Wrapup in 2014 - Six years post surgery

I've received many messages asking me for the current state of my arm. I'm happy to say (knock on wood) I consider the surgery a success. Was it a 100% success? Maybe for what I had done. I believe I have sensitive nerves for some reason. It doesn't seem to take much to cause my fingers to tingle. I can drive a car with my operated arm not flexed but straight and after a long while let go of the wheel and my fingers tingle, but that's not often. Most of the time the arm is great. I don't ever have the burning like I did previously that I can recall.

My right (un-operated arm for that procedure) arm is also quite a bit better than it used to be but every now and then I consider going in for surgery on that arm since it can still act up on occasion. IE my operated arm is definitely the better arm and I hardly ever notice anything with it.

The scar is never a concern of mine now but it was prior to surgery. It's really not visible where it is on the arm unless I hold my arms above my head to stretch but really, who cares :)  Would I do it again? Certainly.

Why did I have that weird recurrence a year after the surgery? No idea and thankfully that went away never to return. I wonder if there was some weird part of the healing process since they say nerves can take a year to heal - maybe that was the final plug-in wake-up recovery portion (although it surely didn't feel like it). That will remain a mystery. I don't weight lift like I used to so maybe that was a cause. I am very active though. I'm an avid mountain biker & runner at age 40 and like to hike big mtns and workout (cardio and light weights) to prepare for challenges like Tough Mudder. I mention this only to make the point the arms hold up pretty good for that, although sometimes the right un operated arm lets me know when I'm pushing it too much (which sometimes doesn't feel like much again prompting thoughts to get surgery but with a third child on the way and two toddlers the timing never seems right)- far far better than it used to be though.


Here's a quick pic of my arm (taken from hotel I'm staying at late night as I write this if you are wondering why I decided to have a shower in the pic). I have very bony elbows anyways, so that's not an effect from the surgery :)

Signing out now - best of luck! Adam

Another update

weird. ok.. so the HNPP test came back negative - which is the good news. Why my nerves seem to be sensitive at times? Not sure. My arms haven't been 'bad' lately (ie no flare up in a couple months now although I still feel it) knock on wood.
Left arm that I had the transposition on I've tried to especially sleep with it straight. I thought I was but my Wife every now and then wakes me up when she sees I'm sleeping with them bent.

Another interesting thing I noted - when we go surfing in cold water and then come out once I'm quite cold - my hands tingle like crazy. its so intense its such a weird feeling. It doesn't hurt.. just weird.. I know : )

HNPP?

Ok so my arm I had surgery on still acts up at times. It's better than the other hand but I do get weird twitches in it. After having surgery and being great for a year and then acting up again made me wonder what the heck is going on. I've seen several doctors and no one seemed to give me anything decent. My EMGs came back fine but something is definitely not OK. Finally I went to a neurologist a friend highly recommended. He said it's possible I have HNPP which I had never heard of. It basically means genetically I am more prone to pressure palsies. Since my arms aren't the only thing affected this does make sense, so we got a genetic test done. I'm awaiting the results.
This is defined as:


What is hereditary neuropathy with liability to pressure palsies?
Hereditary neuropathy with liability to pressure palsies is a disorder that affects peripheral nerves. These nerves connect the brain and spinal cord to muscles as well as sensory cells that detect touch, pain, and temperature. In people with this disorder, the peripheral nerves are unusually sensitive to pressure.
(from http://ghr.nlm.nih.gov/condition=hereditaryneuropathywithliabilitytopressurepalsies)

Hereditary neuropathy with liability to pressure palsies causes recurrent episodes of numbness, tingling, and/or loss of muscle function (palsy). An episode can last from several minutes to several months, but recovery is usually complete. Repeated incidents, however, can cause permanent muscle weakness or loss of sensation. This disorder is also associated with pain in the limbs, especially the hands.

Strange issue a year later

My left arm had been doing great.

In the last week both arms kicked into high gear.. including my left arm which has been on the rise for a year, now tingling is back.. bad sensations. pin prickles that pulse with my heartbeat at times. Also other areas are acting up too (legs) which leads me to wonder if something else isn't going on here to make my nerves (all of them) more sensitive... but the left operated arm feels worse than my other arm today for literally the first time since this all happened. I did a long drive recently.. but Im pretty sure I've done that before so this doesn't make sense. I have a blood test scheduled to see if there isn't something else going on (btw.. I had an emg recently that showed my operated left arm to be basically back to normal) so this is all weird.

