273. Brain Fog After Surgery: What to Know Before You Go In

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1:00What is the conversation about brain fog after surgery needs to happen before you go in? Not when you're struggling for your words after surgery. Anacesia and surgery plays a tremendous stress on our brains. Well, actually a lot of areas of our body, but especially our brains. And understanding that ahead of time can be one of the best things you can do to protect yourself afterwards. That's what we're talking about today on Wellness by Design. I'm your host Jane Hogan, the Wellness Engineer. And my guest today is Sandra Bergeron. Sandra has spent 30 years in the field of anesthesia and surgery. And she is passionate about helping people understand that they can build resilience before surgery to help them have better outcomes afterwards and serve their brain afterwards.

2:00And what I really love about what we learned today is that this applies. These tools that she teaches for building resiliency before surgery and afterwards can be applied to anyone to help improve brain health, to help reduce cognitive decline. So everyone can get something out of this episode today. She shares a wonderful tool that she's created to help you evaluate your brains resiliency. A lot of great insights in this, whether or not you're having surgery, but especially if you're having surgery or have had surgery, there's a lot of hope and there's actually a lot of empowerment in this episode is what I really love. So if you're new here, welcome. I'm glad you found us and my mission is to help you become empowered in your health to help you create the environment in which your body can heal, whether you've got chronic pain or any other chronic conditions.

3:01And if you are a long time listener, thank you so much for subscribing for tuning in for helping Wellness by Design become a top 3% podcast in alternative help in the whole world. I just am so, so grateful to you this wouldn't happen without you so huge gratitude. All right, if you haven't already got your free chapter of my book, pain free on purpose, use your mind to heal your body and get your life back. You can do that just by going to my website, the wellness engineer calm slash free chapter and I'll send it to you. Okay, let's dive into the episode. I think you're really going to enjoy it. Welcome to Wellness by Design. The podcast that helps you understand the powerful role your nervous system plays in chronic pain, chronic conditions and your body's ability to heal.

4:01I'm Jane Hogan, the wellness engineer, author and former engineer turned functional medicine certified health coach, who found my own path from debilitating pain to greater freedom. Here we bring together science, spirituality and simple nervous system practices to help you feel safer in your body, reconnect with its wisdom and become an active creator in your own health. Your body is always listening. Let's give it a new message. Sandra, barzharon, I'm so excited to have you on the podcast today because I don't think I've had a guest like you. We're going to talk about how well, I'm going to share you a little story first. And that is I used to think most people think surgery, you have surgery, you get your anesthetic, you post surgeries over and the recovery is all about the physical surgery.

5:04I don't think people are thinking about what's going on with their brains before and after surgery. I remember hearing Dr. Andrew Huberman talking about one of the biggest risk factors for dementia is actually how, you know, have you had surgery? How many surgeries have you had? How many times have you had anesthesia? So this has been really the focus of your work. Let's hear a little bit about that. And I also want to touch on, it's not just surgery, it's also like other things that happened to the brain, other brain stressors and we can get to that as well. So even for people who aren't expecting to have surgery, there's important things for you to learn in this podcast episode. Let's talk about that and why that is. Well, first of all, you make a good point. You know, Andrew Huberman, I think he's probably reflecting the concept that was outlined in Dale, redisins book, the end of Alzheimer's where he quantifies the number of anesthetic and surgery as you've had as a risk factor for dementia.

6:21And there's a good reason for that. A lot of times the problem in functional medicine and I mean, I am in functional medicine. So I know I work in anesthesia, I do functional medicine. But a lot of times in like the, let's just say functional holistic space, they, they silo it down to the problem of a toxic event, but it's really more complex than a toxic event. And this is why it applies to other neurologic stressors. And consider anesthesia, first of all, know that this is something that happens often, like 9 million a year and the US have surgery, most above 65. And the other than the second, I think second largest category children and then everybody in between and they all have their own risk factors associated with it, 65 and older is particularly vulnerable because resilience declines as we age. And resilience overall does, including our neurologic resilience, which is part of the story that, that I'm going to be talking about today. But think about surgery this way.

7:24Most people just think I go to sleep, I wake up, I've had surgery, they operate on, but they on a physiologic perspective, what's happening is we are giving you a controlled anesthetic, which is a. For lack of better words of neurotoxin, I mean, I hate to say that because it puts it categorizes things and then people go, it's a toxic, it's all about the toxic. It's not just all about the toxic, but it is look, it's selectively turning off consciousness. And if you ask any honest anesthetist or anesthesiologist, how does your drug work? They kind of go, ah, you don't, we don't really know. We don't really know how it works to turn off consciousness. Because it's one of those, yeah, it's one of those medical mysteries where we're like, it works, that's all we know. Yeah, wow, it's got a crazy, crazy that we rely heavily in such a big field on something that we don't can't fully explain. But we're putting you to sleep, we're selectively blocking consciousness. Now the brain continues to respond to the environment.

