Often times, those that suffer with chronic illness have to undergo some type of surgical procedure. I have created a guide to help you prepare for surgery to obtain the best results possible before, during, and afterwards. For best results, begin this guide 14 days before your surgery. I have incorporated physical , mental, spiritual recommendations along with references for further study.

  1. Avoid some Supplements and Foods– many people that suffer with chronic illness often take supplements to benefit their health. However, there are some foods and supplements that increase the chances of bleeding during surgery. You will want to give your body two weeks away from these to eliminate their effects.
    • stop taking the following supplements at least two weeks before surgery: Flaxseed oil/ meal, Ginkgo, ginseng, echinacea, ephedra, ginkgo, ginseng, , kava, evening primrose, saw palmetto, St John’s wort, valerian, coenzyme Q10, glucosamine and chondroitin sulfate, meadowsweet, and fish oil (1) (2) (3)
    • eliminate the following foods two weeks prior to surgery: garlic, ginger, green tea, aloe, cranberry, feverfew, turmeric, oregano (1) (3)

2. Probiotics – Taking probiotics has become mainstream, so much so, that it has become a multimillion dollar money maker. Many physicians even recommend purchasing a probiotic at the local health food store before surgery. However, a monumental study done in Israel found that this practice could actually impair the gut instead of helping it. (5) This “Hope for Pain” plan encourages you, the patient, to begin a program two weeks in advance to load your body with natural prebiotics. What are prebiotics? Prebiotics nourish your gut and help healthy bacteria grow. Fiber that we obtain from plants are prebiotics. For example, apples have hundred million bacteria, when introduced to our guts, help feed the good microbes. (4) According to Dr. Bulsiewicz, the author of Fiber Fueled, “Fiber consumption increases the growth of healthy bacteria species such as Lactobacilli, Bifidobacteria, and Prevotella.” (4) If able, obtain a copy of his book before your surgery to prepare for optimal healing. Recipes are included in the book. His biome broth is a personal favorite.

3. Go Gluten – Free for two weeks – Gluten has been linked with causing inflammation. Multiple studies have linked markers of inflammation to the consumption of gluten, even those without celiac disease. (6, 7 ) The goal of the “Hope for Pain” plan is to decrease inflammation. When undergoing surgery we want our bodies to heal, eliminate any factors that may cause inflammation. So for two weeks, eliminate all gluten. I love the whole foods brand gluten free bread. It’s the bomb!

4. Get HydratedIncrease your water consummation – here’s a formula to plug in your weight to figure out how much you should drink. Take your weight and divide by 2.2. Then take that number and multiply 15. For me, I’m 68 kg. So, 68 kg x 15 = 1020 ml. I need to drink at least 1000 ml per day. Try to increase your water intake to at least to that formula per day (8). In a study evaluating patients prior to kidney surgery, they found that “patients who were dehydrated and mildly dehydrated had an increased risk of acute kidney injury” (9) My personal suggestion, find a 1 liter water bottle, have fun with it, decorate with your favorite stickers, and drink up every day until your surgery. The hospital I work at allows patients to drink clear liquids up to two hours before surgery and even provides a carbohydrate mix to add to water to drink the morning of your surgery. We have come a long way, from the days of complete nothing by mouth after midnight. According to a study done in 2018, ” Preoperative hydration with (complex) carbohydrate drinks up until 2 h before surgery is safe and should be encouraged, as this helps improve metabolism, decrease insulin resistance, reduce anxiety, and reduce nausea and vomiting.” (10)

5. .Stop shaving anything below the neck! – What? This sounds like crazy advice. No shaving for at least 5 days prior to surgery. There have actually been many studies on this issue. Your health care professionals are always trying to figure out causes or sources of infection. Believe it or not, shaving is one of those. Shaving may cause risk of something called microtrauma which could lead to infection to the wound and can “significantly influence postoperative infection rates”. (11) (12) (13) I have attached three studies for your reading pleasure.

6. Incorporate Sources of Concentrated Fruits and Vegetables. Juicing would be ideal, but if you do not have a juicer, blender, or resources to buy from your local juicer, then include a big green salad to each day along with five servings of fruits and vegetables.. The antioxidants in vegetables fight free radicals which cause disease and could effect your rate of healing. Get creative. Try new recipes. Make it fun, not stress provoking. (14),(15)

The next items are for your personal and spiritual preparation before surgery, Having surgery can be very stressful. Getting ready for surgery emotionally is just as important as the physical.

7. Do something you will not be able to do immediately after surgery. Often recovery from surgery involves non weight bearing on an operative extremity, no heavy lifting, or no traveling. Plan ahead and do something you physically are able to do and make it fun. I traveled before a big surgery to see my daughter in another state. Go camping. Get outdoors.

8. Get ready spiritually. Preparing for surgery the “Hope For Pain” way includes preparing mind and soul for this event. Do what is right for you, “You do You”. Make it fun. Begin a new bible study to continue after surgery. Dive into a new book of the bible two weeks before and do some deep study. Start a prayer journal. I started a new bible study called “Flooded” by Nicki Koziarz which I love so far. Also, I find it extremely helpful to find a verse that speaks to you personally and use that verse during this season. Meditate on it, memorize it, keep it close to your heart. Need help finding a verse? Go through the bible and search for verses with your birthdate. For example, your birthday is May 5th. Look up Psalm 5:5 and see if that verse speaks to you. Keep searching each book of the bible until you find one.

