Laser Rays

The expanded form of the term LASER is Light Amplification by Stimulated Emission of Radiation.

Light emitted through electromagnetic radiation is focused on a particular object to find out, investigate or cure it. The light is manipulated by lens to focus on the subjects to be investigated. Light here does not mean only the light that we see with our naked eyes, but even infra red rays and ultraviolet rays which we cannot see.

History of Laser

Though Albert Einstein, the famous physicist, first laid the foundations for LASER in 1917, LASER as a common tool used for diagnostic and curative measures was invented much later. May 16, 1960 was the important day when Theodore Maiman demonstrated how laser could be used for storing data in devices like the Compact Disc (CD) and DVD. This was shown at a Research Laboratory. People called it ‘a solution looking for a problem’ in the 60s but now lasers are used everywhere, in thousands of applications.

Applications of LASER

Science, medicine, industry, information technology, law enforcement, entertainment, military, consumer electronics and others use laser beams extensively. So much so that one wonders how people survived without the use of laser all these years. Lasers have become very common now. We have all seen extra terrestrial beings using laser beams in science fiction movies and on screen films. It looks like magic, the way the sci-fi heroes shoot using laser beams. Perhaps the first important use of laser in the lives of common people was in the supermarket barcode scanner where a laser beam is used for scanning the price of the products. This started around 1974. Laserdisc players, compact disc and laser printers became common around 1982.

Laser today is used in several useful medical procedures. We now see laser applications being used in bloodless surgeries like removal of kidney stones, or in dentistry, laser eye surgery and the like. Laser treatment, though expensive, is used for curing and solving many medical problems. Cataracts in the eyes are removed safely using laser treatment and the patient gets cured very fast, without any side effects. In industry lasers are used in cutting, welding and in heat treatments.

The latest are laser light shows which are common in Singapore in their shows for public entertainment, on opening days of sports festivals and the like. They are very attractive and mind-boggling. Laser is used in research as in spectroscopy. Thermometers and bubblegrams also use laser technology. The defense section uses lasers in guiding ammunitions, marking targets and can be used to blind enemy troops. Actual laser weapons are being invented and are entering the market. The laser beams hit the target with pulses of light which rapidly evaporate and expand, causing shock waves on the target which can damage it.

Beauty treatments too use laser in various forms. Unwanted hair removal using laser, acne removal, cellulite reduction all use laser. By removing hair through laser, there is less chance of hair growing all over again, but beware of laser hair removal side-effects and complications. People use laser treatment in the reduction of fats as well. There are several new methods of using laser technology and everywhere round the world people are experimenting and inventing them.

Prostate cancer is the second commonest cancer in men. The reasons causing some men to have it are not clearly understood at the moment. Hence we don’t know the exact reasons why some men develop prostate cancer.

* It is usually seen in older men and is rarely seen in men under 50.

* Unlike other cancers it grows very slowly and may not cause any problems during a man’s life. It is especially true in men in their 70s and 80s. However there are some types of prostate cancers that do grow fast, spreading to bones and become the cause of death.

Risks of having Prostate Cancer

* The risks of having prostate cancer increase with increasing age. But it is known to cause fewer problems in older men.

* It is also more common in people who have close relatives with prostate cancer.

* It is more commonly seen in Afro-Caribbean or African-American decent.  

Symptoms of Prostate Cancer

Early prostate cancer may not have many symptoms. But when it grows it may present with these symptoms which may be seen in other medical problems as well. They are:

•    Difficulty in passing water.

•    Increased frequency in passing water, which can be more prominent in the night.

•    Occasionally blood may be seen in the urine.

What is the Trans-Rectal Ultrasound Scan (TRUSS)?

This is an Ultrasound scan of the Prostate via the back passage (Rectum). Usually used to see rectal conditions and to take biopsy of the prostate gland.

* It takes about 15 minutes to do and you can eat and drink 15 minutes after the procedure.

* You will need to lie on your left side with your knees tucked into your tummy to help in passing the lubricated probe into the back passage.

* An image of the prostate gland is seen on a monitor by the doctor and helps in accurate assessment of the size and shape and in accurately taking biopsies from different areas.

* Local anaesthetic is injected into the prostate and small samples of the prostate tissue are taken using a biopsy gun. (biopsy).

* Before you leave the department it is important that you pass water. It may take up to 14 days for the results of the tests to come back.

