June 11, 2025 • 31 mins
What REALLY Happens Before, During, and After Surgery? The Truth Behind a Smooth Perioperative Experience
The last two jawdropping episodes you heard the OR horror stories—now let’s talk about how it’s supposed to go. In this no-holds-barred episode of Plastic Surgery Uncensored, I’m joined by our very own nurse practitioner, Paula, for a deep dive into what the ideal surgical journey should actually look like—from the night before your procedure to your ride home. Ever wonder what questions you should be asking before surgery? Or why your surgeon is obsessed with your fish oil, your edibles, or that last-minute nose ring? We cover it all—clearances, labs, anesthesia prep, what to expect in recovery, and why showing up in skinny jeans is a rookie mistake.
We also reveal the red flags you should never ignore—like meeting your surgeon for the first time the morning of your operation (yes, that really happens).
Whether you’re planning surgery or supporting someone who is, this episode is your ultimate guide to knowing what’s normal, what’s not, and how to avoid becoming a cautionary tale.
🎧 Listen now—then share it with that friend who just found a great deal on TikTok. Don’t forget to leave us a review and send this episode to someone you care about—because when it comes to surgery, what you don’t know can hurt you.
The last two jawdropping episodes you heard the OR horror stories—now let’s talk about how it’s supposed to go. In this no-holds-barred episode of Plastic Surgery Uncensored, I’m joined by our very own nurse practitioner, Paula, for a deep dive into what the ideal surgical journey should actually look like—from the night before your procedure to your ride home. Ever wonder what questions you should be asking before surgery? Or why your surgeon is obsessed with your fish oil, your edibles, or that last-minute nose ring? We cover it all—clearances, labs, anesthesia prep, what to expect in recovery, and why showing up in skinny jeans is a rookie mistake.
We also reveal the red flags you should never ignore—like meeting your surgeon for the first time the morning of your operation (yes, that really happens).
Whether you’re planning surgery or supporting someone who is, this episode is your ultimate guide to knowing what’s normal, what’s not, and how to avoid becoming a cautionary tale.
🎧 Listen now—then share it with that friend who just found a great deal on TikTok. Don’t forget to leave us a review and send this episode to someone you care about—because when it comes to surgery, what you don’t know can hurt you.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:06):
All right, welcome to another episode of Plastic Surgery and Censored.
I'm your host, doctor Roddy Rabon, and we are honored
to have Paula, our nurse Practier, on with us today.
Is a big honor because Paula doesn't like to be
on these shows and do these things, but we've dragged
her on and she's agreed to participate. We've done a
two part series which you must listen to, which was
(00:29):
about oh ur nightmarage and things that were just jaw
dropping and you definitely want to check those out. And
we thought how appropriate if we then have another episode
which then follows with what things should be like? So
basically the two part episode is what goes completely wrong
and what it shouldn't look like. And today we're going
to have an episode about the Perry operative experience. What
(00:53):
do I mean what you should expect immediately before your surgery,
the day of your surgery, and then immediately after your surgery,
In other words, how should it go? What would be
the perfect uh, you know, perfect experience, and what should
I expect? And then that way, as you're going through
the process, you have cused that wait, wait, this this
(01:15):
is this doesn't sound right, this is not what they
told me. And because unfortunately, as patients having your first surgery,
for many of you, you may not know that something
is off because you're like, how do I know that
they were supposed to check my pregnancy test? How do
I know that you know? And so on and so forth.
So welcome again, Paula. You know, very nice of you
to join us. All right, So the success of your
(01:39):
surgery begins before your surgery. So as you had said
in your previous experiences, many times you would come to
the day of surgery. You weren't on the clinic side.
We're on the clinic side. By clinic, we're referring to
the doctor his staff getting you ready for surgery. Many
times Paula would show up the day of surgery at
the op room and the patients were clueless, had no instructions,
(02:04):
knew nothing about their surgeries. Frankly, were like deer in
her headlight regarding what's about to happen. That right there
is a catastrophe. You're automatically going to have a bad experience,
so with me and has been for twenty years, and
now Paula is now part of that and is experienced
it on the operating room side, because she was the
beneficiary of all the work we did on the clinic side,
(02:25):
but now is involved in the clinic side. There is
a pre op in which we prepare you for surgery.
It's a whole own visit. So a lot of doctors
flow through the fly through the pre op. It's something
they do on the phone, or maybe they send you
a couple of emails. We make an entire visit associated
(02:46):
with the pre op. And the pre op is critical
because two things happen. One, it allows us to give
you every piece of information that you need in order
to be successful. And two, it gives you yet another
opportunity unity to ask every question you need to ask,
because well, shit, I saw the doctor a year ago.
Oh I don't remember what he said. Oh I've seen
(03:09):
five other people since then, and I want to ask it.
So we go out of our way to have a
second appointment. So, Paula, what are some of the things
that are really important that we discussed with patients in
the pre op that need to be discussed in order
for them to do well and not have a complication.
So let's go through some of our pre op requirements.
Speaker 2 (03:31):
So, first and foremost, you always do a very thorough
like history and physical on the patient. So if they
need any blood work, if they need any clearances from
certain doctors that they see, if they need a mammogram, anything.
Speaker 1 (03:44):
Like that, great. So I'm going to highlight those as
you go through it. So one thing we do, what
I've done for twenty years, is you come in, Hey,
doctor Rbon, I'm interested in having a mommy makeerk. Great,
tell me about your medications, blah blah blah, tell me
about your medical problems blah blah blah. Oh, yes, I
had history of a supervnenticular tachycardia, and I had a
cardiologist and the cardiologist did electrophysiology and they you know,
(04:08):
they zapped my A Barrent heart pathway and I'm good, Okay, great.
So when in if you decide to do your mommy makeover,
you need a cardiology clearance. Oh but my cardiologists you know,
I haven't seen him in a few years. He says,
I'm good. Great. When and if you have your mommy makeover,
you need a cardiology clearance. So I am psycho about
(04:30):
getting specialty clearances from people who have taken care of
you for your problems. You can have successful surgery with
almost any medical condition as long as that medical condition
is well controlled. I have done surgery on patients who
have had pulmonary emboli pulmonary ambuli, which is like one
(04:51):
of the worst complications you can have, and I've successfully
done surgery because I was side by side with their
hematologists and we had a plan and we executed it.
So absolutely, if you have any medical conditions, we're going
to expect you to get a clearance. If you are
older and you're having a surgery, we're going to ask
you to get a regular clearance by your general doctor,
(05:13):
which includes your EKG and your chesticks ray. You said mammogram.
Every patient, every patient who is over thirty five used
to be forty, gets a mamogram within six months. What
if I just had a mamogram it was nine months ago.
You need another mamogram. I just had it. You need
(05:36):
another mamogram. I have a story for you that I'll
tell you. I was taking care of a doctor, worst
patients in the world. I was taking care of a doctor.
She had her mammogram seven months prior to her rest surgery.
So we have a protocol. Protocol means you stick to
your protocol. NASA doesn't like the day of a launch'd
be like, well, it's close close enough. It's like, no,
(05:58):
it's not what we said six months prior. You need
a mammogram. So she had it seven months We told
her she needs another mammogram. She threw a cow, wrote emails,
was nasty to the staff. This is an abuse of use,
a waste of resources and money, and YadA, YadA, YadA.
And I was like, listen, I don't know what to
tell you. I can't help you. She finally did it, begrudgingly,
(06:20):
and what do you know, they found a mass. Now
it turned out that the mass was benign, but they
had to work it up. And she was so apologetic,
as she should have been, because she's like, wow, I'm
so sorry, because you know, at seven months it was clear.
