Tag: recovery

Get RID of post op restrictions? I think not.

As most of you may or may not know, I have to renew my board certification for obgyn on a yearly basis, often with a multitude of articles and modules that require completion and a series of tests to take. I think they think that it is a good reminder to stay invested and keep up to date. I personally feel that I am capable of that on my own without paying exorbitant fees, but oh well.

Anyway, I regret to say that it is rare that one of these required articles contains information that is either brand new to me or significantly useful. Most of the time I am looking at them and having to read them for credit and just go with that approach. Some of the articles I feel are downright potentially harmful. I need to tell you about one of them.

Most recently, I read an article in a very reputable journal suggesting that we abandon all post op restrictions. Post op restrictions are the what I feel is very necessary guidelines to maximally assure a good recovery after surgery. They include things like holding off from sexual activity for six weeks. No lifting, pushing, pulling anything over a full gallon of milk for six weeks and no driving for a car for at least one week. Yes, I know, it potentially sets a patient up for ultimate boredom and frustration. You are watching your house get dirty. You are watching your kids run amuck. You are missing out on your normally awesome cooking, etc.

However, having said that, I have found that, in my almost thirty years of experience, that these recommendations, while not popular, are the way to go. It is my way of helping to ensure a good recovery for my patients. So, I read this article, claiming that all these recommendations are anecdotal/heresay at best and have no scientific evidence or backing. This article also says that there is the same change in intrabdominal pressure with getting out of a chair as lifting something heavy. I am sorry, but that cannot possibly be true.

So, I started doubting myself. I thought maybe I am being too strict. Maybe these “experts”( that probably haven’t treated an actual patient in years) were right. So, I gave it a try. I gave up the post op recommendations for one set of surgeries for one day. You know what happened? Two of my patients ended up bleeding after wrestling with a dog or picking up their kids since they couldn’t stop….and one ended up back in surgery after tearing their vagina open. That was a definite turn off for me. I guess my anecdotal self realizes after thirty years that not all incisions are created equal. I can see that with a visible abdomen incision you might get a heads up if you are about to make a big mistake and tear your incision open. With a vaginal incision, there is nothing you can monitor visually and no good prior warning signals you have to to tip you off before it’s too late.

The bottom line is, I tried to follow this nonsensical potentially dangerous advice and it backfired almost immediately. So, we are officially BACK to the post op restrictions!

Dr. Katz

Man! It’s lonely being a patient right now!

Yet another reason to hate what changes Covid has brought to the world. It seems like no aspect of our lives has gone unchanged or untouched. A lot of it has been inconvenience like not being able to go to concerts and having to wear masks everywhere, which a lot of us complain about, but yet our lives have still gone on. Other restrictions have been down right tragic like not being able to see loved ones for gatherings, accompany them to the doctor or even visit them in the hospital when they are sick. Even with some of the restrictions lifted or modified, it is a lonely lonely time to be a patient right now.

It is study proven that family support increases the likelihood of successful treatment and recovery, whether that be from surgery, addiction, or cancer. So, what have we done? We have completely eliminated that extra advantage with the Covid restrictions. I feel like we have failed patients because we didn’t even consider other options. Patients have had to go alone to complicated doctor appointments. We all know that it is always better to have more than one set of ears to listen, especially when it comes to complicated diagnoses and instructions. Patients have had to go through chemo treatments alone with no one to pass the time with. Sometimes those sessions last for 8 hours. For a while, patients were languishing in the hospital with no visitors, unless their case became terminal, at which point all communication opportunities and precious time were already gone and families experienced twice the loss: the loss of the loved one and the loss of the time they could have shared. When I was in the hospital in January, there were patients that had been on the oncology floor for almost a month with no visitors, fighting for their lives with no family support.

Back to reality. Of course, I understand the concern for spread of the virus and the potential consequences. But now we have rapid tests for covid. We could test visitors and assess for positivity in a potentially expedient manner. I know what you are going to say. The tests could be false negative. Yes that is true. Nothing is 100% fool proof and there could be risks. I understand how serious it is. However, my educated crystal ball says that we are going to look back on this time period and notice that recovery rates for all hospital-based illness went down by at least 25%. At this point, I am just not sure that the tradeoff has been worth it. None of those lonely patients will ever get that time back.

Dr. Katz