Healthcast 626 – What makes us heal after injury or surgery?

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Recently I had a shoulder replacement that went according to plan, and I healed amazingly fast. Of course, my surgeon was excellent, and he gave me preoperative instructions that were integral to the speed of my recovery. I began to think about the reasons people heal and why they may not heal from either surgery or an injury.

I started with the instructions given to me by my surgeon, and the reason he gave asked me to prepare my body for healing prior to the surgery. His instructions included diet, activity, and supplements to my diet. The first recommendation was to load my diet with protein to provide my body with the necessary building blocks to heal my muscles and connective tissue during the surgery and afterwards. His instructions told me to eat a diet including meat, milk products with yogurt and cheese, eggs, and protein shakes. The amount of protein a day required was grams of protein equal to my weight in lbs. For example: I weigh 125 lbs. and therefore I was instructed to eat 125 grams of protein/day. I ate the foods that he recommended, and I took daily whey protein shakes with 25 grams of protein each, plus 20 grams of collagen (another animal protein) every day in my coffee. That satisfied the need to eat the building blocks of what I would use to heal.

The next recommendation was to eat a diet with fresh fruit and vegetables at every meal, avoid sugar, and junk food, and avoid all alcohol and sugared soda and diet drinks. This part of the instructions provided the enzymes and vitamins necessary for healing, as well as advised me to avoid toxins and junk food which can prevent healing. Elevated blood sugar that accompanies intake of carbohydrate food and drink, promote insulin resistance and poor healing. Alcohol is a toxin that blocks the liver from normal activity and blocks processing of nutrients. It is absolutely contraindicated while you are pre-op and healing.

Next, there were supplement recommendations given to me to provide the necessary vitamins and minerals involved in healing, that are difficult to get in a normal diet. These included the Vitamins methyl B12, multi-methyl-B vitamins, Vitamin D, Vitamin A, Vitamin C, and the minerals Magnesium, Zinc, Selenium and copper. The additional supplements were herbs and other substances that help healing including Quercetin, NAC (or Glutamine), Bromelain and Probiotics.

I was told to start all of these recommendations 6 weeks before surgery, and for 6 weeks after surgery. I believe that following these recommendations is key to a great recovery after surgery or an injury.

The other factors that are key to success after surgery is to have a healthy level of testosterone, and I have taken T for 20 years and I realize that my health has been greatly improved after age 40 because of testosterone replacement. Testosterone is an anabolic steroid and is necessary for healthy healing. Most men and women have good levels of testosterone until they get older, and ovaries and testes stop producing enough T. When women become deficient at an average age of 45, and men at 55, our immune system decreases their production of healing white cells, our growth hormone decreases and stem cell activity decreases, all of which are deficient secondary to testosterone deficiency. This makes healing as we get older much more difficult unless we replace the key hormone of T.

The success of surgery is dependent on our overall health so we can heal, the skill of our surgeon, our own health status at the time of surgery, our diseases, and our age/testosterone blood levels, our nutrient status and our diet providing the necessary building blocks to heal our tissues. Surgery is not something you can just show up for, it is something you should plan to prepare yourself for and to follow up with excellent self-care until you are discharged from surgery, or until you are healed.

Other issues that can cause a surgery to fail or to be redone:

· Surgery did not completely fix the problem (lack of surgical skill or complications secondary to your anatomy or physiology).

· Your medical condition or medications can decrease your ability to heal (steroid treatment or treatment for autoimmune diseases).

· Diabetes, heart disease, autoimmune diseases, cancer or other chronic illnesses

· Old age, female over 45, male over 55.

· Testicular or ovarian removal

· Poor nutrition

· Lack of exercise

· Smoking and drinking alcohol

· Lung disease that decreases your O2 levels

· Obesity, Body fat % > 20 % in men and > 26% in women, or BMI > 25

· Medications that decrease your ability to heal: corticosteroids, cancer meds, autoimmune disease medications

· Lab results that indicate your poor risk of healing: High CRP (inflammation),

Anemia, Cortisol is high, Free T is low, Estrone is high in men > 30, High CO2 , high HBA1C, High fasting BS and fasting insulin > 10, Elevated liver enzymes, poor kidney functions, low white blood cells, low GH (IGF-1) < 150.

Follow the instructions that my surgeon gave me and get your hormones replaced, clean up your diet and lifestyle, and get as healthy as possible before and after your surgery so you will have the shortest recovery and the most successful possible.