While all is fresh in my mind, following a recent surgery and hospitalization; I thought I'd throw out a few ideas for other E4s facing the same.
-Even though my surgeon had a complete list of all of my supplements, he NEVER asked me to stop taking them
I had a consult with him 10 days prior to surgery and I asked at that time if I should stop taking supplements that could thin my blood. He was taken aback...perhaps at his own failure to address this. My guess is that he wasn't used to patients taking so many supplements, nor being so aware of their impact. FWIW, these are the ones I stopped prior to surgery and resumed a few days after: fish oil, circumin, Nrf2, ALCAR, ALA, NAC, citicoline, vitamin E, aspirin, reservatrol, vinpocetine, ubiquitol. (I also stopped Mk7, but that probably wasn't necessary.) You will most likely automatically be given inflatable boots to prevent a blood clot during surgery and throughout your whole stay. ASK for them,
if you're not. They're a really good idea especially when your body is used to supplements that naturally thin the blood.
-General anesthesia is generally not considered a good idea for E4s. http://www.ncbi.nlm.nih.gov/pubmed/22108393
I realize alternatives may not be an option for some surgeries. Ask your surgeon. Luckily, mine was open to exploring different avenues to better protect my 4/4 brain. General anesthesia is fairly traumatic (even without the E4 variable) and recovery is much easier if you can avoid it.
-Begin a discussion with your anesthesiologist days (not minutes- as is common practice) before surgery. I called my hospital, asked for the surgery coordinator, and tried to track down whom would be acting as my anesthesiologist. Once identified, I requested a phone consult. Just like my surgeon, the anesthesiologist was open to avoiding general anesthesia given my greater preponderance for cognitive impairment. She got creative and settled on a combo spinal & epidural. The spinal gives greater numbness for major surgeries (good,) but the med wears off after a set time (around 3 hours- bad.) Not knowing if my doc would encounter complications, increasing surgery time; they compromised by adding the epidural component so more meds could be added as necessary. This is the first time this technique had been used at my hospital; hope other patients will now benefit.
-Being awake for a long surgery presents challenges; mainly conquering nerves and dealing with awareness of complications- like the need for a blood transfusion, etc. I began listening to an excellent meditation, guided imagery, affirmation, soothing music download several weeks before: http://www.healthjourneys.com/product_detail.aspx?id=29
It was extremely helpful, equivalent to strong relaxation/pain medication. My anesthesiologist also used very light IV profofol per the Sieber protocol http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2800291/
I was awake, relaxed, cooperative, etc. The surgeons, attendees, anesthesiologist and recovery nurse were all shocked at how smoothly the actual surgery went and how alert I remained throughout. Unfortunately, I still experienced severe post-operative shivering/tremors (as had happened in previous surgeries.) I had always attributed this to general anesthesia, but perhaps not... My hospital had me wear a gown that was insulated and had attachments for heating hoses. That, along with many hot blankets, helped.
-Another major pitfall for me was avoiding sugar. I'm convinced that glycemic control is imperative for E4s in preventing AD/CVD and in reducing general inflammation. Seems to me that this would be MORE important, not less important, in preparation for surgery. I've worked very hard to maintain low blood glucose that rarely spikes. I was asked to do a bowel prep, in conjunction with a clear diet, the day before surgery. A clear diet is supposed to provide around 1500 calories of mainly simple sugar: jello, fruit juices, Popsicles, etc. NONE of which I choose to eat. I had the option of fasting, but I knew I would also be denied food the day of the surgery. I opted to sip organic broths. Once cooled, I got calories by adding EVOO. Ingenuity is the mother of invention
This technique is non-physician approved...but got the job done. I had to drink several bottles of magnesium citrate. Sucrose/sugar is a major ingredient. I found alternatives that used saccharine- meh, but avoided the BG spike.
-In the hospital, sugar was pushed with great regularity
In recovery, I could sip Sprite or ginger ale. Following surgery, I was offered jello, applesauce, pudding, ice cream. I was hungry and after several hours negotiated some broth and added my own EVOO (smuggled in a small glass bottle in my purse.) Once I was cleared for a soft diet, I could easily avoid sugar: eggs, veggies, lean soft meats, etc. and get adequate calories. I was able to limit carbs by explaining I was gluten-free. At one point, I was given a sugar IV. I asked for a regular one, but was denied per my surgeon's orders. Learn from my mistake and discuss your anti-AD diet regimen with your surgeon prior to your surgery/hospital stay...didn't realize it was necessary, but he/she really controls your healthcare the entire time you're hospitalized.
-Lastly, having a support person along, who was aware of my medical history/dietary needs, was great. I quietly and assertively negotiated for what I needed, but greatly appreciated my husband's back-up when necessary. On my last day in the hospital, a dietician, noticing my small stature and refined carb limitation, came to my room with the USRDA food pyramid for a quick tutorial
(CR is a part of my anti-AD regimen, but I still maintain a healthy 18.5 BMI.) She concluded by asking me pointed questions about my weight, referencing anorexia. My husband smoothly brushed her off, joking that he had a hard time earning enough money to feed me as I eat so much & effusively complimented her on the amazing
hospital food. This is the same man who chases off visiting Mormans by answering the door in his boxers with a big smile
(Forgive my diversion, but those nice boys can run.)
It's sad that that hospitals, which are supposed
to be places of healing, can turn into minefields for E4s. I thought I'd share my recent experiences in an effort to help others. PLEASE share your experiences/tips. The more of us who do, will better help protect the next E4, who finds themselves needing surgery and/or a hospitalization.