Surgery – The AIP Way, Part II

After four abdominal surgeries (the last two since adopting AIP to help me manage my autoimmune diseases), I was inspired to write a small blog series about “AIP surgery.” This post is Part II of the series and is focused on the recovery period. You can find Part I here, it’s all about research and pre-surgery preparation. Be aware that all my guidance is based on a planned procedure.

To begin the recovery portion of this series, I think it’s very helpful to explore two big ideas:

1. This is where the conventional medical system excels. This first idea can help you handle surgery fear and anxiety. You can calm your nerves by keeping in mind that although the Western model for healthcare is sometimes woefully inadequate for treating chronic issues (like autoimmune disease), it is usually at its best with active short-term treatments that require highly specialized skill sets and medical teams. All surgeries carry risk, but you are most likely in very good hands.
2. Surgery is an event, recovery is a process. I recently came across this second idea on a clinic website. Remembering this as you come out of surgery can help a lot with mindset as you heal. Surgery, in most cases, takes less than five hours. That’s actually pretty fast for something so complex and it can feel like recovery ought to be just as fast. Reminding yourself that surgery is just an event, while recovery is a long-term process helps settle feelings of frustration or impatience with your healing body.

Now that those two big ideas are considered, let’s dig into the recovery process.

There are three broad categories of recovery you’ll need to consider to maximize healing:

• Navigating medication needs
• Nourishing the body
• Drawing on support

When navigating medication needs, here are a few things to have in mind:

• Pain management is appropriate and critical
  • The overarching thing that needs to be emphasized here is, “Don’t be a martyr!” While it is true that there can be some negatives to these drugs, suffering in pain is very stressful and is not conducive to healing.
  • Not only is it unwise to try to forgo pain management altogether, but it’s also not smart to try “skipping” doses, since it will become increasingly difficult to get the pain back under control. Work with your doctors on a clear plan for safely tapering and be honest with your needs as you follow this plan.
  • I’ve found that when combined with an anti-inflammatory diet (that’s AIP!), pre-and post-surgery, I am generally able to spend less time on pain management than an average patient and any damage done by the drug is offset by my nutrient-focused diet.
• Antibiotics may be necessary and potentially life-saving
  • Again, while we all know that overuse of antibiotics is detrimental to our good health, especially our gut flora balance, surgery often requires antibiotic use. This is not the appropriate time to argue with your doctor about taking it.
  • Focusing on slowly rebuilding gut flora, through fermented foods and probiotic supplements, during recovery can help offset any damage done by what was a necessary and potentially life-saving step.
• Depending on the procedure, you may need medications to help the bowels move
  • If you had a surgery affecting the gastrointestinal system, your body may need a little help “starting” again. Additionally, narcotics for pain management make the whole body slow down, including the intestines. Stool softeners or other medications might be helpful to keep waste moving without constipation that will result in risky straining. Do yourself a favor and take the medicine!

When it comes to nourishing your body as you recover from surgery, these are the steps to consider:

• Eat elimination phase AIP for a few weeks to 30 days or more following your procedure (depending on the level of invasiveness)
  • Give significant focus to nutrient-density. You will be helping to bring inflammation down and load your body with the vitamins and minerals necessary for major wound healing. Important foods to include are broth, gelatin, collagen, and when possible liver pate.
  • Be sure you are progressing from a liquid to solid diet per your medical team’s ideal.
  • Remember that an AIP template will not be offered in the hospital, so if any part of your recovery will be in-patient you will need to plan to bring in your own food.
• Add targeted supplements 30-90 days following the procedure
  • Supplements to consider are those that aid wound healing, decrease inflammation, support detoxification, and/or offset the damage of NSAIDS and antibiotics. However, do not take this step without discussing it in detail with your medical team, since some supplements are contradicted following surgery (for instance, if they decrease clotting ability, etc.)
• Focus on sleeping as much as possible
  • Hospitals can be a bad environment for proper rest, so work with your medical team for the earliest possible safe discharge.
  • Maximize a restful environment in terms of light, temperature, comfortable clothing/bedding, noise, etc. Think ahead about the most comfortable pillows, clothing (for instance, nothing that will rub on tender surgical sites), and even rooms in your house (for instance, maybe setting up in the family room for a week or two will help you avoid straining due to staircases).
• Begin to gently move around several times a day
  • Work with your medical team for the earliest possible safe time to begin walking short distances, this is an important step to help prevent clots from forming, move carbon dioxide out of the abdomen (if it was used as part of the surgical procedure, it can cause severe pain in the shoulders) and help the bowels which may be sluggish due to narcotics.
• Have a plan to keep your mind busy
  • At some point, you are going to stop feeling sleepy, groggy, and generally out of it, but that’s not usually the same time your body is ready to jump back into the swing of things. Think about TV shows, books, magazines, phone calls with loved ones, a card or board game, game apps on your electronic devices, or other relaxing things to do while you are resting, but awake. Don’t succumb to “I’ll just work from bed.” Work does not equal healing.
• Give yourself more time
  • Remember what we established at the beginning . . . recovery is a process. There’s a very strong chance that what you think is enough time to recover, is not even close to enough time. Take as much time as possible for your recovery period, slowly dipping your toes into your normal full-time routine, rather than going from bed rest to “daily grind” in a sudden jolt.

Next, you’ll be tapping the support you need (and hopefully arranged ahead of time) during your recovery. Surgery is not a one man show! You’ll want to consider these steps:

• Have one point-of-contact for medical information
  • Choose someone close to you who is going to have the initial consultation with your surgeon following the procedure, keep track of discussions with your medical team, and gather instructions for you and/or any caretaker following discharge, because you are most likely not going to be in a state to take in any of this information.
• Understand wound care and pain medication instructions
  • Be sure you and your main caretaker (whoever is going to be helping you the most following surgery) thoroughly understand how to clean any surgical sites and how and when to administer pain management drugs. Knowing these two things can be all the difference between successful healing and life-threatening complications.
• Schedule follow-up appointments with your medical team
  • This seems simple, but having these appointments on the calendar takes one thing of your list of worries and helps you be prepared with any questions or concerns when it is time to follow-up post-surgery (believe me, there is usually a lengthy list you want to discuss!). If possible, have your point-of-contact person take care of this detail for you.

Finally, take time to reflect on your strength and bravery as you recover. Surgery is scary and, frankly, it doesn’t feel good! Nobody wants to go through it, but if you find yourself facing an operation, don’t forget to take time to recognize your resilience and courage during recovery. I have found this step to be a secret to a good recovery. Telling myself I was strong made it so and added vigor to my healing process.

I hope this short series was useful for any of you that are or will be negotiating surgery. If these tips helped you or you have handy ones to add, let me know! And don’t forget to read Part I of this series.