Apparently, nine out of ten people are unhappy with their scars at 12 months post-surgery. Scars undoubtedly give us mixed feelings – they’re a new body artefact we have to come to terms with. Every scar will be different. And our relationship with our scar will be unique. Some of us will be lucky and will heal well; others won’t. Some will have a relatively minor scar; others a huge, loud thing. Some won’t really care; others will be very self-conscious.
The first piece of advice I can give you is to accept your scar and accept the feelings you have about it. (See how I felt about this issue in On scars)
But is there anything practical you can do to help with healing and promote a better result? The answer is yes. Firstly, how you heal is going to depend on your age, health, ethnicity and so on. But understanding the healing mechanism can help with the outcome. Your body is going to have to make new skin and new tissue, and mend itself. To do this it needs nutritional building blocks, which can be a challenge for those of us recovering from colon cancer as we probably haven’t been eating well for some time, or might be severely anaemic. It’s also hard for us in the colon club to stick to an ordinary recovery diet, because our colons are recovering.
You need to be prepared to experiment with food and discover what your body can handle – don’t push it too hard as there’s nothing worse that overdoing it and causing problems such as constipation or diarrhoea. Also don’t rule out a food simply because it causes diarrhoea today. Reduce the amount of it you eat in one sitting, or avoid it for now and come back to it in a few weeks.
Remember that unresolved anaemia will generally make it harder to heal. So if you’re on iron tablets or advice to help with anaemia then keep on with it, don’t give up. Remember to get your iron levels checked by your GP to ensure you are getting back to normal.
That said, here’s a combination of simple advice that I was given, along with my experience. If in doubt, always ask your GP or colorectal team to see a dietician – especially if your stools don’t return to normal, you’re having difficulty eating, or you continue to lack energy.
- Keep the scar clean and dry. Don’t fuss with it in the early stages – leave it alone but keep an eye on it. Too much washing, creams and potions can actually interfere with healing. Again, we’re all different, but many people fuss too much with their scar before it is properly healed because they’re fearful of infection. This can delay healing and make scarring worse. Moderation in all things! If you must clean your wound then a quick zap in the shower is all you need – do not immerse the scar in water until it is properly healed as you will soften the wound and risk opening it up again.
- Wear clean, loose fitting clothing – preferably something like cotton. The last thing you want is to chafe, open up the wound or irritate the scar. If you had an open procedure this can be a challenge because your wound is going to be exactly where your zip would be on your trousers. I got around this by either wearing dresses or loose, soft leggings. Be aware of fastening and zips, rough fabrics and avoid anything that fits too tightly. If you want to heal better, let your body do its job and don’t make its job harder! Get naked if you can bear it (bare it!) and get plenty of fresh air around your scar.
- Get plenty of good quality protein. You need this because collagen is what helps knit your wound back together. You will probably need 2-3 times the normal amount of protein initially – think like a body builder. This means eating things like chicken, fish, eggs and beans. If you’re having problem with solids or digesting these type of foods, try mixing whey protein mix with soy or almond milk and make a smoothie.
- Get enough vitamins. Start eating vitamin rich foods such as berries, avocados, carrots, sweet potatoes, dark green vegetables, bell peppers, cabbage, cauliflower and so on. These will provide you with a mixture of vitamins you need to heal. eg anthocyanidins, which improve capillary integrity and stabilize collagen; beta carotene, which your body converts to Vitamin A and is essential for repairing tissue; vitamins C and E, also essential for wound healing. If you’re having trouble getting enough fruit and vegetables in your diet talk to your doctor about supplementation.
- Get enough minerals. You need zinc to heal and boost your immune system, so ensure you include zinc-rich foods such as nuts and seeds and red meat.
- Pineapple and Papaya are extra good for reducing swelling and inflammation.
- Gently massage your scar with a moisturising cream. My surgeon and colorectal team tell me that their patients have lots of different favourite creams for this – coconut oil, vitamin E creams, and various brand name creams. I was told that what matters most is to regularly and gently massage the scar once it has healed to help stop it going hard. I used coconut oil because it also has antibacterial properties and it worked really well.
- Keep an eye out for infections. If your wound isn’t closed in a week or so then that’s not normal. Any sign of reddening, heat, smells, pus. dampness or pain and get yourself to a doctor to get it checked out.
One hint is to use home-made smoothies to get the nutrition you need. Use soy or almond milk and add berries, bananas, and so on. Try small amounts to begin with and add more as your colon adjusts.
And remember, if after six months to a year you’re unhappy about your scar then go back and talk to your GP. There are things they can prescribe or offer. They can also help you understand whether the way you see your scar is objective, because sometimes we see things as worse than others. Or it could be that the scar has become a focus for a touch of cancer depression. This, by the way, is also entirely normal and your GP can help you with this as well. Find out more about how I coped with my feelings after surgery in my next post.
Anything I’ve forgotten? Any hints and tips of your own to aid wound healing and reduce scarring?