Long Time, No Talk
Many of you will have noticed that aside from adding comments to Participant threads, I haven’t “been here” for some time. At least I hope you noticed. 🙂
Several months ago I had to set a date for hip surgery in late September. I spent those months getting ready for surgery, and the last month recovering from it. During that time I learned a lot about the current state of medicine, hospitalization and what is ‘normal’ recovery (bad) vs. what I did instead. I’d like to share this with you, because some of it is eye-opening. So grab a cup of whatever libation you enjoy, and meet me back here in five.
First, this wasn’t my first hip op. That took place six years ago, to the month. Research convinced me that I didn’t want to settle for the standard “hip replacement” but that I should have the new (to the U.S.) “hip resurfacing.” For those of you who might need a new hip, or who might be putting it off, here is the one important difference between the two that NO surgeon will ever tell you about unless you ask: Wolf’s Law.
More Than You Ever Wanted To Know About Hips
A hip replacement is easy. They dislocate your hip, then amputate your femur head and (perfectly healthy) bone below. They then insert a long metal spike with a ball on top into what remains of your leg bone. A cup (ceramic or metal) is placed in your hip socket, the ball of the spike is put into it, and voila – new hip. This is the surgery that’s been done forever here, though materials and designs have changed over the years. The problem is, not only do you have restrictions on movements forever (there are even manuals about ‘allowed’ positions for sex), but the younger you are when you have the surgery, the more Wolf’s Law comes into play.
“German anatomist and surgeon Julius Wolff (1836–1902) postulated that: bone in a healthy person or animal will adapt to the loads under which it is placed. If loading on a particular bone increases, the bone will remodel itself over time to become stronger to resist that sort of loading. The converse is also true: if loading on a bone decreases, the bone will become weaker due to turnover, it is less metabolically costly to maintain and there is no stimulus for continued remodeling required to maintain bone mass.”
Unfortunately, in hip replacement “loading” only goes from our feet up to the lower tip of the spike. None of the bone above that tip ever gets reloaded. So over the next ten to fifteen years the bone surrounding the metal spike grows thinner from the inside out, and eventually pulls so far away that the spike loosens from the bone. When that happens you must undergo a ‘revision’ — a simplistic euphemism for breaking your remaining bone in pieces to get out the old spike, putting in a new one, and wiring everything back together. After five to ten years of that, a new revision is usually needed, which could mean spending the rest of your life in a wheelchair. And the more active you are — the more you load the bone beneath the spike tip — the shorter the time to revision. Nice.
This is why, for decades, surgeons told young people with arthritis and bad hips to live on painkillers for up to half a century, and told older people to suck it up until they were in their sixties and wouldn’t have to worry about living long enough for revision number one, let alone number two. Which did not sit well with Derek McMinn, a British orthopedic surgeon who got tired of telling young patients to live in pain for years on end. In a successful attempt to end-run Wolf’s Law, Mr. McMinn developed the first successful metal-on-metal hip resurfacing (Birmingham Hip Replacement – 1997) and the instrumentation and surgical technique to implant it.
Hip Resurfacing is a very sophisticated surgery. The hip is dislocated, as with hip replacement, but any similarity ends there. The femur head and bone are completely preserved, arthritic tissue removed, and a large metal ball with a tiny two-inch stem is affixed to the head and attached to a metal cup in the hip socket. You regain a full range of motion in just a few months. All restrictions on movement are discarded about a month after surgery. If you were an Olympic Athlete before surgery, you can go back to being an Olympic Athlete a few months later – and many have. But most importantly of all, you’ve satisfied Wolf’s Law, since bone load continues from the foot all the way up to the hip. Short of doing something incredibly stupid like jumping off your garage, or being hit by a bus, a resurfaced hip can theoretically last a lifetime.
The FDA approved resurfacing in May, 2006, but since it takes at least 200 surgeries to know what you’re doing (and 500 should be the minimum when selecting a surgeon), there was no one here who could do it back then. So off I flew to Belgium, to be resurfaced by a surgeon who had more than a thousand of them under his belt. A new hip and all the Belgium chocolate I could eat. Win-Win! 🙂
How To Survive Surgery And Thrive
Fast forward six years. When my other hip started sending me twinges, I wasn’t willing to wait. Decades of being morbidly obese had taken their toll and even though I’d lost well over a hundred pounds, years of medical research taught me about the devastation inflammation wreaks on the body. And arthritis is inflammation on steroids.
But since I knew more now than I had six years ago, I was able to do better preparation of the kind that would stand me in good stead on the operating table, and in recovery.
First came pain management. Because if you’re in constant pain (and my hip was bone-on-bone), you can’t even think straight let alone follow a plan for months before surgery. So if you have pain, especially joint pain, keep reading. Just as my Protocol doesn’t treat the symptoms of obesity or diabetes but gets to their root causes and reverses them, so proper pain treatment should do more than mask symptoms. It should get to the root cause — inflammation — and stop it in its tracks.
