In Episode 1 of the Sokolov MD Podcast, plastic and reconstructive surgeon Rebecca Knackstedt, MD PhD, explains how prehabilitation improves surgical outcomes. We discuss protein dosing, immunonutrition, GLP-1 agonists, exercise, microbiome health, stress, and practical perioperative protocols to optimize recovery before surgery.

0:00:00 Intro
0:02:46 How Rebecca Developed Her Perioperative Care Framework. Clinical experience, evidence, and real-world patient management
0:05:06 What Is Prehabilitation? Definition, scope, and why it matters
0:06:27 Which Surgical Outcomes Can Prehabilitation Improve?
0:08:01 NUTRITION as the Foundation of Prehabilitation
0:08:27 Protein Intake Before Surgery: RDA vs optimal dosing and kidney injury concerns
0:16:28 Collagen Supplementation: Low-quality protein, clinical utility, or both?
0:20:14 GLP-1 and GIP Agonists in the Preoperative Setting
0:27:16 Recovery Drinks: Evidence-based support or marketing hype?
0:31:40 EXERCISE Prescription in Prehabilitation
0:34:43 “Banking Early”: Building physiological reserve before surgical stress
0:36:27 SUPPLEMENTS in Prehabilitation: What helps, what doesn’t, and what lacks evidence
0:45:13 Probiotics: Oral vs topical use in the perioperative period
0:51:59 Optimizing Wound Healing
0:55:05 STRESS MANAGEMENT with Prehabilitation. Optimizing the Hospital Environment
1:00:36 Can Patients Meaningfully Change Habits Before Surgery?
1:03:37 Prehabilitation Protocols: From “sprint” to comprehensive programs. Surgery as a Powerful Motivator for Behavior Change
1:09:14 Rapid-Fire Questions
1:10:57 The Single Most Important Thing to Do Before Surgery
1:11:44 Closing Thoughts
1:13:10 Medical Disclaimer