10 months later all is well

am indeed doing quite well now. I've successfully beat up both arms this summer between software development and lots and lots of mountain biking. My right hand, still an issue (that arm I had the endoscopic procedure on) and my left hand (the arm with the transposition) has been doing great. Its not 100%, but prob 80-90%. I still have a weird feeling in it every now and then - like mild pressure in the hand, but no burning like before. Sometimes though I do wake up with the fingers tingling. It is rare and this didn't happen to me often before the surgery, but would surely take that over what I had before. That is rare though and probably if I sleep with the arm all curled up. So all in all looking back, recovery was a snap and now I dont even think about the arm much. The scar is slightly numb around ie.. well not numb but decreased sensation. That is normal though with any significant incision to the skin and I really don't notice/think about it unless I specifically touch the elbow and think about it. If you are about to get the surgery, its not bad. Besides sleeping discomfort the first few days it wasn't a huge deal. I just remember thinking 'wow.. wondering after all this time I finally had it done.. and now its all uphill from here' so keep that in mind : )

The incision is of course visible but the part along the formarm is hardly visible but the part near the bicep side of the arm is a little more visible. Not bad though at all. I may have the other side done this November or so.. we'll see : )

I did not have an emg yet on that arm but may have to get one just to see what the difference is and if there was a full nerve recovery in terms of conduction speed across the elbow.

Hopefully almost last doctors appointment

Had my roughly two month appointment last friday.
Grip strength:
Left 130, Right 150

I was told things are looking good (elbow still somewhat numb but at the same time hypersensitive to the prickly wheel they run down your arm and hands). That was from the incision itself I believe.

Its been pretty good lately.. definitely better than two weeks ago. I was told I can use it for most things now, just basically dont beat it up... IE no mountain biking yet. Doh.

So... next followup is end of february, hopefully I will get the OK then and I can fully test arm out with exercise and bike riding. Right arm has actually been pretty good lately as well. I've had almost no tingling in the left hand, even after taking both dogs for a long run the other day and a leash in both hands. I was told I can go skiing now too. WOOHOO!!!!

About 7 weeks post op

Grip strength: 100 left, 150 right

The last doctors appointment two and a half weeks ago I didn't post anything on. The doctor said my symptoms were not typical, and you would think that the surgery corrected the issue and shouldn't feel additional tingling when I do activities like type on the computer or lightly use my arm. He thought maybe it was just my body saying "you are doing too much" and to give it another month or two.

I spent the last two weeks in PA. When back there I didn't use my arm much. I used it on the computer with no problems. I did some painting with it back East utilizing the arm lightly and had no problems. I came back to CA and used the arm a little bit more and bam. Today my hand felt worse and fingers tingly again.

So.. 7 weeks and still tingling. This tingling is not what I felt before surgery.. it is worse.. err should I say different. I didn't really feel specific pins and needles, that was rare, more numbness, lack of sensation and an irritated feeling. So.. I have to be careful with the arm. I was going to try to get the other arm operated on quickly.. but its best to wait and see outcome.. although I feel confident (hopeful) this will resolve itself.

Almost a month post-op for ulnar nerve transposistion - Second follow up appointment

Monday Night -
still the same pains that developed Friday. They were gone in the Am but even when I use the arm a little bit they are back. I thoughts maybe it is hypersensitivity from the nerve 'waking up' but I wouldn't have thought i had that much damage to do that.. since at times I felt very minimal symptoms (although more severe at other times of course - warranting surgery).

Who knows...

The thickness under the scar is getting smaller. I wish my fingers would feel normal all the time though. It felt like it was getting like that a week ago but since last friday has been worse again. Weird.

I can sleep ok now though without really any discomfort from the surgery.

Unexpected Pain Today - Three Weeks + 2 days post-op for ulnar nerve transposistion - Second follow up appointment

Friday

At about 2 pm today at work started noticing arm feeling weird and getting worse. Within an hour or two I would hold out my hand and ring and pinky fingers were trembling and feeling tingly again. Its now 10 pm and I've been resting arm since work.. it still feels bad, like I took a step back about two weeks. It feels tighter again too. I can only think that I must have done something 'just right' and it caused it to swell - I've been using it a lot lately having to work late (without pain) and there was no single incident today that I can recall, although I was moving something in a room at work and remember noticing my forearm muscle was flexed.. so maybe I did work it a little too much... although I wasn't trying to 'push myself'.

