46 yo M with a previous laparotomy and bowel resection for perforated diverticulitis (? IBD component). 

Background

• Myocarditis and associated cardiomyopathy -> normalised (?IBD secondary to mesalazine) 
• Family history of Huntington’s disease – indeterminant genetic testing, nil current symptoms
• BMI 32

Issues

• ? for prehabilitation
  • Not in peak fitness but “normal” exercise tolerance (DASI > 34, > 4 METS)
  • Surgeon keen for patient to undergo prehab
  • Challenges due to pain with hernia and stoma management

Discussion

• While DASI not indicative of high perioperative risk, patient likely to still benefit from improved fitness. 
• Surgery not planned until August therefore natural window of opportunity.

Plan

• Cardiac rehab may accept the patient for early supervised formal exercise
• Home, self guided exercise (with stationary bike?) afterwards
• Supervised sessions of HIIT through Team Care Arrangement immediately prior to surgery, to maximise benefit