I go, I don't. That's exactly the point. It can
change over time. So mammogram labs, what kind of labs
(06:42):
do we get?
Speaker 2 (06:44):
I mean depends how all the patient is and everything
like that, but basic globs, even if you're a twenty
five year old going in for just a straightforward like
breastog or like a RHINOPLASTU just your basic glob work
just to make sure everything's normal. Your blood cloth's out
of normal, right, things like of that.
Speaker 1 (06:59):
So we take a base panel because we're assuming you're healthy.
If you have other medical problems, then we will defer
to that expert to get those additional labs. But as
far as we're concerned, high nice to mutual, we're healthy.
I need these basic labs. Right. What else do we
ask patients to do before surgery? Smoking? Drinking? Right? But
(07:20):
what does that have to do with anything? Smoking is massive?
Any smoking, smoking, hookah, smoking pots, smoking cigarettes? Why because
it affects your lungs and then when we intubate you,
you're at a higher risk of having pneumonia after surgery.
Stop that shit. And smoking in particular has an impact
on blood supply. And you can lose a nipple, what,
(07:43):
lose a belly button? What? You can lose the skin
flap on a facelift? What? Yes, smoking does that? So
we don't want you smoking? Right?
Speaker 2 (07:52):
What else important to always if you want to talk
about like ozombic mendaros?
Speaker 1 (07:58):
So now it is huge semi glue tides. So what's
the issue with semi glue tides? So we I think
the national requirement national. But I think what's generally required
is for you to be off of a semi glue
tide like an o zempg Manjaro kind of thing, for
two weeks. We here in our practice require a month.
(08:19):
And this is why. So what's the issue with the drug.
The drug works in many ways, and one of the
ways that drug works is by slowing down your stomach,
and therefore you eat and you're not hungry because you
haven't cleared the food out, and so it kind of
just lingers and keeps you satiated. The problem with that
(08:39):
is that when you have surgery and you're under anesthesia,
if your stomach is full and you vomit while you're asleep,
you will aspirate that goes into your lungs and you
will die. And there are people who have died since
the introduction of these drugs from ards or lung issues.
(08:59):
And so we want you off. The reason we want
you off at a month instead of two weeks is
because there are still people at two weeks where their
gut motility is still affected. We want to make sure
that's off. The other thing we want you to do
is we want you to be close to your weight.
If you've got a few more weeks, do not gain
weight before your surgery. But I'm having a rhinoplase, then
(09:20):
I don't care if you're five hundred pounds. But if
you're having a breastlift, if you're having a tummy tech,
if you're having a live section, if you're having a facelift,
it matters for your weight. So we really want you
to ratchet down your weight.
Speaker 2 (09:33):
What else Recreational drugs Marijuana, Like you mentioned, cocaine is
a big one. A lot of people don't find the
need to disclose that, so I always ask them specifically
about that because they don't realize how much you can
change your heart and your ecging and surgery.
Speaker 1 (09:48):
Right, And it's cocaine in particular. Right, All drugs before
surgery are bad because it jacks up your medical system,
but cocaine in particular. People of people know of young
adults getting on a basketball court and dropping dead, and
that's because they did a bunch of coke. And cocaine
has the ability to alter your conduction pathways, and a result,
(10:11):
you can end up getting what's called a barren pathways
and leads to techycardia and things of that nature, and
you know it doesn't take a lot of it. And
so especially if you've done it recently, you want to
tell your doctor in the antethesiologists, we're going to turn
you into the police. I don't care. Do whatever you want,
but sure as hell you should let us know so
that when we put you to sleep, we don't end
(10:31):
up having a complication. Also with supplements, one of the
things that we try to avoid is bleeding right, Like
I'm operating on you, I'm gonna cut you open, and
we're going to pray to God that you stop bleeding
right because your body has to clot So there are drugs,
many of them that affect the clotting pathway, so aspirin,
(10:53):
all the anti inflammatories. And then this is the one
that people don't expect. A boatload of supplements, such as.
Speaker 2 (11:01):
A lot of things in food too, like garlets for
all those things.
Speaker 1 (11:06):
The oil, flax seeds and chia seeds. Wait, those are
so good for you. Yeah, they're great for you, but
not great for surgery. And I have had patients who
are on like megafish oil levels removing a mole or
getting filler and bruising. Like hell, it really thins out
your blood. So those are very very important things. And
(11:26):
what you want to make sure is that you get
all the instructions. So instructions mean what you had had
said in one of your in one of your kind
of the nightmare stories we talked about as a patient
had a tummy tuck and posts up. Instructions for surgeries
are really important because what you do after a facelift
is not what you do after a tummy tuck, right, right,
(11:46):
So you were telling me that a patient was having
a tummy tuck. You were seeing them in the morning
of their surgery, like, all right, let's just go over
everything again one more time. So you're gonna do X,
Y and Z, which is like stay hunched over and
they're like, huh.
Speaker 2 (11:58):
Yeah, Like no one told me that. I was like,
what do you mean, what did you do in your
pre op? And she's like, I never had a pre
op And it was like her first time meeting the
doctor in person. She's only met him on zoom. She
didn't know she was gonna have a drain after a time.
He took like basic, basic things.
Speaker 1 (12:13):
Right, and so often now surgery has become casual. Oh,
I'm where'd you meet your doctor. Oh, I saw him
on TikTok oh. And then so did you meet him? No,
I did a consult with him online. Okay, great, when
are you going to meet him the day of surgery?
You're gonna fly from across the world and meet the
guy the morning of your surgery. So I do a
lot of patients that are from abroad or out of state.
(12:37):
We meet them on zoom. Every single patient I've operated
on in twenty years, I meet them the day before
I meet them in a formal consult. Hi, nice to
meet you, Jane. Let's look at your nose in person.
Oh wow, you have a perforation. I didn't expect that.
Oh my god, you've changed since your zoom Or wow,
(12:57):
I didn't What do you mean I'm meeting you? The
more of how the hell am I meeting you in
the morning? Well, don't you want to meet your doctor
before the surgery? So I'm very adamant and instructions are critical.
So we have pages and pages where the binder this way,
where the drain this way, this is how you would stand,
expect this, take the wrap off at this many days,
(13:19):
so we really want to educate them so that in
going into it. They have read it, they prepared, We
given the paperwork, they can sit there and study it.
It's very very important. Okay, So that's the before the surgery,
So tell me the process. The day before we call them, right,
do we call them the day before?
Speaker 2 (13:36):
Yeah, So either myself or Sandra from the surgery center
will call and we review everything about what to do
the day before the surgery. In the morning of surgery,
so we go over what time we have to stop
eating and drinking because that's super important because you can't
eat and drink for anywhere from eight to twelve hours
before your surgery, or your surgery will get canceled.
Speaker 1 (13:55):
Right, So stop there for a moment. We're going to
elaborate on that. So, first of all, eight to twelve
there's a lot of discussion about that. Eight to twelve
is fine. If you don't eat anything or drink anything
after midnight, you're usually okay if your case is around eight. However,
if you have had a semi glue tide and I
stopped a month in advance like you asked me, still
is twelve hours of NPO Why because your guy can
(14:16):
still be slow. So that's that. And secondly, we have had.
I don't know how many patients come in the morning
you're like, oh, I just had a sip, A sip
of what, A sip of coffee, A sip of this? Wait,
what part of NPO do you not understand? That's eating,
like drinking is eating. So we mean NPO. What else?
Speaker 2 (14:36):
Like to before we also go over what to wear
to surgery? You have to come in loose clothes, something
that zips in the front, nothing over your head, a
lot loose pants, easy to put on, shoes, something warm
Souseeople are usually really cold after surgery. No makeup, no
lotion on your body.