8:27So under conscious inhibition, we're blocking your consciousness, you're still having response to pain. So surgeon operates, your body still says, out. Okay. So there's still a physiologic response to pain. And so that if anybody who's lived with chronic pain can attest to like that is a cycle of inflammation and just everything is impacted with pain. Right. So the brain is already impacted in one pain is stimulating. There's an immune cascade that is then set up because we're traumatizing the body to have surgery. It's necessary, but we are doing that. So controlled trauma. So that means there's inflammatory response. There's an immune response. So the immune system has to activate because it's going to have to heal the stuff, you know. So the immune system gets up. Let me, we shoot it through the roof. We shoot the inflammation through the roof. We shoot pain through the roof. We give you a control toxin. We give you a circumstance where the microbiome gets altered.

9:31We give you steroids, we give you antibiotics. We give you polypharmacy. I think they'll, you know, in a general anesthetic now colonoscopies are number one question I get that's a little bit different. I usually give very little anesthetic medication for it's not polypharmacy like a general anesthetic, but in a general anesthesia, it's a very common to give five, six, seven, eight, ten drugs in one anesthetic. So, you know, when people say, you know, it's the drug that causes, and I'm like, which one? Which one of these ten causes you dementia? It's the polypharmacy event of that. And the inflammatory response, the cytokine, the storm, the immune response, the, you know, controlled trauma, the, all of those things combine in one situation under anesthesia. So that causes a tremendous amount of neurologic stress. And I would argue that except for maybe a stroke, right, or like some major direct physical trauma like a, you know, like a surgery where we have to remove part of the brain, things like that.

10:35These obviously large large traumas, but outside of those anesthesia, I would argue is one of the V, if not the highest neurologic stress event that a person can undergo. So, anything that we do that helps strengthen resilience for anesthesia and surgery will also do so for other neurological stressors like say migraines, you know, chronic migraines, chronic seizures, TBI, things like that. These are all other neurologic stress events every time you have a seizure, it's a neurologic stress every time you turn it. It's a neurologic stress. TBI traumatic brain injury just for the people in case they're not familiar with the term. Yeah, TBI is my baby. I really, really a heart for the TBI community because especially in certain populations, I feel like they get the double hit. So say, let's say our professional sports athletes and our soldiers. Okay, those people number one, they hit them, they get higher amounts of TBI than the rest of the population across the board.

11:39And number two, they also have to have surgery more than the average population. So now they're getting a two hit. Again, TBI and they're having an anesthetic surgery. So they, they, it is crucial that neurologic resilience in that population is optimized and protected. You know, long term and before surgery and after any major neurologic event. So that's my, that's kind of my thesis in the national. How do we build neurologic resilience? Why is it matter? And yeah, that's the basis of the book and the tool that we created. Right. So you've got a book called Breakthrough Anacesia Fog. All of this, of course, born from your, as a physician's assistant and your work in anesthesia and seeing the surgeries and, and your own history and your son's history, which I'm sure we'll get into in a moment. So you've got a book you're, you've, you're actually studying this because I mean, Sandra, I can feel your, your, your compassion and your drive to make a difference in this because it's not something that's typically talked about.

12:48For people going into surgery, what can you do to build resilience before and after so that those effects, the long term effects, which a lot of people may not even be aware of. Um, can be, can be mitigated. Right. And then as it so happens, the same tools that you teach for building resiliency are also helpful. Well, just in general, yeah, for brain optimization. Yeah, you know, there's just, we just take it very seriously and dive in deep and, and don't mess around when we're trying to build resilience before surgery and recover after. You know what I mean? Like we really mean we have, we have a time constraint to really protect those neurons and, and can rebuild communication. Think about anesthesia. I like to say it's a fragment of mine in my last book and my last chapter in the book. I have a chapter on like trauma medical and anesthesia and the emotional side of anesthesia that's not often talked about.

13:53And that's has a lot to do with the fact that conscious and is separated from the rest of the brain and the basically selective inhibition of certain areas of the brain that don't reintegrate very quickly or immediately with the rest of the brain that interprets this their experience. Right. So if consciousness is turned off, we, we perpetrate a trauma to the body. And then the body, the brain wakes up. It has not integrated that there's a trauma that has happened. Right. There, it hasn't consciously taken, taken that into account. It has not integrated with the rest of the brain. And so there's another, there's another element of like this emotional disconnect that can happen. And if you're already traumatized or if you have PTSD or things like that, that makes that fragmentation of the brain, even more significant and sometimes harder to reintegrate. So there's a lot of components to this story that I think are really important to talk about. And I think what's interesting is, you know, when I first started mentioning this, I got the, I got a lot of the public saying what they heard their doctor, I would say, say, which is, you're just trying to scare people. This is clickbait. This is, you know, like, you're just, that's true.

