How a Functional Medicine Doctor Takes Care of Herself after Surgery
Posted on 19 January 2018
Many people have asked me what I am doing to help myself heal quickly since my recent surgery.
I think this is such a good question because it is always important to care for our bodies, but during an acute healing process, such as a surgery, it becomes critical to be highly accountable to yourself for a speedy recovery. And since I have experienced a couple of minor complications, I realized that this is the perfect opportunity to share with you how I have managed my healing process in detail. So, thank you for that important question!
In general, when you are healing from any illness, (and actually always), you should consider your body as a whole. Each and every system in your body interacts with one another and can be effected by one another.
So, let’s cover each of these areas to make sure you are prepared should you have some expected or unexpected surgery or illness.
Optimizing the Endocrine System:
The Endocrine System is an intricate, Wonderful system of glands which make and secrete numerous hormones based on the instructions from our Commander in Chief, our brain. The triad of glands and hormones that you want to make sure are functioning in tip top shape before AND after surgery are Adrenal Hormones, Sex Hormones, and Thyroid Hormones.
The brain tells our glands what and how much hormone to make and secrete and is constantly monitoring how the glands are functioning. If the glands aren’t producing enough hormone, then the brain will send out more Stimulating signal to the gland which tells the gland to produce more hormone. If the glands are producing too much hormone, then the brain will send out less stimulating hormone which tells the gland to slow down on the production of its hormone. This is called a Feedback Loop and there is a different feedback loop with the brain for every gland.
The Adrenal glands are extremely important as primary players during any illness or recuperation. When the Adrenals are functioning well, they are ready to fight for us and help us through the entire healing process caused by stressors, may those stressors be physical, (such as an illness, injury or surgery), or emotional, (such as the loss of a loved one, financial, work related, and any other life stressor).
When our bodies experience stress, our Adrenal Glands step up to bat and take first place. The Adrenal Glands produce Cortisol, the strongest anti-inflammatory substance the body makes. When we need it, it is our friend to help us recover more quickly. As inflammation subsides, our wounds heal, infections resolve, muscles and bones recover, homeostasis is restored, and we return to our healthier and stronger self. We're quite fortunate to have Cortisol and are dependent on high functioning Adrenal Glands.
But even with well-functioning Adrenal Glands going INTO any form of surgery, the surgery alone is going to set the Adrenal System into overdrive and you are sure to experience the havoc it plays on your body. And if you must face any complications, even minor complications, this places additional requirements on your Adrenal System for which you should be prepared.
The extra Cortisol that we're making to help us heal is also sending messages down to all the other Hormone systems. That includes ALL of the Endocrine Hormone Systems, the Sex Hormones, Thyroid Hormones, GUT Hormones and even back to the Adrenal Glands themselves!
The more complicated things become, the harder they have to work. The longer it takes to recover, the longer they are in overdrive. And as you may figure, the harder and longer they have to be in overdrive, the more tired they become.
For some unfortunate individuals who undergo ongoing extensive physical or mental stress, the Adrenal glands can actually go into failure. When this happens, the medical condition is called Addison's Disease. Addison's Disease is commonly nonreversible, and the individual is dependent on lifelong supplementation of the medication Hydrocortisone (which is simply Cortisol). Without this medication, a person with Addison's disease could not survive.
As an interesting side note, one famous person you know who had Addison's disease is President John F. Kennedy. His survival was dependent on Hydrocortisone.
So, let’s talk about what happens in the body when your Adrenal Glands have to speed up, produce more Cortisol, and support you during an acute stressor, such as what I am personally experiencing as a post-operative healing patient right now.
I put this little diagram together for you to try to show you what happens. I'm the little Zebra at the top left of the picture... with stripes coming off from excessive stress. My current stress is being sensed by my brain. If I had just had a surgery, this would have been enough to rev up my Adrenal Glands and thus increase my Cortisol levels.
