Supporting the patient undergoing surgery.

By: Dr. Colleen M. Bland

Homoeopathic remedies are extremely beneficial before and after surgery because the remedies usually do not interact with other medication that may be given and can be administered even if the patient is not allowed to eat – no water is needed and they can be slowly dissolved in the mouth. These surgical protocols can be used during cancer surgery as well as any other planned surgery.

Possible complications of surgery can include:

Scarring and adhesions, bleeding/bruising, infection/sepsis, pain, adverse drug reactions, blood clots, cognitive and memory decline (POCI – post operative cognitive impairment), poor self-image and dysbiosis. The healthier and stronger a patient is before undergoing surgery, the better the recovery. Homoeopathic, herbal and nutritional medicine plays an enormous role in recovery and preparation for surgery.

General remedies to consider:

Arnica montana 30ch: for connective tissue or soft tissue injury, it prevents bleeding, sepsis and treats bruised tissue. Generally used after surgery (“after the trauma”). Traumeel (Heel) tablets or drops could be used.  Bellis perennis: more specific for lymphatic tissue (breasts), glands and abdominal surgery. Pyrogenium: for catheter infections, dissecting wounds and septic states. Infections and suppurative conditions. Calendula officinalis: to promote healthy granulation and prevent sepsis. “Healing agent” = promotes rapid healing. Staphysagria: surgical incisions, lacerated tissue, severe pain following abdominal operations.

Hypericum perforatum: nerve rich areas, coccyx/spine, circumcision. Conium maculatum – glands and lymph node surgery.

Abdominal surgery:

The opening of the peritoneal cavity and the manipulation of the intestines can cause flatulence, constipation and hiccups.

• with constipation and paralytic ileus consider Opium, China officinalis, Raphanus sativus niger and Carbo vegetabilis (distension/bloating).
• with flatulence/gas consider China officinalis, Lycopodium clavatum and Raphanus sativus niger (intense bloating, paralytic ileus, post-operative gas pain).
• with nausea consider  Bismuthum subnitricum, Nux vomica, Ipecacuanha, Arsenicum album and Allium cepa. Ginger or Peppermint tea.
• with hiccups post abdominal surgery use Hyoscyamus niger and Ammonium muriaticum.
• for pain and infection prophylaxis consider Bellis perennis and Hypericum perforatum.
• with postoperative adhesions consider Thiosinaminum 30ch daily for at least 2 weeks after surgery, possibly longer (some texts 6ch 3 times day). This prevents fibrotic scarring. Other remedies include: Staphysagria (accelerates healing of linear wounds), Fluoricum acidum (itchy red scars), Silica to heal connective tissue and Graphites (scar red, swollen with induration). Serrapeptase is a natural proteolytic enzyme produced from the enterobacteria Serratia mercesans (originally found in the intestine of the silkworm) – it reduces inflammation, pain and swelling and is useful to reduce scar tissue post-surgery, prevents post-operative swelling/inflammation and clotting (see below).

Opthalmic surgery:

• Eye surgery with pain and burning use Staphysagria, Zincum metallicum and Strontium carbonicum.
• Eye surgery with photophobia use Strontium carbonicum.
• Ocular haemorrhage: Bothrops lanceolatus, Ledum palustre, Hamamelis virginiana.
• Black eye/ecchymosis: Arnica montana, Ledum palustre.
• Inflammation/irritation after surgery: Calendula officinalis, Staphysagria, Hypericum, Symphytum officinale, Euphrasia officinalis.

Urogenital surgery: for sphincters (cystoscopy, hysteroscopy etc) and circumcision remember Staphysagria. For the prevention of catheter irritation and infection consider Pyrogenium and Calendula. After a laparoscopy or biopsy (or sharp instruments and injections/punctures in general) consider Ledum palustre.

Complications from anaesthesia:

Phosphorus is the main remedy. Other remedies to perhaps consider are Opium (antidote for general anaesthesia), Chloroforum (dizziness/drowsy/weakness), Aceticum acidum (severe & prolonged anaesthesia), Nux vomica (analgesic medication side effects). Strontium carbonicum (great weakness, persistent pain and sensitivity to cold).

Prevention of bleeding (haemorrhage): Phosphorus (30ch about 2 to 3 days before operation), Achillea millefollium (red blood and bleeding tendency), Ipecacuanha (fainting), Hamamelis (dark blood).

Post-operative fatigue and weakness: Phosphoricum acidum (physical and mental fatigue), Avena sativa (weakness and asthenia), Alfalfa (tonic eg. Natura Alfalfa tonic – OTC). China officinalis after fluid loss/ post-operative bleeding/haemorrhage.