15:09And then you have zero power to change the outcome. You know, if I'm just trying to go viral by telling you that, and see, it causes dementia and give you nothing to help you prepare. Then yeah, I'm clickbaiting you. But the reality is it gave an insight into the mind of the public, the public thinks that, well, it's a necessary thing. I got to have it. And there's nothing I can do about it. But now we're a lot of us just dropped me nuts as well. Right. And, you know, I'm like, no, but there is. There's, there's a lot to studies show it. The medical study show. Yeah. So there's a lot that you can do to prepare for surgery. And that's the key. We've known this for a very long time since the 90s. We've known this. There was a study done by Yale in 1999, where they, they literally post operatives, a controlled environment. So postoperatively, they applied just six major human modifications to postoperative care. They made sure that people had their hearing aids, they made sure they had their glasses, they made sure they sleep wasn't interrupted. They, they limited narcotics and then blue of narcotics, they gave them like massages, like, you know, like this kind of they oriented them to time, they gave them light.

16:21Made sure that they had some light and they knew what time of day it was. Those types of things were what they did. And they dropped to delirium. Now that's a short term form of dementia. Delirium scores dropped by 40%. And all those six things inpatient, not even nutrition outside of surgery. We're just talking about six simple things in hospital. Now that's 1999. Three years after that study, there were some hospitals that employed that they saved something like $7.3 million cumulatively by doing that hospitals, because delirium is expensive when people are delivering, they're re admitted and all this. So we've proven the proof of concept. We've proven there's a cost savings. It's now nine to 2026. Have we implemented that across the board despite the fact that we saw that outcome in 1999. And so there's no we have not. And it's an infrastructure problem inside the hospital system. It's not that the medical doctors don't care or they are not aware.

17:23It's just like how do we this is a cross departmental problem. We need more than anesthesia. We need anesthesia. We need surgery. We need a hospitalist. We need PT. We need the nursing staff. Multiple departments are involved in like setting up the care system like that. And that has a lot of implications. One, who's going to lead that when it's multi departmental. Number two, who's going to get paid for it? You know, three, how do you scale out across the system? So the point I'm making is 30 years later, we haven't we have had this information. We haven't been able to do change the system. So the reason I'm public about the somebody I wrote a book, why I created all the resources and why I have a platform is because the patient is the one with the skin of the game. If we're waiting for the system to do it. Clearly the system had spent 30 years. I haven't done anything and they've known there's an issue and something they can do. So if the patient knows the patients and powered the patient can do something patient can protect their brain. They're the one who has to live with it. So that's kind of my message in the nutshell.

18:30Yeah, I love that message. And well, I know you mentioned that you when we were talking before we had record, you had had an auto mean condition. I had an auto mean immune condition. Your son also had health challenges and I very quickly learned that I am not going to wait for the system to change because that could take years. In fact, I'm 10 years into this. Nothing has changed in terms of what's offered to someone in my I had rheumatoid arthritis. And so I had to change. It had to it had to begin with me. But the thing that we've learned through functional medicine through all kinds of stuff. Now is that these changes are we are capable of making these changes. There are a lot of them are lifestyle changes. And so we can do that. Well, let's hear about what what you're talking about as changes. How how someone can build their resilience to support. I mean for a lot of people not having surgery is not an option.

19:34Not having the anesthesia is not an option. No, what can change is what you do leading up and what you do afterwards post on right. Yeah, this is not about anti medicine. I mean medicine. You know, as like we talked about earlier, I was a PA first practice medicine for six years. What I did think was a limitation of medicine was that I'd prescribed. And then that would lead to more medications or side effects. And it didn't take me very long to be kind of disillusioned with that right. So I was like, you know, all we have is this prescription had and that leads to more stuff that doesn't improve quality of health. And so I was like, I'm not trying to do more reversing disease. If we did it. The other alternative is cutting them surgery. You know, and so I just like I didn't want to. So that's actually why I ended up doing anesthesia because I was like, I got to find something in medicine that I'm not making people chronically dependent on drugs. I didn't love that. So rather than go back to medical school, I actually did an anesthesia trading.

20:40And I think you said my autoimmune condition was was flared because of that additional training. So I had already had two children have third that I got pregnant with during anesthesia school toward the end of it. And so imagine the stress of school and the there's the schedule is grueling. You don't get a lot of time off and it's in the OR and it's just. And the young family. It was stressful. So I had an autoimmune condition that was kind of managed with the medications and became resistance of the medications. And the next step was, you know, your biologic medications, you're you're you're you're renegade things like that. Your method tricks. And I was like, I had looked at the studies enough to get no, I will never take those drugs. I was the same way. I consigned to like living with it. But the the reality is somebody pointed out during that time like, Hey, you looked at this research on gut health and stuff like that. And that's all I need. It was Pandora's box. I went down the rabbit trail of revisiting studies that, you know, I never had the well actually visiting studies that never had the opportunity to see.

