulty chewing and swallowing: this apple pie is soft and fluffy since the apples are peeled and cooked. To make the pie easier to chew and swallow, try cutting the apples into smaller pieces before baking and adding a dollop of whipped cream to make things slip down more easily.
  • Constipation: you can help to get things moving by baking the pie with wholemeal flour and unpeeled apples. Also, to further aid your digestion, you can try adding one more apple to the pie to increase the amount of dietary fibre it contains.
  • Inflammation of the mucous membrane in the mouth: this pie delivers little mouthfuls of pleasure without irritating the inside of your mouth. If you are in severe discomfort, try using less acidic apples and cutting them into smaller pieces before baking.
  • Ascites: even if you can only eat a small slice of this delicious pie, it will still deliver lots of energy. It’s also ideal for home freezing – perfect if you’d like to save some for a later date. If bloating is bothering you, try reducing the amount of margarine and sugar.
  • Ileostoma: you can indulge in this pie without regret – and freeze some to enjoy at a later date.

Caution with:

  • Stomach resection: simple carbohydrates can promote dumping syndrome. For this reason, you might want to make the pie with less sugar.
  • Bloating and heartburn: if you are in severe discomfort, try adding less fat and sugar. And it’s a good idea to eat a little and often rather than a lot in one go.
  • Taste disorders: if you find that very sweet foods taste unpleasant to you, try adjusting the amount of sugar to suit your palate.

Author: Christiane  Hübbe| Reviewer: Dipl. oec. troph. Karin Kastrati

Sources:

  • Specialist Society for Nutritional Therapy and Prevention (FETeV), cancer diseases – nutritional therapy, specialist article, July 3rd, 2022, retrieved on September 6th, 2022 from
  • https://fet-ev.eu/cancer-diseases-nutrition-therapy/#taste-changes
  • Cancer Association Baden-Württemberg e.V.; NUTRITION IN CANCER Brochure 01/2021 accessed 06/09/2022 from
  • https://www.krebsverband-bw.de/mehr-wissen-besser-leben/broschueren
  • German Cancer Aid and German Cancer Society: Blue guide on nutrition for cancer, information brochure, 01.2021, retrieved on 06.09.2022 from https://www.krebshilfe.de/infomaterial/Blaue_Ratgeber/Ernaehrung-bei-Krebs_BlaueRatgeber_DeutscheKrebshilfe.pdf
  • German Cancer Society e. V., taste disturbance as a side effect of cancer therapy, information article, 04/18/2017, retrieved on 09/06/2022 from
  • https://www.krebsgesellschaft.de/onko-internetportal/basis-information-krebs/nebeneffekten-der-therapie/beschwerden-bei-krebstherapien-und-gegenmassnahmen/ges.html
  • Specialist society for nutritional therapy and prevention, nutrition in constipation (constipation), 07.06.2022, retrieved on 06.09.2022 from
  • https://fet-ev.eu/obstipation-nutritional therapy/
  • Nutritional practice oncology, treatment algorithms, intervention checklists, advice recommendations, Schattauer Verlag, 2016
  • Breast cancer center, swallowing difficulties after chemotherapy, information article 2021, retrieved on 06.09.2022 from https://www.brustkrebszentrale.de/leben/ernaehrung/schluckbeschwerden-nach-einer-chemotherapie/#:~:text=Schluckbeschwerden%20und%20andere% 20problems%20of%20the%20processing%20of%20the%20cancer%20therapy.
  • Institute for Nutritional Medicine, nutritional recommendations for stoma systems, specialist article, April 2016 retrieved on 09/06/2022 from https://www.mri.tum.de/sites/default/files/seiten/stoma-anlage_april-2016.pdf
  • German Cancer Society e. V., taste disturbance as a side effect of cancer therapy, information article, 04/18/2017, retrieved on 09/06/2022 from
  • https://www.krebsgesellschaft.de/onko-internetportal/basis-information-krebs/nebeneffekten-der-therapie/beschwerden-bei-krebstherapien-und-gegenmassnahmen/ges.html
  • Specialist society for nutritional therapy and prevention, nutrition in constipation (constipation), 07.06.2022, retrieved on 06.09.2022 from
  • https://fet-ev.eu/obstipation-nutritional therapy/
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Recipes

Mediterranean Couscous Salad

This salad is easy to digest and can even be modified to your liking. You can replace the feta cheese with chicken, egg or tuna, for example.

This recipe can help if you suffer from a loss of appetite, nausea, vomiting and also heartburn.

Preparation time: 30 minutes

Servings: 2

What you will need:

  • 150 g of couscous
  • 1 tsp of tomato paste
  • 150 ml of vegetable stock
  • ¼ cucumber
  • ½ red onion
  • ½ red pepper
  • ½ yellow pepper
  • ¼ iceberg lettuce
  • 2 tbsp of Italian herbs (frozen or dried)
  • Salt & pepper
  • 3 tbsp of olive oil
  • 125 g of feta cheese

Instructions:

  • Put the couscous in a bowl and pour the hot vegetable broth over it. Let the couscous sit for 10 minutes.
  • Wash and remove the seeds from the peppers and the cucumber. Peel the onion and chop everything finely.
  • Crumble the feta cheese and add it to the vegetables.
  • Wash the lettuce and chop it. Add it to the vegetable mix.
  • Mix the olive oil with the Italian herbs and tomato paste. Season with salt and a pinch of pepper.
  • Loosen the couscous with a fork and mix all the ingredients together. Give it a taste and add more seasoning if needed.

Tip: Pomegranate seeds or coriander are a great addition!

Author: Christiane  Hübbe| Reviewer: Dr. Christian Keinki

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Nutrition

What to do when you have no appetite

Here are some tips that can help if you have no appetite:

  • Arrange food in an appetising way.
  • Eat several small meals instead of a few big meals.
  • Eat slowly and chew well.
  • Try cold or lukewarm meals.
  • Avoid foods that are difficult to digest and cause flatulence.
  • Prepare food gently: little cooking liquid, low heat.
  • Choose unprocessed foods.
  • Avoid intense spices if you find their smell unpleasant.
  • Stock up on food so that you are always prepared if your appetite comes back.
  • Eat lots of protein: meat, fish, tofu, eggs, dairy products, and wholemeal products.
  • Try bitter foods, they can stimulate your appetite.

Avoid enhancing metallic tastes by using plastic cutlery

Author: Dr. Christiane  Hübbe | Reviewer: Dr. Christian Keinki

Sources:

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Nutrition

Adding protein to your daily meals

Easy ways to add 90 g of protein to your daily diet.

The following example corresponds to the protein needs of a person with a weight of 65 kg who is currently receiving treatment for cancer.

  • Breakfast: Bircher muesli (about 12 g of protein).
  • Snack: energy balls made of dried fruit and nuts (6 pieces) (about 8 g of protein).
  • Lunch: pan-fried salmon fillet with fennel (about 35 g of protein).
  • Snack: Greek yoghurt with walnuts and honey (about 12 g of protein).
  • Dinner: 2 slices of farmhouse bread with spreadable fat, 45 g ham, 20 g of gouda and vegetable garnish (about 23 g of protein).

Author: Dr. Volker Henn | Reviewer: Dr. Christian Keinki

Sources:

Picture credits: © Yulia Furman – stock.adobe.com