During a Prostate Biopsy a sample of the prostate cells are taken and seen under a microscope after special tests.

Indications of Prostate Biopsy

* The most common indication for a Prostate Biopsy is an abnormal PSA. PSA more than 4.0 ng/ml is an indication for biopsy.

* Abnormal digital (means finger) examination of the prostate

Procedure of Prostate Biopsy

The biopsy is done using a Trans Rectal Ultrasound Scan (TRUSS) and a probe which is passed through the back passage. It can be uncomfortable and can cause a few complications like blood in the urine, infection of the prostate or blood.

A normal biopsy result again does not rule out cancer of the prostate fully. There might be further repetitions of the PSA test and the biopsy after some time.

Possible Complications of Prostate Biopsy are:

•    Discomfort

•    Risk of infection.

Antibiotics will be given before and after the procedure to prevent germs from the bowel to cause infection of the prostate, depending on local policies, departmental protocols and surgeon preference. If you develop fever, burning while passing water, or heavy bleeding please visit your specialist.

•    There may be bleeding into the urine, semen or stools for a few days afterwards. Blood with sperms may take up to six weeks to go away fully.

•    Occasionally blood clots may get stuck in the urethra making it difficult to pass water.

•    You need to inform your specialist if you are on blood thinning medicines like aspirin or warfarin prior to the test.

What is the PSA (Prostate Specific Antigen) Test?

PSA (Prostate Specific Antigen) is a protein produced by the prostate gland.

* The PSA test is a blood test.

PSA is one of the chemical substances manufactured by the prostate gland which is found in the bloodstream. Hence the purpose of the test is to find out the amount of PSA in the blood.

What is the need for having a PSA test?

It is always better to find a prostate cancer in its early stages. Hence even before any symptoms arise or your doctor detects changes in your prostate the PSA test may help in detecting a prostate cancer if present. If prostate cancer is detected in its early stages then it can be surgically removed or treated by radiotherapy.

How reliable is the PSA test?

It is not a very specific test for diagnosing prostate cancer. A raised PSA level may point to prostate cancer but it could be raised due to other prostate problems like infection or enlargement of the prostate that is normally seen due to ageing. At the moment only 30% of men with a high PSA level will have prostate cancer.  Some times the PSA level may be normal even in the presence of prostate cancer.

How is the PSA test interpreted?

There are three main ways of interpreting a PSA test. They are:

•    PSA not raised: Usually no further action is needed as there are very few chances of having a prostate cancer.

•    PSA slightly raised: There might be a need to repeat the PSA test, probably not cancer.

•    PSA definitely raised: Now a definitive investigation like a prostate biopsy is needed to confirm prostate cancer.

Examination for Laser Eye Surgery

Laser eye surgery implies a procedure performed by eye surgeons using laser beam to correct various eye conditions.

This surgery is done to correct eye problems like astigmatism or short sightedness and other such defects. Laser eye surgery is also done to correct vision problems for cosmetic purposes in image conscious patients and generally, this is the most popular use of lasers at present.

Is laser Eye Surgery Safe?

It is relatively safe to use laser’s for eye operations and the majority of these operations are successful. That said, there are some side-effects of laser eye surgery. Some of these procedures are used so that the patient need not wear spectacles or contact lenses. This means that you can get rid of those horrible looking glasses!

What is the exact procedure in Laser Eye Surgery?

Laser eye surgery, in a nutshell, is a procedure where a thin flap is created on the eye surface (called the cornea) and folded so that the surgeon can remodel the tissue below it with the help of laser. Then the flap is put back in position and allowed to heal.This is done with the help of a computer and flap angles are measured to give the correct vision. This is very precise surgery, as you can well imagine. Complications of laser eye surgery are rare, but you need to be aware of them.

What kind of Anesthetic is given for Laser Eye Surgery?

Normally the patient is just given a local anesthesia or some anesthetic eye drops when the surgery is done and he can walk out (with adequate protection of the operated eye) soon without any need of hospitalization. This is called a day case procedure, where the patient goes home on the same day.

What is LASIK?

Laser eye surgery is also called LASIK, which stands for Laser Assisted In Situ Keratomileusis. The first laser assisted eye operation was performed around 1950 by a Spanish ophthalmologist Jose Barraquer and since then many other doctors, ophthalmologists and surgeons round the world have improved upon his technique or discovered newer methods of corrective eye surgery using laser on thousands of patients. Laser’s used today are mostly the state of the art ones and perform way better than the old ones first used.