But for the first week after my surgery, I had difficulty with a partial post-operative ileus causing extreme bowel gas and an inability to eat. Just a few bites of any food made me feel like the girl on Willy Wonka and the Chocolate Factory who turned purple and blew up into a big round balloon. Because of that, I could not take any pain medication or muscle relaxers which became a real problem when I ended up with a large muscle spasm in my back on post-op day 4, due to the odd positioning required for sleeping. I am required to sleep on my back at an elevated position, and as a lifelong side sleeper, this position is not what my muscle memory has come to expect. And thus, the muscle spasm. So... these two complications have set my Adrenal System in full swing.
My revved up Adrenal Glands are fortunately healthy enough to put out the Cortisol that I need to recover. But with the Adrenal System in Overdrive, all of the systems in the Endocrine system, Digestive system, (which is also part of the Immune System) and the Nervous system, are all ALSO being effected.
What am I doing about it and how am I coming along?
For my Endocrine System:
Sex Hormone Support:
Sex Hormone imbalance occurs with essentially ALL women as we age, AND Sex Hormones are an easy fix for most women now that we have Bioidentical Hormones available to us right over the counter! It’s really become the easiest Hormonal System to fix! (You ought to consider ALL the important reasons for Restored Sex Hormone Levels. You can find out more about that in my Hormone Library here!)
Depletion of Sex Hormones effect the Thyroid Hormone System, (which is the hardest to fix without prescriptions), the GI Hormone System (which is also part of the Immune System), AND the Adrenal Hormone System. Sex Hormones also effect the chemical messengers of the Immune and Nervous Systems.
So, balancing and restoring our Sex Hormones to more Youthful Levels is critical for ALL of our Hormone Systems.
One of the most important things that Estrogen helps is its stimulation of the immune system and ability to ward off viruses by increasing a type of white blood cell called lymphocytes. I don't want a virus right now! So, a little temporary increase in my Sex Hormones will do me good.
- I use Young Hormones, Hormone Heaven, which is a Combination of an 80/20 mix of Estriol (E3) and Estradiol (E2) at a dose of 3mg Estriol (E3) and 0.6mg Estradiol (E2). That equates to 3 pumps of Hormone Heaven twice daily.
I increased my Hormone Heaven to 5 pumps twice daily and plan to keep it at this dose for 2 full weeks to give myself a little boost in virus fighting lymphocytes. 5 pumps twice daily are equivalent to the highest prescribed dose of Estradiol (E2).
With increased Estrogen, of course I need more Progesterone to balance the higher Estrogen, but Hormone Heaven already has the right ratio of Estrogens to Progesterone, so this is taken care of and I don’t have to worry about any other additional Progesterone.
- I have just been prescribed Testosterone by my new Age Management doctor, Dr. Jeffery Life M.D. Since I just started this supplement, I didn't increase it. Basically, I have used Testosterone at low doses for a number of years, but have not been on any for almost a year, because I had been dragging my feet in choosing a new Age Management doctor. I saw Dr. Life for the first time just last month, and am looking forward to the 2018 changes that my body will be going through as I aim for the goal he has set for me, (and I agree with), which is an 8-pound weight gain of muscle and a 2% body fat loss which will bring me down to 19% body fat. Make sure you stay tuned for my body transformation this year because I will document the entire process for you! Once I am back to my full strength, nothing is going to stop me!
Adrenal Hormone Support:
One of the best supports you can offer your Adrenal Glands are medicinal herbs that have been used for centuries in India and now all over the World. These specific medicinal herbs are called Adaptogens. Adaptogens are safe and non-toxic, and are used for both under-functioning Adrenal Glands and overstimulated Adrenal Glands. They reduce stress, both mental and physical, and provide the extra support the Adrenal Glands need in times of stress.
Think of Adaptogens as medicinal herbs that help you Adapt!
Though there are a number of excellent Adaptogenic herbs. My two favorites are the ones that actually have the most research and are the most frequently used all over the World: Ashwagandha (Withania somnifera), and Rhodiola Rosea.