Post operative bronchitis/respiratory & breathing issues:

Aether, Antimonium tartaricum (rattling mucus) and Carbo vegetabilis (must be fanned/air hunger). NAC (N Acetyl cysteine) as a respiratory antioxidant, for detoxification and to improve glutathione levels could be considered. Natura OTC range – Lungen/Ephecuan.

Post operative cognitive impairment (POCI): Ginkgo biloba, Centella asiatica, Rosmarinus officinalis. Perhaps also Lion’s Mane , Omega 3 fish oil, Phosphatidylcholine.

Cosmetic surgery (face lift etc): A formula from my student days (lecturer was Dr. R. Boyer) was Apis mellifica 9ch + Arnica montana 9ch + Poumon histamine 9ch.

Anxiety before surgery:

Gelsemium sempervirens (anticipation, nervous & trembling), Argentum nitricum (diarrhea, hurried), Aconitum napellus (panic attack and fear of death), Aethusa cynapium (fears not waking up after anaesthesia), Tabacum (vagal episode – passes out from syringes, cold sweat, pallor), Ignatia amara (knot in the stomach and lump in the throat), Cimicifuga (certain it will all go wrong/deep fear of surgery). Rescue Remedy. L-Theanine.

Allergy to plasters: Apis mellifica (burning, stinging), Cantharis (blisters and vesicles), Histaminum (allergy – homoeopathic histamine).

Nutrition plays a critical role in wound healing, the prevention of post operative infections and supporting the immune system. We must remember that surgery is always traumatic to the body. A well-nourished body will heal well.

The following nutrients are especially important:

1. Zinc: good food sources include shellfish, oysters, red meat, chicken, liver, eggs, cheese, beans, nuts, fortified cereals and brewer’s yeast. Use zinc picolinate or citrate. Zinc oxide is less bioavailable. Keep in mind that Zinc on an empty stomach can cause nausea. Should be taken with food. Copper competes with zinc to bind to metallothionein in the intestine, so excess zinc will deplete copper. Ideally zinc and copper should be in a ratio of 8:1 or 10:1. Plasma zinc is an insensitive indicator of zinc status. Red blood cell zinc may reflect longer term zinc status. Very important for wound healing.
2. Protein: essential for tissue repair, recovery and wound healing. A good quality whey-based protein shake could be included.
3. Probiotics: essential after routine antibiotics. Boost the microbiome. Muscle relaxants and opioids for pain cause constipation, hospital food is often low in fibre and antibiotics are routinely prescribed as prophylaxis. Weed-Seed and Feed Protocol.
4. Boost immune system: Medicinal mushrooms, Astragalus membranaceus, Echinacea. Homoeopathic: Thymuline 9ch (Thymus).
5. Vitamin C: antioxidant, anti-viral, strengthens walls of blood vessels and maintains the integrity of skin, tissues and bones. Use in divided doses. Caution if there is already diarrhea.
6. Proteolytic enzymes such as Serrapeptase mentioned above as well as Bromelain (Pineapple extract) can reduce inflammation and pain after surgery. Proteolytic enzymes such as nattokinase or lumbrokinase reduce the risk of blood clots.
7. Remember to check all herbal medication/supplements to assess for bleeding risk. Generally, to stop at least 4 days before surgery if possible.

Main herbal remedies to consider:

Centella asiatica (Gotu kola): wound healing, prevention of keloid and hypertrophic scars, accelerates healing of tissue, connective tissue regenerator, anti-fibrotic, cicatrisation after surgery.

Silybum marianum (Milk thistle): hepatoprotective, anti-inflammatory and cytoprotective. May be useful after a lot of conventional medication/pain killers. Supports toxin clearance. Kerry Bone recommends 200mg Silymarin three times per day for 2 weeks before and 2-4 weeks after surgery.

References:

Bagot JL. (2013) Cancer & Homeopathy: How to alleviate the side effects of chemotherapy, radiation, surgery and hormone therapy. UniMedica.

Faramarzi M.,Sadighi M., Shirmohammadi A. And Zohdi M. (2023) Effectiveness of Bromelain in the control of postoperative pain after periodontal surgery: a crossover randomized clinical trial. Journal of Advanced Periodontology & Implant Dentistry 15(1):22-27.

Kulkarni S. (2001) Surgery & Homoeopathic Therapeutics. India: B. Jain Publishers (P) Ltd.

Mateu-Ratera M. (2016) First Aid with Homoeopathy: The ultimate medical guide for travellers and athletes, also covering work-related accidents and major disasters. Kandern, Germany: Narayana Verlag.

Paxton F. (2015) Foundations of Naturopathic Nutrition: A comprehensive guide to essential nutrients and nutritional bioactives. Australia: Allen & Unwin.