Speaker 1 (14:52):
Don't bring a thousand piercings.
Speaker 2 (14:54):
Yeah, no piercings exactly, no body of jewelry. If you
have a nose ring and you're getting a rhinoplasty, can't
get it out yourself, go to the tattoo shop and
get it out right before your surgery. Things of that sort.
Speaker 1 (15:05):
Number one so exactly, So we're gonna elaborate a little
bit on that. So don't come in here with your
rolex and your jewelry and your cardier brace that you
can't take off. Sort these things out before you go
to surgery. Don't be that patient. You know you're having surgery.
Don't come with a bowloa of makeup and perfume. I
had a patient once that I operated on. She had
(15:26):
so much perfume on that I actually had to step
out of the or was I don't think it was
having some kind of like seizure or like some kind
of reaction. So don't put on perfume, don't put on makeup.
You're just gonna get sick. If you have dentures or
loose teeth and things of that nature, tell anethesiologist take
them out, do whatever you have. Don't come with your
contacts in your eye and then loose clothing. I had
(15:48):
patients come. I'm sure you've had it because you're the
one who changes them and dresses them. They come in
like like a tube top or something like tight jeens.
Are you out of your mind? You just had surgery?
Why are you wh wouldn't you be in sweats and
a zip hop? Yeah, So that's very very important. So
then you get there, let's talk about the day of
(16:10):
what should they expect. Because again, why we're telling you
these things is one just so you know them. You're like, oh,
this sounds oh this looks famili you're gonna have surgery
one day, you're gonna be like, oh, this sounds like
kind of familiar. And secondly, when it's not this way,
then you know something's wrong because this is not special
what I'm telling you, this is standard. So what should
expect the day of.
Speaker 2 (16:30):
Yeah, the morning of surgery, they come in. There's gonna
be some extra consense that you have to sign for
the surgery center part of things. After you sign all
those things, review those papers with you. If you're a female,
will bring you back, get your ensample to run a
pregnancy test, hopefully that is negative. Once that is negative,
bring into the room we have you get changed into
(16:50):
our gown. You take all your clothes off, you put
all of our stuff on, and we arrange your hair
in a certain way if you're getting a facelifover things
like that. These things all take time.
Speaker 1 (17:01):
So why I should be there ten minutes before? Right?
What time should I get there?
Speaker 2 (17:06):
Well, we usually have patients come about an hour or
two before surgery because all of these things take time.
Speaker 1 (17:12):
It's exactly like the airport people. If you are told
to come five minutes before surgery, you should be alarmed.
You need to come. It's time consuming, it's slow, it's methodical,
it's decisive. So come, take your time. Fill out the paperwork,
go to the back, go pee before surgery, put your
(17:32):
belongings aside, say goodbye to your loved ones. You don't
want to be in a rush the morning of surgery,
just like you don't want to be running down the
tarmac praying to get on an airplane. So definitely take
some time. Right. So then you put them in the room.
They're in a gown. Yeah.
Speaker 2 (17:46):
And then usually before you come in or the antestes
autist comes in, I go over my own history and
physical with them, reviewing everything again, any changes to their
medical history, anything, Oh, I accidentally had a bagel this morning,
things like that. Well I had coffee for god, I
was on enough coffee. So I review all the things.
I go over all the prescriptions with the patient, especially
if they're not going in aftercare. I review all the
(18:07):
prescriptions with them so they know which ones to take,
when to start, how to take them right.
Speaker 1 (18:11):
So so many times you get medications and you don't
know anything about them. Well, if you don't know what
your meds are, when to take them and why you're
taking them, how are you going to be successful post off?
Pain management is a really big problem with surgery, and
that is I need to know when to take my
pain meds, how much of it to take, how often
it take, what if it doesn't work, those kinds of things.
(18:31):
Nausea is a big part. What if I'm nauseous? What
do I take? When do I take it? So these
are things that you're surgeant and his or her team
should have told you well in advance in the pre
op that you should have had and again reiterated by
the nurse that morning and review with your medication. So
if no one is talking to about your meds, no
one's telling you when to take what, you got a problem?
Speaker 2 (18:52):
Yeah, I think the morning of surgery. I don't really,
there's no new information in the morning of surgery. It's
just kind of reiterating things. And we always have everyone
actually bring the physical prescriptions with them in the morning
so I can physically show them this is your pain pill,
this is.
Speaker 1 (19:05):
What it looks like.
Speaker 2 (19:06):
Everything's labeled, but it's still good to see it.
Speaker 1 (19:09):
And how many times in the past because what you
just said was exactly right. All I'm doing the day
of is going over what you've been told, just re
reminding you about it. But how many times in the
past have you've shown up the morning of and it's
like you're telling things to patient for the first time.
Speaker 2 (19:25):
Yes, I mean a lot as almost all.
Speaker 1 (19:28):
The time, right, because patients are not either prepped and
we are not paying attention. Yeah.
Speaker 2 (19:33):
I've had patients come to surgery and I'll be like, Okay,
I have your antibiotics and your pain pills, you have everything.
Did you pick them up? And they'll be like, oh no,
the office said they're going to call them in for me.
Like they come into surgeon, they don't have their prescriptions ready,
things of that sort, and I'm just like what.
Speaker 1 (19:46):
Yeah. So it's very very important and we're very thorough,
but not everywhere is going to be that thorough. So
it's on you. If you haven't gotten these things and
no one's explained them to you, that they literally explain
these things to you. The antithesiologists will come in or
they ought to. You should meet the anesthesiologists. If you
are brought back and you never meet and never see
(20:06):
the eyeballs of your antithesiologists, and the eyeballs of your surgeon.
You should be stressed. Every single case. The anti caesiologist
walks in, introduces themselves, tells you about what's going to
happen from an anesthetic standpoint, and I come in and
I see you in mark you. There have been instances
where patients never see the surgeon in the morning and
(20:28):
they have no idea if they were there or operate
on them. Do you hear what I just said. You
literally come to the operating room, the nurse takes you
to the back and you fall asleep, and then you
wake up and you never know if the guy was
there or not to do your surgery. So eyeballs, you
need to see eyeballs.
Speaker 2 (20:44):
I would also recommend patients before they come in. There's
been so many times when patients come in and they're like, oh,
I had a question last night, but I can't remember
it in this and that. So I'd always recommend if
after your pre OBVI you still have you went home
you had a question, I'd always recommend physically writing it
down either on your phone on your notepad, and then
bringing that with you the morning of surgery to review
that so you don't forget it, so the question gets answered.
Speaker 1 (21:06):
Before you go home. Yeah, so you have three options.
Let me rephrase this, at least in my practice, you
have three opportunities one, two, three in which to see
me and have discussions with me. One is it your
consult psycho long Thorough. Two is your pre opt psycho
long Thorough. Three is the morning of should be sweet
and quick, but you still have it, so you should
(21:29):
be able to be like, hey, doctor b I'm so sorry.
I can I ask you one more question? Sure, honey?
What's up? Oh? I forgot to ask you? Da da
da da da. Now's not the time to be discussing
surgical plan and all that other stuff. Because if that's
the case, then you and your surgeon are in big trouble.
If you are going to morning of surgery and you
need to sit down and have a full on discussion
with your surgeon, cancel the case. Did you hear what
(21:51):
I said? If you get to the morning of your
surgery and you're like overwhelmed with anxiety because you don't
really understand what's about to happen, cancel the case. It's elective.
