Few things make people as anxious as the prospect of surgery. Yet the odds are that you’ll eventually find yourself “going under the knife”. More than 46 million surgeries are performed annually in the United States, just about equally divided between those done in hospitals (in-patient procedures) and in doctors’ offices (out-patient procedures).
The big question: is all that surgery necessary?
Much of it certainly is, but don’t let dazzling new procedure tempt you to make a quick decision. “Surgery often looks like a glamorous high-tech industry,” says Peter Langsjoen, M.D., a cardiologist in Tyler, Texas. “It’s easy for patients to get swept away by it. The biggest mistake is that people devote little time looking for alternatives.”
The Most Common Surgeries
The likelihood of surgery increases with age, and women are operated on more than are men. Many of the procedures are diagnostic-that is, done to figure out what’s wrong with a person. Arteriography and endoscopy of the small intestine are the most common of these procedures, in which doctors examine the heart and gastrointestinal tract.
The most common corrective surgical procedure (2.6 million annually), according to data from the Centers for Disease Control and Prevention, is the removal of eye lenses, usually because of cataracts obstructing vision. Not surprisingly, the next most common procedure is replacing the lens with an artificial one (done 1.8 million times a year).
The next most common type of surgery is cardiac catheterization (1.6 million yearly), in which doctors weave a spaghetti-size tube to the heart and inflate its tip to stretch out clogged arteries. Other common surgical procedures include the removal of skin for biopsy or treatment, such as for skin cancer (1.3 million times), repair of muscles or tendons (915,000), and the insertion of “tubes” to prevent ear infections (512,000 in children under age 15).
Needing surgery is a sign that something has gone seriously awry with your body. Sometimes it’s impossible to avoid, as in the case of accidents. And sometimes, regardless of how well you take care of yourself, surgery becomes inevitable.
However, you don’t have to cast your fate to the wind. Good nutrition and supplements help maintain health-and they can reduce your risk of disease and therefore surgery. Optimal nutrition can also speed your recovery and reduce your risk of complications when you have surgery.
Nutrition provides the raw materials that form your body-proteins, fats, carbohydrates, vitamins, and minerals. Meanwhile, your genes contain the biological programs that tell cells what to do with these raw materials. For example, if you’re injured, your genes tell cells to make copies of themselves as part of the healing process. After an injury heals, genes tell cells to stop proliferating.
What follows are some of the most commonly performed surgeries, ways to reduce your risk of the diseases that necessitate them, and what to do if you have little choice about being operated on. One important bit of advice: always tell your personal physician and surgeon what supplements you’re taking (regardless of whether or not he favors supplements).
Coronary Artery Disease
What it is: Coronary artery disease is a narrowing of the blood vessels leading from the heart. Blood vessels walls are initially damaged by homocysteine, a substance produced during the breakdown of protein. Cholesterol and other substances are deposited to limit the damage, and “smooth muscle cells” in blood vessel walls proliferate and choke off blood flow.
What surgery entails: One of the most common symptoms of coronary artery disease is angina, or chest pain. Surgeons treat it with cardiac catheterization or coronary artery bypass graft surgery. In bypass surgery, physicians take a blood vessel from another part of the body and graft it to coronary arteries to bypass the blocked blood vessel.
Avoiding the knife: For long-term prevention, eat a diet that reduces your risk of insulin resistance, a prediabetic condition that increases the risk of heart disease. This diet should consist of quality animal protein, such as poultry and fish, along with lots of fresh vegetables; it should avoid refined carbohydrates, such as breads, cereals, and sweets.
Leafy green vegetables in this diet provide ample amounts of folic acid, a B vitamin needed to break down homocysteine. Supplements of folic acid and other B vitamins also lower homocysteine levels, and this reduces the risk of heart disease. Vitamin E is critical for protecting cholesterol from being oxidized (damaged by free radicals), and this appears to be more important than cholesterol levels per se. In his cardiology practice, Langsjoen has found that coenzyme Q10 (CoQ10), a vitamin-like nutrient found, very effectively reduces angina pain. He has also observed that bypass patients fare much better if they take CoQ10 before and after surgery. Daily dosages: Folic acid, 400 mcg; vitamin E, 400 IU; CoQ10, 100 mg.
