Most patients are told one thing before surgery: stop all supplements. Duke surgeon Dr. Rebecca Knackstedt says that advice is often wrong – and that what you do in the days before surgery changes how you heal. In this episode: how much protein to eat (no standard exists, and most women get half of what they need), why surgery is catabolic and muscle is your reserve, the night-before carb loading trick that reduces pain, and the 5 day window that lowers complications and even mortality.

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 rehab after it. She and Dr. Lyon cover 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), why bed rest is over, hormones after breast cancer, why mammograms still beat thermography, what chemo does to metabolism, and the questions to ask before you consent.

Connect with Dr. Knackstedt

Instagram → https://www.instagram.com/surgical_recovery/

Website → https://www.clararecovery.com/

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Find Dr. Gabrielle Lyon at:

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- Order my book – https://www.amazon.com/exec/obidos/ASIN/1668085623

Mentioned

- Dr. Jocelyn Wittstein on estrogen, joints and injury → https://youtu.be/ILyzNTjZTGI

- Menopause Is a Muscle Problem (solocast) → https://www.youtube.com/watch?v=OvK21cHM_RE

- 5 Protein Myths Your Doctor Is Still Repeating → https://youtu.be/cYtTRTwUzcs

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 — 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.

How to Prepare Your Body for Surgery: Protein, Prehab and the 5 Days That Change Your Recovery | Dr. Rebecca Knackstedt

The Dr. Gabrielle Lyon Show

How to Prepare Your Body for Surgery: Protein, Prehab and the 5 Days That Change Your Recovery | Dr. Rebecca Knackstedt