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Having surgery of any kind is not something to take lightly. There is always a risk of dying in surgery, and the risk of a life-threatening infection is also very real. Hospitals are one of the best places to pick up an infection that is resistant to antibiotics. That alone is reason enough to avoid hospitals unless absolutely necessary.
When you see a physician who is recommending surgery, keep in mind that surgeons like to do surgery. That is their business, that is what they are good at. Always get a second opinion from someone not connected to your physician or the same hospital or HMO, and go to a naturopathic doctor or an M.D. who practices alternative medicine to find out if he or she thinks the problem can be solved without surgery. Even if the visit is not covered by insurance, it may be one of the best investments you ever make.
Having given you all the warnings, there are times when surgery is definitely necessary. Dental extraction, appendicitis, and some cancers come to mind. With elective surgeries, only you can make the final decision about whether surgery is truly necessary, and when you do choose to have it, go into it fully prepared and in the best health possible.
In addition to the list of supplements you can take to support your body, it’s also important to support yourself emotionally and get plenty of rest before and after surgery. Be sure you have plenty of help at home, and stock the kitchen with nutritious fruit and vegetable drinks and soups. If you are experiencing a lot of anxiety in the week or so prior to surgery, you can use the antianxiety herb St. John’s wort or the relaxant herb valerian to help you through. Follow the directions on the container, and don’t overdo it, please. Chamomile tea is mild and soothing.
Preparing for Surgery
The two biggest challenges of surgery for your body, besides that of healing the actual wound, are the threat of infection and the stress on your liver. There’s no way around it: when you have surgery, you will be given lots of drugs, and most of them are very hard on your liver. This especially applies to anesthesia drugs. Take extra good care of your liver before, during, and after surgery. Your liver is responsible for taking nutrients and farming them out to the rest of the body, and it is also responsible for breaking down or neutralizing toxic waste products such as excess hormones and pesticides. If your liver is busy fighting damage from drugs, it won’t be able to heal your body as quickly or effectively.
One of the most irresponsible practices in mainstream medicine is giving people large doses of acetaminophen (i.e., Tylenol) after surgery. This painkiller is notoriously hard on the liver and is the last thing your body needs after surgery. If at all possible, avoid this drug before, during, and after surgery. Make it clear to your physician and your anesthesiologist that you are not interested in being given acetaminophen after surgery unless it is absolutely necessary.
To spare your liver, you should also avoid alcohol for the week before surgery, as well as foods high in fat (especially hydrogenated oils and fried foods). Other factors that can stress the liver include exposure to pesticides, solvents, paints, and gasoline.
Many prescription drugs can harm the liver. These include steroids (prednisone), antifungal drugs such as ketoconazole (Nizoral), and tuberculosis drugs (Laniazid). If you are taking any kind of prescription or over-the-counter drug, get out a magnifying glass and read the package insert for warnings about “hepatic function impairment” or “hepatoxicity.” This is medicalese for liver damage.
We recommend that you support your liver by taking some special supplements before and after surgery:
• Milk thistle (Silybum marianum) is an herb that is very supportive of the liver. Take it as a tincture, one dropperful three times daily, or as tablets or capsules (follow directions on the container), in a standardized product (meaning that the amount of the active ingredient, silymarin, is guaranteed). Take it between meals for a week before surgery and for two weeks after.
• Alpha-lipoic acid (also called thioctic acid) is a substance made by the body that directly supports the detoxifying abilities of the liver. Diabetics should use alpha-lipoic acid with caution as it can cause hypoglycemia. You can take two 100 mg capsules three times a day, with meals, for a week before surgery and for two weeks after.
• Cysteine is an amino acid precursor to the important liver antioxidant glutathione. It is commonly used in hospital emergency rooms to treat patients with acetaminophen-induced liver poisoning. It will also help stimulate your immune system. You can take one 500 mg capsule of N-acetyl cysteine three times daily between meals for the week before surgery and for two weeks after.
• Fiber is important to good bowel function, which is important to a healthy liver. If your colon is not effectively eliminating toxins, they will be sent back to the liver. Eating plenty of fiber will ensure that your bowels are moving well. This means eating plenty of whole grains, fresh fruits, and fresh vegetables. Having your bowels moving well will also be helpful when you are required to take a laxative the day before surgery.
Avoid Infection, Speed Healing, and Boost the Immune System
Infection is a major risk of surgery. The sooner you get yourself out of the hospital the lower your risk of getting an infection. You can help avoid infection and speed up the healing process by keeping your immune system strong. In addition to the vitamins you’re taking as part of the Six Core Principles for Optimal Health (see Chapter 9), you will support your body if you take the following supplements.
• Your biggest ally in fighting infection and speeding healing is vitamin A. Take 15,000 IU of vitamin A (not beta-carotene) daily for a week before surgery, 50,000 IU the 2 days before and after surgery, and then continue with 15,000 IU daily for about 10 days. (If you’re pregnant, don’t take more than 15,000 IU daily.) If you’re having dental surgery, you can rub it on your gums before and after surgery to greatly speed up the healing process.
