GDD and Surgery. Recommendations.

I generally recommend people wait till they have had at least 5 and maybe 10 chelations before undergoing surgery, This is so that enough Gd has been removed that not that much is left behind that can move to sites of surgery. For a number of reasons, principally that Gd moves to regions of increased blood flow, which surgery causes through the healing phase, and the attendant granulation tissue (early fibrosis tissue) and subsequent progression to fibrosis, creates a milieu that Gd will be mobilized to, and retained in.

In the setting where GDD is very mild and you have had only 1 GBCA administration, waiting till after surgery and starting chelation soon after that, also makes sense. Start relatively soon, at 1-2 months post surgery- so, Gd that has moved to the granulation tissue developed at surgical sites, can be removable. Gd imbedded in vascular loosely structured granulation tissue can be readily removed, unless Gd in mature scar, which is more tightly bound.

In general terms, surgery, as well as other interventional or aggressive procedures, should wait till at least 5 chelations, when feasible. Cancer surgery may not be able to wait that long, and maybe only 1 chelation can be performed prior to surgery. Firstly so there is less Gd in the body that can re-equilibrate to sites of surgery, which may then become more symptomatic. Secondly, because surgery may be planned for something which actually is GDD, and waiting for a sufficient number of chelations will allow the ability to determine if the finding where surgery is intended for is actually GDD, and hence should not be operated on (for most things), or not related to GDD and hence surgery may still be indicated.

Richard Semelka, MD