Why is having a pre and post operative plan essential to healing and recovery??
Marathon runners do not spend their days preparing for a race by eating bon bons and being a couch potato. They know that in order to complete their race they must not only physically train but they HAVE to prepare their body nutritionally. For a marathon runner that means carbohydrate loading and ensuring they meet their protein and fat requirements as well. They know the taxing physical demands placed on their body during a race require adequate nutritional support. Just as a marathon runner would not neglect their nutritional requirements preparing a race, those planning to undergo surgery should not neglect the nutritional requirements the body will need in order to heal.
Studies consistently show that preventing malnutrition and supporting anabolism is the key to recovering with minimal down time and preventing complications that often require hospital readmission.
Let’s face it, no one likes “going under the knife” to have your body cut into while under general anesthesia. However, for many people they don’t always have a choice and for others, it is a choice that will bring relief and perhaps even confidence back into their life. Whatever the reason is, surgery requires a great deal of time, resources and energy. Whether insurance is involved or not, surgeries are quite costly and require scheduling time off of work, as well as time away from your everyday “duties” as a parent, spouse, employee or business owner etc. In addition, the recovery process after surgery can cause a great deal of fatigue while the body is trying to mobilize energy resources to heal. Not only do people want to get back to life as usual as soon as possible, they want to thrive and be free from the pain and or issues that necessitated the surgery in the first place. Therefore, anything that would create obstacles to being the best new version of themselves would want to be avoided (ie preparing the body nutritionally to withstand the inevitable surgical stress response and optimize recovery post operatively in order to minimize risk of postoperative complications and heal optimally!).
The body endures a great amount of stress in surgery, in fact in the literature it is referred to as the “surgical stress response”. Understanding this and the changes that occur due to this stress response; hormonally, metabolically, immunologically, and hematologically, allows us to mitigate and even shorten this inevitable response with appropriate nutritional intervention. So, what exactly is the “surgical stress response” and how can we mitigate and or shorten it’s duration?
The surgical stress response becomes activated at the surgical site due to the trauma of the incision, which communicates to the brain via your nervous system that the body has been injured. This communication activates the immune-hypothalamic-pituitary-adrenal axis which turns on an entire cascade of events that activates the immune system and shifts hormone production, metabolism and blood flow in order to restore homeostasis.
Hormones involved in the “surgical stress response” include; cortisol, epinephrine, glucagon, aldosterone and hormone sensitive lipase. The combined downstream effect of these hormones mobilize energy resources from the skeletal tissue (muscle) in the form of amino acids and lactate, adipose tissue (fat) in the form of glycerol, and the liver in the form of glucose so that the body can produce energy for tissue repair and recruitment of the immune system. This systematic mobilization of energy puts the body into a state of catabolism (wasting of muscle tissue) and insulin resistance (even in healthy individuals).
While this body wide response is inevitable and necessary, the key is to shorten the window of this response so that the body can recover quickly and optimally. The prolonged consequences of this response leads to hyperglycemia, body wide protein catabolism and suppression of the immune system, preventing the body from healing and increasing the chances of post-operative complications such as surgical site problems and infections.
Now, I know that all sounds like such bad news. However, the GOOD news is that with proper nutritional preparation and support this stress response can be mitigated while optimizing your ability to heal and recover quickly and beautifully! The goal is to substantially increase your nutritional (macro and micro nutrient!) stores because the key to healing and recovering is adequate cellular nutrition!
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