A similar thing happened when I had in situ decompression performed on the other arm - I lifted something fairly soon after the surgery, and my hand got significantly worse and it actually swelled up Its hard to say if the swelling was from the surgery.. but it sure seemed like the day after the surgery it wasn't swollen, and two days later when I used the arm it swelled up.. which makes sense. You might be saying "duh.. dont push yourself" and I only used the arm because at the doctors office they said after surgery you can use it - your body will let you know if you shouldn't be doing something. So.. I guess it did. Even though the in situ felt so minor after the surgery - it really didn't seem that invasive.

So... Im taking ibuprofen probably at higher doses the next few days to help keep it down.

Three Weeks post-op for ulnar nerve transposistion - Second follow up appointment

Wednesday

Its been three weeks, wow.. it has gone by fast.
I can do almost anything with my arm barring lifting anything heavy...not that it would hurt.. but Im not going to find out. The arm doesn't really hurt during any daily activity from the surgery.. unless I rest my elbow right on the sensitive portion of the scar. Interestingly enough there is still one stitch in there that didn't dissolve. The scar right around the elbow has gotten a little more inflamed from rubbing scar cream in it.. seems like even though it was 'sealed' it may still be healing on the outside, so I've switch to scar cream and triple antibiotic cream.

My left hand hasn't hurt at all, although Im not using it for anything heavy so don't expect to tell a big difference for a while.

At night my arm still burns some.. but also interesting, not where the surgery was, but midway down starting about 5 inches above my wrist. It is sore when I put pressure on it and hope its not a minor clot. I cant think of another reason why the incision area itself wouldn't hurt much but that spot would as it is lower and out of the way of the work that was performed.

16 days post-op for ulnar nerve transposistion - Second follow up appointment

Friday

(ok.. these pics were the next day ... Saturday at a friends place I went over while he was brewing beer. He had a camera and my cell phone cam stinks and my camera is packed away somewhere from the last move)

Note the bruising is only up top.. none around the incision which I was very surprised at how it healed up so far. When I tap my finger above the part of the incision towards the bicep, I feel a tingle in my pinky and ring fingers. This is probably from the nerve still being sensitive and swelling/healing process going on.








I had the appointment to get the stitches out today. It turns out they were dissolving stitches and when the bandage was removed, there were no stitches. Its pretty amazing, there is basically no bruising at all around the incision. Its a little swollen, not too bad. Today I can reach my thumb back and touch my shoulder without any assistance from the other hand.

At the appointment I was told to still take it easy with the arm as it is healing still of course - but now I can use it to eat, lift things like a cup of water no problem. I asked if its ok to drive in two weeks - he had me squeeze his hand and said the strength seems pretty good so I could prob use it to drive now. Of course I was told if I do anything that hurts the arm - don't do it.

Tonight sitting at home my wrist started hurting after waking from a nap.. don't know why- but it hurt a decent amount so I took some ibuprofen.

My hand is slowly feeling less 'dull' (not from the nerve issue before surgery but after effects from the surgery)

The tip of my elbow is hypersensitive. When the prickly wheel was rolled across it.. it was pretty uncomfortable - which is weird because to the touch it feels pretty numb. The elbow is definitely swollen.. but it is a lot less than I thought it would be and am shocked there is basically no bruising except for the 'garbage' that is on the bicep area flowing towards the chest cavity from keeping the arm elevated (which I am no longer doing).

I was told today I can start putting cream on it. I used a little alcohol and q-tips to remove some of the pen lines after washing it twice. I purchased some scar cream with silicone and spf (it seems better creams have silicone in it to reduce scar formation). I had used ScarGard on a previous surgery but stopped quickly because it just flaked up and came off easily after applying it. I want to keep the area moisturized so the cream is pretty good for that rather than a brush-on dried up flaking scar treatment.

13 days post-op for ulnar nerve transposistion

Tuesday

I can't wait until tomorrow to type.. sooooooo I started typing a bit today.. now tonight I'm typing fully with both hands. I doesn't hurt at all and hand speed is pretty normal for typing. Then again laptop is in lap and only wrists are moving slightly... so I wouldn't expect it to hurt at all.

Fingers on left hand are still 'duller' than right hand.