9. Practice Gratitude. Prior to surgery begin preparing a list of things you are grateful for big and small, help focus yourself on the big picture and continue this practice after surgery. Last time I went through a difficult season, I used a journal to record EVERYTHING. I wrote down the people that helped me along the way, sent thank you cards, set up reminders, and kept a list of all the things I was thankful for, adding a little each day.

10. Are you Ready for Recovery? Get mentally prepared for the best recovery possible. The mind is a very powerful organ, use to only think positive thoughts. If negative thoughts begin to creep in, listen to a song on your phone, read a chapter in the bible, pray. Do whatever it takes to keep your mind on the positive. Get plenty of rest. Have your ride setup, your bedroom ready, pillows on the couch, and easy access to the things you will need. You’ve got this!

References:

  1. Wang CZ, Moss J, Yuan CS. Commonly Used Dietary Supplements on Coagulation Function during Surgery. Medicines (Basel). 2015 Sep;2(3):157-185. doi: 10.3390/medicines2030157. Epub 2015 Jul 27. PMID: 26949700; PMCID: PMC4777343.

2. Over-the-counter natural products in cardiac surgery: a case of ginseng-related massive perioperative bleedingAlessandro Viviano, Duncan Steele, Mark Edsell, Marjan JahangiriBMJ Case Rep. 2017; 2017: bcr2016218068. Published online 2017 Aug 7. doi: 10.1136/bcr-2016-218068PMCID: PMC5612204

3. Abebe W. Review of herbal medications with the potential to cause bleeding: dental implications, and risk prediction and prevention avenues. EPMA J. 2019;10(1):51-64. Published 2019 Jan 8. doi:10.1007/s13167-018-0158-2

4. Bulsiewicz, W. (2020). Fiber fueled: The plant-based gut health program for losing weight, restoring your health, and optimizing your microbiome. New York: Avery, an imprint of Penguin Random House. p. 143,

5. Suez, J., Zmora, N., Zilberman-Schapira, G., Mor, U., Dori-Bachash, M., Bashiardes, S., … Elinav, E. (2018). Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT. Cell174(6), 1406-1423.e16. https://doi.org/10.1016/j.cell.2018.08.047

6. Soares, F. L. P., de Oliveira Matoso, R., Teixeira, L. G., Menezes, Z., Pereira, S. S., Alves, A. C., … Alvarez-Leite, J. I. (2013). Gluten-free diet reduces adiposity, inflammation and insulin resistance associated with the induction of PPAR-alpha and PPAR-gamma expression. Journal of Nutritional Biochemistry24(6), 1105–1111. https://doi.org/10.1016/j.jnutbio.2012.08.009

7. Jamnik J, García-Bailo B, Borchers CH, El-Sohemy A. Gluten Intake Is Positively Associated with Plasma α2-Macroglobulin in Young Adults. J Nutr. 2015 Jun;145(6):1256-62. doi: 10.3945/jn.115.212829. Epub 2015 Apr 8. PMID: 25855121.

8. Yavuz MS, Kazancı D, Turan S, Aydınlı B, Selçuk G, Özgök A, Coşar A. Investigation of the effects of preoperative hydration on the postoperative nausea and vomiting. Biomed Res Int. 2014;2014:302747. doi: 10.1155/2014/302747. Epub 2014 Jan 20. PMID: 24563861; PMCID: PMC3915899.

9. Ellis, R.J., Del Vecchio, S.J., Kalma, B. et al. Association between preoperative hydration status and acute kidney injury in patients managed surgically for kidney tumours. Int Urol Nephrol 50, 1211–1217 (2018). https://doi.org/10.1007/s11255-018-1901-2

10. R. Makaryus, T.E. Miller, T.J. Gan, Current concepts of fluid management in enhanced recovery pathways, British Journal of Anaesthesia, Volume 120, Issue 2, 2018, Pages 376-383,ISSN 0007-0912,
https://doi.org/10.1016/j.bja.2017.10.011

11. Shi D, Yao Y, Yu W. Comparison of preoperative hair removal methods for the reduction of surgical site infections: a meta-analysis. J Clin Nurs. 2017 Oct;26(19-20):2907-2914. doi: 10.1111/jocn.13661. Epub 2017 Mar 12. PMID: 27875033.

12. Suvera, M., Vyas, P., Patel, M., Varghese, V., Ahmed, A., Kashyap, R., & Nair, D. (2013). Two methods OF PRE-OPERATIVE hair removal and their effect on post OPERATIVE period. International Journal of Medical Science and Public Health, 2(4), 885. doi:10.5455/ijmsph.2013.050720131

13. Adisa AO, Lawal OO, Adejuyigbe O. Evaluation of two methods of preoperative hair removal and their relationship to postoperative wound infection. J Infect Dev Ctries. 2011 Oct 13;5(10):717-22. doi: 10.3855/jidc.1527. PMID: 21997940.

14. Song W, Derito CM, Liu MK, He X, Dong M, Liu RH. Cellular antioxidant activity of common vegetables. J Agric Food Chem. 2010 Jun 9;58(11):6621-9. doi: 10.1021/jf9035832. PMID: 20462192.

15. Anoop A Shetty1*, Santoshkumar Magadum2 and Kalmesh Managanvi3, Vegetables as Sources of Antioxidants, Review Articles, j Food Nutr Disor Vol:2 Issue: 1