- I personally use AdreneVive by OrthoMolecular. This product contains a group of synergistic Adaptagens including my two favorites. I use this product off and on during all of my intermittent “life stressors” such as when I face extended work hours, family illness, and even when I am planning a positive, but potentially “nerve wrecking”, event such as a speaking engagement or even leading up to a vacation.
|OM Adrenevive||Supplement Facts|
- DHEA is my second Hormonal support for my magnificent Adrenal DHEA is critical for brain and nerve function as well as in supporting healthy Adrenal Gland function. It is commonly seen depleted during Chronic Fatigue, Fibromyalgia, other chronic illness or pain syndromes because it is produced by the Adrenal Glands.
I normally take 10mg daily, but I decided for this short time it would be good for the support of my glands to use 20mg orally. Normally I do not recommend any oral dose of DHEA to exceed 10mg, and that any dose over 10mg should be compounded into a cream for topical use. Since DHEA is critical for Adrenal Health and the Nervous System including the brain and individual nerves, increasing my dose temporarily while I heal serves me well. And since I have a low Estrone (E1) level (tested through ZRT laboratories), using greater than 10mg of oral DHEA for a short period of time is safe. (If you want to discover more about DHEA, watch the 4 DHEA videos in the Free Hormone Library on my website.)
Thyroid Hormone Support:
Thyroid function is critical for healing, and hopefully you have addressed Thyroid Health with your Health Practitioner. Hypothyroidism, in my opinion, is one of the most missed diagnoses of a Conventional physician. And unfortunately, hypothyroidism is the hardest to correct without thyroid hormone supplementation. In addition to that, many people do not recover fully from hypothyroidism with the most commonly prescribed medication, Levothyroxine which is strictly the hormone - T4. T4 is just one of the hormones produced by the thyroid gland and not nearly as active in your body as T3. In fact, T3 is 4 times as active as T4. In addition to that, T4 must be converted to T3 and there are numerous processes by which the body may be deficient in the ability to properly convert T4 to T3. Or the body may convert more T4 to something called Reverse T3, which is completely inactive, instead of T3, which is the primary thyroid hormone your body needs for a healthy metabolism.
This is critical for every day of your life, so you can imagine how important it is when your body is under additional stress of healing from a surgery.
- I personally take a combination of Levothyroxine and Armour Thyroid for Hypothyroidism. I have remained stable at the same doses for over 5 year And thus, in terms of my body, I feel this same dosing is perfectly appropriate. I think the key here is to make sure your body’s metabolism is optimal going IN to surgery by being proactive in making sure your thyroid is functioning well.
For my Digestive System:
Remember that our Digestive System plays a huge roll in our immune system. In fact, it is estimated that 70% of our immune function depends on a healthy functioning GUT. The most important parts of our GUT that we need to think about are the microbiome, (or the host of bacteria in our GUT- the balance of good and bad bacteria), and the GAP junctions between the cells in our GUT.
The healthy bacteria in our GUT is dependent on many factors, far too many to review in this article. However, toxins, medications, nutrition, hydration, and even our genes effect our GUT microbiome. Probiotics should be a staple supplement for everyone.
- Normally I take 1 of a few probiotics. However, in getting ready for my surgery, and since, I have been taking Garden of Life RAW Probiotics for Women - 1 capsule three times daily (total 85 billion per 3 capsules).
The second feature of our GUT that we must always protect is the GAP junctions between each cell in the lining of the GUT. The lining of our GUT is actually only 1 layer thick. This is pretty amazing considering 1 layer is practically nothing. But in order for our body to easily absorb nutrients from our food, the mucosal lining of the GUT through which the nutrients are absorbed is ONLY one layer thick. In addition to this single layer, there are “GAP Junctions” between each of the cells making up this mucosal lining. The GAP junctions connect each cell to the next and keep the cells tightly together. Unfortunately, poor diets, toxins, medications and so forth cause these GAP junctions to loosen which then allow the toxins within the GUT to leak out into the body. This is where the term “Leaky Gut” comes from.