21:49Because I'd refer to endoscopy and gastroenterologist all the time. And here we have studies from the 80s and 90s showing the link between gut health and autoimmune conditions and cardiovascular health and all these things. And I was like, what? Dimension, dementia as well. Dimension, brain health seizures all of it. Even psychiatric illnesses. So, you know, I was like, they're what? Wait a minute. We are what's going on here? Why is nobody talking about this? I was actually really dissolution. I was like, medicine is published in the American College of Gastroenterology. We're talking about medical journals. And I was like, why is every GI dog not talking about this is so important. And why are they not prescribing probiotics for everyone? Like, at least for my eyes. I mean, there's more to get health than that. But, you know, it basically opened like Pandora's Box. So anyway, I spent a lot of time looking at the gut and the body from now a whole person perspective holistically.

22:53My body spirit got health all the things. And it was kind of, and I promise I'll answer your question. But I wanted to give the context here was kind of a blessing that my health had an issue because when my that child that I was pregnant with six years later started having weird symptoms. I didn't go straight to what drug do I go pediatrician give me a drug. I was like, there's something going on here environmental. We changed his diet. He had some improvement. He had an anesthetic and he had a major decline. We ended up getting him evaluated by a functional medicine doctor and he had Lyme disease. And he was very sick. I mean, this child could not walk. Oh my goodness. Like upstairs. He would collapse. So he looked horrible. He had gray. It was terrifying. I was in the first chapter of my book. How helpless I felt because I was like, this is bad. And I'm thinking as a medical professional with, you know, I got an air integrating both worlds here functional medicine, but really my kid was sick.

23:53You know, you couldn't gain weight. He was thin. He was gray. He was couldn't walk. And all I knew was if I gave him steroids, it would be he'd feel better, but he wouldn't get better. So I'm looking through the arsenal of what I have medically available. And when I'm looking through the arsenal, what I got holistically available, this is what's going to work. I've got to be patient. Like, yeah, I got to really apply these strategically, these tools. And I've got to let the body heal. You know, so that's basically what we did what we did. I ended up, you know, supporting him. And in that I had to get more training and functional medicine, which is where where my whole world changed around anesthesia and how I view it. When I started looking at me, it was a nervous system that was impacted. Think about that. So now I'm going. And this was also during COVID. So everyone's nervous systems were on alert. I was like, yeah, but okay, wait a minute. So these these things apply to him and he's getting better.

24:54What about dementia people with anesthesia that there's we know there's a link to cognitive decline, whether it's brain fog, which is why it's break through anesthesia fog, which is more common across the board for everyone. Like a period of just fog and this orientation that nobody really acknowledges your doctor doesn't say anything. You're not going to see the anesthesiologist. Your primary care thinks you're just tired. Like fog is more common than cognitive true cognitive decline, but it's an indication of neurologic resilience. So, you know, I started going or the drugs, the problem. I started the research of what I was doing for my son with Lyme, neurologic Lyme and looking at it from the anesthesia standpoint. And basically that's how I discovered that like here's the body of research we're now doing and medicine that actually keeps pointing to the brain and its resilience to handle stress more than the drugs. So we have a lot of different drugs in anesthesia believe me. Anesthesia has for 50 years been studying whether this drug caused cognitive decline or that drug that that lack of there's no lack of research on that.

26:03And every single if you if you do a meta analysis of it, they go the drug doesn't matter. The drug doesn't matter. It is the brain walking in now there are maybe one or two drugs that they have modest indication that they help not hurt. But overall the anesthetic drugs, they all fair the same across the board. There's not one that's better and their tiva isn't better than gas. People always ask me should I just use IV? It's the stress of the brain. So if that's the case, how do we build resilience? So now I'm picking back into research that we have in the longevity space and the functional medicine space and like really how do we build resilience. We build it with lifestyle modifications. The cool thing is what I discovered was that the nervous system is actually very unique and it has multiple domains that influence your neurologic resilience that actually have been researched studied and understood. Even especially in my position, I was looking at it like I want the research around pari operative brain health.

27:08So person with this situation coming out of surgery, looking like this. So what I compiled was about 137 studies that showed that metabolic health sleep to sleep health, a medication burden, previous head traumas, infections to the brain. These are all things that influence neurologic resilience and post operatively. And so how do we modify these things? I'm going to talk about metabolic health. We're talking about PCOS. I mean, we're talking about insulin resistance. How many people do you hear about that have insulin resistance? This is not full one type two diabetes. We're talking insulin resistance. That's PCOS. That's the 30 year old. You know what I mean? So the spectrum becomes bigger. It's PCOS. Polycystic ovarian syndrome. So like one of the main causes of infertility and hormone issues for young women. So we're very common. Yeah. So and they're younger. And you know that we know that those group of 30 year olds with PCOS have a higher risk of heart disease later in life.

28:16And it drives that because it's the same mechanism. It's insulin resistance that drives that mechanism later in life. And it's those things that impact neurologic resilience. And there are things you can do in a short period to modify that to increase your insulin sensitivity. And then you know, movement is an enormous piece. And you're probably going to ask kind of what you literally can't supplement your way out of what movement can do to your body. It's so powerful. Like there aren't any supplements to match what walking for a mile will do for your brain. Because of the amount of BD and F and all the things in the circulation and nitric oxide. All the things that happen when you move your body. So anyway, I applied those principles. I did created the neurologic resilience test based on that research. And it looks at each of those domains. And it helps you understand like, okay, where your effort needs to be applied in a short period before surgery or after surgery. That's where you focus your efforts to really improve your outcome.