• Take extra antioxidants, zinc, and a B-complex vitamin for two weeks before and after surgery. They will support your immune system and the healing process. Take an extra 1,000 to 2,000 mg of vitamin C (don’t take so much that you get diarrhea), 200 mcg extra of selenium, and 15 mg extra of zinc. Also take a bioflavonoid antioxidant such as grapeseed extract and green tea extract to help speed wound healing.
• Glutamine is a nonessential amino acid that becomes essential when we’re under certain types of stress, such as surgery. The immune system can’t function without glutamine. It speeds up the healing process, aids in detoxification in the liver and kidneys, and supports the health of the small intestine. Take 500 mg twice daily between meals for a week before and two weeks after surgery.
Homeopathic Remedies for Surgery
Homeopathic remedies are particularly effective for helping cope with surgery, and you can safely take them just before surgery and just after since they are tiny sugar pellets or tablets that dissolve under the tongue.
Homeopath Dana Ullman, author of The Consumer’s Guide to Homeopathy (Tarcher/Putnam, 1996), recommends arnica in a 30C dose before and after surgery. Take four pellets under the tongue the night before, the morning of the surgery, and just before the surgery.
Homeopathics also work well to treat the nausea that almost always occurs after surgery. Ullman recommends nux vomica in a 6C or 30C dose. You can refer to Ullman’s book for homeopathic remedies for specific types of nauseas and treatment for different types of surgery.
Chapter 8
How to Avoid Medical Errors in the Hospital
Stan was a cardiologist for 35 years in a major American city. He was in and out of a large hospital every day looking after his patients and, of course, was intimately familiar with all the goings-on in his medical community. After he retired, Stan was told by his physician that he needed to be hospitalized for some surgery. This normally calm, cool, and collected professional went into a panic. He was terrified at the prospect of being hospitalized. He made his wife promise that either she or his sister would be by his side at all times during his hospital stay, day and night. He conferr
ed with his physician ahead of time about what drugs he would be getting, how often, and in what dosages, and he wrote this all down for his wife and sister. He instructed them to double- and triple-check any medication he was given against what he had written and told them that under no circumstances was he to be given anything else unless he or his physician, in person, specifically approved it.
It may sound to you like Stan was being a bit paranoid, but in reality he was just being smart. After decades of working in a hospital, he was all too aware of how easy it is for patients to be injured and even killed by improper medication. According to a Harvard study done a few years ago, these types of errors result in 200,000 injuries to hospital patients every year.
Have an Advocate
Don’t go into a panic if you need to be hospitalized, but do have a friend or relative be your advocate to make sure you’re getting the proper care and medication. Stan’s concerns were confirmed in a study published in the Journal of the American Medical Association in which over a six-month period, 4,000 patients admitted to two Boston hospitals were tracked by Harvard researchers. They found 247 “adverse drug events,” meaning medication errors that injured the patient in some way. Of these, 70, or 28 percent, were considered preventable. Of the 70, 56 percent were caused by physician error and 34 percent by improper administration by a nurse.
Watch Closely for Errors: This Is Your Life
To look at the media today, you’d think that medical error would be the least of your worries—but you’d be wrong. You are more likely to die from medical error than from breast cancer, a car crash, or AIDS. The likelihood of being killed by a medical mistake is 80 times greater than being killed in a gun accident. Taking steps to protect yourself may not win you any popularity contests in the hospital ward but could very well save your life.
You can protect yourself by keeping track of what medications you are being given. Before you go into the hospital, ask your physician what medications you will be given; the exact brand name and generic name; what they are being prescribed for; the dosage (how many mg per pill) and how many pills you take each time; how many times in a 24-hour period you will be given them; in what form (i.e., oral, intravenous); and for how many days. Make your own daily chart with these details, and each time you are given a medication by a nurse, double-check what the physician told you against what the nurse is giving you. If anything changes, ask why, and if you don’t receive a satisfactory answer, refuse the medication until you can personally check with your physician or with the hospital pharmacist. If you are unable to do this, have a friend or relative do it for you. This may sound like a lot of trouble to go through, and you may get some resistance from the hospital staff, including your physician. On the other hand, it could save your life. These precautions are especially important if you are going into the hospital for an operation.
The most frequent types of medication mistakes are:
• Prescribing the wrong drug, that is, mixing up the names of drugs that sound alike or giving inappropriate drugs to seniors and children
• Giving the wrong dosage of a drug, that is, too much or not enough, or too frequently or not frequently enough
• Mixing drugs without being aware of adverse drug interactions
• Giving a drug via the wrong route, that is, orally instead of intravenously
• More than one physician prescribing drugs without paying attention to what the others are ordering
• The side effects from a drug not being monitored
• Stopping a drug too soon or not continuing it long enough
Before You Go to the Hospital
1. Select the hospital—and surgeon—with the most experience treating your problem. If you have the luxury of choosing between two or more hospitals, choose the one that has done your procedure the most. Practice may not make perfect, but it does reduce the chances of mistakes being made. Choose the surgeon with the most experience in performing the surgery you’re going in for, as well.
