Nutrition has been an interest of mine for many years. As an athlete in high school and college, I was looking for ways to improve my performance so I got into things like creatine, HMB and protein supplementation when they were a bit eccentric.
I was with that background as I went in practice I noticed that there was a gap between surgery and nutritional recovery. There is substantial evidence demonstrating that protein supplementation and specific simple vitamins improve various outcome parameters. So it was an opportunity for me to really just take those interests to help provide my patients a better experience and outcome.
I began providing vitamin recommendations to my patients. I saw they were seeking that input and appreciated it and then it morphed into adding protein. Eventually we formed our own company Complete Surgical Nutrition around the idea of trying to provide patients with an opportunity to optimize their nutrition in a simple to take form. Increasingly patients want to get back to life quicker and more reliably. At the same time, we as surgeons obviously have an interest in trying to reduce complications, decrease length of stay, and increase speed recovery as well. It’s really a win-win opportunity for patients and docs.
People ask me how we went from “idea” to “actual product?” I think that is just about not being afraid to take the first step, breaking down the parts, and being consistent in effort. I floated the idea to other thought leaders in orthopedics and the feedback was positive. From there it was just effort. A little bit every day adds up to a lot over progress over a year.
Our first product is a 4 week surgical kit that includes a carbohydrate drink to take prior to surgery and a daily protein, high in amino acids and vitamins with evidence in recovery. Patients received information in their surgical packet with QR code linking to the website. From there they review the evidence and decide if they want to order it and it’s shipped directly to them. Little to no effort is required for the physician which is important in our busy practices.
As to the timing on when to start protein around surgery, the studies vary. There are studies that suggest loading a couple of weeks prior to an stressful event and taking it for a couple of weeks after. There are also studies showing that just starting immediately after surgery and taking for 4 weeks afterwards is beneficial. Ideally, we recommend 1-2 weeks of loading in advance and for a minimum of 2 to 3 weeks after surgery. But some data event suggests out to 3 months after surgery is still beneficial.
The patient feedback thus far has been very positive. We haven’t quantified outcomes in the shoulder yet but there’s quite a lot of evidence that has demonstrated that in randomized control trials in other areas. What is clear is that there is no downside and patients are asking for this. When you have a patient buying into their recovery and potentially getting better quicker, that is a win.