What is Refractive Eye Surgery?

Refractive surgery is the term used when an ophthalmologist changes a patient’s eye measurements by a surgical procedure.This is usually done for cosmetic reasons, when someone wants to get rid of spectacles or contact lenses etc.

Laser eye surgery has become very popular because it is quick, safe and one can see the improvement immediately. Also there is less pain and discomfort when this method is used. Over the years the technique has improved greatly.

Before the surgery patients wearing lens are asked to stop using them from a few days earlier. This period depends upon how long the patient has been using the lens. The cornea is thoroughly examined to calculate and measure it for surgical correction.  The patient may be asked to take antibiotics to prevent infection after the operation.

Read about how to take care after laser eye surgery and see the cost of laser eye surgery in UK and alternatives to laser eye surgery.

What is Anaesthesia?

The word comes from the Greek and means loss of sensation. Nowadays it is used to mean not feeling pain during an operation. This can mean being “asleep” for an operation.

Who are Anaesthesists?

Anaesthetists are fully trained medical doctors who have had training in anaesthesia. The anaesthetist works in partnership with the surgeon, providing a team approach to surgical care.

What Happens before my Anaesthetic?

You will be able to meet your anaesthetist, who will ask questions about your general health, and discuss the anaesthetic plan for your operation.

You will be asked about smoking and alcohol intake, medicines you are taking, any allergies to medicines you have had, and whether you have had an anaesthetic before. This will allow the anaesthetist to plan the anaesthetic to suit your health, and the needs of surgery.

Pre – medications (or pre – meds) are usually used to make you feel more relaxed  before the operation. The anaesthetist may have to postpone your operation if they find a significant problem with your health that could be improved by further treatment before surgery. This is only done for your safety. You should feel free to ask any questions you have, at this time.

There are certain things that you can do to prepare yourself for the anaesthetic.

You will be asked to avoid eating before an anaesthetic, to protect you from being sick and choking whilst you are unconscious.
You should not eat food, sweets or chewing gum or drink milk for 6 hours before an operation. Between 6 and 3 hours before the operation, you may drink water and nothing else.

This allows the stomach to empty properly.

If you smoke, there is good evidence that cutting down, or stopping, before the operation helps your recovery afterwards. Glasses and contact lenses should be removed before surgery, to prevent them getting damaged by the anaesthetic equipment.

The anaesthetic will relax your neck and mouth, and the anaesthetists will need to use equipment to help keep you breathing safely. This is why dentures or false teeth need to be removed just before the anaesthetic, and why the anaesthetist needs to know about loose or crowned teeth.

Is Anaesthesia Safe?

Yes they are, but all operations and anaesthetics have some risk. The risk of death due to anaesthesia in the United Kingdom, is less than one in 2,50,000 anaesthetics. The risks of a particular procedure to a particular patient will vary, and your anaesthetist will discuss any risks that are relevant to you before the operation. There are side effects of having an anaesthetic, such as drowsiness, nausea, muscle pains, headaches or a sore throat. These symptoms are usually short lived.

Are there different types of anaesthetics ?

There are three types of anaesthetic used:

* General Anaesthesia:- This is a state of deep unconsciousness, where you are free of all sensation, including pain, during the operation. Anaesthesia is usually started by an injection of medicine into a vein. Sometimes, a  mixture of gases can be breathed in to give the same effect. Your anaesthetist will stay with you, monitoring your vital functions, ( heart rate, blood pressure and oxygen levels in you blood) and maintaining the correct level of unconsciousness. The process of anaesthesia will be reversed at the end of the operation.

* Regional Anaesthesia:- This is a technique where a local anaesthetic drug is used, to numb a group of nerves, and make a large part of the body, such as the legs, numb and pain free. This can be used on its own, or with sedation or a general anaesthetic. The numbness wears off sometime after the operation, when other forms of pain relief are used. As with a general anaesthetic, you anaesthetist will be monitoring you continuously.

* Local Anaesthesia: - Here the local anaesthetic drug is injected near a few nerves, or into the site of the operation. As with regional anaesthesia, the painful sensation is removed, but there may be some sensation of pressure or movement.

What is Sedation?

This is where a sedative drug is used to make you sleepy and comfortable during surgery. You may not remember much of what happens at this time, although your anaesthetist will be able to talk to you to confirm you are comfortable. Sedation is used during procedures that are uncomfortable rather than painful.

