Completed consult

Integrative Medicine

September 24, 2024 · 55 minutes

Dr. Jared D. Ament

Video visit

Concerns captured

Left-sided radicular leg pain (worse with sitting)
Sleep disruption averaging 5.5 hours/night
Anxiety related to upcoming surgery
Concern about pre-surgical nutrition and recovery time

Assessment

Alex presents 3 weeks ahead of a planned L5–S1 left microdiscectomy with Dr. Ament. Pain is well-localized and consistent with disc-mediated radiculopathy. ODI score 38 (moderate disability).

Labs show borderline-low vitamin D and ferritin, mildly elevated hs-CRP, and otherwise reassuring metabolic markers. Sleep and stress are the main modifiable inputs for surgical readiness.

Alex is a strong candidate for our four-pillar perioperative protocol with emphasis on Fuel (protein optimization, micronutrient repletion) and Mind (breathwork, sleep hygiene, pre-op visualization).

Labs

Vitamin D, 25-OH24 ng/mLLow

Ferritin28 ng/mLLow

hs-CRP3.2 mg/LHigh

HbA1c5.3 %<5.7

Magnesium2.0 mg/dL1.7–2.2

Hemoglobin13.8 g/dL12–16

Creatinine0.8 mg/dL0.6–1.1

Supplement protocol

Vitamin D3

5,000 IU

Morning with food

Sep 25 → Dec 15

Iron bisglycinate

25 mg

Evening, away from coffee

Sep 25 → Nov 15

Magnesium glycinate

300 mg

30 min before bed

Sep 25 → Ongoing

Operative Protein+

30 g

Daily, AM

Sep 25 → Oct 14

Omega-3 (EPA/DHA)

2 g

With dinner

Sep 25 → Oct 8 (hold pre-op)

Follow-up

Surgical clearance call with Dr. Ament on Oct 7. Post-op integrative follow-up scheduled for Oct 22.

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