Pre- and Post-Surgical Care

Ask him/her what to expect in terms of bruising and swelling, recovery period, pain and what you can do about it, hospital stays and arranging for home care. The more prepared you are for what to expect, the easier it will be to handle issues as they arise.

Make a list of anyone who can help you, along with their phone numbers. Ask in advance if anyone can volunteer to help with laundry, meals or taking you to appointments. If you need to arrange for home health care, contact a social worker at the hospital prior to surgery.

For clients facing surgery, Lymphatic Drainage Therapy (LDT) offers a myriad of benefits. For optimal results, it is recommended that LDT be applied for one to two sessions prior to surgery. This process drains toxins and stimulates the immune system and the autonomic nervous system. It is important to drain and stimulate the lymphatic system before it is inhibited by surgery and medication. Every one of my clients who have had to have multiple procedures have commented on how much easier the recovery process is and how much better their scars look when they have had LDT prior to surgery. Another bonus is that LDT relaxes your nervous system which will make you feel much calmer before the big event. Clients who will benefit in particular are those who have had prior surgery, experienced injury or trauma or those who smoke. Adding LDT before surgery helps the lymphatic system perform at its best before it is encumbered or altered. Patients whose lymphatic systems are already heavily burdened often have slower and sometimes more painful recoveries. Everyone is a good candidate for pre-surgical LDT but those who can benefit even more are those who have suffered an illness, or who are sedentary, overweight, have had previous injury, previous surgery, chronic pain, chronic infection, or scar tissue.

Prepare the room in your home where you will be recovering. Put fresh sheets on the bed and set up a bedside table with all the essentials you will need. Some good things to have nearby include a pitcher for water and a glass, telephone and doctors’ phone numbers, medications, ice packs or compresses, tissues and snacks.

Drink Water. Your doctor will most likely have you stop eating and drinking the evening prior to surgery but the days and weeks leading up to surgery should be water plentiful. In other words, drink water. I can’t emphasize this enough. Staying hydrated will allow you to more easily release the medications, seroma and cellular waste that builds up with surgery. Eat simply and well. Surgery creates major stress. Now is the time to really take care of your body and provide it with the maximum dose of nutrients to choose from for the repair function to kick in. Get plenty of lean protein. Avoid foods that will make you swell or get inflammation; salty, high fat, highly spiced, sugary foods, dairy for some people and even some fruits or vegetables for others. Cheetos may be comforting to the brain but the effects will be short lived and cause pain in the end. Cessation of smoking, alcohol and soda pop consumption 2-4 weeks prior to surgery will offer you a much better outcome, faster recovery period and less pain during recovery. I know this is really tough and I hate to be the one to say it but this is really important. Let’s talk about smoking first. Smoking often reduces your lung capacity and makes oxygenating your tissues very difficult and much slower. On top of that smoking increases your blood pressure which puts additional stress (besides the surgery) on your heart and blood vessels which can increase your risk of a heart attack or stroke. If that wasn’t enough, smoking constricts the blood vessels in your skin and when you are full of seroma and lymphatic fluid, it makes the skin painful. Here’s how it impedes your recovery: When you breathe in a lung-full of cigarette smoke, the carbon monoxide passes immediately into your blood, binding to the oxygen receptor sites and figuratively kicking the oxygen molecules out of your red blood cells. You need the oxygen to make you heal. Drinking alcohol before surgery is never a good idea. If at all possible, give yourself a respite from alcohol for a couple of weeks prior to surgery. Your surgeon and anesthetist will want to know if you’ve had any alcohol with 24 hours prior to surgery. Besides the fact that alcohol and medications don’t mix well, it puts you at greater risk for complications during and after surgery. Claudia Spies, a German doctor working out of the Charite University Hospital, cautions that even people who drink only 2 or 3 drinks day suffer more complications and infection after surgery, and she cites the high incidence of alcohol involved injury in emergency rooms for equally high immune-system complications seen in emergency medicine. Elizabeth Kovaks, a doctor out of Loyola University, agrees, and explains that alcoholics are in fact more at risk of death through opportunistic infections than cirrhosis of the liver. Soda is also something to avoid. The sugar can cause inflammation and the caffeine constricts blood vessels.

Be sure to tell your doctor if you take blood thinners which not only include medicine like aspirin, Aleve or Motrin but vitamins as well. It might be a good idea to stop taking vitamin E, Vitamin K and CoQ10. Many herbs, too, are causes for concern and you should discuss taking them with your doctor. Even too much garlic can act as a blood thinner and inhibit clotting.