29:20And it's really empowering and practical. So let's just come back to that test because we'll have a link that's the test for how the link to write in. Yeah. So that test anyone can do this test to evaluate your neurological resilience. That's right. Whether you're having surgery or not. I mean, this is a, this is a neurological resilience. It's like a what we want in life. That's right. That's right. Yeah, resilience literally means that you can handle. You can handle the stress of life and not let it tank you. So it's like, it's like having a really good boat with a nice floatation of ice. No holes. But a lot of weight of that thing. And it's, you know, you fill it up really high and you take it out. It's just going to bounce right back and float right back to the job. You know, like, and that's that's the idea. You can be handled degrees of stress. As long as we don't let that stress them break systems, like create oxidation and break cellular physiologic demand, energy demands to the point where now we're in a disease state.

30:32Right. That that's resilience. And we want to really be able to build it. And the cool thing is the patient has the power to do that. Like they have the power to do it. You can't, you don't medicate yourself into resilience. Yeah, you don't, you don't take a resilience supplement. Right. Yeah. I mean, supplementation does help build resilience. And then, and I do talk about that in my book a little bit. It's all chapter two chapters. I think on some three, three, I think maybe on some, like pre post after that kind of thing. I think supplementation does there's there's lots of research, but it's not the only thing. You're not going to supplement your way out of that lifestyle. So foundation starts with your lifestyle. And supplementation builds upon that to help build resilience. For sure. So, so everyone watching and listening, we'll, we have that link. Just check below in the description. And you can go ahead and take that test. But let's talk about you've mentioned a few of the lifestyle factors that were identified in these studies.

31:32Do you want to dive into them a little bit more just so that people can understand how they can be the ones to make this change they can be empowered to do it. This episode of the Wellness by Design podcast is sponsored by the Harmony pendant. I love wearing this pendant because it helps protect me from harmful EMFs. That's electromagnetic fields. No matter where I am, our cells are under pressure from the constant exposure to radiation from EMFs that we are bombarded with 24 seven from Bluetooth devices, Wi-Fi routers, cell phones, cell phone towers, satellites, and even electrical wiring in our homes. Some of the potential consequences of EMF exposure include cellular damage, fatigue, chronic pain, poor sleep, poor attention and concentration, neurological damage, skin and hair aging and weekend. If you suffer from any of these symptoms, it could be caused by your nervous system and cells being bombarded by EMF radiation.

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33:40Yeah, so there's two sets of studies, right? I specifically looked at studies that I could verify had a postoperative arm like we knew this and this had this outcome to create the neurologic stress and recovery index. I wanted to be very medically validated because the goal is for this to be used in the system that's broken eventually. Once I've proven the research, I would love to see this change, how we prepare a patient for surgery. That's my goal. I had to limit the research to what we had in medicine on pre and postarms. But there's another body of medicine that has not, it has a lot of research about brain optimization resilience that doesn't include a postoperative arm. So for example, lots of research about gut health and the brain. It has modest links to postoperative. There were some studies that came across after with more, I mean, the research continues, right?

34:47There's a lot of, a lot of studies that came out discovered afterwards that were like, you know, people who who are well, whose gut is in nice good healthy shape, you know, with these markers intact low LPS, good probiotic and this kind of thing. They had less delirium scores after surgery. So there was a little bit of that postoperative arm. But the key really is is we know, for example, that your gut is tied to your brain. I mean, this is, if you listen to any holistic podcast, you will hear that. You have to optimize your gut. Well, and the guts, the main thing that gets a big hit. I mean, it's under, understated in surgery. But the gut is taking a massive hit. You're wiping it out with antibiotics. And usually it's a lot of antibodies depending on your surgery. Gosh, bless you if you're on your, you're having kidney stone surgery because you have really strong drugs for that. You know, like just antibiotics for that. Yeah. So we wipe our microbiome across not just the gut, but the whole body.

35:52And then the microbiomes involved in detoxification. It's involved in nutritional absorption anesthetics to plead be vitamins. Okay. Now we wiped out our microbiome. We're depleted and we're depleted our nutrients because of the aesthetic. And we don't have a good microbiome in order to absorb those, those nutrients from our food and our supplements. So the gut, again, it's felt too old. Yeah. So you can see why I would say why there's a whole section in my welcome bag of health. Yeah. You know, how do you support gut health? I always found it so interesting that someone who gets a brain injury will, will often also have gut issues. And then people, we know the other way around is true, right? Gut issues can cause problems with brain health. Okay. I, I'm just thinking of someone is listening to this and like, oh, I've got surgery coming up. Like how, how much time do I need to prepare?

