T Nation

After Surgery: Dealing w/ Inflammation


#1

I have surgery scheduled for August 21st to repair my AC joint. Collectively, it is called a Mumford procedure, including distal clavicle resection, acromioplasty and subacromial decompression, which as I understand it involves removing the bursa and cleaning out the joint.

I have been on a very anti-inflammatory diet for a while now and have been taking all sorts of anti-inflammatory and joint support supplements while exhausting all non-surgical treatments. It looks like surgery is going to be the way to go.

My question is this: Is inflammation an important part of the healing process post-surgery? In the article "Injuries: Nutrition and Recovery," Dr. John Berardi says a "balanced inflammatory profile" is beneficial rather than an anti-inflammatory one.

Also, my doctor said no anti-inflammatory meds for 1 week prior to surgery. I realize many NSAIDs are also blood thinners, maybe this is why?

This all seems counter intuitive, as ice and the standard R.I.C.E technique (which reduces inflammation) are recommended for recovery.

Also, I've recently discovered systemic enzymes (Wobenzym being the most researched/popular) which besides all the anti-inflammatory benefits, actually claims to help surgery recovery. Bromelain(one of these enzymes) is even mentioned in the Dr. Berardi article mentioned above.

Any thoughts on how it can be both anti-inflammatory and boast cutting post-op recovery time? There does seem to be plenty of long-term research on the subject to back it up.

Should I stay on the anti-inflammatory and joint supps (Flameout, Curcumin 500, SuperCissus, Glucosamine/Chondroitin/MSM, Animal Flex) or drop it and pick back up after surgery? I realize there are multiple questions here, and I will be asking my doctor the same questions.

I was hoping someone here could offer some insight into my surgery recovery nutrition conundrum.


#2

As far as the no NSAIDs issue is concerned...it is all about anticoagulation. In general, all surgeons, no matter the type of operation, ask patients to stop taking NSAIDs. While a Mumford procedure normally has very little bleeding, work is being right around some major blood vessels (subclavian). If anything were to go wrong (which is won't...not trying to scare you) the correction of the problem would be made much more difficult if your clotting cascade were to be slowed. Aspirin is worse than others because it irreversibly inhibits clotting factors, but ibuprofen should be stopped too.

When it comes to surgery, listen to the doc. They may not know much about nutrition (as we all know) but they do know a lot about preventing post-op morbidity. Believe me, you will probably get a nice cocktail of pain meds/anti-inflams AFTER the surgery.


#3

Thanks for the reply. I've decided to stop everything but my multivitamin as I've seen recommendations to stop even fish oil prior to surgery. I'll probably pick back up a few days after surgery when the internal bleeding has stopped.

Am I right to believe that post-op recovery will be focused on lowering inflammation? Some things I've read say that "controlling" inflammation is the key rather than just lowering it. I assume that surgery triggers the body's inflammation response so much that it's out of control. Wouldn't things like Omega 6 & 9 (inflammation promoters as I understand) be a bad idea in this case?

If you check out the reports/claims for systemic enzyme supplements (Wobenzym N, Medizym, etc) they actually claim to regulate inflammation by balancing the anti-inflammatory and pro-inflammatory responses of the body. Is this ideal? (or true?)

My interest in the enzymes is their claim to be able to reduce recovery time and boast all sorts of other benefits for joints and athletic performance. There appears to be plenty of research supporting it and many who swear by the stuff. I haven't tried them yet so I'm just hoping someone can offer some insight?


#4

I don't have a clue what all is involved in a Mumford procedure, but I've read many times that people have had better results with Active Release Technique (ART) on the shoulder than with some types of surgery. It might be worth the time to just get another opinion from an ART practitioner if you can find one.


#5

I absolutely 100% endorse Wobenzyme for injury recovery. My wife and I have used it successfully for years, and recommended it to many others whom reported only positive feedback.

I sent you a PM with some more details.


#6

I checked out ART and it looks like it's only good for soft tissues. Is it more or less just a specific sports massage technique or have I missed something?

I've had 3 separate orthopedic surgeons and sports doctors tell me that what I have is actual damage to the bones and bursa and after 8 months of rest, therapy, massages, supplements, a clean anti-inflammatory diet and cortisone shots, the only thing left is surgery.

Even though I was trying my best to avoid it, I've been assured that it's a rather routine thing and I can expect 100% recovery to contact sports in 3 months. 6 months if they discover a labrum tear while in there with the arthroscope, though nothing showed on the MRI. Besides weightlifting I train and compete pretty heavily in Judo, which according to my doctors is just about the worst thing you can do to yourself... but I love it and can't wait to get back for the big tournaments in the spring.

bk, thanks for the info on the Wobenzym, I've replied to your PM with some questions about dosage. Just about every review I found online was inline with yours, I just hadn't heard much about it until recently. Evidently it's been around and in use for a really long time. I will definitely be giving it a try.

Surgery is less than a week away, I really appreciate all the help guys. I'm not looking to set a record for earliest Mumford procedure recovery time, but as nervous as I am for the surgery I'm really excited to finally be pain free and back to Judo!

Any additional tips?


#7

I always heard NSAIDS were bad pre/post surgery. Something with inhibiting the natural inflamation/healing process. I was prescribed percoset (sp?) only post surgery on my knee.

Tips: Do your physical therapy. Take it easy for a bit after any surgery.


#8

There's more to ART than just sports massage. You're right that it's soft tissue specific. The problem is that soft tissue problems, including adhesions in the fascia, trigger points, etc., sometimes appear as orthopedic problems, especially in the more complex joints like the shoulder. For example, I've experienced problem where my muscles were pulling abnormally on my clavicle, causing all sorts of pain. The problem was a adhesion in my SCM.

Anyway, it reads like you've done your research. Good luck.


#9

Therizza, I've read the same thing about NSAIDs. Does anyone know if it's true for Flameout, Curcumin 500 and other anti-inflammatory supps? I would imagine they work in entirely different ways.

As tired as I already am of resting and rehabbing, I realize the importance of properly healing before doing anything dumb. I'll be sure to take it easy and do what my PT and doctor tell me.

yorik, thanks for the clarification. What you said is really interesting. There's an ART place not too far from me, I might try to stop by and ask their opinion.

Thanks!


#10

  You may be in or through surgery by the time you read this but something that gives a good GH boost might speed healing.  Myself, I'm saving up to get some of the Alpha-GPC that Biotest sells.  The life extension people suggest that CDP-choline (cytidine-5'-diphosphate choline) is also a good GH releaser, as well as glutamine, niacin, arginine, and ornithine.  Their website is lef.org.