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General Health - What can you do to prepare for surgery?

By Brian Wright

Any kind of surgery causes physical, mental and metabolic trauma to the body. Trauma in any form puts pressure on our stress response and nutrient demands, and lowers immune defences. Unfortunately, despite the best intentions of hospitals to keep theatres and wards clean, opportunistic, drug-resistant bacteria increase the risk of post-operative wound, chest, skin and urinary infections. The ability of the body to recover from the physical impact of surgery requires key nutrients which, if deficient, may lengthen recovery time. It is very worthwhile to make sure that the body is optimally prepared beforehand, as far as good nutrition is concerned.

Support your body beforehand

If you know you are due for surgery and have a couple of months to prepare, it is worthwhile supporting yourself with nutrients that help skin and tissue renewal, as this will aid the healing process. Increasing the good microflora of the gut with probiotics, glutamine and other nutrients enables your immune system to be better equipped to respond quickly to possible infection. The best basis for support through surgery is a healthy body and, for this, you need a good diet (organic if possible), based on vegetables and fruit, varied whole proteins and complex carbohydrates, with a minimum of processed and refined food. Reducing stress and achieving a relaxed and harmonious state will also help to provide the resources required during stressful surgery and the hospital experience. Supplementation with the best multivitamin/mineral provides assurance that you are covering the basic nutritional needs.

Zinc is an essential mineral required for growth, repair, wound healing and immune function. It plays a structural role in the formation of proteins and collagen, required for skin and tissue repair. Signs of zinc deficiency are white marks on the fingernails, poor sense of smell or appetite, frequent infections and poor wound healing. Zinc is found in lean meat, fish. wholegrains, nuts and seeds (especially pumpkin seeds or pumpkin seed butter), though phytates in wheat and other foods prevent its absorption. Zinc supplements provide a clear source of this important mineral and are best when complexed, rather than in inorganic forms like sulphates.

Zinc’s partner in making collagen and supporting immune function is vitamin C. Like zinc, the demands for vitamin C in the body are increased under trauma. Animals, who make their own vitamin C, increase production to as much as 13 grams (human body weight equivalent) under stress. Although we cannot store very much, taking extra, regularly on the run-up to surgery supports the elasticity and suppleness of the skin, encourages the immune system to run at optimal strength and buffers stress. Vitamin C is found naturally in fresh fruits and vegetables but can easily be depleted though cooking and long storage times. You should reduce vitamin C supplementation just before surgery as it may lower the effects of the anaesthetic.

One nutrient we can store is vitamin A. This nutrient underpins the first-line mucosal defence of the immune system and is needed for the growth of new tissue, connective tissue and new blood vessels.  We get vitamin A from fish, cheese and milk or can convert it from beta carotene with adequate zinc supplies. Beta carotene is found in yellow, red or orange fruits and vegetables. A multivitamin may contain enough vitamin A for normal use, but extra may be useful in preparation for surgery.

More research is coming to light on the importance of probiotics and their ability to prime and balance your immune response. The presence of good probiotic bacteria in the digestive system may reduce the risk of infection from pathogenic bacteria such as Clostridium difficile. There is evidence to support the fact that probiotics taken prior to gastrointestinal surgery ensure a healthy gut flora, which lessens post-operative diarrhoea and infection. A healthy gut flora will also manufacture vitamin K for us, which is needed for clotting mechanisms after surgery.

The ability to form fibrin and healthy clotting after surgery is very important to begin to heal wounds and prevent bleeding. If your iron levels are low, your ability to clot is impaired. Iron could be deficient if you are vegetarian, vegan, elderly, have suffered from internal bleeding, are pregnant or have heavy periods. Your doctor may suggest that extra iron should be taken until you go into hospital. It is important to supplement with an easily-assimilated iron, as inorganic compounds cause constipation and are not well absorbed.

Are there any nutrients or supplements I should stop prior to surgery?

The body’s ability to stop the flow of blood after surgery is vital. Certain nutrients, herbs and foods that have blood-thinning effects may reduce the blood’s natural ability to clot. These nutrients should be avoided on the week preceding surgery. They include vitamin E, omega 3 and 6 essential fatty acids, garlic, ginger, ginseng, cranberry and ginkgo biloba, green tea and cranberry.

A nutritionist can help you to check the drug interactions of any herbal supplements and you should stop taking anything problematic two weeks before the operation.

Is there anything I can take into hospital with me?

Medical professionals need to know about any supplements taken in hospital and they may or may not be knowledgeable or supportive, since nutrition is not part of medical training and supplementation is considered unnecessary by most hospital dieticians. If you can maintain a good diet with some nutrient-rich foods, this is probably the best approach.

Despite hygiene rules, hospitals’  challenges to immune function, through exposure to bacterial infection and outbreaks of bacteria that are resistant to antibiotics are, unfortunately, frequent. Colloidal silver has strong antibacterial properties and can be sprayed or applied topically, as appropriate. Probiotics can be added to food.

Other natural therapies may be very useful to deal with the stress and trauma of surgery.

Post-operative aftercare

On release from hospital, you are again free to take control of your nutritional needs and to support the natural healing process of your own body. You can safely re-start the probiotic, vitamin C and zinc, and a multivitamin should be the basis of any nutritional supplement programme, together with essential fatty acids.

Extra collagen could provide nutritional support for skin, cartilage, joints, tendons and ligaments, aiding flexibility and movement. Arginine (required to make collagen), used alongside omega 3 fish oil, has been shown in studies to aid recovery and keep wounds healthy. If you are unfortunate and suffer from an infection while in hospital, grapefruit seed extract or a herbal all-seasons formula, used alternately with probiotics, may help restore microbial balance both in the urinary and digestive tract and colloidal silver can be sprayed in the nose and mouth as well as on the skin surface.

The advice provided here is general and cannot cover all surgical procedures.

For specific nutritional advice, you should contact a qualified nutritional therapist.  

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