The incision is getting more sensitive around the elbow. Even resting it on a pillow is sensitive. not as in "Im infected" sensitive but more as in "Im healing so Im extra sensitive"

The burning that I had I dont think I had this morning waking up.. if I did it was minor. Im able to bend my arm back and touch my hand to my shoulder now. I can't do it on my own.. but need to push gently when I do it. There is no pain though.

12 days post-op for ulnar nerve transposistion - more flexibility/new minor pains

Monday

Differences: Last night was first without pain meds. I could've not used them sooner.. but wanted to sleep. Sure enough.. my arm burned last nigh for some reason and it wasnt a good nights sleep. This only seems to happen at night before sleep or while I'm sleeping. When I lift up and then lay it down I get a burn in my hand for about 5 seconds. It didn't happen during the day at all though. Last night I was able to touch my thumb to my shoulder for the first time since surgery, so flexibility is coming back. I had to push gently and slowly on it with my other arm though. The bruse is slowly diffuing, no new garbage. Im typing with one finger on the surgery arm now so I can still keep it still and type with the right hand. It;s going pretty fast. I still have to force myself to not use it, as it feels good enough so my body goes to use it.. ie close a door, etc, but I stop myself. I've also not been keeping it up as much as I should during the day since Im running around work a lot, although I dont see additional swelling from it.. and when I stop I usually hold it up. When I eat I just rest it on the table.. so its at least not flowing 'down'.

My right arm is definitely acting up more from using it as the sole arm.


Here you can see there is still a lot of bruising. It is not painful though. Stitches come out Friday.. cant wait for that, although I think the bandage makes it a lot more pleasant to rest it on.

Ten days post-op for ulnar nerve transposistion - more flexibility/new minor pains

Saturday

Differences: Garbage on arm (brusing) is very visible still, purple lines, etc.... but I guess it is supposed to look like that as everything is supposed to flow like that. Last night my hand was tingling a bit. Today it felt better though. Each day a bit better - the fingers are moving faster and possibly less numbness. Something dangerous is occurring though - since my arm is feeling a lot better since the surgery (in terms of surgery caused pain/swelling/slowness in hand) I find I'm automatically almost using it in daily activites, opening the door, etc. I have to consciously make sure I don't use it, even though I feel I could to say..open a door. I can't use it for anything yet though according to the doctor. Tonight going to lift laptop on lap I suddenly put the other ghand on it and just started to use it to move it and caught myself and stopped. close call.

Today my middle finger started buzzing off and on. It feels like someone hooked up the smallest amount of voltage to the finger and it was clicking.

Now I am giving a little amount of force in stretching arm, I dont allow it to become painful though.. just enough to slowly trying to touch my thumb to the same side shoulder. If you try the same, slowly lift the arm away rather than fast.

Eight days post-op for ulnar nerve transposistion - more flexibility/new minor pains

Thanksgiving Thurdsay!
Great day - dinner with family at my Sister's and my Mom is in town too.
We ate so muchgood food today. yummy.

Lets get right to it with a more 'to the point' format. I'll prob change older posts at some point to reflect this too.

Differences: Last night my hand was burny/tingly when I went to sleep. I have not been using it, but it is not elevated all the time just most of the time. When I woke up my hand was burning. I thought maybe its some hypersensitivity fom everything healing, its hard to say though. Today my arm hurt in one specific spot in front of my elbow when I put my arm down. It has not done this before today. Also yesterday around the point of my elbow I would feel a minor sting, prob the incision healing, Overall the arm is becoming a little more mobile (ie flexible) each day. The arm is still stiff feeling. It is by no means very painful - it actually hasnt been at all - just annoying at times. The brusing under my arm is smoothing out and the whole area is a diffused yellow now with the purple lines essentially gone. However new 'garbage' as they call it (all those dark bruises/spots) has appeared more to the backside of the arm near the armpit. I gather its the stuff 'flowing' out of my arm. It's typical too see this after surgeries. When I had torn meniscus/acl repair done on my knee in 1999, the same thing appeared in my foot a bit after surgery.

I can bend my arm almost straight to about 105 degrees (ie slightly more bent than half way).
It is easier to hold your arm straight up, start slowly bending it over in front of your face and let gravity slowly pull it further. After a few seconds it will flex further as the arm gets used to it. I do not force it - I do give maybe an extra slight slight push (like one finger from the other hand hardly pushing)

Happy Turkey Day!

Six days post-op for ulnar nerve transposistion

Tuesday - almost a week.
Slept bad last night. Arm didn't hurt but shoulder was sore again only while sleeping (I am sleeping basically flat). Suddenly I'm wondering if all the iced green tea I was drinking is keeping me up at night.. hmmm.

