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Support Before & After Surgery

Surgery has a major impact on your body. Even though it's done with the best of intentions and in a clean environment, your body needs to put out extra effort to mend from even minor surgery. While you're recuperating, you're more vulnerable than usual to:

Providing the body with the nutrients it needs is vital both before and after surgery. "It gives your body the building blocks to fight off infection, replenish lost blood and mend tissues, all things that can help you heal as quickly as possible with the least pain and discomfort," explains Ray C. Wunderlich, Jr., M.D.(author of Natural Alternatives to Antibiotics and a doctor in St. Petersburg, Florida, who practices nutritional/preventive medicine and health promotion).

Not all doctors have the same approach to nutritional therapy and surgery. If you are facing surgery and want to pay special attention to nutrients that might be helpful, you'll have to find a doctor who uses methods that you feel most comfortable with.

Here are a few key nutrients that are important for getting your body on the road to healing.

Vitamin C

Any kind of trauma, including surgery, can deplete your vitamin C stores. After surgery, blood levels of vitamin C drop rapidly and a vitamin C deficiency makes wounds heal slower. Many studies have shown that vitamin C is essential for the body to produce wound-healing collagen, which provides the basic structure for many tissues, including skin, bone and blood vessels. Vitamin C is also needed for the skin to produce elastin, a tissue that lets wounds stretch without breaking.

Vitamin C also helps maintain a healthy immune system, vital for anyone who's undergoing surgery, so that they are able to mount a defence against the possibility of infection.

One study, by Russian researchers, found that people who had gallbladder surgery who received 200 to 250 mg of supplemental vitamin C a day were able to leave the hospital one or two days earlier compared with people who simply got their vitamin C from foods.

At most hospitals, you're expected to get your vitamin C from foods such as citrus juices and fruits. Eight ounces of orange juice, for instance, offers about 124 mg, while one orange has about 70mg. However, it is recommended that you receive amounts of vitamin C that are much higher than you normally obtain from foods alone. Dr Wunderlich believes this to be especially important when you're recovering from surgery. He tells his patients that "If you can take 1,000 mg of buffered or esterified vitamin C every eight hours for two weeks before and several weeks after surgery, you'll most likely be able to keep the vitamin C in your blood at a level that promotes optimum healing." He also recommends 1,000 mg of bioflavonoids a day to some of his patients. These chemical compounds are related to vitamin C and are often found in the same foods as the vitamin, especially citrus fruits. Dr. Wunderlich maintains that bioflavonoids can help maintain blood vessel strength and control inflammation.

Some people experience diarrhea and other digestive discomforts from high levels of vitamin C. Buffered vitamin C and esterified vitamin C (a slow-release form) are easier on the stomach.

Vitamin C can interfere with the results of certain diagnostic blood and urine tests, however, so it's important that you discuss supplementation with your doctor.

Vitamin A

Retinol is the naturally occurring form of vitamin A. Vitamin A (as retinol) is found in the following foods: liver, fish-liver oil, cheese, butter.

Beta-carotene (which is a carotenoid) is converted into vitamin A by our liver. It is found in brightly colored fruit and vegetables such as carrots, apricots, cantaloupe, spinach, kale and sweet potatoes.

Vitamin A is required for cell growth and differentiation, or the ability of a cell to mature into its final form. This is important for the generation of new tissues. Vitamin A also seems to activate the production of connective tissue, including collagen, and to promote the growth of new blood vessels. This is important for nourishing newly forming tissues.

Adequate vitamin A really is essential for anyone undergoing surgery. Dr. Wunderlich recommends up to 25,000 IU of water-soluble vitamin A for certain patients undergoing surgery.

Vitamin A can be toxic in doses exceeding 15,000 IU daily and has been found to cause birth defects in doses of 10,000 IU daily when taken during early pregnancy. For this reason, the dosage of vitamin A recommended here should be taken only under medical supervision, especially if you are a woman of childbearing age. And you should not use this therapy if you are pregnant. For this reason vitamin A is often taken as beta-carotene (which is also called the 'plant' vitamin A). Beta-carotene is converted by the body into vitamin A.

Zinc

Medical research shows that for people who are low in zinc, supplements can dramatically speed up the healing of surgical incisions. In a study by researchers at Wright-Patterson Air Force Base in Ohio, people taking 220 mg of zinc sulfate three times a day were completely healed in roughly 46 days, while a group taking no zinc required about 80 days to heal.

Zinc, like vitamins A and C, is needed in the body for many functions. It is necessary for the production of collagen, the connective tissue that allows scars to form. It interacts with vitamin A, making the vitamin available for use and it plays a vital role in immune function.