When surgery is inevitable: Some vitamin supplements, particularly antioxidants, can greatly reduce complications and improve survival among patients undergoing heart surgery. Antioxidants, including vitamins E and C, CoQ10, and alpha-lipoic acid -can quench dangerous free radicals, hazardous molecules produced during surgery. Some doctors may be concerned about the anticoagulant effect of vitamin E during surgery, but this minor risk is generally offset by the vitamin’s benefits. One study found that vitamin E slowed the thickening of blood vessels after bypass surgery. Daily dosages: vitamin E, 400 IU; vitamin C, 1,000 mg; CoQ10, 100 mg; alpha-lipoic acid, 50 mg.
What it is: Cancer is the unbridled growth of abnormal cells that infiltrate organs and glands (in contrast to noncancerous tumors that form on but do not invade tissues).
What surgery entails: Physicians typically try to “debulk” a tumor by removing it surgically. Often, chemotherapy or radiation therapy follow to destroy residual cancer cells. The rationale behind chemotherapy and radiation is that these therapies will generate large numbers of free radicals, with the hope that cancer cells will succumb before normal cells.
Avoiding the knife: Cancer cells are created by mutations in deoxyribonucleic acid (DNA), the molecule that programs cell behavior. Many of these mutations are caused by free radicals. Antioxidant nutrients, such as vitamins E and C, quench free radicals and reduce DNA mutations. Vegetables and fruit contain large quantities of antioxidants, including carotenoids and flavonoids, so any cancer-prevention strategy should include eating a lot of these foods. Daily dosages: Vitamin E, 400 IU; vitamin C, 1,000-2,000 mg; mixed carotenoids, 10 mg; flavonoids, 25-1,000 mg.
When surgery is inevitable: By the time a cancerous tumor becomes large enough to be diagnosed, it’s usually too late to reverse its growth through diet or supplements alone. Sometimes, however, it may be possible to reduce tumor size. One recent study found that lycopene (a carotenoid found in tomatoes) can reduce the size of prostate tumors in men scheduled for surgery. Knud Lockwood, M.D., of Copenhagen, Denmark, has found high doses (390 mg daily) of vitamin-like coenzyme Q10 (CoQ10) to reverse the growth of recurrent breast cancers. Always work with your physician; there may not be time to treat an aggressive cancer with natural therapies.
About 20 years ago, psychiatrist Abram Hoffer, M.D., Ph.D., of Victoria, Canada, began treating terminal cancer patients with a high-potency vitamin/mineral regimen-at first to ease their anxiety and depression. It soon became clear that patients taking vitamins and minerals tended to live longer. Thirty percent of Hoffer’s early cancer patients have lived 10 or more years longer than generally expected.
Daily dosage: Hoffer’s basic cancer regimen (after the patient undergoes surgery) includes the follow nutrients daily, though the doses may vary from patient to patient: vitamin C, 12 grams or more; vitamin B3, 500 mg-3 grams; vitamin B6, 250 mg for some patients; folic acid, 5-10 mg (not mcg); other B vitamins, 25-50 times the RDA; vitamin E, 800 IU in the “succinate” form; carotenoids, 25,000-50,000 IU; selenium, 200-600 mcg; zinc, 220 mg (or 59 mg zinc citrate); and CoQ10, 300 mg.
What it is: Cataracts are opacties, or cloudings, of the eye’s lens, which impair vision. A major risk factor is excessive unprotected sun (ultraviolet) light exposure, which generates free radicals and damages proteins in the lens. However, some nutrients influence the risk of developing cataracts.
What surgery entails: Surgery involves removing the damaged lens and usually replacing it with an artificial one.