Had my first post-op appointment today.

The bandage was changed. I still need to keep the arm elevated for one more week. doh. At work Im talking with people holding my arm up while sitting like Im in school and have a question.. I find it funny. Most of the time I'm not in my office so its about the buildings talking with others on projects.

Today the top of the arm near the armpit is definitely more sore. The bruising has been going away, but for some reason it is much more sore today in that region. When I raise my arm up it is sore. The doctor said it is good the bruising is showing up there, as that was is hoped for by elevating the arm. I was surprised at how clean the incision looked. ie not much scabbing, etc around it.. just the skin almost perfectly sealed together in a fine line. Sometimes sutures pull the skin up one one side more than the other. I have to give Dr. John Cook in Newport Beach credit here (besides being a cool doctor who will take the time to explain things in more detail if you want to know - he has also been more cautious with rushing to judgement I needed surgery until was has a solid case for it).

We did some minor strength tests - for ex. I hold my fingers together and he tries to get them apart. I was instructed though not to use the arm for really anything yet.. not even flossing - although I can't reach that close to my mouth with that arm yet, so I'm to keep working at increasing range of motion. It seems I may be losing a little size in the arm already even with the swelling.. the definition isn't the same in some spots.. my Wife disagrees though.

I asked if during surgery the problem was identified. He said the nerve appeared to be thickened at one spot of compression . This can happen from aggravation of the nerve.

That being said.. here is an interesting abstract from a study
http://www.neurology.org/cgi/content/abstract/63/9/1675

"Conclusion: More pronounced ulnar nerve thickening at the time of the diagnosis is associated with poor outcome at follow-up, especially in conservatively treated cases, while "electrodiagnostic signs of demyelination on testing indicate favorable outcome"

and... in my case conservative treatment didn't work.

Why didn't my "in situ" procedure work? The doctor explained a possible case - in the "in situ decompression" procedure the tunnel itself is opened up. Think of your nerve going through a hose. If the nerve gets too big for the 'hose' it will have pressure on it. The tunnel is cut open to release that pressure. If the cause is not the tunnel being too tight and the nerve is being pressed on my other structures (muscle) then in situ decompression doesn't seem to be the right choice to resolve it. Unfortunately it doesn't seem there is a check ahead of time to determine which is the choice to use.. although in my case nothing was lost by trying in situ, I feel zero effects from that procedure and have just a small Z shaped scar on my elbow from it.

The doc also didn't feel numbness in hand was a big deal.. since it is on the whole hand and seems to be pretty minor, prob because of swelling. He did the roller point test which is a wheel with spikes on it they roll across fingers to check if you feel the same sesitivity in each finger/hand. It was pretty close between left and right.. but not as 'sharp' feeling on the surgery arm (even close to the incision it felt more like a long scratch than individual points).

Here are pics today after bandage was removed before the smaller one was put on.

A lot of the yellow is brusing, but also a lot is from the ointment they use before surgery.

It looks all like there are raised lines because the bandage was just on pretty tight.

The new bandage is now much smaller and easier to move.

Five days post-op for ulnar nerve transposistion

Monday

First day back at work. I was trying to use my arm without putting pressure on it to tie my shoes - not successful as it became untied three times today.. so I pulled my move from when I was a youngster and didn't know how to tie my shoe - I tucked it in : )

I didn't have it up as much as I could as I was running around a lot at work today. It was about a 10 hour day there .. a lot of the time I tried to hold my arm up.. other times I didn't and let it down and get more circulation as I moved it. I can move it almost 90 degrees today. The bruise is yellowing a lot more. Working didn't seem to have a terrible effect on it.... but still wish I could've rested it today more... at least I flexed it a lot as I was walking around. I want to keep my elbow as extended as reasonably possible (it doesnt hurt when I try..just feels tight and Im not going to force it straight until it is more healed unless doc tells me otherwise)

Last night I woke up a lot again... definitely from having my arm on the side on a pillow. When I put the pillow slightly on me and had my hand lying on me it was a bit better. For a bit I let it just lay directly on me and that felt much better.. cant wait - two more nights until I dont have to keep it elevated.

My hand still has a lack of sensation in all fingers. I can only attribute this to trauma/swlelling. I would think if it was only the ulnar nerve being affected then only the pinky and ring fingers would feel that way - but the whole hand does.