Sedation can be administered in combination with other techniques and by trained doctors other than anaesthetists.

The anaesthetist chooses the type of anaesthetic, but your wishes will always be taken into account. Nothing will be done without your agreement.

Where do I go to Sleep ?

When it is time for your operation, you will be moved from the ward to the anaesthetic room next to the operating theatre. It is here that you will have a cannula, a narrow plastic tube through which injections are made, put into a vein and you will go to sleep. Occasionally, you may be anaesthetized in theatre. It may be possible to have a friend or relative accompany you to theatre. A parent can usually come with their child.

What is Monitoring?

The anaesthetist constantly looks after your body’s function during the anaesthetic. This “monitoring” usually includes using special machines, which measures blood pressure, the heart rate (ECG), and the amount of oxygen in your blood.

Where do I wake Up?

Usually you will wake up in the Recovery area, which is near to the theatre. Some times, you will wake up before you get there, but your anaesthetist will only wake you when it is safe to do so. The Recovery area has specially trained staff to look after you following you operation, and  to make sure that any nausea, pain or discomfort is treated. The Anaesthetist continues to have a role in keeping you pain free, and looking after your fluid and drug requirements, on the ward afterwards.

Hemorrhoid

What is a haemorrhoid?

Haemorrhoids, also called ‘piles’ are swollen blood vessels in the back passage/ anal canal. They are similar to varicose veins and are very common. They may occur inside you body, in the anal canal, or sometimes be felt outside your anus. In this case they are called prolapsed haemorrhoids. As many as one in three of us will experience haemorrhoids at some stage in our lives.

How do I know if I have haemorrhoids?

Haemorrhoids is a distressing condition which, at its least, can cause itching and discomfort around the back passage and, at its worst, become a severe condition involving pain and bleeding. You may feel an uncomfortable ‘weight’ around your anus, or experience discomfort or pain when opening your bowels. You may find blood on your stools or on your underwear after opening your bowels, and, if your haemorrhoid is prolapsed, you will be able to feel it when wiping after opening yours bowels. These are usually painless.

How do you get Piles?

The most usual cause is constipation-pushing hard to open your bowels. This puts strain on the veins in the anal canal/ back passage and they will eventually enlarge and become haemorrhoids. They are more common in women during pregnancy and after childbirth. There is some evidence to suggest that haemorrhoids run in families.
Obesity, straining during bowel movements, sitting too long on the toilet, or standing or lifting too much can make hemorrhoids worse.

Is there a way of preventing Hemorrhoid’s in the first place?

The most important thing is to avoid straining to open your bowels so a careful look at what you eat is important. Try to increase the amount of fibre in your diet, that is eat more cereals, fruit and vegetables, preferably with the skin still on, and drink plenty of liquids. The fibre and liquid will add bulk to your stools which helps the waste move through the intestines and results in soft stools which are quick and easy to pass. Eating 5 – portions of fruit and vegetables a day, drinking plenty of water and doing regular exercise are recommended.

You are also more likely to suffer from haemorrhoids (just as you are from varicose veins) if you are overweight.

Internal haemorrhoids

Internal haemorrhoids can be classified into grades, from 1 to 4.

* Small haemorrhoids (grade 1) are common, develop on the inside lining of the back passage, and cannot be seen or felt from outside the anus.

* Grade 2 haemorrhoids are larger, and are sometimes pushed out (prolapse) from the anus when you go to the toilet. However, afterwards, they return inside.

* If you have grade 3 haemorrhoids, you may be able to feel one or more small lumps hanging from your anus. You will be able to push them back inside using your finger.

* Grade 4 haemorrhoids can become quite large, and permanently protrude (hang down) form the anus. They cannot be pushed back inside.

Protruding haemorrhoids can cause itching and discomfort, and there may be a mucus discharge from the irritated mucous membrane (skin around the anus).

Sometimes, haemorrhoids can become inflamed and swollen, but are rarely very painful, unless associated with an actual splitting of the anus (anal fissure). However, if haemorrhoids are causing you pain and discomfort, you should see your doctor.

I’ve heard that surgery for piles isn’t very pleasant?

Surgery is an option that doctors have historically hesitated to recommend. It is an unfortunate fact that many patients suffered some post operative pain and had to take considerable time away from work.

