Over the years working with clients before and after surgeries, I’ve come to organize the work in three steps. They’re not original — they’re mostly common sense — but written down they make the difference between a recovery that goes smoothly and one that gets ambushed.
Step 1 — Pre-surgery setup
Two to four weeks before the procedure, we sit down and build out:
- A second line of support: who will be in the home and when.
- A meal plan and prep schedule.
- The home itself: sleeping arrangement, paths, hazards.
- A magic folder: the printed pages of every plan and backup, in one place.
- Two or three pre-op BCST sessions, spaced a week apart, to bring the system into a calmer baseline.
The intent of Step 1 is no surprises. Surprises are what use up the recovery’s reserves.
Step 2 — The day of surgery
A short, specific plan for the 24 hours that bracket the operation:
- Driver coaching: what they’ll see, what they’ll be asked, what to bring.
- The discharge handoff: who’s present, what gets printed, what the first night looks like.
- A protocol for the first eight hours home: hydration, medication on schedule, lights low, noise low.
The day of surgery is a high-stress day with very little decision-making bandwidth. Step 2 means most of those decisions were already made.
Step 3 — Recovery and life beyond
The first two weeks are the highest-leverage period of recovery. Step 3 covers:
- A daily rhythm: the pain cycle, sleep, meal cadence.
- Weekly BCST sessions to keep the autonomic nervous system regulating.
- The transition to outpatient PT and any other professional support.
- A check-in cadence with the second line of support so they don’t burn out.
- The taper: when to step down medication, when to step up activity, when to begin the return to your life.
I think of Step 3 as the long quiet — not glamorous, but the part of the recovery that decides whether you come back to your life more than recovered or only barely recovered. The plan is the difference.