Pre-Surgery Optimization Protocol

Getting ready for surgery lowers complication risk and speeds recovery. The biggest changeable risks: Smoking slows wound healing by reducing oxygen to tissues and raises infection risk several times over, plus lung complications. Quitting at least 4 weeks ahead helps, and longer is better. Blood sugar: people with diabetes and a high A1C have more infections and wound problems, so bringing blood sugar into range with your clinician in the weeks before matters; your prescriber makes any medicine change. Nutrition: poor protein and calorie intake (for example a low albumin) raises complication risk, so eat enough protein and calories in the 2 to 4 weeks before and do not diet. Vitamin D: low levels are linked to infection after surgery. Vitamin C and zinc support collagen and immune function, and vitamin A supports skin healing. Probiotics may lower infection risk after some surgeries, especially bowel surgery. Some supplements raise bleeding risk (higher-dose fish oil, vitamin E, ginkgo, garlic, ginger, curcumin) and some affect anesthesia (kava, St. John's wort, valerian), so surgical teams usually pause them 1 to 2 weeks before. Enhanced recovery (ERAS) programs use a carbohydrate drink before surgery, which reduces insulin resistance, nausea and hunger afterward, and many allow clear liquids up to 2 hours before anesthesia. Always follow your own team's fasting instructions. Prehabilitation, meaning conditioning for 4 to 6 weeks before major surgery, improves function afterward. Relaxation and guided imagery reduce anxiety and are used by many hospitals. Anemia, high blood pressure, heart failure and lung disease should be in their best possible shape before elective surgery, and elective surgery can be delayed for that. People who are informed and involved in their care tend to recover better, so ask questions and bring a full medicine and supplement list to every visit.