Treatment Options of Hemorrhoid’s

1st Degree –     Dietary modification and general advise

2nd Degree – Sclerotherapy, banding

3rd Degree –     Banding, Haemorrhoidectomy, PPH

4th Degree -    Haemorrhoidectomy

A new procedure is available – PPH – Procedure for Prolapsed Haemorrhoids!

However, a new procedure has been under evaluation by surgeons in a number of hospitals around the country.  Many thousands of patients in Europe have had their haemorrhoids successfully removed using this procedure, but it has only been introduced in the UK recently.

Called Procedure for Prolapsed Haemorrhoids (PPH) this operation can also be performed as day surgery under a very light general anaesthetic (even under a regional anaesthetic under certain conditions) and you may go home the same day. Patients who have undergone this operation report that their post-operative pain levels are low, and say they feel able to resume normal activities within a very few days of going  home.

How long will I have to stay in hospital?

This is your surgeon’s decision but it is possible that you may be admitted as a day case and be able to go home on the day of your operation. However, this varies from place to place.

What to expect after the operation?

Whether you have the new PPH operation or a more conventional procedure you might experience certain post-operative symptoms. One of these is some bleeding from the rectum, this is not unusual. If the bleeding becomes heavy and troublesome; you need to return to the hospital where your surgery was performed.

Preventing the return of piles

Having got rid of your piles there is a lot you can do to help prevent their recurrence.

* Do make sure you stick to a high fibre diet and drink lots of liquid – every day

* Do not rely on convenience foods/ fast foods.

* When you open your bowels, don’t strain. The correct diet should ensure that you pass stools quickly and without discomfort.

* Drink plenty of water and exercise in moderation.

Complications of Laparoscopic Surgery

Before you read this, please read about Laparoscopic Surgery or Keyhole Surgery.

Pain – occurs with every operation. Efforts will be made to minimise pain. A local anaesthetic may be injected into the skin and local nerves to ease the pain for several hours after the operation. You will be given medication to control the pain and it is essential that you take the medication as instructed so you can move about and cough freely.

Sickness (vomiting) – Occasionally patients feel sick after a general anaesthetic. This generally doesn’t last more than 24 hours. If you feel sick after the operation, please tell the nurses or doctor and they will give you something to relieve it.

Bleeding can occur during or after the operation. It is common to get bruising after the operation into the area where the surgery was done. This can be marked and may cause a swelling around the wound but normally settles in a week or two.

Infection (SSI – Surgical Site Infection) – can occur in the surgical wound, which may need treatment with antibiotics. This usually settles after a few days. In cases of laparoscopic hernia repair, the mesh may become infected and may need more surgery.

Chest infection – early mobilization and stopping smoking will reduce this risk.

Scars – a small percentage of people have an inherited tendency to scar after any cut to the skin. These scars are unusually red and raised. This may cause an unsightly scar.

Blood clots (thrombosis) DVT or Deep Vein Thrombosis

You are encouraged to get out of the bed soon after operation to prevent the formation of clots in the legs. The blood clots usually occur in the veins of the legs and therefore can move through the blood stream to the lungs causing breathing difficulties (embolus).
Depending on your risk to form blood clots, you will be given either compression stockings (TEDS- Thrombo – Embolic Deterrent Stockings) or heparin injections in the skin to thin the blood or both.

Numbness

There is small risk of numbness over the scars. This is due to the nerves being cut during the operation. This usually recovers in due course of time.

Complications specific to Laparoscopic Surgery

Damage to internal organs-

This can occur when placing instruments into the tummy (abdomen). This is rare (risk 1 in 2,000 approximately). The risk is higher in patients who have had previous surgery on the tummy. If an injury does occur, open surgery may be needed, which involves a bigger cut. About one in three of these injuries are not apparent until after the surgery. So if you have pain after the surgery, which does not improve the day after the surgery or are feeling unwell, you must let your doctor know.

Surgical Emphysema (crackling sensation under the skin due to trapped gas). This occurs due to trapped gas under the skin; this settles quickly and is not serious. There is no need to release the trapped air, as it gets reabsorbed by the body.

Conversion from Keyhole to Open Surgery – In some cases, due to various reasons, it is not possible to do the operation by keyhole method and a conventional operation/ incision may be necessary. Should this happen it will entail staying in hospital for a longer.

Laparoscopic Surgery

Laparoscopy is also called Keyhole Surgery.

Laparoscopy is a technique of performing a surgical operation using instruments inserted through small incisions via narrow hollow tubes (‘ports’) rather than through a larger incision, as in traditional surgery. The result is shorter hospitalisation and convalescence, less bleeding and post-operative pain and fewer wound complications.