The more nurses per patient, the better. You’re safest in a hospital with a low patient–registered nurse ratio. According to an analysis by the Chicago Tribune newspaper, overworked or poorly trained nurses are often to blame for medication errors, delay of needed care, or the improper performance of medical procedures they have not been adequately trained to do. The Chicago Tribune report also revealed that at least 119 deaths had occurred while unlicensed nurse’s aides making nine dollars an hour were caring for patients. In two of the Chicago-area hospitals included in the analysis, administrators had created cost-saving plans that allowed housekeeping staff to dispense medications to patients!
2. Get a second opinion. Visit a practitioner not connected with the physician who recommended the surgery. An alternative medicine M.D. or naturopath may be able to help you solve the problem without an operation. Hysterectomies, bypass surgeries, cesarean sections, and gallstone surgeries are often recommended when less extreme, gentler treatments can take care of the problem.
3. Become an expert on your condition and its treatment. This is easier to do than ever before with the resources available on the Internet. If you have trouble understanding the information you find, ask your doctor to explain it to you. You and your advocate should have a good idea of what your hospital stay will be like, such as which tests and other procedures will be performed and when. Medication is often given via IV after a surgery, so be sure to ask about everything that is put in your IV. That way, when your treatment deviates from your expectations, you can ask questions and be sure you’re not getting a procedure or a drug meant for the person in the next bed.
In the Hospital
1. Demand that anyone who touches you wash his or her hands or wear new surgical gloves. Virulent, antibiotic-resistant infections abound in modern hospitals, and they can be life threatening for patients whose bodies are weakened by surgery. These infections are most often passed to you via the hands of medical staff. It is required procedure in all U.S. hospitals that medical personnel wash their hands or change gloves inbetween patients, and yet it rarely happens.
2. Insist on seeing an attending (senior) physician from time to time. Most teaching hospitals push their interns and residents to the limit, and an exhausted resident who has been working for 24 hours straight is more likely to make a mistake than a senior physician who has had a good night’s sleep. Besides, there’s no substitute for the knowledge that attending physicians have gained over years of experience.
3. When you do see an attending physician, take the opportunity to ask any questions that have come up for you during your stay. If you have any doubts about the care being given by nurses or medical students, bring them up with the attending physician.
Stay on Good Terms with the Hospital Staff
Overworked, underpaid, overwrought hospital staffers are likely to take offense if you repeatedly question their judgment. Tell them that it really isn’t anything personal, that you know they’re being worked too hard, and that human error is inevitable even under the best of circumstances. Let them know that you understand that everyone involved is working toward the same goal: the best possible outcome in your treatment. Tell them that you believe the patient should take on some responsibility to ensure that mistakes don’t happen. Make your inquiries and demands non-threatening; be direct, but don’t adopt an adversarial tone if you can avoid it. Keep things as friendly as possible so that no one has to waste energy on unnecessary confrontations.
When you leave the hospital, take home in writing your doctor’s instructions for a smooth recovery, including a list of all medications and dosages. Ask friends and family to help you out with nutritious meals and tender loving care during your recovery.
PART 2
PRESCRIPTION DRUGS AND THEIR NATURAL ALTERNATIVES
Chapter 9
Six Core Principles for Optimal Health
The number of ways to stay healthy is at least as great as the number of ways to get sick. Because eve
ryone is unique in their genetic, physical, emotional, mental, and spiritual makeup, no one program will completely cover everyone. You will discover for yourself, through trial and error, what works for you and what doesn’t, and hopefully with the help of a competent health care professional you can create a lifestyle that rewards you with vibrant good health and energy.
That being said, there are some guidelines that everyone can use to lay a solid foundation for good health, and they are summarized in the Six Core Principles for Optimal Health. These six core principles are basic and simple, and anybody can follow them.
While this book is not a substitute for the individual medical care your health care professional provides, it can help empower you to become a more active and knowledgeable participant in your own health care.
The Six Core Principles for Optimal Health are simple and effective whether you do one step or all six. The more steps you take, the better you’ll feel. Optimal health is like driving a finely tuned automobile instead of an old clunker. Either one might be able to get you from place to place, but what a difference in the drive!
Step 1: Drink Plenty of Clean Water
Two-thirds of the human body is water, yet water is our most neglected nutrient. Of course water is a nutrient. It’s more necessary for sustaining life than food. You can survive more than a month without food, but without water, the human body can function for only about a week. You cannot expect to enjoy optimal health if you deprive your body of the water it needs.
If you drink four to eight glasses of clean water daily (more or less depending on your size, lifestyle, and individual biochemistry), your body will thank you in so many ways. For one thing, your skin will be glowing with good health in just a month or so. Constipation will be a thing of the past, especially if you also exercise and eat fiber-containing foods. You will find controlling your weight easier. Many times when you think you’re hungry, a glass of water will suffice.