Avoiding the knife: Although reversing cataracts seems unlikely, it may be possible to slow or stop the progression of small cataracts. The fluid surrounding the eye is rich in antioxidants, which quench free radicals and reduce damage to the proteins forming lenses. These antioxidants can be obtained through the diet and supplements.
A recent study of more than 36,000 male physicians found that diets high in lutein and zeaxanthin were associated with an 18 percent reduced risk of cataracts. Spinach and broccoli, both rich in these antioxidant carotenoids, were among the most protective foods. Long-term use of vitamin C supplements can also reduce the risk of cataracts. A study at Tufts University, Boston, found that women taking 400 mg or more of supplemental vitamin C daily for more than 10 years had an 83 percent lower risk of cataracts, compared with women who did not take supplements.
Vitamin E and alpha-lipoic acid (an antioxidant found in spinach and beef) may also reduce the risk of cataracts. Researchers at the University Medical Center, Stony Brook, N.Y., found that people taking vitamin E supplements had a 57 percent lower risk of cataracts. A combination of alpha-lipoic acid and vitamin E prevented damage to the lenses of diabetic rats. Daily dosages: Lutein, 20 mg; vitamin C, 400-1,000 mg; vitamin E, 400 IU; alpha-lipoic acid, 50-100 mg.
When surgery is inevitable: As surgery goes, cataract removal and replacement is relatively straightforward and typically done in a doctor’s office. Focus on nutrients that promote healing and healthy eyes. Daily dosages: Vitamin A, 15,000-25,000 IU; lutein, 20 mg; vitamin C, 1,000 mg; vitamin E, 400 IU; bilberry, 80 mg.
What it is: The gallbladder stores bile, which aids the digestion of fats. An estimated 16-20 million Americans suffer from gallstones (formed somewhat like a pearl in an oyster), and overweight middle-age women have the highest risk of developing gallstones. Surgery may remove the gallstones or the entire organ.
What surgery entails: Large gallstones may erode the wall of the gallbladder or enter and obstruct the intestine. Surgery may remove just the gallstone or the entire gallbladder.
Avoiding the knife: A study by Joel A. Simon, M.D., of the University of California, San Francisco found that women consuming large amounts of vitamin C-especially as supplements-were 23 percent less likely to have their gallbladders removed, compared with women eating little vitamin C. Other researchers have found that gallstone patients tend to consume less food and less fish and fruit and more cereal, sugar, and meat compared with healthy subjects. Large doses of fish oil may reduce the risk of gallstones, according to Stephen Holt, M.D., in an article in the Natural Medicine Journal. In a study of women, Harvard University researchers found that exercise reduced the risk of gallbladder disease, regardless of weight. Daily dosage: fish oil, 1-3 grams; vitamin C, 500-1,000 mg. In addition, consume more fish, fruits, and vegetables and less sugar and red meat; exercise and maintain a normal weight.
When surgery is inevitable: Many people have “silent” gallstones that do not cause any symptoms. An inflammation of the gallbladder wall, caused by a gallstone blocking a duct, can be painful and may necessitate surgery. After surgery to remove a gallstone (rather than the entire organ), moderate physical activity, fish oil, and vitamin C supplements may reduce the risk of recurrence, though this has not been conclusively established. Daily dosages: fish oil, 3 grams; vitamin C, 500-1,000 mg.
Carpal Tunnel Syndrome
What it is: Carpal tunnel syndrome (CTS), characterized by numbness or pain, results from pressure on the median nerve that travels through the risk. It is common in people who perform repetitive tasks with their hands, such as typists, factor workers, and cashiers.
What surgery entails: Surgery involves adjusting the fibrous tissue that puts pressure on the median nerve.
