Hay Bales
April 21st, 2009
A farmer’s wife came into my office for a breast reduction, shortly after I started my practice. We discussed the surgery, its benefits, and the possible complications. She had the surgery with a near perfect result upon examination at her appointment one week following surgery. She returned for another aftercare visit two weeks later complaining of pain, soreness and swelling. The examination verified this. It really surprised me since she was doing so well at one week. I asked her what she had been doing at home. She told me she and her husband had been bailing hay during the past week. She had spent the entire day lifting and throwing 100lb bales onto the trailerand in the barn! I told her that the resulting symptoms were because of this extreme activity. I strongly suggested she not do this again until her breasts were healed completely at six weeks after surgery. Thank goodness she did not have serious bleeding! and only minor complications.
Surgeons formulate after care instructions in an effort to reduce your risk of discomfort, complications and poor results. The instructions are not merely suggestions, but they are important guidelines that are based on experience, training and regional differences. None of us, except for my wife, are perfect. (I had to say that in the likelihood that she’ll be reading.) However, it is really important to be a perfectionist in this particular incidence when following aftercare instructions. Funny enough, to this day my aftercare instructions that I give patients specifically state you should not throw hay bails for six weeks after surgery! It usually raises a more than a few eyebrows.
Surgical Revisions
April 16th, 2009
There is a saying among surgeons, “If you don’t operate, you will not have complications.” The same can be said of surgical results. On occasion, the results of surgery do not go according to plan. All surgeons have surgical results which sometimes disappoint them. Occasionally the result requires secondary surgery to improve on the outcome.
The causes of less than optimum results are complex. Complications such as unwanted bleeding or infection may occur. Sometimes patients do not follow after care instructions as carefully as they could. Pre-existing medical conditions may also interfere with healing and scarring. The surgical design may just not work out for a particular patient. Generally, the final outcome is a combination of some or all of these. It really is a shared responsibility and must be remembered as such.
Revision surgery is difficult. Not only must the surgeon contend with previous surgical scarring but must also deal with changes in anatomy. Feelings of disappointment and possible mistrust by the patient are not to be over-looked. Expectations of perfection may present the burden of unrealistic results.
Results are rarely perfect. The decision to have revision surgery is usually based on the likelihood of possible improvement weighed against the risk of making things worse.
Finally, often small improvements are always the most difficult to achieve. I know this sounds counter intuitive, but I find that to be true.
Follow Us!