Get ready to spend a few hours on PubMed reading about these two incredible substances, but here’s a brief run-down. From Sloan Kettering: “Boswellia or Indian frankincense is an Ayurvedic herb derived from the resin of the plant. It is used traditionally to treat arthritis, ulcerative colitis, coughs, sores, snakebite, and asthma. The major component is boswellic acid, which was shown in animal studies to be a potent 5-lipoxygenase inhibitor with anti-inflammatory and anti-arthritic effects. Other studies suggest that it has cytotoxic [anti-cancer] properties.”
From one randomized double-blind placebo controlled trial on PubMed (there are several others, including a test of Boswellia/Curcumin combo against Celebrex, in which Celebrex came in second): “All patients receiving drug treatment reported decrease in knee pain, increased knee flexion and increased walking distance. The frequency of swelling in the knee-joint was decreased. Radiologically there was no change. The observed differences between drug treated and placebo being statistically significant, are clinically relevant.”
Although my surgeon wanted to prescribe pain pills prior to surgery, I took three-to-four Boswellia and one Super Bio Curcumin every day instead. And despite being bone-on-bone, which is as painful a condition as it sounds, I was in no pain whatsoever. I could exercise, though I did so in the pool so as not to worsen the femur head condition before surgery. I could walk up stairs, go shopping and carry heavy loads when necessary. I had no pain, because these two supplements drastically lowered the inflammation. Protocol Participants with arthritis who now take this combo have had the same result. And best of all, there are no toxic liver and kidney side effects.
These two amazing substances have other properties, including anti-edema and anti-coagulation, both of which stood me in good stead after surgery. Adult aspirin twice a day for a month is what is now commonly prescribed after surgery to prevent swelling and blood clots. I tried it for a few days until getting sick to my stomach, and switched back to the combo instead. Zero edema. No blood clots or thrombosis.
The race to research the hell out of Boswellia and Curcumin is on. For breast cancer: “Similar to our previous observations in human bladder cancer cells, Boswellia sacra essential oil induces breast cancer cell-specific cytotoxicity. Suppression of cellular network formation and disruption of spheroid development of breast cancer cells by Boswellia sacra essential oil suggest that the essential oil may be effective for advanced breast cancer.”
From The American Cancer Society on brain cancer: “BACKGROUND: Patients irradiated for brain tumors often suffer from cerebral edema and are usually treated with dexamethasone, which has various side effects. To investigate the activity of Boswellia serrata (BS) in radiotherapy-related edema, we conducted a prospective, randomized, placebo-controlled, double-blind, pilot trial. RESULTS: Compared with baseline and if measured immediately after the end of radiotherapy and BS/placebo treatment, a reduction of cerebral edema of >75% was found in 60% of patients receiving BS and in 26% of patients receiving placebo (P ¼ .023). There were no severe adverse events in either group. CONCLUSIONS: BS significantly reduced cerebral edema measured by MRI in the study population.”
And finally, in using Curcumin for prostate cancer and Parkinson’s Disease: “Curcumin, an ingredient of the Indian spice Turmeric, has been shown to stop the formation of metastases in prostate cancer patients, researchers from Ludwig-Maximilian-Universität (LMU) in Munich, Germany, reported in the journal Carcinogenesis today. Several studies over the last few years have discovered a wide range of potential medicinal uses for Curcumin. In March 2012 researchers from Michigan State University found that curcumin may be beneficial for people with Parkinson’s disease.”
Important: For those who are obese and therefore have huge amounts of inflammation, whether or not they also have join pain, eliminating that inflammation is crucial. It is what causes ruptures in the arterial wall, and it is now believed to be the main cause of heart disease and attacks. There is an even more potent inflammatory on the market, an extract of Boswellia itself, called 5-Loxin. From a Monograph on why AKBA works better than regular Boswellia:
“Boswellia-related agents are one of the most thoroughly studied natural remedies for inflammatory diseases. Both in vitro and in vivo studies have established that the AKBA content in the extract greatly influences the modulation of therapeutic effect. Accordingly, 5-LOXIN has shown significantly better potential than the Boswellia extracts, that are less affluent with respect to AKBA content, in inhibiting 5-lipoxygenase, preventing TNF-α induced expression of MMPs and especially protecting against adjuvant-induced inflammatory response. As strategies to inhibit over expression of inflammatory mediators, cell adhesion molecules and proteolytic enzymes are considered important for intervention, 5-LOXIN offer therapeutic means for the prevention and treatment of many inflammatory diseases.”