36:53Is there like a minimum and optimum, you know, as long as possible? What, what do you say? I mean, I call it in my book, I use the, the concept of good, better, best. Like, you aren't helpless just because you picked up the book the day after surgery. Right. I didn't do any optimization. No, no, I'm going to get to mention no. No, there is still a tremendous amount of power in your hand. You know, you're limited on your bandwidth, probably. You're probably a little more fatigued and taking in concepts from a book and trying to optimize everything on your own. You'll need to rely more on your social network to kind of help you after surgery. If you just discovered that, that, oh, while I really do have this issue and I need to kind of, I need help. So there's that, you know, thing to consider like your, your brain is the thing that you're using to prepare or recover. And after you've had the hit, you probably need some help, you know, on that side of brain is not functioning where it should be.

37:55Like quite frankly, in the book, I even say, look, you need your social network in place. You need the people that are going to be positively and supporting you in place. And you need to limit the ones that won't, even the ones that talk who tend to have just the negative vent on life, just those people shouldn't be part of your post operative recovery. You know, like, like to have sarcastic humor, fine, do that three months after surgery. But don't do it right after because that actually has a biological impact on the nervous system. Like, I know, negativity. Yeah. Yeah. Yeah. Okay. So. So, but to your point, your question was really how much time do you need? It's a good, better, best, right? Best. 69 months. Good. Zero to three months. You know, our best. Good, better, best, best, 69 months. Better. Better. Zero to three before surgery. Best, good.

38:55Anytime you do that. Anytime that, you know, I've had surgery and I'm having these impacts or I'm going to have surgery on a day. I'm just, what can I do now? You know, what about? I'm not sure if it was before before we hit recorder afterwards that the, the, the populations that have the most surgeries are, you know, 65, 60 older. And also children and my younger son had a surgery for hernia when he was, I think he was only six. And so I think, is there anything we can do now that's going to. Yeah, you know, or, or anyone that's listening that maybe they're, you know, they're a year or two out of surgery. Is there anything that they can do? Yeah, so two things I want to talk about on that point. But yes, yes to that answer.

40:00I want to make a point about children because that's another population. That, you know, if it's child's having surgeries for good reason, typically most surgeons are not flippantly having operating on kids because they just want to make money. Yeah, yeah, child going in surgery has likely had a good freaking reason. And, and that puts them in a little bit of a vulnerability to start typically, right. So I mean, let's we're having. I mean, like something like my son was a minor surgery. He had a five minute surgery with colleagues that I worked with because the child was being a silly kid and swallowed it was putting money in his mouth and swallowed a nickel. And I got logical. It's off. I guess because you know, that's what we do with money. We stick it in our mouth. It's not like it's touching it millions of people's hands or anything. But so like, these are kind of rare cases, but the cases a lot of kids indoors in the younger popular people kids are sick. And they in the team population, it's awfully often the athletes. Right. So that these kids are trying to get their scholarships and they have to have knee scopes and shoulder scopes and things like that.

41:13The thing is with anesthetics and children is that there is a well known and well documented drop in IQ scores after an exposure to an anesthetic. The research. So and it's transient and it doesn't prove, but it can last up to two years. So think about the college, get the kid, the teenager trying to get their SAT scores or be competitive in school so they can get a scholarship. And they have to have surgery and they have a measurable drop in their IQ scores and their reasoning. That's a literally translational impact on their life. You know, so optimizing their brain is really important before and after surgery for children earlier on in life. The great thing is that the brain is so it's really still pruning and the architecture is changing for children between like what zero and 25 some I think now one study said 26 so we still have a really big window. You know, for neuroplasticity and and changing the architecture of the brain, which is really encouraging right so even if there's a hit early on in life, it's just it's not deterministic.

42:23For your child, there's a lot you can do a lot of power you have with. And I would say I would say even what they know now is that the brain never stops developing neurons. Right. So it's constantly got the ability to improve so I want to give people hope, right? Yes, exactly. And so that that's the hope that I mean, for sure, there's more there's we have less plasticity just by ourselves left to our own after 25 but the thing is lifestyle is really geared lifestyle determines your plasticity, your neuroplasticity, what we're talking about children with their modifiable architecture is plasticity of the brain, right? So after after 25, yeah, your natural innate plasticity starts to decline, but that doesn't mean it has to. I mean, doing hard things has been proven to be a neuroplasticity building. Yeah, hard things. I kind of make the joke in chapter three. I'm like, you're doing hard thing right now reading this book. So good job. And here's, you know, so I mean, but really learning something new like my mom picked up the guitar, never had touched it.

43:33She was 62 years old picked up a guitar and learn how to play guitar. I'm like, wait a bill, do you neuroplasticity, mom? Oh, my duo, Lindo is helping me. Right. Yeah, do hard, do hard things. And that applies to the kids, but to your to your point with the children, there's still like again, the principles remain the same. You know, what is what is this child who had surgery at six years old? What's their lifestyle looking like right now? Do they eat in an out burgers? Do they, you know, or do they eat a nice diverse diet? Do they smoke marijuana? You know, I mean, that's very common. That doesn't help your neuroplasticity, by the way, in fact, it really destroys your dopamine centers. And that's not something I would do. So like what's going on with that child now that we can do that we can address immediately very simply to start to improve that outcome from that stress amount of surgery. There's a lot you can do. So I just gave two examples, but there's many more. Yeah, well, people will have to get your book to learn about more.