Also if I put my hand straight above my head I feel a slight pain right at the start of the armpit. I felt this in the 'in situ' procedure but that was because my nerve was blocked by injecting it several times and as such hurt a lot. For this procedure it is just sensitive.

My right arm is acting up some because it is now the only arm being used.

No twitching/flexing spontaneously is happening anymore.

Four days post-op for ulnar nerve transposistion

Sunday


Bruise is starting to yellow (disperse)




this does not hurt:



So - not too much different than yesterday - bruise is slightly dispersing.
The one thing different - I had a bad nights sleep (I did take pain meds last night). Worst night of sleep yet. I will say though part of it was because the dog was on the bed and he was healing from surgery so when I heard him move I woke up - fearing he was getting to his incision which was sutered and then glued on top of it. He wont wear a cone - he freezes and trembles.. so he's still getting used to it, meanwhile we keep it off most of the time.

Anyways... my shoulder and elbow burned during the night it was quite uncomfortable. I'm certain it's because of how elevated it is, as during the day I don't have that issue and the arm is moved around.

Three days post-op for ulnar nerve transposistion

Saturday

Notice the jellyfish sting looking marks - ie significant bruising (I'm not one that usually bruises easily)


Notice they stop at the bandage from the pressure - weird.





I'm half way to not having to keep arm elevated all the time....woohoo! The bandage isnt changed until a week after. I can flex the arm a little easier today, being careful not to force the arm. Im twisting wrist, moving up and down/left/right, and moving figers ok.

What does the arm feel like today?
Fingers still feel fat and feel slightly numb.
I won't describe the arm as usually pain, more of a burn and thats when I move it or hold it up as I move - like if you held your arm straight out and held a book, the burn you would feel in your arm is similiar. Every now and then there is pain, I can tell the incision area is a little sore but the bandage is so big. The actual pain though is not bad. I take meds only at night now just so I sleep better. When I had the 'in situ' procedure on the right arm that much smaller incision was sore for some time so I fully expect that to be worse since this incision is about 6-7 times longer.

Today it was slightly itchy, but not directly in the incision area.. at least itching just in the bandage works.

The bruising is really out today..in a way I've never had before after injury/sugery. It looks like I was stung by a jellyfish near my armpit, red/purple odd shaped lines - but it is not sore to the touch there like it was the day after the surgery. Intrestingly enough if I pull the bandage back a little there is _no_ bruising there - it seems the pressure from the bandage stopped it right on a straight line. I had a couple 'cramps' in my index finger.. they werent painful but the finger just flexed and tensed up for a few seconds.
The hand this am felt cool again, my Wife came back today and felt my hand and thought the same thing, although not too much different than thw right to cause concern and there was no lack of color or blueness either. Later in the day it was the same temp as my right arm.

We babysat my Niece and Nephews tonight (1,2, 5 yrs old) and their dog. So with my surgery and my dog being there... we were always on the lookout from their dog wanting to say hi.. and the kids playing around. I assumed the recently usual position on the couch with the arm propped up above heart level on two big pillows.

I had to drive shortly today although I dont recommend it yet if possible. There was an accidental alarm triggering at work and no one else was available so I put a pillow on the armrest, set my foot up on the paperholder in the door and was good to go (work was only about 10 minutes away and it was a saturday night). It wasnt bad driving like this..but for safetys sake you only have one hand so avoid as long as possible.

Eating right while recovering

Just a quick note on this. Since protein is absolutely essential for muscle growth/repair its important to eat a lot of protein during the healing process. Just like if you are physically active you need a lot of protein, now with cut skin and a cut muscle your body needs protein to repair everything as best it can. I'm eating a lot of tuna and drinking a lot of green tea (buy an iced tea maker - they rock). There is an asian food market nearby that has green tea w/ roasted brown rice which gives it a very unique and tasty flavor. Drink lots of liquids too.

Insert blurb about eating your vegetables here, using whatever nagging voice from your childhood that fits : )


Here is more info:

http://www.thedietchannel.com/Post-Surgical-Nutrition-Speed-Your-Healing-With-A-Good-Diet-and-Supplement-Plan.htm


Now to play devil's advocate here is an interesting study on rats and having them heal under malnutrition doesn't seem to affect the healing process. These are rats, not people though. Does the same hold true? Why risk finding out, it only makes sense to be healthy while healing.

http://cat.inist.fr/?aModele=afficheN&cpsidt=3677619