Most patients are told one thing before surgery: stop all supplements. Duke surgeon Dr. Rebecca Knackstedt says that blanket advice can do harm, and that what you do in the days before surgery changes how you heal.
Dr. Knackstedt is a plastic and reconstructive microsurgeon on faculty at Duke, an MD-PhD researcher and a certified functional medicine provider whose research focuses on surgical prehabilitation: preparing the body, mind, and home before surgery, the way we already do with rehab.
In today’s episode, we discuss:
• What prehab looks like for any operation
• The labs she checks
• Which supplements to keep and which to stop (omega-3s do not increase bleeding)
• Hormones after breast cancer
• Why mammograms still beat thermography
• What chemo does to metabolism
• The questions to ask your oncologist before a treatment decision
• How much protein to eat (no standard exists, and the average woman gets 60 to 70 grams a day, well short of the 100-gram floor)
• Why surgery is catabolic and muscle is your reserve
• Carbohydrate loading before the fasting cutoff and why it can reduce pain
• The five-day window that lowered complications and even mortality in head and neck cancer patients
• Why early walking replaced routine bed rest
Connect with Dr. Knackstedt
Instagram → https://www.instagram.com/surgical_recovery/
Website → https://www.clararecovery.com/
Sponsors
• Perfect Amino by BodyHealth, https://bit.ly/4wZgg6N, code LYON20 for 20% off your first order
• Timeline Mitopure → https://bit.ly/4x18cm5, for an extra 20% off
• Lola Blankets → lolablankets.com (http://lolablankets.com/), code: DRLYON for 40% off select blankets (limited time)
Find Dr. Gabrielle Lyon at:
• Instagram: https://www.instagram.com/drgabriellelyon/
• TikTok: tiktok.com/@drgabriellelyon
• Facebook: http://facebook.com/doctorgabriellelyon
• X: http://x.com/drgabriellelyon
• Apply to become a patient – https://drgabriellelyon.com/new-patient-inquiry/
• Weekly newsletter – https://institute-for-muscle-centric-medicine.ck.page
Chapters:
00:00 Prehab saves lives and money. So why isn't it standard of care?
01:05 Meet Dr. Rebecca Knackstedt: Duke microsurgeon and functional medicine provider
05:35 The patient who changed everything, and why good surgery isn't enough
08:34 What prehab is, and the exercises to do before any surgery
12:14 Hormones after breast cancer, rising rates in young women, and real risk factors
18:42 Chemo, metabolic syndrome and why body composition matters
23:13 The end of bed rest, and the labs that matter before surgery
27:04 Mammograms vs. thermography, and absolute vs. relative risk
34:12 Protein before surgery: 2 g/kg, track 3 days, never under 100 g
38:43 Supplements to take, and why "stop all supplements" is wrong
44:40 Preparing the mind: anxiety, sleep, anesthesia depression, expectations
51:21 Red light, saunas, hyperbaric oxygen, wound vacs, scars and pain control
1:04:59 Surgery is catabolic: muscle as your glucose reserve
1:07:34 Carb loading, the 5-day window, probiotics and the surgery go-bag
1:14:15 Why prehab isn't standard of care yet, and why she's hopeful
Disclaimer: This podcast is for general informational purposes only and does not constitute medical advice or create a doctor–patient relationship. It is not a substitute for professional medical advice, diagnosis, or treatment. Do not disregard or delay seeking medical advice because of something you heard here.
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