Do not move on with the surgery. I don't care
what financial damage occurs. I don't care what kind of
deposit you lose. The mourning of your surgery should be
(22:12):
the morning of your wedding, filled with a little bit
of butterflies, mostly excited and in anticipation of positive and
you can't wait for it all to be finished and
for you to be on the other side. It should
not be nerves, anxiety, nausea, scared, not knowing what's going on,
(22:32):
and being misinformed. That is not the way to have
your first the morning of your surgery. That way, okay.
So we take you in, Oh, and then inners will
start an IVY. So patients are always wanting to know,
oh is it painful? What do I know? And the
worst part, at least far as pain, is an IVY starting,
which in and of itself is not painful, but they'll
start your IVY and then after that you don't remember
(22:55):
anything because what happens is we take you to the
operating room. And we talked about this with to Houston
and the anesthesia podcast we've done. We bring you into
the oar. You're talking, Hey, wow, it's cold in here.
Oh that's cool. Oh wow, this looks just like a
TV show. And we're going to say to you count
back from blah blah blah, and next thing you know,
you're putting on your underwear and your pants. What time
(23:17):
is it, Oh, it's noon, twelve o'clock. Are we done? Yep,
we're done. Wait what happened? You're like, what do you mean?
What happened? We did what we said we're gonna do,
because that's all you remember. Modern anesthesia is phenomenal, and
that has something called retrograde amnesia. You actually forget walking
(23:38):
in the room, You forget the last bit of conversation
you had with your anesthesiologists because it erases about fifteen
minutes of it. That's what's so amazing. So all right,
surgery is done. They wheel you into recovery so that
we hand you off to the nurse. So what should
they expect from there on? Once they're in recovery.
Speaker 2 (23:57):
Most people, you know, they wake up. You're going to
be groggy for the beginning. You'll probably be speaking and
talking to me. You probably won't remember it the day after.
Sometimes you'll wake up, just depending on the nature of
the surgery, a little cold, a little shivery, which is
totally normal. That will also go. Everyone always gets a
little frightened by that, So I always warn people of that.
Put up on a bunch of warm blankets, just give
you some time to wake up. We'll hook you up
(24:18):
to all the monitors. I'll be checking your vitals every
five to ten minutes, just depending on what the orders are,
and if you have any pain, if you have any
nause or anything. We try to control all of that.
Before you get discharged with medications, I'll be taking care
of your drains and things of that sort of recovery.
(24:38):
We're viewing with you how to take care of your
drains again and just making sure you're comfortable before you
go home.
Speaker 1 (24:45):
Yeah, so the key for your recovery is that when
you enter your car with your loved ones and or
the recovery center, you are not in massive pain. You're uncomfortable,
that's normal. You're not nauseous and hurling, but your nausea
is reasonably well controlled. Your drains aren't filling up with
blood constantly, but they're dry and been drained out right.
(25:09):
Your dressings are clean and dry and you're not bleeding
through them. You need to be stable when you leave
the operating room, and you'd rather acxcoose me when you
leave the recovery and you hand it off to the
next person. The baton is passed off, and what needs
to happen is that your loved one needs to receive
a verbal verbal sign out by the nurse. Hey, okay,
(25:31):
Julie's did great, she did fantastic. Here you are, We're
gonna put her in your car. Hear her clothes. There
needs to be some conversation. I just gave her a
pain med. She should probably in a few hours go
home and start taking some cold chips and maybe some banana.
You might find. If she's uncomfortable, I'd give her another half.
There needs to be this dialogue again. If you just
get thrown into a car, slam the door, and off
(25:53):
you go, that's a problem. At that point, it's too
late because he already did the surgery. But if a
friend of yours describes that experience, that you should be
very careful when you're at that facility because that's not
a normal discharge experience.
Speaker 2 (26:06):
Yeah. I always with the family, Like if they're going
to an aftercare then it's a different story. But if
they're going home with like a family member or anything,
I always go over all the discharge with the family
member as well. I go over all the medications, take
this medication at this time, so they know because a
lot of the times they're like, what are all these men?
They're freaking out. So I go over everything with them
to make sure that they know how to take care
(26:28):
of the patient at home and they're comfortable with all
their questions are answered. I never just put someone in
a car and okay, good luck.
Speaker 1 (26:35):
Coming by.
Speaker 2 (26:36):
Yeah, So just making sure that whoever's taking care of
them after is also educated, making sure that there's someone
to stay with them after and they're not just dropping
them off at home.
Speaker 1 (26:44):
But by the way, this is a huge thing. Huge,
But you cannot be discharged to Uber. Do you understand, people,
I'm going to reiterate this. You need okay, no problem
my fourteen year old. No, no, no, you need a
goddamn adult to pick you up that knows you if
you have a complication, if you are that one in
five hundred thousand that has a reaction to lightokane. Oh
(27:06):
my god, I hemerate. You need someone to give a shit.
So patients, Oh my god, I can't tell you how
many patients are like, can I just go home with
an Uber or a taxi? I live real clothes to Airbnb. No,
we are not going to hand you off to a stranger,
no less a robotic car that's empty. Right, Like, you
(27:28):
need an adult. Don't come to LA to have a surgery,
or go anywhere in this country without an adult with you.
Do not go to Oh the guy said, I don't
need anybody, and I'm okay by myself. You're not okay
by yourself because you are still a patient and there
is still always something that can go wrong. So definitely
make sure that at least for the day's immediate days
(27:50):
following a surgery, you have an adult with you, someone
that is responsible, someone that can call nine one one,
someone that could call the doctor and ask questions, someone anything,
just take care of you. I think that's really really
important because I'm sure I'm we won't, but I'm sure
you've had doctors discharge patients to a taxi or do.
Speaker 2 (28:07):
I won't like in pre op the morning of surgery,
I'll always ask who's your right after? And I've had
patients say, oh, I'm just gonna uber. I can't legally
sign out a patient to an uber like, I just
can't do that. That's I can't do it. So I've
told surgeons, I won't do it right.
Speaker 1 (28:21):
But the thing, but that's that's the crazy part that
I'm talking about, is you have to be like, no, no,
I'm when I sign out, it's me saying I discharge
the patient. So it falls on me. I'm not going
to do that. The crazy part is had you not
done that, they would have discharged them. I mean, it
wasn't like because you know that who's picking you up
gets decided in pre op that happens in the office.
(28:43):
You should just be there to just be like, okay,
who is it. You shouldn't be the one arguing in
the morning of wait, wait, wait, I'm not sending you
home with this. You got to find someone before you.
So that goes to show you that had you not
been the one who called them out on it, they
would have patient would have been put into an uber
and it sent home. It happened all the time.
Speaker 2 (29:01):
Yeah, and it's like they have them, they go to
their hotel, there's no one there, God forbid. What if
something happens to you. What if you're dizzy afteranasy, you
get up, you fall, you hit your head.
Speaker 1 (29:09):
And it happens. It happens all the time. So many instances,
so and says mother of eight found in hospital Da
da da da da was taken like you cannot have
even if it was even if it's just a normal
reaction to anesthesia, like you just you just got light headed,
Like you literally can get up and go to the
bathroom and get light headed from orthostatic from still having
(29:29):
some narcotic in your system. My wife had severe spine surgery,
was on a ton of pain, met she went to
go to the bathroom and she passed out. That's not
anyone's it just that's what happens when you have surgery.
