Recovery
The PreoperativeNutritional Protocol.
How to fuel — in the weeks, days, and hours before spine surgery.
This guide is designed to help patients understand what to expect before surgery and how to prepare for a safe and successful recovery.
Stock yourmetabolic reserves.
To mitigate the catabolic stress of surgery and prevent your body from breaking down its own skeletal muscle to heal your spine, we use a targeted nutritional protocol in the weeks and days leading up to your operation. The goal is to aggressively stock your metabolic reserves so that your body is in an optimized, "fed" state when the scalpel hits the skin.
You do not need generic wellness supplements. You need specific, clinically proven nutritional formulations — and the timing matters.
A timeline ofwhat to take, and when.
Here is the exact timeline and the specific items you need to acquire — from weeks before, through the morning of your procedure.
Correcting Deficiencies — Vitamin D3
WEEKS TO MONTHS BEFORE THE SCIENCE A perfect spinal fusion relies on your underlying bone biology. Correcting a Vitamin D deficiency is critical for bone healing, but it is not a rapid process; it can take anywhere from 4 to 12 weeks to appropriately raise your blood levels. THE PROTOCOL You should have your 25(OH)D levels checked well in advance of your surgical date to allow time for appropriate supplementation.
The Amino Acid Load
ONE WEEK BEFORE SURGERY THE SCIENCE The acute trauma of surgery increases your body's demand for essential amino acids (EAAs) by up to 80%. Without an external supply, your body will harvest these critical building blocks directly from your skeletal muscle. Juven is a readily available, targeted essential amino acid supplement clinically formulated and optimized to preserve skeletal muscle and support tissue healing during the severe postoperative catabolic state. THE PROTOCOL Take one packet of Juven in the morning and one packet in the evening, starting exactly one week prior to your surgery, and continue this regimen for two weeks following your operation.
What's involved
- Juven
Antioxidants & Glycogen Storage
THE DAY BEFORE SURGERY THE SCIENCE Vitamin C is a powerful antioxidant proven to decrease inflammation, improve tendon and bone healing, and attenuate postoperative pain. THE PROTOCOL Take 500 mg of Vitamin C the day prior to surgery, and continue taking 500 mg twice daily for eight weeks after your surgery. THE SCIENCE · CARBOHYDRATE LOADING Entering surgery in a starved state dramatically increases insulin resistance and muscle breakdown. We use complex carbohydrates to optimize your liver's glycogen storage so your body has an immediate, sustained energy source. THE PROTOCOL · CARB LOADING DOSE Consume 100 grams of complex carbohydrates (two 50-gram bottles of Ensure Pre-Surgery) the evening before your operation.
What's involved
- Vitamin C (500 mg) · Ensure Pre-Surgery
Placing the Body in a Fed State
THE MORNING OF SURGERY THE SCIENCE The goal of the pre-anesthesia dose is to shift your metabolism out of a starved state and into metabolic regularity — but it is strictly contingent on anesthesia clearance. THE PROTOCOL If permitted by your anesthesiologist, consume 50 grams of complex carbohydrates (one bottle of Ensure Pre-Surgery) approximately 2 to 3 hours before anesthesia. Not all anesthesiologists will permit this protocol. It’s always safer to adhere strictly to the NPO (No Food or Drink) rules, which entail abstaining from eating or drinking after midnight on the night of surgery, unless you receive explicit instructions that allow for pre-surgical carb loading.
What to pick upbefore surgery.
Bring this list to the pharmacy or order ahead. Total cost is usually under $80–120 for the entire course.
SUPPLEMENTS
- Vitamin D3 — 2,000–5,000 IU softgels
- Calcium citrate — 500 mg tablets (if needed)
- Vitamin C — 500 mg tablets
- Abbott Juven packets
PROTEIN SUPPORT
- Ensure or Premier Protein (single-serve)
- Greek yogurt · cottage cheese
- Eggs · chicken · fish
- Lentils · beans · chickpeas
HYDRATION & COMFORT
- Bottled water (easy to grab from bed)
- Electrolyte packets (Liquid IV, LMNT)
- Herbal tea · broth · clear soup
- Stool softener (post-op constipation)
Stop thesebefore surgery.
| NSAIDs · ibuprofen · aspirin · Aleve | Stop 1 week before surgery | Increases bleeding; impairs fusion healing |
| Fish oil · omega-3 supplements | Stop 1 week before surgery | Mild anticoagulant effect |
| Vitamin E (high dose) | Stop 2 weeks before surgery | Anticoagulant effect |
| Ginkgo · garlic · ginseng · ginger (supplements) | Stop 2 weeks before surgery | Bleeding risk |
| Turmeric / curcumin supplements | Stop 1 week before surgery | Anticoagulant effect at high doses |
| Marijuana / CBD | Discuss with anesthesia | Affects anesthesia dosing |
Eating afterthe OR.
Most patients can eat lightly within hours of surgery. Expect appetite to be low for 2–3 days — that's normal. Focus on hydration and small frequent meals.
DAY 1–3
You’ll begin in the recovery room, where you’ll progress from liquids to soft foods. Remember to drink water and other healthy liquids, as anesthesia can be dehydrating.
WEEK 1
Resume Phase 1–3 supplements. Aim for 60–80 g protein daily (3 palm-sized portions). Constipation is common — fiber, fluids, stool softener as needed.
WEEK 2–4
Appetite returns to normal. Continue protein focus. Reintroduce normal meals. Anti-inflammatory foods help — leafy greens, berries, fatty fish, olive oil.
WEEK 4+
At this stage, most supplements can be discontinued if you’re healing well and your diet is back to normal, unless your surgeon advises otherwise.
Clear it withanesthesia first.
While modern clinical evidence supports clear fluid carbohydrate loading up to two hours before surgery, airway management is strictly governed by the anesthesia team, and many still enforce a traditional "NPO" (nothing by mouth) after midnight policy.
You must explicitly ask your surgery center or hospital what their specific anesthesiology policy is regarding preoperative carbohydrate drinks. Never consume fluids on the morning of your procedure without direct, explicit clearance from your anesthesiologist.
Next Steps
Build the full recovery plan.
Start your journey to recovery with us. Reach out to book a consultation, and remember to bring your imaging scans for a comprehensive assessment and tailored advice from Dr. Lomedico.