Bouncing Back

Tips for faster healing after surgery

One is nutrition. A well-nourished person usually heals well. But Elizabeth Yurth, M.D., who practices orthopedic medicine at Mapleton Hill Orthopaedics, says that even though many people are deficient in nutrients that are key to healing, surgeons rarely focus on nutrition. “It’s a big missing piece,” she says. “For recovery of tissue, you don’t need normal levels of nutrients, you need optimal levels of nutrients.”

Yurth tests levels of certain nutrients in almost all of her patients. Around 80 percent of people are deficient in Vitamin D, she says, despite living in our sunny state. Levels that fall toward the lower end of the “normal” range of 30-100—which becomes more likely if you’re laid up before surgery—are insufficient for tissue healing. She recommends getting 2,000 IU a day, a level she says won’t put you at risk for toxicity.

Vitamin B-12 is another one to watch, Yurth says. More than half the patients she sees (particularly vegetarians and vegans) lack B-12, important to neural recovery, recovery from anesthesia and regaining energy. B-12 is also well known for its benefits in times of stress, and, says Yurth, “certainly injury itself and surgery are stressful events.” Yurth notes that B-12 is not well absorbed in pill form, so she recommends a sublingual form that bypasses the gut and absorbs directly into the bloodstream. She suggests 1,000 micrograms a day of methylated B-12, in combination with a B-complex.

Stay away from alcohol and other chemicals that are depleting, and avoid sugar; it lowers immunity and decreases the body’s ability to fight infections. Give the boot to foods that are inflammatory or otherwise aggravating to you, such as dairy, gluten or any other foods that tend to bother you. “Eat the diet you thrive on,” Shevins says.

Don’t skimp on those four to five cups of vegetables a day. Shevins suggests juicing vegetables to get an easy boost of nutrients. This can be particularly beneficial when surgeons take patients off their supplements, which they often do because some supplements (such as fish oil, vitamin E and many herbs) are anticoagulants, or they may interfere with anesthesia.

While strong nourishment aids in recovery, focusing on nutrition shouldn’t add to the stress of surgery, Shevins says. Some people feel nauseated leading up to or after surgery, and if that’s the case, “just eat what you can.”

Hydrate, hydrate, hydrate, says Yurth, up to the last minute you’re allowed. And start right up again with clear liquids postsurgery, to clear your system of the anesthetic.

Shevins emphasizes the importance of rest as well. And, she says, you can’t underestimate the power of being in good spirits and having people lined up to help with food, personal care, errands and daily chores, such as feeding the dog. Creating a chart to log the timing and taking of medications can also be very useful.

“I could list 50 things that you could take,” Shevins says, but going into surgery in good spirits and with basic needs taken care of is most important. “Do things that lift your spirit, do what moves and strengthens you, listen to great music.”

Getting Back to Business

Following surgery, the first order of business is often getting the bowels working again because both narcotics and surgery can be constipating. Stool softeners and probiotics are helpful, says Shevins, and magnesium citrate is beneficial both as a laxative and in healing. Shevins often starts patients on a low dosage of 150-250 mg, taken before bed. Magnesium is another vital nutrient many of us are lacking, Yurth says. “It helps with sleep, it helps with pain, it helps the gut move better, and it helps with muscle relaxation after anesthesia,” she says. While juicing vegetables prior to surgery boosts nutrients, blending them after surgery and tossing in some fruit keeps the benefit of fiber in the mix.

In addition to vitamins D and B, vitamins A, C and E help replenish the system, as do zinc and protein, Shevins says. She frequently recommends using gotu kola (Centella asiatica) to speed the healing of wounds, at a dosage of 100 mg twice daily. Bromelain is also commonly used to aid with tissue healing. While it’s often recommended for use prior to surgery, bromelain is an anticoagulant, so it’s important to check with your surgeon.

Finally, Yurth advises, get out of bed and off the couch after surgery, if your doctor allows it. Pain and postsurgical inflammation are part of recovery, she says, “and so the faster you get yourself moving and push through that, the better off you’re going to be.”

Shannon Burgert, Ph.D., is a freelance writer and Ironman athlete. She teaches fifth grade at Fireside Elementary School in Louisville.