So yeah, I think the purpose of this episode was
for you guys to know what's normal. Right, then you
can compare your crazy boyfriend to that amazing boyfriend you
(29:51):
once had. You have to have a point of reference
to know what is or isn't right. And while it
isn't the Holy Grail, none of the things we just
mentioned to you are at all, by any means outrageous
or unusual or weird. They're all basic things that they
would be required. So hopefully you found that helpful. This
is what I call the immediate perioperative, the immediate time
(30:11):
around and operating an operation timeline and what to expect,
and if you decide to surgery, we obviously wish she
was successful in a very healthy outcome. All right, Paula,
you're off the hook. You get done. You can go
eat your lunch, you can go and a frolic and
enjoy your day. As always, that's a wrap with Plastic
Surgery Uncensored, we have two parting requests. Number one, go
(30:36):
and write a review. Stop whatever you're doing, unplug your earbuds,
don't listen to the next episode of any other true crime.
Go write a review right away, because I know you
love our show. And secondly, share this immediately with people
you love. Everyone's like after the fact, Oh my god,
I didn't know my cousin had a surgery she got.
I wish she had told me. I can't believe she
(30:57):
went to blah blah blah. Well it's after the fact.
It's too late. So if you share this show preemptively
to free friends and family, you will have done them
a service. All right, guys, that's a wrap. That's another
episode of Plastic Surgery Uncensored. As always, your host, doctor
Roddy Rabon, I will see you all next week.
All right, welcome to another episode of Plastic Surgery and Censored.
I'm your host, doctor Roddy Rabon, and we are honored
to have Paula, our nurse Practier, on with us today.
Is a big honor because Paula doesn't like to be
on these shows and do these things, but we've dragged
her on and she's agreed to participate. We've done a
two part series which you must listen to, which was
(00:29):
about oh ur nightmarage and things that were just jaw
dropping and you definitely want to check those out. And
we thought how appropriate if we then have another episode
which then follows with what things should be like? So
basically the two part episode is what goes completely wrong
and what it shouldn't look like. And today we're going
to have an episode about the Perry operative experience. What
(00:53):
do I mean what you should expect immediately before your surgery,
the day of your surgery, and then immediately after your surgery,
In other words, how should it go? What would be
the perfect uh, you know, perfect experience, and what should
I expect? And then that way, as you're going through
the process, you have cused that wait, wait, this this
(01:15):
is this doesn't sound right, this is not what they
told me. And because unfortunately, as patients having your first surgery,
for many of you, you may not know that something
is off because you're like, how do I know that
they were supposed to check my pregnancy test? How do
I know that you know? And so on and so forth.
So welcome again, Paula. You know, very nice of you
to join us. All right, So the success of your
(01:39):
surgery begins before your surgery. So as you had said
in your previous experiences, many times you would come to
the day of surgery. You weren't on the clinic side.
We're on the clinic side. By clinic, we're referring to
the doctor his staff getting you ready for surgery. Many
times Paula would show up the day of surgery at
the op room and the patients were clueless, had no instructions,
(02:04):
knew nothing about their surgeries. Frankly, were like deer in
her headlight regarding what's about to happen. That right there
is a catastrophe. You're automatically going to have a bad experience,
so with me and has been for twenty years, and
now Paula is now part of that and is experienced
it on the operating room side, because she was the
beneficiary of all the work we did on the clinic side,
(02:25):
but now is involved in the clinic side. There is
a pre op in which we prepare you for surgery.
It's a whole own visit. So a lot of doctors
flow through the fly through the pre op. It's something
they do on the phone, or maybe they send you
a couple of emails. We make an entire visit associated
(02:46):
with the pre op. And the pre op is critical
because two things happen. One, it allows us to give
you every piece of information that you need in order
to be successful. And two, it gives you yet another
opportunity unity to ask every question you need to ask,
because well, shit, I saw the doctor a year ago.
Oh I don't remember what he said. Oh I've seen
(03:09):
five other people since then, and I want to ask it.
So we go out of our way to have a
second appointment. So, Paula, what are some of the things
that are really important that we discussed with patients in
the pre op that need to be discussed in order
for them to do well and not have a complication.
So let's go through some of our pre op requirements.
Speaker 2 (03:31):
So, first and foremost, you always do a very thorough
like history and physical on the patient. So if they
need any blood work, if they need any clearances from
certain doctors that they see, if they need a mammogram, anything.
Speaker 1 (03:44):
Like that, great. So I'm going to highlight those as
you go through it. So one thing we do, what
I've done for twenty years, is you come in, Hey,
doctor Rbon, I'm interested in having a mommy makeerk. Great,
tell me about your medications, blah blah blah, tell me
about your medical problems blah blah blah. Oh, yes, I
had history of a supervnenticular tachycardia, and I had a
cardiologist and the cardiologist did electrophysiology and they you know,
(04:08):
they zapped my A Barrent heart pathway and I'm good, Okay, great.
So when in if you decide to do your mommy makeover,
you need a cardiology clearance. Oh but my cardiologists you know,
I haven't seen him in a few years. He says,
I'm good. Great. When and if you have your mommy makeover,
you need a cardiology clearance. So I am psycho about
(04:30):
getting specialty clearances from people who have taken care of
you for your problems. You can have successful surgery with
almost any medical condition as long as that medical condition
is well controlled. I have done surgery on patients who
have had pulmonary emboli pulmonary ambuli, which is like one
(04:51):
of the worst complications you can have, and I've successfully
done surgery because I was side by side with their
hematologists and we had a plan and we executed it.
So absolutely, if you have any medical conditions, we're going
to expect you to get a clearance. If you are
older and you're having a surgery, we're going to ask
you to get a regular clearance by your general doctor,
(05:13):
which includes your EKG and your chesticks ray. You said mammogram.
Every patient, every patient who is over thirty five used
to be forty, gets a mamogram within six months. What
if I just had a mamogram it was nine months ago.
You need another mamogram. I just had it. You need
(05:36):
another mamogram. I have a story for you that I'll
tell you. I was taking care of a doctor, worst
patients in the world. I was taking care of a doctor.
She had her mammogram seven months prior to her rest surgery.
So we have a protocol. Protocol means you stick to
your protocol. NASA doesn't like the day of a launch'd
be like, well, it's close close enough. It's like, no,
(05:58):
it's not what we said six months prior. You need
a mammogram. So she had it seven months We told
her she needs another mammogram. She threw a cow, wrote emails,
was nasty to the staff. This is an abuse of use,
a waste of resources and money, and YadA, YadA, YadA.
And I was like, listen, I don't know what to
tell you. I can't help you. She finally did it, begrudgingly,
(06:20):
and what do you know, they found a mass. Now
it turned out that the mass was benign, but they
had to work it up. And she was so apologetic,
as she should have been, because she's like, wow, I'm
so sorry, because you know, at seven months it was clear.
I go, I don't. That's exactly the point. It can
change over time. So mammogram labs, what kind of labs
(06:42):
do we get?
Speaker 2 (06:44):
I mean depends how all the patient is and everything
like that, but basic globs, even if you're a twenty
five year old going in for just a straightforward like
breastog or like a RHINOPLASTU just your basic glob work
just to make sure everything's normal. Your blood cloth's out
of normal, right, things like of that.
Speaker 1 (06:59):
So we take a base panel because we're assuming you're healthy.
If you have other medical problems, then we will defer
to that expert to get those additional labs. But as
far as we're concerned, high nice to mutual, we're healthy.
I need these basic labs. Right. What else do we
ask patients to do before surgery? Smoking? Drinking? Right? But
(07:20):
what does that have to do with anything? Smoking is massive?
Any smoking, smoking, hookah, smoking pots, smoking cigarettes? Why because
it affects your lungs and then when we intubate you,
you're at a higher risk of having pneumonia after surgery.
