Being known for being "into health," I get my share of "what should I do?" requests from friends and family who have health-related questions. A Paleo buddy on mine, Jason, is getting ready for long-planned surgery, and he's got some questions about how to minimize the trauma of the surgery itself, including effects of anesthesia and possible post-op pain medication. I have never had surgery so am not the guy to answer his queries. Jason is 42, fit and healthy. His questions for PH readers are below:
"The surgery is to repair an inguinal hernia. No pain and no urgency. It's just time to get it done, as it won't repair itself and risks increase over time. I did extensive research into the two main types of hernia repair ??? open and minimally invasive (laparoscopic) ??? and opted for the open method. Mesh will be sewn over the weakened area in the abdominal wall after the hernia is pushed back into place. I will be able to go home the same day. Surgeon says: 'Surgery day Friday will be the most painful, after the anesthesia wears off. Saturday, pain should be 50 percent less. Sunday pain will be 50 percent less than Saturday.'
"I very seldom use pharmaceutical medicines, including over the counter pain relievers. I just don't like taking or using drugs. I have been practicing a variety of self-hypnosis and guided-imagery methods well known for pain management. I hope to be able to manage the pain well naturally. However, my doctor has given me a prescription for Vicodin. I am not a purist and would be willing to take it if the mental methods fall short. I will also have a medicinal marijuana prescription as a pain-management option.
"What are the trade-offs to bear in mind, in terms of deciding between using Vicodin or medicinal marijuana? Note: I am not a recreational drug user. Have used pot in the past but not extensively and it's not part of my current reality. Again, I would like to be able not to use either V or MM.
"If I decide to use Vicodin for a day or two, rather than medicinal pot, any thoughts about diet and/or supplements to help move the medicine out of my body as fast as possible?"
"During the procedure, the anesthesiologist will administer Propofol (please, hold those Michael Jackson jokes). I plan to learn as much as possible about how Propofol affects the body beyond pain management. I would like to expedite the departure of Propopfol from my body in the hours after the surgery. Any thoughts on handling 'Propofol toxicity'? Liver enhancements like milk thistle?"
"As for the surgery itself: it's a routine procedure, but any form of surgery represents a trauma. Are there herbs/supplements that can be taken pre-op to minimize trauma, or taken post-op to speed recovery from the procedure?
"Thanks for any guidance you may have to offer on these issues!"
asked byDorado_Galore (8239)
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on January 08, 2012
at 01:39 AM
Having had a couple of surgeries on my leg this year, here is what I have to offer in advice:
He's going to want to start a zinc supplement immediately, eating oysters occasionally is awesome for that as well if possible. Attempting to build up zinc levels in the body for 4 - 6 weeks pre-surgery (if he has that much time) will help tissue healing time afterwards; one should continue taking zinc after the surgery as well. 100 - 200mg a day is what I've read and used myself. See: Acceleration of healing with zinc sulfate.
Offal will also help to build up the systems that are responsible for cellular repair, specifically liver due to it's easily absorbable vitamin A content. See: Influence of vitamin A on wound healing in rats with femoral fracture.
I've read repeatedly that vitamin C also has a positive affect post surgery; I didn't specifically include any in my regimen, but it can't be a bad idea given the evidence and that it's a fairly innocuous, water soluble, vitamin. See: The role of vitamin C in wound healing and Vitamin C and Wound Healing.
As far as painkillers go, the problems I can think of with medical marijuana are 1) the short duration of the numbing affects, and 2) I tend to get twitchy when I take it, and twitching with an abdominal wound could be painful. YMMV on that. I would say it couldn't hurt to give that a try first and use the vicodin as a back up. Opiates will definitely provide relief and promote sleep (as should the MMJ.)
A few days, even a week shouldn't really be enough to build up much toxicity on the opiates. After 6 weeks on Diluadid and Morphine, I did a typical detox diet for a few days; lots of leafy greens, cruciferous veges, chlorella supplements, bone broth, fasting when I could and eating good quality protein when I couldn't. Ample protein intake overall will also help cellular repair.
on January 08, 2012
at 01:30 AM
Vicodin is effective for post-surgical pain, marijuana is much less so. If he wishes to use both, great. If he wishes to use only one, Vicodin is the obvious choice. It is obviously not desirable to reduce the effectiveness of Vicodin or Propofol by trying to remove them from the body faster than would normally be the case. Neither is likely to present any problem in normal dosages.
NSAIDs can help with post-surgical pain, of course--the most potent, which could be very useful for 2 days after surgery (and no longer) is http://en.wikipedia.org/wiki/Ketorolac.
The obvious postsurgical supplements for a surgery which involves infusion of IV antibiotics are probiotics...
on January 08, 2012
at 03:57 AM
Don't cry 'til you're slapped. Meaning perhaps the after operation pain may be less than he is expecting so I wouldn't make a cast in stone plan for pain in advance.
Usually we humans can tolerate a bit of pain if it tends to improve with time and the less drugs we take the better. I have had various surgeries including a left parietal cranioplasty, broken limbs and two knee replacements and never needed anything stronger than Tylenol 3's once I was released from hospital.
on January 08, 2012
at 03:03 AM
I'm a big fan of self hypnosis for pain... never underestimate the human power of self-delusion! But I think it's wise to have a painkiller available for post-surgical pain. Excessive pain ain't so great for the cortisol. If he's concerned about using the Vicodin he may want to speak to his doctor about using a less strong opioid, such as Tylenol 3 which has less opiate as well as less Acetaminophen (which is hepatotoxic).
on May 09, 2012
at 11:56 PM
A bit late now for the original poster, but this info may be of interest to others recovery from surgery or injury;
Text taken from the bottom of the page here: http://blog.vitamindcouncil.org/2012/05/09/metabolic-clearance-of-vitamin-d-after-heart-attack/
They measured 25(OH)D before and after a knee replacement on 33 subjects and found 25(OH)D reduced by 40% from before to 2 days after the surgery. Even at three months, 25(OH)D was still 20% lower than preoperative levels indicating, perhaps, the healing knee was “using up” or metabolically clearing the vitamin D. Again, since we don’t know what the 25(OH)D levels were before the MIs in Dr. Barth’s paper, we don’t know if acute MI’s metabolically clear any vitamin D. I suspect they do, although nothing like a knee replacement, which involves major damage to a large joint.
While we only definitively know about the effects of knee replacement surgery on 25(OH)D, I think in the meantime it’s important to be sufficient in vitamin D for lots of reasons when going to the hospital. The take home message is that if you are going into the hospital for any reason, especially surgery, make sure you have plenty of vitamin D reserves by having your 25(OH)D at around 50 ng/ml before admission.