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Contemporary Approaches to Postoperative Pain Mana ...
Video 1: Patient Expectations
Video 1: Patient Expectations
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Video Transcription
You just finished your mastopexy with a little reduction and you were awake. Did that bother you a lot? Absolutely not. Stung a wee bit from time to time? Just a tiny little, like little pinches every once in a while. So overall it was worth being awake? Totally. Good. So let's talk now about how to look after pain after surgery. So right at this moment are you feeling any pain at all? Not at all. Not at all. Okay, good. The important thing is that you shouldn't do anything until you know what hurts. So right now you have no idea what hurts. So we just want you to be a princess, nice and quiet. When you get home you're just going to sit there, not move your arms around too much, because right now it's all numb from the freezing, so you can't feel anything and you don't know what hurts. When you get home and it starts to sting, you go ahead and take 800 mg of Advil. It's twice as much as what the bottle says, but you're only going to do it for a few doses. If you did it six times a day for a whole week, you might burn a hole in your stomach or have trouble with your kidneys. But just a few doses is not going to bother you. And you can take it every four or five hours as you need it. And if 800 of Advil is not enough, you can add one gram of Tylenol half an hour after, because it works in a different way. So you can take both drugs at the same time. And between 800 of Advil and a gram of Tylenol, all of the breast reductions and mastopexies that I've been doing for years are just fine. So you're going to be fine with that. Sounds very good. There's no nausea with that, and there's no narcotics with that, and it's just a better way. What about constipation? Zero with these drugs. If I gave you narcotics, you'd have trouble with constipation. Sometimes you can't pee. But these are not going to get that to you. So when you get home, you're still not going to move if you're on Advil, because you don't know what hurts when you're on Advil or Tylenol. So the sting of the cut is going to be gone in a day or two, maybe three. And then you're going to get into the second kind of hurt or sting, and that's the pain of, gee, doctor, if I sit here quite like this, it doesn't hurt at all. It only hurts now if I do stuff or bend over. That's when you quit taking Advil and Tylenol and don't do stuff and bend over if it hurts. We didn't spend two billion years evolving pain because it's bad for us. It's nature's only way for your body to say to you, hey, would you quit that? I'm trying to heal her, and you're screwing it up. Stop that. And that's a little voice in your head that you can't hear with Advil or Tylenol in your ears. So you're a princess until you're off all drugs, and then you listen to your pain. It's called pain-guided healing. And if you follow pain-guided healing, what you're going to find is, like most every other of my patients, you're doing most things by a week or two. You'll be kind of amazed, like you're not going to do much for the first three or four days because you're going to be on painkillers. But after that, you're going to be just fine. So we're going to see you here again tomorrow. And does all that make sense to you? Totally. So we're eight days after breast reduction surgery. Yeah. And how are you feeling? I'm feeling great. Great. So we talked about pain-guided healing. We did. And I talked to you about quit taking Advil when it doesn't hurt anymore. Mm-hmm. And so how long did you take it? We did your surgery eight days ago. Yep. So I took it again. I took it once before bed that night. Tuesday night. Yep. Late in the morning the next day. On Wednesday. On Wednesday. And that's when you came here so we could have a look at you. Right. We asked you to do that. That's right. And what did you take? You took Advil? I took 800 of Advil. Right. And the recommended amount for the Tylenol. Tylenol. Which would have been 600 or something like that. And it worked for you? It worked perfect. You didn't think, oh, man, I need more than that? Absolutely not. Which makes you normal. That makes you the same as everybody I've been doing for years. Yep. And I didn't actually have to take any until the next day. Next morning. Right. So you took some on Thursday? So Wednesday and then Thursday morning again. Right. And then I never took any Advil again after that. Right. No? So one on Wednesday morning, one on Thursday morning, and some on Tuesday night. Yep. And then you followed pain guided healing. Yep. Right? Yep. So you were a princess. We asked you to be a princess. As much as I possibly could for sure. Right. For a couple of days. For a few days until Friday. And I didn't really do hardly anything until Saturday.
Video Summary
A patient who underwent an awake mastopexy with slight reduction reports minimal discomfort, describing occasional pinches. Post-surgery, she experiences no immediate pain and follows a "pain-guided healing" approach advised by her doctor. This involves taking 800 mg of Advil and possibly Tylenol for pain, cautioning against overuse to avoid side effects. The method discourages unnecessary movement until pain naturally subsides, negating the need for narcotics. The patient took minimal Advil and quickly resumed normal activities within days, confirming the effectiveness of this approach for recovery.
Keywords
awake mastopexy
pain-guided healing
Advil
post-surgery recovery
non-narcotic approach
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