Stop that shit. And smoking in particular has an impact
on blood supply. And you can lose a nipple, what,
(07:43):
lose a belly button? What? You can lose the skin
flap on a facelift? What? Yes, smoking does that? So
we don't want you smoking? Right?
Speaker 2 (07:52):
What else important to always if you want to talk
about like ozombic mendaros?
Speaker 1 (07:58):
So now it is huge semi glue tides. So what's
the issue with semi glue tides? So we I think
the national requirement national. But I think what's generally required
is for you to be off of a semi glue
tide like an o zempg Manjaro kind of thing, for
two weeks. We here in our practice require a month.
(08:19):
And this is why. So what's the issue with the drug.
The drug works in many ways, and one of the
ways that drug works is by slowing down your stomach,
and therefore you eat and you're not hungry because you
haven't cleared the food out, and so it kind of
just lingers and keeps you satiated. The problem with that
(08:39):
is that when you have surgery and you're under anesthesia,
if your stomach is full and you vomit while you're asleep,
you will aspirate that goes into your lungs and you
will die. And there are people who have died since
the introduction of these drugs from ards or lung issues.
(08:59):
And so we want you off. The reason we want
you off at a month instead of two weeks is
because there are still people at two weeks where their
gut motility is still affected. We want to make sure
that's off. The other thing we want you to do
is we want you to be close to your weight.
If you've got a few more weeks, do not gain
weight before your surgery. But I'm having a rhinoplase, then
(09:20):
I don't care if you're five hundred pounds. But if
you're having a breastlift, if you're having a tummy tech,
if you're having a live section, if you're having a facelift,
it matters for your weight. So we really want you
to ratchet down your weight.
Speaker 2 (09:33):
What else Recreational drugs Marijuana, Like you mentioned, cocaine is
a big one. A lot of people don't find the
need to disclose that, so I always ask them specifically
about that because they don't realize how much you can
change your heart and your ecging and surgery.
Speaker 1 (09:48):
Right, And it's cocaine in particular. Right, All drugs before
surgery are bad because it jacks up your medical system,
but cocaine in particular. People of people know of young
adults getting on a basketball court and dropping dead, and
that's because they did a bunch of coke. And cocaine
has the ability to alter your conduction pathways, and a result,
(10:11):
you can end up getting what's called a barren pathways
and leads to techycardia and things of that nature, and
you know it doesn't take a lot of it. And
so especially if you've done it recently, you want to
tell your doctor in the antethesiologists, we're going to turn
you into the police. I don't care. Do whatever you want,
but sure as hell you should let us know so
that when we put you to sleep, we don't end
(10:31):
up having a complication. Also with supplements, one of the
things that we try to avoid is bleeding right, Like
I'm operating on you, I'm gonna cut you open, and
we're going to pray to God that you stop bleeding
right because your body has to clot So there are drugs,
many of them that affect the clotting pathway, so aspirin,
(10:53):
all the anti inflammatories. And then this is the one
that people don't expect. A boatload of supplements, such as.
Speaker 2 (11:01):
A lot of things in food too, like garlets for
all those things.
Speaker 1 (11:06):
The oil, flax seeds and chia seeds. Wait, those are
so good for you. Yeah, they're great for you, but
not great for surgery. And I have had patients who
are on like megafish oil levels removing a mole or
getting filler and bruising. Like hell, it really thins out
your blood. So those are very very important things. And
(11:26):
what you want to make sure is that you get
all the instructions. So instructions mean what you had had
said in one of your in one of your kind
of the nightmare stories we talked about as a patient
had a tummy tuck and posts up. Instructions for surgeries
are really important because what you do after a facelift
is not what you do after a tummy tuck, right, right,
(11:46):
So you were telling me that a patient was having
a tummy tuck. You were seeing them in the morning
of their surgery, like, all right, let's just go over
everything again one more time. So you're gonna do X,
Y and Z, which is like stay hunched over and
they're like, huh.
Speaker 2 (11:58):
Yeah, Like no one told me that. I was like,
what do you mean, what did you do in your
pre op? And she's like, I never had a pre
op And it was like her first time meeting the
doctor in person. She's only met him on zoom. She
didn't know she was gonna have a drain after a time.
He took like basic, basic things.
Speaker 1 (12:13):
Right, and so often now surgery has become casual. Oh,
I'm where'd you meet your doctor. Oh, I saw him
on TikTok oh. And then so did you meet him? No,
I did a consult with him online. Okay, great, when
are you going to meet him the day of surgery?
You're gonna fly from across the world and meet the
guy the morning of your surgery. So I do a
lot of patients that are from abroad or out of state.
(12:37):
We meet them on zoom. Every single patient I've operated
on in twenty years, I meet them the day before
I meet them in a formal consult. Hi, nice to
meet you, Jane. Let's look at your nose in person.
Oh wow, you have a perforation. I didn't expect that.
Oh my god, you've changed since your zoom Or wow,
(12:57):
I didn't What do you mean I'm meeting you? The
more of how the hell am I meeting you in
the morning? Well, don't you want to meet your doctor
before the surgery? So I'm very adamant and instructions are critical.
So we have pages and pages where the binder this way,
where the drain this way, this is how you would stand,
expect this, take the wrap off at this many days,
(13:19):
so we really want to educate them so that in
going into it. They have read it, they prepared, We
given the paperwork, they can sit there and study it.
It's very very important. Okay, So that's the before the surgery,
So tell me the process. The day before we call them, right,
do we call them the day before?
Speaker 2 (13:36):
Yeah, So either myself or Sandra from the surgery center
will call and we review everything about what to do
the day before the surgery. In the morning of surgery,
so we go over what time we have to stop
eating and drinking because that's super important because you can't
eat and drink for anywhere from eight to twelve hours
before your surgery, or your surgery will get canceled.
Speaker 1 (13:55):
Right, So stop there for a moment. We're going to
elaborate on that. So, first of all, eight to twelve
there's a lot of discussion about that. Eight to twelve
is fine. If you don't eat anything or drink anything
after midnight, you're usually okay if your case is around eight. However,
if you have had a semi glue tide and I
stopped a month in advance like you asked me, still
is twelve hours of NPO Why because your guy can
(14:16):
still be slow. So that's that. And secondly, we have had.
I don't know how many patients come in the morning
you're like, oh, I just had a sip, A sip
of what, A sip of coffee, A sip of this? Wait,
what part of NPO do you not understand? That's eating,
like drinking is eating. So we mean NPO. What else?
Speaker 2 (14:36):
Like to before we also go over what to wear
to surgery? You have to come in loose clothes, something
that zips in the front, nothing over your head, a
lot loose pants, easy to put on, shoes, something warm
Souseeople are usually really cold after surgery. No makeup, no
lotion on your body.
Speaker 1 (14:52):
Don't bring a thousand piercings.
Speaker 2 (14:54):
Yeah, no piercings exactly, no body of jewelry. If you
have a nose ring and you're getting a rhinoplasty, can't
get it out yourself, go to the tattoo shop and
get it out right before your surgery. Things of that sort.
Speaker 1 (15:05):
Number one so exactly, So we're gonna elaborate a little
bit on that. So don't come in here with your
rolex and your jewelry and your cardier brace that you
can't take off. Sort these things out before you go
to surgery. Don't be that patient. You know you're having surgery.
Don't come with a bowloa of makeup and perfume. I
had a patient once that I operated on. She had
(15:26):
so much perfume on that I actually had to step
out of the or was I don't think it was
having some kind of like seizure or like some kind
of reaction. So don't put on perfume, don't put on makeup.
You're just gonna get sick. If you have dentures or
loose teeth and things of that nature, tell anethesiologist take
them out, do whatever you have. Don't come with your
contacts in your eye and then loose clothing. I had
(15:48):
patients come. I'm sure you've had it because you're the
one who changes them and dresses them. They come in
like like a tube top or something like tight jeens.
