Preparing for Surgery: The Awkward Clash between Western & Alternative Medicine
I have several clients on specific herbal and supplement regimens about to have surgery. They were instructed to stop everything two weeks before their operation, so I asked my husband, a nurse anesthetist, about his opinion. His response was insightful so we’ve decided to share it with all of you, just like we did with his two guest posts on natural therapies for pain and more recently on the peer-reviewed science blog jove.com.
To begin, I made a video about this very topic on the set Melanie used with Demand Media to create her recent eHow series Natural and Herbal Medicine. I’ll try not to reiterate the fantastic assertions I make in the above clip. My expertise is based on over a decade of experience in healthcare, assorted research studies, and the textbooks The Essential Guide to Herbal Safety by Mills and Bone and Miller’s Anesthesia.
There is really only one type of drug or supplement that matters to your surgeon: blood thinners. Unfortunately, the list of herbs that affect clotting time, platelets, red blood cells, etc. is quite extensive and includes the vitamin niacin (at 2 grams or more), many herbs beginning with “G” (including garlic, ginseng, and ginkgo), white willow bark, and even fish oil. This is why I recommend complying without question if instructed to stop taking supplements a week before surgery unless you’re on a specific program for a complex health problem. Taking a supplement to give you more energy at the advice of a multi level marketing scheme doesn’t quite meet that requirement. I’ve had several patients with unstable vital signs because they drank a Monster or even a presumably healthy energy drink with large amounts of gingseng, taurine, and caffeine.
So what should you tell your surgeon? Don’t worry too much about him or her–it’s us anesthesia folk who obsess over metabolism pathways and drug/herb interactions. Ask to talk to one of us if a nurse or doctor tells you to stop everything not FDA approved days before your surgery. If you need more information, Google search the half life (how long it works) and side effects of your product. That way, we’ll have to address your concern on an individual basis instead of the same overarching philosophy that requires you to shut off anything electronic when a plane takes off or lands. Enlist help from your alternative health provider too. Chances are, if your product is generic and highly concentrated, you’ll be instructed to stop it two weeks before surgery (and you should). We’ve canceled cases for something as innocent-sounding as a teaspoon of cream stirred into coffee six hours before surgery. Surprisingly, Craigslist and Ebay aren’t the best ways to acquire traditional Chinese medicine, and ingesting “natural” plant products in exponential doses of concentrated powders baked into a tablet defeats the whole purpose of gentle, holistic healthcare that works with your body.
The bad news is that you won’t find much research on proprietary supplements containing trace amounts of minerals, nutrients, and, uh, dessicated animal parts. The good news about herbs and whole food supplements is just that: they’re edible, hopefully unadulterated substances. An excellent example is Standard Process products, a brand Melanie often tests her clients for. Remember that the same dosage from two different companies can vary in potency, depending on the part of the plant harvested, soil, processing procedures, and the phase of the moon during bottling. Ok, maybe not the last one.
Obviously you can’t request for me to be your anesthesia provider unless you come to my facility, but some hospitals do have alternative medicine services–locally, Sacred Heart’s Destin campus has a thorough program encompassing yoga, accupressure, therapeutic touch, and essential oils. These are all therapies that won’t affect medical procedures, unless you’re irritating your airways by snorting lavender oil to calm your nerves. The same is often true for homeopathics because you’re comparing apples to oranges. Just like energy medicine, the effects can’t usually be measured objectively by lab values and vital signs. For example, substituting a homeopathic for a measles shot isn’t going to work much better than substituting eucalyptus for a MAC 4 laryngoscope to open your airway. However, chemical and anesthesia detox homeopathic drops after surgery are an excellent idea if your genetics predispose you to certain sensitivities (but that’s a different subject for another blog post).
My point is that surgery takes care of problems that alternative medicine can’t, no matter how organic and wildcrafted the herbal poultice placed on a broken femur. Your surgeon and anesthesia provider have the final say because you’re in their world. If you don’t like their conclusions, don’t have surgery. I started having gallbladder spasms at the same age that my father had his gallbladder removed. The only answer Western medicine has is a cholecystectomy, so I talked to Melanie and started a program including nasty-tasting Swedish bitters. I avoided surgery because most of us in healthcare know that no matter how simple a procedure, the less invasive route is usually a better choice.
I recommend taking the last dose of herbs and supplements related to hormones one or two days before surgery and resuming them after the procedure. Stop valerian root and similar mood altering concoctions a day earlier than that, and don’t take anything that alters blood clotting for a week beforehand. Of course, the usual disclaimers stand that The Grecian Garden does not diagnose or treat medical diseases and that basing health decisions solely on blog posts is as intelligent as multitasking breakfast and hygiene by toasting bread in the shower. That said, I don’t mind answering your personal questions or vicious hate mail in the comments section for the whole internet to see. For more of my wit and wisdom, buy How to Succeed in Anesthesia School (And RN, PA, or Med School) and check me out @DrippingEther.