Avoiding the knife: Considerable research indicates that a lack of vitamin B6, and likely other B vitamins, set the stage for CTS. It is possible that repetitive motion increases B-vitamin requirements in the wrists. In a recent study of 441 people, Richard C. Keniston, M.D., of Portland, Oregon, found that tingling and other CTS symptoms were strongly linked to low levels of pyridoxal 5′-phosphate (PLP), the biologically active form of vitamin B6. Daily dosage: take a “25 mg” B-complex vitamin supplement.
When surgery is inevitable: John Ellis, M.D., of Mt. Pleasant, Texas, who pioneered the use of vitamin B6 in treating CTS, has long believed that carpal tunnel is the result of vitamin B6 deficiency. Daily dosage: Ellis recommends 200 mg of vitamin B6 daily for at least three months-it takes that long for PLP levels to normalize with supplementation. After this time, lower the dose to 100 mg. In addition, take a “50 mg” B-complex vitamin supplement.
What it is: Dental surgery includes many procedures, such as the extraction of teeth and the treatment of periodontal disease and temporomandibular joint (TMJ) disease.
What surgery entails: Dental surgery is often painful and interferes with eating. Almost everyone endures some type of dental surgery at one time or another.
Avoiding the knife: In general, dental problems are either disorders of the bone (teeth) or periodontal tissue (gums). Gingivitis, or inflammation of the gums, can be reduced by reducing intake of refined carbohydrates, increasing protein consumption, and adding a vitamin-mineral supplement, according to Emanuel Cheraskin, M.D., D.M.D., professor emeritus at the University of Alabama, Birmingham.
A recent study found that antioxidant polyphenols in unsweetened cranberry juice may prevent bacteria from attaching to teeth and forming plaque, an early step in dental decay and inflammation of gingival tissues.
Antioxidants, such as vitamins E and C and CoQ10, have an antiinflammatory effect and may be useful in controlling gingivitis and periodontitis. Researchers have reported that topical applications of CoQ10 may reverse periodontal disease. Vitamin D may also help retard periodontal disease. TMJ disease is often caused by a malocclusion, or bad bite, and the shearing stress generates free radicals, which promote pain. Antioxidants may be of benefit in this condition as well. Daily dosage: Vitamin E, 400 IU; B-complex vitamins, “25 mg” supplement; CoQ10, 100 mg; vitamin D, 400-800 IU. Needless to say, be sure to brush and floss your teeth every day.
When surgery is inevitable: Good nutrition promotes speedy healing. Avoid refined carbohydrates, such as bread, cereal, and sweets. Supplemental B-complex vitamins and vitamins E and C also promote normal healing. The B vitamins also have an analgesic effect, and they may reduce dental pain. Daily dosage: B-complex vitamins, “50 mg” supplement; vitamin E, 400 IU; vitamin C, 1,000 mg; CoQ10, 100 mg.
Prepping for Surgery
When there’s no way to avoid surgery, you can still fortify yourself for the stress. After all, surgery is a medically controlled knifing.
- Supplements of vitamins E (400 IU) and C (1,000 mg), CoQ10 (100 mg), alpha-lipoic acid (50 mg), magnesium (400 mg), and fish oils (1-2 grams) reduce the risk of complications during surgery. Most of the studies have focused on heart surgery, but they are likely applicable to other types of surgery.
- Being hospitalized increases your risk of a serious, antibiotic-resistance infection. That’s because there are germs everywhere. Probiotics (supplements containing beneficial bacteria), garlic (500-1,000 mg), vitamin C (1,000-4,000 mg), vitamin A (25,000 IU), and selenium (400 mcg) boost your immune system and ability to fight infections.
- General anesthesia depletes vitamin B12 levels. It’s likely that the stress of surgery depletes other nutrients as well, making supplementation of paramount importance. Take 500 mg of B12, plus a B-complex supplement.
- Some nutrients and herbs may have undesirable effects. For example, vitamin E, ginkgo, and garlic supplements may increase bleeding time when taken with anticoagulant drugs. In addition, the herbs ginkgo, ginseng, and St. John’s wort may prolong the sedative effects of anesthesia.