Are you out of your mind? You just had surgery?
Why are you wh wouldn't you be in sweats and
a zip hop? Yeah, So that's very very important. So
then you get there, let's talk about the day of
(16:10):
what should they expect. Because again, why we're telling you
these things is one just so you know them. You're like, oh,
this sounds oh this looks famili you're gonna have surgery
one day, you're gonna be like, oh, this sounds like
kind of familiar. And secondly, when it's not this way,
then you know something's wrong because this is not special
what I'm telling you, this is standard. So what should
expect the day of.
Speaker 2 (16:30):
Yeah, the morning of surgery, they come in. There's gonna
be some extra consense that you have to sign for
the surgery center part of things. After you sign all
those things, review those papers with you. If you're a female,
will bring you back, get your ensample to run a
pregnancy test, hopefully that is negative. Once that is negative,
bring into the room we have you get changed into
(16:50):
our gown. You take all your clothes off, you put
all of our stuff on, and we arrange your hair
in a certain way if you're getting a facelifover things
like that. These things all take time.
Speaker 1 (17:01):
So why I should be there ten minutes before? Right?
What time should I get there?
Speaker 2 (17:06):
Well, we usually have patients come about an hour or
two before surgery because all of these things take time.
Speaker 1 (17:12):
It's exactly like the airport people. If you are told
to come five minutes before surgery, you should be alarmed.
You need to come. It's time consuming, it's slow, it's methodical,
it's decisive. So come, take your time. Fill out the paperwork,
go to the back, go pee before surgery, put your
(17:32):
belongings aside, say goodbye to your loved ones. You don't
want to be in a rush the morning of surgery,
just like you don't want to be running down the
tarmac praying to get on an airplane. So definitely take
some time. Right. So then you put them in the room.
They're in a gown. Yeah.
Speaker 2 (17:46):
And then usually before you come in or the antestes
autist comes in, I go over my own history and
physical with them, reviewing everything again, any changes to their
medical history, anything, Oh, I accidentally had a bagel this morning,
things like that. Well I had coffee for god, I
was on enough coffee. So I review all the things.
I go over all the prescriptions with the patient, especially
if they're not going in aftercare. I review all the
(18:07):
prescriptions with them so they know which ones to take,
when to start, how to take them right.
Speaker 1 (18:11):
So so many times you get medications and you don't
know anything about them. Well, if you don't know what
your meds are, when to take them and why you're
taking them, how are you going to be successful post off?
Pain management is a really big problem with surgery, and
that is I need to know when to take my
pain meds, how much of it to take, how often
it take, what if it doesn't work, those kinds of things.
(18:31):
Nausea is a big part. What if I'm nauseous? What
do I take? When do I take it? So these
are things that you're surgeant and his or her team
should have told you well in advance in the pre
op that you should have had and again reiterated by
the nurse that morning and review with your medication. So
if no one is talking to about your meds, no
one's telling you when to take what, you got a problem?
Speaker 2 (18:52):
Yeah, I think the morning of surgery. I don't really,
there's no new information in the morning of surgery. It's
just kind of reiterating things. And we always have everyone
actually bring the physical prescriptions with them in the morning
so I can physically show them this is your pain pill,
this is.
Speaker 1 (19:05):
What it looks like.
Speaker 2 (19:06):
Everything's labeled, but it's still good to see it.
Speaker 1 (19:09):
And how many times in the past because what you
just said was exactly right. All I'm doing the day
of is going over what you've been told, just re
reminding you about it. But how many times in the
past have you've shown up the morning of and it's
like you're telling things to patient for the first time.
Speaker 2 (19:25):
Yes, I mean a lot as almost all.
Speaker 1 (19:28):
The time, right, because patients are not either prepped and
we are not paying attention. Yeah.
Speaker 2 (19:33):
I've had patients come to surgery and I'll be like, Okay,
I have your antibiotics and your pain pills, you have everything.
Did you pick them up? And they'll be like, oh no,
the office said they're going to call them in for me.
Like they come into surgeon, they don't have their prescriptions ready,
things of that sort, and I'm just like what.
Speaker 1 (19:46):
Yeah. So it's very very important and we're very thorough,
but not everywhere is going to be that thorough. So
it's on you. If you haven't gotten these things and
no one's explained them to you, that they literally explain
these things to you. The antithesiologists will come in or
they ought to. You should meet the anesthesiologists. If you
are brought back and you never meet and never see
(20:06):
the eyeballs of your antithesiologists, and the eyeballs of your surgeon.
You should be stressed. Every single case. The anti caesiologist
walks in, introduces themselves, tells you about what's going to
happen from an anesthetic standpoint, and I come in and
I see you in mark you. There have been instances
where patients never see the surgeon in the morning and
(20:28):
they have no idea if they were there or operate
on them. Do you hear what I just said. You
literally come to the operating room, the nurse takes you
to the back and you fall asleep, and then you
wake up and you never know if the guy was
there or not to do your surgery. So eyeballs, you
need to see eyeballs.
Speaker 2 (20:44):
I would also recommend patients before they come in. There's
been so many times when patients come in and they're like, oh,
I had a question last night, but I can't remember
it in this and that. So I'd always recommend if
after your pre OBVI you still have you went home
you had a question, I'd always recommend physically writing it
down either on your phone on your notepad, and then
bringing that with you the morning of surgery to review
that so you don't forget it, so the question gets answered.
Speaker 1 (21:06):
Before you go home. Yeah, so you have three options.
Let me rephrase this, at least in my practice, you
have three opportunities one, two, three in which to see
me and have discussions with me. One is it your
consult psycho long Thorough. Two is your pre opt psycho
long Thorough. Three is the morning of should be sweet
and quick, but you still have it, so you should
(21:29):
be able to be like, hey, doctor b I'm so sorry.
I can I ask you one more question? Sure, honey?
What's up? Oh? I forgot to ask you? Da da
da da da. Now's not the time to be discussing
surgical plan and all that other stuff. Because if that's
the case, then you and your surgeon are in big trouble.
If you are going to morning of surgery and you
need to sit down and have a full on discussion
with your surgeon, cancel the case. Did you hear what
(21:51):
I said? If you get to the morning of your
surgery and you're like overwhelmed with anxiety because you don't
really understand what's about to happen, cancel the case. It's elective.
Do not move on with the surgery. I don't care
what financial damage occurs. I don't care what kind of
deposit you lose. The mourning of your surgery should be
(22:12):
the morning of your wedding, filled with a little bit
of butterflies, mostly excited and in anticipation of positive and
you can't wait for it all to be finished and
for you to be on the other side. It should
not be nerves, anxiety, nausea, scared, not knowing what's going on,
(22:32):
and being misinformed. That is not the way to have
your first the morning of your surgery. That way, okay.
So we take you in, Oh, and then inners will
start an IVY. So patients are always wanting to know,
oh is it painful? What do I know? And the
worst part, at least far as pain, is an IVY starting,
which in and of itself is not painful, but they'll
start your IVY and then after that you don't remember
(22:55):
anything because what happens is we take you to the
operating room. And we talked about this with to Houston
and the anesthesia podcast we've done. We bring you into
the oar. You're talking, Hey, wow, it's cold in here.
Oh that's cool. Oh wow, this looks just like a
TV show. And we're going to say to you count
back from blah blah blah, and next thing you know,
you're putting on your underwear and your pants. What time
(23:17):
is it, Oh, it's noon, twelve o'clock. Are we done? Yep,
we're done. Wait what happened? You're like, what do you mean?