The people most likely have a zinc deficiency include those who have:

Dosage

Zinc can be taken with a good multivitamin and mineral supplement. Daily 15 to 30 mg is useful. It is necessary to increase the copper, iron and selenium if more than 30mg zinc is being taken.

Special Notes

Vitamin E

Vitamin E helps stop the process of atherosclerosis, or the 'build up' of fatty deposits in arteries. One study, by researchers at the University of Toronto, suggests that it can also help limit tissue damage during coronary bypass surgery. In this study, half of a group of people undergoing bypass surgery took vitamin E before their operations. The other half took placebos (blank pills). After the surgery, the people taking 300 IU of vitamin E for two weeks prior to surgery had "small but significant" improvement in heart function compared with the people taking the placebos.

"Heart cells can be damaged when their blood supply is cut off and then restarted, a condition called reperfusion injury," says Donald Mickle, M.D. (Professor of Clinical Biochemistry at the University of Toronto and one of the study's authors). When oxygenated blood circulates through the oxygen-deprived heart, free radicals can form and can injure the heart cells. Vitamin E is known as an antioxidant. In the right place at the right time, it neutralizes harmful free radicals by giving up its own electrons, sparing healthy molecules from harm.

It is recommended that surgery patients be prescribed about 400 IU of vitamin E daily prior to surgery. Don't take more than 600 IU without your doctor's okay, especially if you've had a stroke or bleeding problems in the past. In large amounts, more than 800 IU, vitamin E can worsen bleeding problems and if you're taking anticoagulants, it's best not to take vitamin E supplements. Vitamin E itself acts as a natural anticoagulant.

When you're going into surgery, it's a good idea to be aware that all the nutritional therapy you are taking that might interfere with blood clotting, such as taking garlic for heart conditions. Garlic can cause bleeding problems, and it is recommended that garlic is stopped for a few weeks prior to surgery. Taking any kind of supplementation may interfere with the surgical procedure and recovery so to be safe, take supplements only under supervision of a health professional. A few weeks prior to surgery, you might want to discuss any supplements you've been taking with your doctor.

The hospital and your supplements

When you have to go into the hospital for surgery and you take your supplements with you, someone will tell you not to take them, and you're left wondering why.

The situation is this: Vitamins are considered medications, and in the hospital, you need your doctor's approval for every medication you take. You are not able to take whatever tablets you were taking outside the hospital - not even your vitamins - without explicit approval.

So what do you do?

Keep your doctor and other caregivers as informed as possible about what you have been taking, in order to avoid any possible complications. Talk to your Doctor and gain approval for whatever supplements you want to take. Ask your Doctor to 'write-up' the supplements on your hospital medication chart and to sign them as approved 'medications'. Then if anyone questions your taking them, refer that person to your medication chart.

Special note

Orders for "nothing by mouth" prior to surgery apply to everything and this includes taking supplements. You need to have an empty stomach prior to surgery.

Protein and fiber

Protein, fiber and other components of foods are important to recuperation as vitamins and minerals. Moving the bowels is a much-anticipated event, following surgery and it's an event that has to be initiated if it doesn't happen on its own. Fiber, which provides the bulk for the bowel, is important.

Foods that are able to provide fiber include:

If your bowels need more help, try psyllium.

It is recommended that you drink the equivalent of six to eight glasses of fluids a day (unless your doctor tells you that you need to restrict fluids). Drinking fluids helps to prevent dehydration, helps the fiber work better and flushes out the bladder (the bladder is prone to infection if you've had a urinary catheter inserted due to the surgery).

Eat light and eat often. People recovering from surgery naturally prefer small, light meals, and that's what patients should be served. Aim for five or six mini-meals a day.

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References

Airola, P. 1984, How to get well. Health plus publishers.

Bland, J. 1996, Contemporary Nutrition. J & B Associates.

Davies, S. and A. Stewart., 1997, Nutritional Medicine. Pan.

Holden, S., Hudson, K., Tilman, J. & D. Wolf, 2003, The Ultimate Guide to Health from Nature. Asrolog Publication.

Jacka, J. 1997, A-Z of Natural Therapies. Lothian.

Sullivan, K. 2002, Vitamins and Minerals: A Practical Approach to a Health Diet and Safe Supplementation. Harper Collins.

Trattler, R. 1997, Better Health through Natural Healing. Thorson Publisher.

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Medical experts are aware that every single nutrient your body normally needs is also needed when you're facing surgery. "Keep in mind that every person's condition when undergoing surgery is different, so the types of vitamins and minerals that your doctor prescribes for you, if any, will depend on your own particular case," says Joanne Curran-Celentano, R.D., Ph.D. (Professor of Nutritional Sciences at the University of New Hampshire in Durham). "Because of the wide range of problems and conditions surrounding surgery, it is recommended that anyone who is about to undergo surgery check with his (sic) doctor before taking any kind of supplementation."