Here we go again.... 7th surgery in two years coming up tomorrow. I am used to it now so there is no sense of worry; just a feeling of gratitude for the magic of surgeons, but also a little bit responsible. Responsible because it is up to me to make the most of the surgeons skills by being physically prepared for the event. It is a team effort, a little bit like a marathon, and who would ever prepare for a marathon in a day.
However, the stats say that up to 50% of patients go in to surgery, or try to recover from surgery, without adequate nutrition. These patients can risk mortality four times that of those who are nutritionally prepared. Most of us grossly underestimate the importance of nutrition during illness and medical intervention, or don't consider it much for a one off event. Even if we generally eat well, there are some dietary changes we should consider when going through surgery so that your body can prepare and respond to the effects of surgical stress, as well as repair your damaged tissue.
I have had very smooth sailing surgeries considering the invasiveness of being de-scalped, first by accident and then six more invasive surgeries for reconstruction. Each time I am very aware of the importance of eating to heal.
The importance of nutrition in the lead up to surgery
During surgery, your body will experience shock to varying degrees. Your body will:
- retain salt and water to retain blood pressure
- increase blood flow and oxygen consumption
- increase metabolism and burn energy reserves
- scavenge a lot of lean muscle proteins to support your immune system response and to repair tissue
Your body has a big job to do responding to the shock of surgery, and then preparing for the repair of tissue. Your body will scavenge lean muscle mass to access amino acids for repair and even create glucose for energy. The immediate response and then the recovery involves your immune system and optimal organ function, to supply more enzymes and immune system molecules to the site where the body needs it, and also to transport waste products away effectively. In the case of skin repair from graft sites, the remodelling of skin is a metabolic process that can take over a year to complete. This means that being conscious of keeping up nutrients for repair is important.
Loading energy stores
Unfortunately you often have to fast prior to, and sometimes for a full day, when having surgery. This means that your on hand glucose for energy is already low and your glycogen stores are starting to deplete. Preparation with pasta and long distance energy foods are important.
Increase your protein stores and intake!
Protein is so important for our tissue recovery. In fact, we need to increase our dose of protein to at least 1.5 if not 2g per kg of body weight per day. Even non-essential amino acids will become essential during surgical procedures and recovery. This means I am targeting 120g of protein per day and I have been trying to get diverse quality proteins at every meal.
Eating right pre-surgery for a week
Keeping in mind that you cannot eat everything that you need the day before surgery, a week long planning at least is a good way to go. Building up some additional lean muscle takes time.
So what have I eaten this week leading up to the surgery? Seaweed of course, and here are some favorites without product range, but use this list as a way to think about food for healing in general, seaweed or not.
- Protein for breakfast with Phukka on poached eggs and wholegrain sourdough toast
- Omega-3 (SeaFibre-3) to balance my inflammation processes, but also to help the build up of muscle (noting that if you are on blood thinners or going in to surgery, it has been suggested that Omega-3 supplements may lead to increased bleeding during surgery. However, these recommendations are being reconsidered as a recent scientific review indicates that this is not the case. Discuss it with your doctor and refer them to the TGA position if concerned.)
- Boron (SeaFibre-3 and all green PhycoFoods) to protect my Vitamin D stores which are important in muscle build up
- Additional Phybre in whole-milk yoghurt (protein) alongside SeaFibre-3 supplements - to prepare my gut and bowels for the anaesthetic lethargy and ready to be ready to bounce back from anti-biotics. Colour with anti-oxidants fruits.
- Multiple trace elements with Phukka on avocado for snacks as well
- Protein snacks with our PhycoBites and nuts
- Iron (PhycoMuesli and PhycoBites) to make sure that my blood iron is not too low to tolerate some blood loss
- Mediterranean pasta dishes to build up my glycogen stores, and Phettuccine and SeaSpirals are extra-protein pasta. Lots of colour and tomato based sauces for anti-oxidants.
- I am normally not a meat eater, but occasional meat, especially for times like this, I will add that in for extra and diverse protein. Mediterranean bean soup on whole chicken frame broth (making sure you break down all the cartilage and include it), with celery and ripped nori sheets, with additional protein from seared salmon, calamari and some fermented Chorizo slices, served with fresh baked sour dough and cheese.
Plenty of fluids... plenty of fluids... plenty of fluids...
MUSCLE BUILD UP
I have also made sure that I get exercise each day in the lead up to surgery, and that I include more resistance training to build up my muscle mass. Making sure that I build up some extra muscle prior to surgery will hopefully mean that I don't suffer a net loss afterwards. Just step out from behind your desk or off the sofa and do some push-ups, squats or sit-ups if nothing else. A small amount regularly is so much better than the big workouts that we plan but that don't always happen.
After surgery, strenuous exercise can take a while to get back to, but keeping up fluid movements regularly is very important - even just flexing and stretching those toes each hour will help. I go back to the few Tai Chi movements that I have for the moments that I can step out of my hospital bed safely and with support.
Although you are going to be lying for a while and even get an unusually deep sleep, make sure that you get adequate sleep and relaxing times for the period before surgery, and don't go back to work too soon. Listen to your body.
Good nutrition before, during and after surgery can help to prevent post-surgical complications, reduce infection risk, get you home sooner, lead to a more complete recovery and quality of your newly repaired tissue.