What happened? We did what we said we're gonna do,
because that's all you remember. Modern anesthesia is phenomenal, and
that has something called retrograde amnesia. You actually forget walking
(23:38):
in the room, You forget the last bit of conversation
you had with your anesthesiologists because it erases about fifteen
minutes of it. That's what's so amazing. So all right,
surgery is done. They wheel you into recovery so that
we hand you off to the nurse. So what should
they expect from there on? Once they're in recovery.
Speaker 2 (23:57):
Most people, you know, they wake up. You're going to
be groggy for the beginning. You'll probably be speaking and
talking to me. You probably won't remember it the day after.
Sometimes you'll wake up, just depending on the nature of
the surgery, a little cold, a little shivery, which is
totally normal. That will also go. Everyone always gets a
little frightened by that, So I always warn people of that.
Put up on a bunch of warm blankets, just give
you some time to wake up. We'll hook you up
(24:18):
to all the monitors. I'll be checking your vitals every
five to ten minutes, just depending on what the orders are,
and if you have any pain, if you have any
nause or anything. We try to control all of that.
Before you get discharged with medications, I'll be taking care
of your drains and things of that sort of recovery.
(24:38):
We're viewing with you how to take care of your
drains again and just making sure you're comfortable before you
go home.
Speaker 1 (24:45):
Yeah, so the key for your recovery is that when
you enter your car with your loved ones and or
the recovery center, you are not in massive pain. You're uncomfortable,
that's normal. You're not nauseous and hurling, but your nausea
is reasonably well controlled. Your drains aren't filling up with
blood constantly, but they're dry and been drained out right.
(25:09):
Your dressings are clean and dry and you're not bleeding
through them. You need to be stable when you leave
the operating room, and you'd rather acxcoose me when you
leave the recovery and you hand it off to the
next person. The baton is passed off, and what needs
to happen is that your loved one needs to receive
a verbal verbal sign out by the nurse. Hey, okay,
(25:31):
Julie's did great, she did fantastic. Here you are, We're
gonna put her in your car. Hear her clothes. There
needs to be some conversation. I just gave her a
pain med. She should probably in a few hours go
home and start taking some cold chips and maybe some banana.
You might find. If she's uncomfortable, I'd give her another half.
There needs to be this dialogue again. If you just
get thrown into a car, slam the door, and off
(25:53):
you go, that's a problem. At that point, it's too
late because he already did the surgery. But if a
friend of yours describes that experience, that you should be
very careful when you're at that facility because that's not
a normal discharge experience.
Speaker 2 (26:06):
Yeah. I always with the family, Like if they're going
to an aftercare then it's a different story. But if
they're going home with like a family member or anything,
I always go over all the discharge with the family
member as well. I go over all the medications, take
this medication at this time, so they know because a
lot of the times they're like, what are all these men?
They're freaking out. So I go over everything with them
to make sure that they know how to take care
(26:28):
of the patient at home and they're comfortable with all
their questions are answered. I never just put someone in
a car and okay, good luck.
Speaker 1 (26:35):
Coming by.
Speaker 2 (26:36):
Yeah, So just making sure that whoever's taking care of
them after is also educated, making sure that there's someone
to stay with them after and they're not just dropping
them off at home.
Speaker 1 (26:44):
But by the way, this is a huge thing. Huge,
But you cannot be discharged to Uber. Do you understand, people,
I'm going to reiterate this. You need okay, no problem
my fourteen year old. No, no, no, you need a
goddamn adult to pick you up that knows you if
you have a complication, if you are that one in
five hundred thousand that has a reaction to lightokane. Oh
(27:06):
my god, I hemerate. You need someone to give a shit.
So patients, Oh my god, I can't tell you how
many patients are like, can I just go home with
an Uber or a taxi? I live real clothes to Airbnb. No,
we are not going to hand you off to a stranger,
no less a robotic car that's empty. Right, Like, you
(27:28):
need an adult. Don't come to LA to have a surgery,
or go anywhere in this country without an adult with you.
Do not go to Oh the guy said, I don't
need anybody, and I'm okay by myself. You're not okay
by yourself because you are still a patient and there
is still always something that can go wrong. So definitely
make sure that at least for the day's immediate days
(27:50):
following a surgery, you have an adult with you, someone
that is responsible, someone that can call nine one one,
someone that could call the doctor and ask questions, someone anything,
just take care of you. I think that's really really
important because I'm sure I'm we won't, but I'm sure
you've had doctors discharge patients to a taxi or do.
Speaker 2 (28:07):
I won't like in pre op the morning of surgery,
I'll always ask who's your right after? And I've had
patients say, oh, I'm just gonna uber. I can't legally
sign out a patient to an uber like, I just
can't do that. That's I can't do it. So I've
told surgeons, I won't do it right.
Speaker 1 (28:21):
But the thing, but that's that's the crazy part that
I'm talking about, is you have to be like, no, no,
I'm when I sign out, it's me saying I discharge
the patient. So it falls on me. I'm not going
to do that. The crazy part is had you not
done that, they would have discharged them. I mean, it
wasn't like because you know that who's picking you up
gets decided in pre op that happens in the office.
(28:43):
You should just be there to just be like, okay,
who is it. You shouldn't be the one arguing in
the morning of wait, wait, wait, I'm not sending you
home with this. You got to find someone before you.
So that goes to show you that had you not
been the one who called them out on it, they
would have patient would have been put into an uber
and it sent home. It happened all the time.
Speaker 2 (29:01):
Yeah, and it's like they have them, they go to
their hotel, there's no one there, God forbid. What if
something happens to you. What if you're dizzy afteranasy, you
get up, you fall, you hit your head.
Speaker 1 (29:09):
And it happens. It happens all the time. So many instances,
so and says mother of eight found in hospital Da
da da da da was taken like you cannot have
even if it was even if it's just a normal
reaction to anesthesia, like you just you just got light headed,
Like you literally can get up and go to the
bathroom and get light headed from orthostatic from still having
(29:29):
some narcotic in your system. My wife had severe spine surgery,
was on a ton of pain, met she went to
go to the bathroom and she passed out. That's not
anyone's it just that's what happens when you have surgery.
So yeah, I think the purpose of this episode was
for you guys to know what's normal. Right, then you
can compare your crazy boyfriend to that amazing boyfriend you
(29:51):
once had. You have to have a point of reference
to know what is or isn't right. And while it
isn't the Holy Grail, none of the things we just
mentioned to you are at all, by any means outrageous
or unusual or weird. They're all basic things that they
would be required. So hopefully you found that helpful. This
is what I call the immediate perioperative, the immediate time
(30:11):
around and operating an operation timeline and what to expect,
and if you decide to surgery, we obviously wish she
was successful in a very healthy outcome. All right, Paula,
you're off the hook. You get done. You can go
eat your lunch, you can go and a frolic and
enjoy your day. As always, that's a wrap with Plastic
Surgery Uncensored, we have two parting requests. Number one, go
(30:36):
and write a review. Stop whatever you're doing, unplug your earbuds,
don't listen to the next episode of any other true crime.
Go write a review right away, because I know you
love our show. And secondly, share this immediately with people
you love. Everyone's like after the fact, Oh my god,
I didn't know my cousin had a surgery she got.
I wish she had told me. I can't believe she
(30:57):
went to blah blah blah. Well it's after the fact.
It's too late. So if you share this show preemptively
to free friends and family, you will have done them
a service. All right, guys, that's a wrap. That's another
episode of Plastic Surgery Uncensored. As always, your host, doctor
Roddy Rabon, I will see you all next week.
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