44:41Obviously can't go through all of it today. What we really wanted to do today was make sure that people understand there's something you there is an effect that there is something. Yeah, there is something that you can do you are you can be empowered in this and it can help you neurologically whether you're having surgery or had surgery. Just as a part of a life resiliency tool as well. So Sandra, this is amazing. And I really I could hear and feel the passion that you have for educating people on this. I mean, it's amazing the work that you're doing. Is there anything we haven't talked about yet that you really want to make sure that everyone knows today. Well, I think that it's just important to take ownership of your health like the key here is is what I started up a 30 years ago. We knew this 30 years.

45:42In medicine. The current research on how how house research and medicine impacts and comes to be the standard of care in medicine shows that a study will have been presented 17 years earlier before it gets anywhere near standard of care in practice. Whether it's a drug so the drug that is now being preferred as the top preferred drug that your doctor wants to prescribe you was actually studied 17 years ago. That's cutting edge medicine. That's cutting edge 17 years is cutting edge in the world of AI that's just unacceptable right. I mean like we can we can do predictive modeling on AI and understand and we have the whole genit genome incorporate into databases. We can apply chemistry and science and physiology to predictive modeling with an AI model today and prove that this is really personalized that I know medicine.

46:47But but but we're not doing that yet. We're still on the 17 year old 17 year delay and maybe the system has some some impact on that maybe it's financial maybe there's. Insurance that you know who I don't know what what limits the system, but I do know that when you make yourself submitted to a system without taking ownership and like you know like the reins of control inside that system. Then you're you're going to have what the system gives us as a standard outcome right you're you're kind of the victim of vulnerability instead of being the empowered person inside a system who owns their health like and and truly like I said earlier. You live you're the one with the skin and the game you live with these outcomes. So you know I don't know what else can motivate that's what motivates me like I have to live with the cost of disease and the cost of

47:52relational stress that occurs if some if myself or my husband get dementia. I have to live with that. I have to pay for long term memory care out of my 401k for the rest of my life. If I just let the doctor tell me what to do. You know and I'm not saying doctors don't know what to do and I think that having an educated consultant i.e. a doctor to inform your health is an important piece. I wouldn't go try to like try to write my own contract for a business right I would consult a lawyer but that I also the one giving the input into that contract. Like this is what this contract needs to say is covering this is covering that is a cover me guess what I'm being empowered when I talk to my attorney about a business contract and that your health is so much more valuable than a business contract. So yeah enough knowledge to have an educated conversation with the consultant you're hiring i.e. your doctor is really important and that's kind of what the book tries to do give you the I mean I had to go around and like this is

48:54show you a picture of my anesthesia textbook. This is the this guy is the Bible. Okay so everyone does not have to read that you know very thick book because Sandra's done that stuff. This book is let's see 2200 plus pages long and then I've got over here you know internal medicine. Yeah this is internal medicine okay you want your consultant to have read that book. Yes right and then the whole the whole what I have another set of you know books that are about functional medicine environmental medicine what I've tried to do. Like me I've done so many books is not those books i've done other books but when I tried to do is simplify. Yeah it is relevant to the person so they can have an educated conversation you don't need to be an expert in anesthesia but you need to have enough understanding. And so so for every watching and listening Sandra's been in this for 30 years she's done all this research she's condensed it this is what I think is so wonderful about books like you produced you've condensed it into an easier read book with the relevant knowledge taken out based on research that someone can read and digest in a number of hours.

50:15So actually we'll have a link to your book as well. Yep and it is going out on audiobook for those people who always saw me that you know my brain I just needed on audio just it is there I keep it okay next week so I think it's very close they're they told me they were editing cleaning it up so. Absolutely reported and everything so but the goal is the book brings around I have a framework in a called harp which is holistic anesthesia recovery and preparation it also stands for it like the steps of what we do we take a health assessment assessor our environment we've resilience build and we post operative and prep and preoperatively prepare. So we have a framework in there that helps you kind of walk through okay what is the one a bees and seas that I need to do right now beautiful what does that look like and no it's not like you know go go do ice bath plunging and sitting us on you can don't give me wrong it's not it's not like pat your head and rub your tummy with you know special clay from the Amazon.