There are many surgeons who are now using vitamin and mineral supplementation for better surgical outcomes. Talk to your doctor before using any of these supplements as he may be unfamiliar with them or be using medications during and after surgery that can be cross reactive. Many of my clients have used the following supplements: Arnica Montana 30x Homeopathic Medicine: A homeopathic remedy that helps to reduce bruising and muscular pain. It is available in pellets, gels and creams. Bioflavonoids: Bioflavonoids, found in citrus, isoflavones, apples and tea, they strengthen the walls of capillaries and assist in the prevention of bruising and edema. Bioflavonoids also help build resistance to infection and are potent antioxidants. Bromelain: A natural, proteolytic enzyme (digests protein) that is extracted from the root of the pineapple stem and is beneficial for reducing inflammation (swelling) and treating tissue injury. Bromelain inhibits prostaglandins that cause inflammation and promotes the formation of anti-inflammatory prostaglandins. B-Complex Vitamins: A family of water-soluble vitamins that are useful for the protection against and the recovery of immune dysfunction produced by surgery. B Vitamins have been shown to reduce stress, boost energy, maintain and promote the health of skin, nerves, eyes, hair, liver and mouth. It is essential for red blood cell metabolism. Copper: A trace mineral that works in balance with vitamin C and zinc to form elastin, which is essential for the formation of collagen. Copper is necessary for the function of an enzyme which is required to cross-link collagen and elastin. Collagen also aids in the formation of bone, hemoglobin, and red blood cells. Quercetin: Quercetin belongs to a class of water soluble pigment plants called flavanoids. Found in onions, apples, green and black tea, Quercetin enhances the impact of Bromelain and slows down the release of inflammatory mediators (including histamine) and thus helps reduce swelling. Selenium: A trace mineral essential for good health but required only in small amounts. It has antioxidant properties which help prevent cellular damage from free radicals. Vitamin A: A fat-soluble vitamin that helps regulate the immune system and helps prevent or fight off infections. It is essential for wound healing, has antioxidant properties, is necessary for new cell growth, repair and maintenance of tissue. Vitamin A has been shown to reduce superficial wrinkles, prevent skin disorders, protect against cancer, and help remove age spots. Vitamin C: A water-soluble vitamin, it is essential for wound healing, has antioxidant properties and is needed for repair and growth of tissues damaged by surgery. Vitamin C plays a primary role in collagen formation, which is crucial for wound healing. Zinc: A trace mineral involved in many aspects of cellular metabolism, it is a component of more than 300 enzymes needed to repair wounds. It also plays a role in immune function and protects against free radicals. For more information about supplements check the Office of Dietary Supplements Fact Sheet.

For many patients, it is after surgery that a host of new symptoms may arise, not the least of which is often concern, anxiety and even fear of how their bodies are responding to the surgical intervention. There has never been a better time for rest and a lot of TLC. The medications, anesthesia and trauma of the surgery can have physical effects that will affect your emotional well-being. Refraining from exercise can also make you feel tired and depressed. Take some time to recover but if the depression persists, talk to your doctor. • Do not take aspirin or anti-inflammatory medications (your doctor can provide you with a list of over the counter medications to avoid). • Watch for signs and symptoms of infection. These include discharge, fever, and reddening or heat near the incision. • Refrain from smoking or exposure to second hand smoke. • Refrain from drinking alcoholic or carbonated beverages. • With your doctor’s permission, eat lots of fruit and vegetables; pineapple in particular contains bromelain which can help with inflammation. You will need a lot of fiber rich and vitamin dense foods to help speed up your recovery and keep you from getting constipated. • Supplements to consider: Arnica, Vitamin C, Bromelain. See other supplements listed in the pre-surgical tips section.

It may be a good idea to wear fitted compression garments depending on what procedure you had. Do drink water before, during and after your flight. Do get up, stretch and move around as often as you can. When sitting in your seat, stretch out your legs and point and flex your ankles frequently. Avoid alcohol, caffeine, smoking and crossing your legs.

