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Foundation Staff
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Posted: Fri Oct 29th, 2004 05:33 |
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I need to have a diagnostic procedure/surgery/dental work. What should I know?
Postpone elective surgery and avoid unnecessary diagnostic procedures
If the condition that requires surgery is not urgent, ask your doctor if it can be postponed until more of your inflammation is resolved. Explain that you may have a better outcome because the presence of high levels of angiotensin in Th1 inflammatory disease can cause poor wound healing. Some Th1 patients do not recover easily from surgery because the body can't heal as well with a compromised immune system. Keep in mind that surgeons tend to focus on the procedure more than the recovery process.
"Patients with Th1 inflammatory diseases tend to have problems healing after surgery, and we deprecate all but the most urgent interventions until the patient recovers more fully.
As a rule, it is always safer to put off non-critical surgery until your body's innate immune system gets strong enough to heal the wounds properly again. The decision to delay is a difficult one, and you need to carefully consult your Doctor on the pros and cons." Dr. Marshall
Ask your doctor if the recommened procedure/test is really needed. The key question is "how will the results affect my treatment plan?" If you are convinced it is necessary, ask if it can be postponed until you are further along in the recover process or scheduled for a day when you are likely to be feeling your best. See Which diagnostic tests do I need?
Benicar and IV antibiotics
"After my recent presentation in Perth (Western Australia), an Anesthetist commented to me that he had been having trouble with patients who were taking ARBs for blood pressure. You see, when he gives them the IV antibitotics prior to the surgery (as a precaution against infection) it seems some of them get quite ill .
If you are going to keep taking Benicar, I think you need to have a talk with the surgeon and anesthetist, and make sure there are no surprises." ..Trevor..
We cannot tell you what will happen if a non-MP antibiotic is administered to you during surgery or how a fluoroquinolone might affect you either. We have little data on non-MP meds used during the MP but reports from several members who have successfully used Ciprofloxacin and Levofloxacin, which are flouroquinolones.
See I need to take a different antibiotic for awhile. What should I do?
General anesthetic
If you need to have a general anesthetic or sedating medication via IV, inform your doctor of the Marshall Protocol medications that you are taking. We know of no contraindications to continuing these medications because of the need for general anesthesia or sedating medication.
If you will get an antibiotic before, during or after surgery/procedure, you must discontinue all MP antibiotics and Benicar (unless you take a fluoroquinolone).
Keep in mind that staying on the MP may result in an immune system reactions. You may not want to combine the suffering after a procedure with immunopathology. Use your knowledge of what adjustment of MP meds works for you to dampen immune system reactions prior to, during and during recovery from the procedure.
Use a local anesthetic without epinephrine
If you are getting a local injected anesthetic such as is given for dental procedures, you should request that it not contain any epinephrine (adrenaline). This is added to the anesthestic (numbing) agent to constrict blood vessels and prevent bleeding. However, Th1 inflammatory tissues can react adversely to epinephrine, sometimes negating the effect of the anesthetic, sometime causing a local reaction, and even occasionally causing systemic symptoms. Inform your doctor or dentist ahead of time so they will have the correct medication there for you. See Why do I need to ask for a local anesthetic without epinephrine?
Be aware of protection from lighting, with NoIRs and the importance of increasing the Benicar blockade. See Benicar dosage and schedules
Nitrous oxide
I might tend to avoid nitrous oxide as an induction. It seemed to disagree with me many years ago, and has been reported to be problematic for some folks with CFS. It is important to talk with your anesthetist or anesthesiologist about your concerns and inform them you may need a lower than normal dose than usual and that you may take longer to come up. Depending on the specific type of surgery a spinal or epidural may be a possibility with a propofol or similar drip to keep you sedated. I don't know so much about immune effects, I would relate to it in terms of speed of recovery and the rate of detoxification and elimination of the medications used. P.Bear R.N.
Discontinuing other meds before surgery
Surgeons want patients to stop taking any medications that might cause increased bleeding. Anesthesiologists want patients to stop taking any medication that might interfere with the anesthetic.
NSAIDs such as aspirin, naproxin and ibuprofen, antiplatelet meds such as clopidogrel, Aggrenox, Persantine and ticlopidine, supplements such as garlic, ginkgo, St. John's wort, alfalfa, chinchona bark, saw palmetto, dong quai, clove oil, Vitamin E, fish oil, feverfew and ginseng make platelets less 'sticky' and may lead to increased bleeding during surgery. Kava kava and valerian can interact with anesthestics.
Since many patients have a limited understanding of their medications, sometimes instructions are given to discontinue ALL medications, both prescription and over-the-counter, including any supplements or vitamins or herbs. There are some exceptions such as medications for high blood pressure or seizures. Be sure to question a directive to discontinue any or all of your medications.
Members' experiences
Reporting in after my knee surgery. It went as scheduled yesterday and I was home by 1 p.m. I got a lot of ‘run-around’ in the days before the surgery from my doc and the pre-op about whether I should continue my MP meds, especially if any antibiotics were to be used. I had your recommendations, which also said to discuss and decide with my surgeon. My surgeon said to talk to the local dr. monitoring my plan, but I told him he (my pulmonologist) had never heard of the plan until I took it to him, so he would defer to the MP recommendations. So the surgeon said to contact the director of the MP – which I already had!
Sooo, I decided to continue my meds and I took all the information and MP recommendations with me to the hospital and gave them to the anesthetist. I thought: if they have any reservations, I'll just go home!  She was very happy I did and she had her staff request copies of my August tests and pulmonologist’s notes, which they faxed over. They decided to not give me any antibiotics and modified the other meds they gave me (such as no epinephrine.) So as anyone on the MP knows, it pays to be proactive in your medical treatment!!!! ~okiebug
Related FAQs:
Why do I need to ask for a local anesthetic without epinephrine? (Info your dentist and surgeon need to know)
PAIN CONTROL
Diagnosing cancer accurately
Medications to Avoid While on the Marshall Protocol
Last edited on Tue Feb 5th, 2008 09:41 by Foundation Staff
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Foundation Staff
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| Joined: | Sat Jul 10th, 2004 |
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Posted: Mon Dec 25th, 2006 14:39 |
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(filelink)
Arthroscopic knee surgery
Questioning the value of arthroscopic knee surgery for osteoarthritis
A controlled trial of arthroscopic surgery for ostearthritis
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