For me I am always conscious of my GAP Junctions and use prophylactic nutrients as well as avoid toxins of all kinds.
Here is what I do:
- Normally I use InflammaCore Powder by OrthoMolecular, one scoop daily in coconut, cashew or other milk substitute. Since my surgery I have increased the dose from 1 scoop daily to 2 scoops daily. With this shake, I also add 1 scoop of OrthoMolecular GlutaShield. Both of these are excellent for GUT health, keeping GAP Junctions tight and the InflammaCore has nutrients and herbal anti-inflammatories for the GUT as well.
- As for my diet, I eat ONLY nutritious food. Everything that goes in my mouth has to have high nutritional content and be organic. The ratio of Carbs to Protein to Fat is about 33% all the way (33% Carbs, 33% Fat and 33% Protein) This gives me a balance of all the Macronutrients with not too many carbs, and enough Protein and Fat for immune cells and wound healing.
For my Nervous System:
- At my recent first visit with my Age Management Doctor, my lab work identified a deficiency in Omega 3’s. This surprised me since I take 1 gram of Omega 3 Fatty Acids on most days. At that time, I increased my Omega 3’s to 3 grams (BTW, if you don’t eat red meat, and eat fish only a couple of times a week, you may be deficient in Omega 3’s like I was.) I personally use Carlson's Cod Liver Oil with added Vitamin D (gives me a total of 6000 U of Vitamin D3 plus 3 grams of Omega 3's with equal amounts of DHA and EPA)
For my pain and muscle spasm I consulted with the Naturopathic Physician and Compounding Pharmacist who both helped me design the base cream for the Young Hormones Bioidentical Hormone Creams and the Happy Hoo Hoo suppository base. Though the Omega 3's are critical for Nervous System health, it wasn't cutting the pain from my large muscle spasm. They recommended CBD - Cannabidiol from the magnificent Hemp plant. I started CBD a week after my surgery and what I discovered was something I did not expect! I had still been dealing with excessive gas, bloating and the feeling of fullness after just a few bites of food. These symptoms are obvious signs of ongoing partial ileus (which is caused by anesthesia). After the very first dose, I started releasing an enormous amount of gas! I was literally full of Hot AIR! By the next morning, my bowel troubles were completely over! And I actually woke up hungry! This was a pleasant surprise and not an expected benefit at all. Apparently, the bowel is loaded with CBD receptor sites!
I purchased both a controlled release CBD capsule and CBD oil for as needed break through pain. CBD has multiple positive effects on the body including anti-inflammatory and calming excited nerves. So, CBD has also supported my Adrenal Glands as well. After about a day of use, my pain was far less and definitely controlled.
Here is my regimen:
- Cannabidiol 50mg, (abbreviated CBD), controlled release capsules - initially I took three times a day and reduced to twice daily after 4 days use.
- CBD concentrated oil, (sublingual): The dose I found to be right for me was 0.4ml twice daily.
So, there you have it. That's a Functional Medicine Doctor’s regimen for a Speedy Recovery after surgery! I do take some other basic supplements, but this outlines the specifics that are key to my post-surgery healing. I think I have it all covered.
I hope this helps you think about what you might need during acute times of stress, or if you are currently dealing with a chronic condition that has left you pretty worn out. Remember, the easiest thing you can do is to start with straightening out your Sex Hormones. At the same time, make sure your Adrenals are well cared for.
ABOUT DR. KAREN LEGGETT
Dr. Karen Leggett is a board certified physician in family medicine and geriatrics. She has spent the last 17 years helping and supporting midlife women in balancing their sex (reproductive) hormones, stress (adrenal) hormones, thyroid (metabolic) hormones, and gut (digestive) hormones so they can regain their young little chick spirits.
She practices what she teaches! "We women control the aura of our environment! How we act is dependent upon how we feel, so you have to feel great to really achieve your goals!" Dr. Karen Leggett. Her own experiences led her to her passion today - to help YOU.
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