What happens before my operation?

You will be seen in the Pre- assessment clinic by the nurse or the anesthetist and information will be given about your operation.

On the day of the operation you must not eat or drink for at least 6 hours before the operation/admission.

When you arrive on the ward, a nurse will show you around the ward and record your temperature, blood pressure and pulse. The anesthetist and the surgeon will see you before the operation.

What happens during the operation?

Three to four small cuts are made; one under your belly button (umbilicus) and two or three in other places. Gas (usually CO2) is inserted inside your tummy to allow the surgeon to have  a good look inside the tummy. Narrow telescopes are passed through these cuts and the surgeon then looks at the various organs in your tummy. The procedure varies depending upon the operation you are undergoing. When the operation is finished the cuts are stitched.

If you are being investigated for infertility, a blue dye will be inserted through the cervix into the womb and tubes. This enables the surgeon to see with the telescope whether your tubes are open or blocked.

The operating time varies from operation to operation and can be from 30 minutes to 2 hours, depending on the surgery.

What risks or complications can occur during Laparoscopic Surgery?

Most operations are successful with few complications. However, every procedure has risks and potential complications. Please discuss them with your doctor if there is anything that you do not understand.

Complications can be related to the anaesthetic, general complications of any operation and complications specific to the operation you are about to undergo.

Read further about Complications of Laparoscopic Surgery.

Laparoscopic Surgery

Helpful hints to aid your recovery following Surgery

This web- page has been produced to give you general information about your recovery. It is not meant to replace the discussion between you and your doctor, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with the doctor who has been caring for you.

General advice

Many people are surprised at the length of time it takes to get over an operation even if it is fairly minor, but time, nature and a bit of determination are usually effective.
Do not be afraid to ask for advice, however small your worry may seem. A few words can often save a lot of anxiety.

Most people feel rather tired and insecure when they first go home and are frustrated by not feeling able to do all the things they want. Do not worry if this happens to you as it is quite normal. Instead, make a plan for yourself of gradually increasing the things you do by yourself over the following weeks.

It is often helpful to plan a ‘rest time’ during the day when you can be undisturbed. On the whole, resting on your bed rather than in a chair is more relaxing. If possible, let your friends and relatives know when you will be resting so that they will not disturb you during this time.

Pain control

Adequate pain control is essential to help you recover following your surgery.
Take suitable pain killers at home, which have been advised by your doctor.

Wound healing

All wounds progress through several stages of healing and you will be able to see changes in your wound. The following points are normal and are frequently experienced:

1.    Unusual sensations such as tingling, numbness or itching.
2.    A slightly hard lumpy feeling as the new tissue forms
3.    Slight pulling around the stitches as the wound heals

Remember – do not pull off any scabs as they protect the new tissues underneath and act as ‘nature’s dressing’. They will fall off without any help when ready.

Remember-gentle massage around the wound will stop the new tissue ‘sticking’ to the underlying structures, particularly if your wound lies over a hard surface such as bone.

Seek help if-the amount of pain in your wound increases, if the amount of redness and / or swelling increases and if there is any discharge from your wound.

Household jobs

The sort of movements that can cause discomfort are bending or stretching (e.g. reaching high or low shelves), lifting heavy weights (including  small children), and pushing or pulling (such as vacuuming or mowing the lawn). Similarly, standing for long periods (eg. washing up or cleaning vegetables) can be tiring.

If help is available for the first one or two weeks after discharge it is very useful.

Sexual relations

There is no rule about the time at which you can resume your usual sexual relationships. As a rough guide, by the time you are ready to go back to work this activity can be resumed, although some people will feel ready earlier.

Ask for advice if your operation is related to this area or if you are concerned about resuming your usual contraceptive methods (especially the pill).

Work and exercise

The time at which you can return to work depends on both the type of operation you have had and what the job is. It is better to feel completely well before you return as many people feel tired and find concentration difficult to start with. More specific advice can be given either by the hospital staff or your local surgery.
If you take regular exercise, swim or attend a gym ask your doctor for advice for when you can resume these activities.

Driving

The time at which you can safely start driving varies a great deal with the type of operation you have had. Ask for specific advice from your care team, but do remember that your movement and strength must be up to coping with an emergency stop as well as normal driving. Also some drugs affect concentration especially strong pain killers.