LDT stimulates fluid circulation and urination thereby addressing some of the impacts of edema and also detoxification of medicines used before, during and after surgery. It can help prevent infection and relieve distortion (promoted by edema) by releasing toxins and macromolecules, while at the same time stimulating immunity in the body. As toxins are released and circulation is restored, pain and numbness or tingling is often reduced and mobility begins to return. With a physician’s approval and barring any contraindications, LDT can be safely applied as soon as 24 hours after surgery to stimulate local immunity, alleviate edema, and reduce recovery time. LDT is also reported to provide specific benefits to the post-surgical patient: prevention of infection by increasing the speed with which metabolic waste, toxins, excess water, medications, and so forth are transported out of the body; alleviation of spasms and pain by stimulating the parasympathetic nervous system; stimulates the autonomic nervous system; counteraction to the effects of immobilization in bed; and reduction in the formation and severity of fibrous and scar tissues. Between two and eight sessions are recommended.

There is no better therapy for helping you feel more like yourself after surgery than CranioSacral Therapy. Relaxing and rejuvenating, it can help boost the immune system, normalize traumatized tissue, promote fluid exchange, and release toxic anesthetics from the nervous system. It is effective in helping relieve depression, getting patients remobilized, energized and feeling more self confidence. My clients tell me frequently that combined with LDT, CranioSacral is the most winning combination of post surgical care.

(Lymphatic Drainage Therapy for Special Surgical Procedures, Cancer Removal or Node Dissection Surgery) LDT is especially applicable for patients who have undergone cancer removal or other surgeries that interfere with the lymph vessels or node dissection. Post-surgical symptoms can include pain with or without movement; a sensation of tightening across muscles; a reduction in or loss of range of motion; aches or even a heavy quality/immobility in the limbs; localized edema or swelling. Lymphedema, too, can occur post-surgically. Lymphedema is a condition of localized fluid retention caused by a compromised lymphatic system. The removal of lymph nodes and vessels by surgery and/or radiation treatment can cause lymphedema. Please note that while Lymphatic Drainage Therapy is important for the lymphedema patient, lymphedema management is crucial.

Patients undergoing plastic surgery have found LDT to be uniquely helpful in that their levels of comfort are greatly increased while their recovery times are considerably reduced. Moreover, those patients who receive lymphatic drainage prior to surgery and then again afterwards often report less pain, swelling and recovery time than those patients who received no treatment at all. Many plastic surgeons are currently requiring their patients to have lymphatic drainage therapy post-surgically. Michelle Copeland M.D., D.M.D., author of Change Your Looks, Change Your Life: Quick Fixes and Cosmetic Surgery Solutions for Looking Younger, Feeling Healthier and Living Better writes, “One week after their procedure, I have most patients come in for a post surgical lymphatic massage. This is a light-touch massage given by a trained therapist, which stimulates the lymph system, ridding it of impurities that cause and prolong swelling…. Perhaps almost as important, massage is a relaxant. Massage has been shown to short-circuit the body’s stress response (known also as the “fight or flight” impulse) by boosting the production of endorphins, the body’s feel-good hormones, and reducing the level of sympathetic hormones, such as adrenaline, that cause the pulse to race. Relaxing the body creates an environment conducive to healing. If your surgeon doesn’t offer massage at your follow-up appointments, book your own in consultation with the doctor. ”

Patients undergoing liposuction find additional benefits with LDT. Plastic Surgeons typically inform their patients undergoing liposuction that the cellulite they may have will not go away and may even look worse after surgery. Because liposuction is performed in the deep layers of tissue, not in the more superficial layers where cellulite resides, liposuction does not reduce cellulite. While no definitive treatment for cellulite removal exists, lymphatic techniques applied after liposuction often dramatically reduces the appearance and texture of cellulite.

Scarring and lumpy or fibrotic tissue are frequent problems for the post-surgical patient and LDT can help here as well. Doctors Hutzschenreuter, P. O. and Brummer, H., authors of “Manual Lymph Drainage for Scar Healing,” found that as “local circulation and immunity are enhanced, growth of impaired lymphatic vessels is stimulated, and the release of local toxins helps tissue heal faster.” Stanley G. Rockson, MD of The Stanford Center for Lymphatic and Venous Disorders notes the following: “[Lymphatic drainage] stimulates lymphatic flow and has been shown to reduce the incidence of infection. Our therapists can reduce edema in areas not readily accessible to compression devices and garments (head, chest, shoulder, back, flank, and groin). The massage techniques are also effective in the promotion of wound healing and the restoration of normal skin texture.” Although it is never a good idea to cross a fresh scar in order to drain lymph, alternate pathways can be used to the reduce edema around the scar initially. Later when the scar has matured, a procedure called mapping can be used to locate the direction of lymphatic flow through the scarred area. When the direction is found, LDT can then be applied to help encourage the growth of lymph vessels in the area.