When Surgery Awaits

Even the best of natural and preventive health programs can do only so much, and it is sometimes necessary to use surgery as a treatment. But, while “going under the knife” may be scary, it does not have to include a total surrendering of the principles of self-care and good healing. In fact, preparing and going through surgery are good times to demonstrate a true complementary medicine approach.

Good nutrition is as important before and after surgery as it is at any other time. Years ago, Dr. George Blackburn at N.E. Deaconness Hospital demonstrated the improvement in post-operative healing that accompanied better attention to what the patient ate. While opinions on good diets continue to evolve (my preference for limiting grain-based and sugar-based carbohydrates has been stated in this column before) it is clear that good weight management, attention to an adequate amount of protein (necessary for wound healing) and fresh, nutrient-rich produce are good starts. Sugar and alcohol are well known to suppress wound healing, and should be eliminated. Caffeine withdrawal is bad enough at any time, but worse when compounding a post- operative experience. And, (if it must be stated in a health periodical), cigarette smoking drastically increases the risk of anesthesia and post-op complications.

Several vitamins and minerals help to speed the rate of healing, and to limit the formation of scar tissue. Vitamin C is known to increase wound healing, as are the minerals zinc and copper. If possible, it’s helpful to begin taking these nutrients several weeks before the surgery, and to continue for a month after. Vitamin C can be taken up to 3000 mg per day without much risk of diarrhea, but the dose can be lowered if there are digestive problems. A good dose of zinc for wound healing is 30 mg per day, balanced by 2 mg copper. The vitamin C can be accompanied by bioflavinoids, usually 500 mg for each 1000 mg of vitamin C. The bioflavinoids (and other flavinoids such as pycnogenol and grape pips) help scars to heal. Vitamin E 400 iu is also helpful, and vitamin E oil (from capsules) can be rubbed on a healing wound once it is safe to do so. Any stress increases the need for B vitamins and for magnesium. Finally, common herbs for surgery preparation include Siberian ginseng or eleuthrococcus (which aids in withstanding stress), gingko biloba (which helps circulation) and gotu kola (which is demonstrated clinically to speed wound healing).

While homeopathy is a system of medicine in itself with an intricate diagnostic and treatment plan, it adapts well to self-care. Arnica montana is a remedy which is frequently used to heal from trauma, and is readily available in strengths of 30X (more potent remedies are best given under a homeopath’s care). Arnica tablets (or remedy mixtures containing Arnica) are usually taken under the tongue every 2-4 hours post-surgically. Likewise, the flower remedy called Rescue Remedy has been used by many patients both before surgery (to calm down) and after (to make for a more relaxed healing). Homeopathic Arnica montana is available in a cream-base as well, for rubbing on a healing area.

Many systems of medicine can be useful to help with post-operative care and well-being. Acupuncture is a time-honored way of bringing a body into balance, and many acupuncture techniques, including the use of magnets pioneered by Japanese acupuncturists, can have a marked positive effect on scar tissue, as well as a measurable lessening of post-operative pain. Indeed, the latest introduction of acupuncture to the U.S. was largely due to a New York Times columnist, James Reston, reporting on his post-appendectomy acupuncture pain control in the pages of his prestigious newspaper in 1972. Massage therapy can encourage good blood flow into an area of healing, help to break down excessive scar tissue, and combat the stress of a scary procedure. Spinal alignment, and craniosacral rhythms, can be thrown off during surgery and therefore may be addressed by appropriate practitioners.

Hands-on healing goes by many names. Reiki is a technique which is fairly easily taught, and there is much anecdotal evidence of its help in healing. An emergency room physician and Reiki Master, Dr. Nancy Eos, described many cases in her book Reiki and Medicine. Dr. Mehmet Oz, a Columbia-Presbyterian cardiac surgeon, made the cover of the New York Times Magazine for his use of hands-on healers in the operating room during coronary bypass surgery. Therapeutic Touch, a similar technique taught mostly to nurses, has been shown in the laboratory to improve wound healing. In another study, Dr. Bernard Grad of McGill University measured a famous healer’s successful ability to influence healing rates in artificially induced surgical wounds in mice. And the Chinese system of QiGong can be used as a self-care tool, and a powerful energizer when performed by an experienced practitioner. Finally, the most ancient system of healing is still probably the most widely practiced in the waiting rooms and post-op units. Prayer has shown demonstrable results on healing, as well as on hope. Dr. Larry Dossey has spoken widely of the effects of prayer and the clinical studies supporting it (most recently in his book, Healing Words: The Power of Prayer and the Practice of Medicine).

Most complementary medicine programs to help deal with surgery rely on the well-known fact that stress and anxiety will slow the healing process. This is true whether physical measures are being studied (the increase in catecholamines and other stress neurotransmitters which interfere with the smooth healing process and with proper organ function), or emotional (a 1995 article in the medical journal Lancet showed that people who were major caregivers of sick relatives healed an experimental wound slower than a control group without such stresses). So, a number of techniques, including music, meditation, visualization and psychological preparation, have been and are being studied for their effects on the surgical process.

Much of this information is available in a remarkable book by a Cambridge, Mass, psychotherapist, Peggy Huddleston. Her book, Prepare for Surgery, Heal Faster: A Guide of Mind-Body Techniques, is a recently-published compendium of stories, data, referral sources, guided imagery techniques, and solid wisdom for the patient faced with surgery as a likely option. Ms. Huddleston’s suggestions encourage an active patient who is a partner in his/her care, a critical stance for someone who is facing a terrifying and seemingly powerless experience. Her Five Steps to Prepare for Surgery (Relax to feel peaceful, Visualize your healing, Organize a support group, Use healing statements, and Meet your anesthesiologist) lead a reader to a more participatory place of healing. The book is well-referenced, and there is plenty of space allowed for one’s own ideas. And, included toward the back, are statements to give to the surgeon and the anesthesiologist to repeat (e.g. following the operation, repeat 5 times: “Your operation has gone very well”). The book probably should be on home shelves before an emergency necessitates a sudden hunt for it in bookstores.

Many in alternative medicine look at surgery as the enemy, to avoid at all costs and to submit to with fear and loathing. But in a true spectrum of healthcare taking the best of the conventional and complementary worlds, surgery can be (along with chemotherapy, drugs, and radiation) a powerful ally, one that is used sparingly and appropriately, in cooperation with the best ways of preparing the mind, body and spirit for a necessary trauma and for a safe and easy recovery.