51:19It's like it's it's simple basic things you can do you know what I mean so that's the desire of my work is to bring the information to the public and then and power them and change the landscape of the health industry in the space by doing good research currently we're getting ready to publish the white paper on the results of the almost 3000 people who were participant in the neurologic stress recovery index in the first cohort. And that's basically just kind of summarizing what we found it's a convenient study I did it based off of my platforms right every month my platforms you know 250,000 people across my platforms kind of participated in that voluntarily which is great research to start a proof of concept next we're be we're building out perspective research which which we'll be looking at those of you who are wanting to participate anybody who's got surgery scheduled we're going to do it. We're going to be looking at you know what does your resilience look like before what does it look like after and what can you do in between so building that out as an app and providing resources through that it's going to be even better than what we've had to start with so I'm very excited about.

52:35Oh, that is exciting okay i've got one question for you and that is whether people are having surgery or not what's one thing someone could do today that's going to I always say shift your body into the healing state maybe for you it's like. Build resiliency which is to me the same thing anyway so what would you say is one tiny thing someone could do today right after listening to this. Some point before they go to bed tonight what would that great question and because of the brains fragmentation i'm talking about build resilience for surgery I typically get lean toward the circadian circadian balance focus so. Arboring is really fragmented our centers of circadian balance get really disoriented and surgery in that contributes in a large part to the hormone imbalance that occurs after surgery we talked about that's one thing I left off like inflammation immune hormone right skyrockets and you know there's a lot of so that's why I didn't see just a lot of stress but.

53:36But because hormone balance I mean it's not just course all that influences then you're downstream hormones right you're. As should interest australian all of it if you're if you're circadian balance is all so I tend to say look if nothing else make sure that you've oriented your body well with circadian balance what does that mean that means early morning light you're really getting outside and you're you're getting your. naked eye exposed to sunlight yeah bonus if you put your bare feet on the ground yes. And then throughout the day being cognizant of your blue light here are like me and doing podcasts and lots of research in your in front of the screen blue light blocking glasses or full spectrum light to balance it in your room things like that to help make sure that you're you're not. Being overexposed to blue light past say two and three in the evening blue light which is what we have the skies blue remember that is okay early in the morning that's designed to raise our course all and wake us up but later in the day the more affecting our sleep.

54:45So you know these that that one thing just checking your circadian balance getting outside getting sunlight early in the day and being conscious of your blue light. Effects your hormones your reorientation in your sleep and sleep is its own domain and the neurologic stress recovery and so I would say that's the one thing I would. Really prioritized and it's beautiful and it's simple yeah I love that okay amazing amazing. Body of work that you've shared with us in this short period of time today Sandra thank you so much for your passion in this for just really driving change in this and educating people that become the CEOs of their health. I just love your message of empowerment there's so much people can do themselves so thank you for all that work and for being a guest on the podcast today. Thanks so much for having me it's Mr. Joy and I like I can I can talk about this all day long I can tell I can tell we could talk for hours and to all the people watching listening look whether you've got surgery coming up or you've had surgery.

56:00What we've been talking about today can really help anyone so but especially if you've got surgery coming up really understand that there's so much that you can do or maybe you know someone that has it coming up so make sure you share the. This episode with them leave a comment let us know what you thought check out the quiz that Sandra Scott did so you can evaluate your resiliency and also her book this is amazing when 30 years of experience and all this research is shared in one book that's a tool for you it's available to you so why not take advantage of it yeah that's. Take it so yeah alright we'll see oh sorry go ahead and you can find more research I hope you don't mind if I share you find more research on my website where I thank you for my research yeah yeah the beyond brain health is my website all my all my handles are beyond brain health so you two okay you're on Instagram as well Facebook okay all right perfect and we we will have those links as well below so you don't have to like what does she say we've got the links in the description you want to see the.

57:09Preliminary white paper stuff it's all on the website if you're one of those people I think you know about every everything you can all the tools are there so you can. I'm excited for this research and actually when it comes out I'd love to have you back on the podcast again to talk about it yeah absolutely I love that beautiful okay everyone we'll see you again soon on the next episode of Wellless by Design. Thank you for listening to Wellless by Design for more information and any resources mentioned in today's episode be sure to visit the show notes and if you're ready to better understand your pain and begin creating a new path forward I'd love to share a free chapter of my book pain free on purpose use your mind to heal your body and get your life back. You can receive your free chapter at the wellness engineer dot com slash free chapter that's all one word that's the wellness engineer dot com slash free chapter.

58:10If this episode brought you hope or helped you see your health in a new way please subscribe leave a review or share it with someone who may need to hear it and remember you are not powerless every small step towards. Safety awareness and self trust can help create the conditions for healing. This podcast is for educational and informational purposes only and is not a substitute for personalized medical advice diagnosis or treatment please consult a qualified healthcare professional regarding your individual health needs. The views expressed by guests are their own and do not necessarily represent the views and opinions of the host or any of the companies they represent. It's fall in jeep country and during the drive into fall sales event get a great deal on four by fours that refuse to be contained like jeep rankler confidence built into every drive with the most awarded SUV ever jeep grand Cherokee and freedom that can't be denied with the open air freedom and jeep gladiator after 85 years it's no surprise that jeep became America's SUV brand get a great deal during the jeep drive into fall sales event jeep is one more awards over its lifetime than any other SUV brand.

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