Muscles and Meals
Even though hip resurfacing spares the femur head, the hip is dislocated and several muscles cut and re-sewn. That means major trauma to the body, which means rising levels of cortisol, depressed insulin, and higher blood sugars. Add the organ shutdown (however brief) as a by-product of anesthesia, and quick muscle repair with optimal overall recovery is dependent on good nutrition. So, a week before surgery I contacted the hospital’s head dietician and asked for meals high in saturated fat (butter, sour cream, yogurt), modest plain protein (like grilled steaks) and zero sugar or vegetable oils. Great hospital that they are, they said ‘no problem’ and they kept their word.
I also made what I call Recovery Fudge, which had every good thing in it that I could think of: coconut oil, butter, heavy cream, dark chocolate, cocoa and even my sugar-free granola sprinkled on top for crunch. I kept that and heavy cream for my coffee in the patient fridge on the floor, and ate some twice a day until it was gone – about two weeks after I came home. I also increased my overall calories with lots of extra fat, and upped my protein and carbohydrate levels by drinking heavy cream, organic protein concentrate shakes twice a day. I added wheat grass daily to help rebuild my red blood cell count. This plan not only worked, I’ve lost three more pounds an another inch from around my waist. 🙂
But just as important for my muscle repair was the intense water exercise I did for two months prior to surgery. Three times a week in the pool for an hour wearing my Water Walkers, highly effective exercise equipment I’ve used for years. Even if joint pain or arthritis or other problems make it difficult to exercise on land, you can still get a vigorous workout that will burn fat and build muscle. Water resistance is so powerful, if you harness it you can achieve the same aerobic improvement as on land. Better in some respects, because the cooler-than-your-body-temperature of water wicks away the heat from your entire body, lowering your pulse rate and allowing your muscles to work harder and longer.
The results in my case were what I hoped for. The hospital nurses and the PT workers who came to my home the first few days were surprised by my strong quads and hamstrings. Those muscles allowed me to go from two crutches to one the second week, a cane after that, and nothing at all the fourth week. At my post-op third week visit, my surgeon said he was astounded at my recovery process and said it was “way ahead of the bell curve.” I got permission to go back into the water, and to start Body By Science work-outs again. The former I did immediately, and the latter begins this week.
The Bionic Woman
And I’ll need it to build even more powerful muscles than I have now, because recent knee x-rays show one side is bone-on-bone. Thanks to my Boswellia/Curcumin regime I had no pain, but the damage wreaked by inflammatory fat was already done. Mako-plasty (the knee version of hip resurfacing) will fix it, but since it’s also major surgery I have to wait another six months or maybe a year to do it. Building strong calf, quad and core muscles will help take pressure off the joint and the rest of my skeleton as I move. Water walking and weight training will also increase my bone density, a very good thing as you age.
Of course another artificial joint will also add another hunk of interior metal to my growing collection. Not only do I set off alarms when traveling through airport security, it’s funny to watch the faces of doctor’s assistants when they weigh me and I say “please don’t forget to subtract the four pounds of titanium in my hips” — soon to become six. Given all that metal, I figure I’ll either become a T-1000 before I die, or valuable for scrap metal after. 😀
One Last Thing
Although this is already a long thread, I would be remiss not to share with you the nurses’ reactions to all things Protocol that got discussed. Yes, even on my hospital bed. They were all curious about my food choices (fat, fat and more fat), and the reasons behind it. Every time a new shift came on (three times a day; two nurses a time), they were in my room wanting to talk about Protocol. The reception really surprised me. To a man (they were all guys, go figure) they told me that their working with real people (as opposed to common medical wisdom) showed them that nutrition was the key to almost everything, and certainly obesity and diabetes. But they are stymied at every turn by a medical system that is hip-deep in too much money to change. And that is especially true, they said, for doctors, who “think they know everything,” and who “refuse to listen to nurses,” and who “don’t want to hear or learn anything new.” Throw in the “arrogance and condescension” that comes their way and they feel helpless to make or offer any real change. That makes for a bleak outlook, no doubt, but it also says that real change is possible, because it’s happening all around the stubborn, but ever-shrinking medical core.
I may have spent the last few months water-walking and becoming bionic, but I’ve also done a ton of medical and scientific research, all of which I intend to share with you. Hopefully, a new post every week. Wait till you hear what I’ve discovered about how to effectively take thyroid meds if necessary, and about a single subset of the Vitamin B family that’s about to become the greatest fat and obesity fighter – ever.
I’d like to know what you think. Was this information helpful?
Till next time . . .
Update: I forgot to include a $10 off promo code from Vitacost for anyone thinking about trying the Boswellia, Curcumin and/or 5-Loxin, so here it is:
Click this link and then register on the site as a new Vitacost customer. You will instantly be sent a $10 coupon code via email that you can use for your first order. Don’t forget to click the ‘SUBMIT’ button at the bottom of the registration page. Once you get the Welcome Email, just copy and paste the code into the promo box at checkout.
ONLY FOR NEW VITACOST CUSTOMERS – or those with new/different email addresses!