Speaker 1 (00:03):
Welcome to the Holistic and Scientific Podcast, with board certified plastic surgeon, Dr. Robert Whitfield, Austin's natural choice for plastic surgery and the expert in smart laser and energy treatments.

Dr. Robert Whitfield (00:20):
Today, we're talking about our pre-op appointment. For patients who live in or near Austin, this appointment typically happens between one to two weeks before surgery. For my patients traveling from out of state or further away, we'll do this the day before. I always have an in-person appointment with my patients pre-op.

Dr. Robert Whitfield (00:40):
It's incredibly important to have an in-person appointment. If you're always doing things virtually, you lack the ability to do a physical examination. And so, our preoperative appointment in general, is to propose to go over, to reiterate our surgical plan again, based on our initial consultations, our virtual discussions, and then answer questions regarding the plan.

Dr. Robert Whitfield (01:05):
We'll go over specifically about why I do that, why I choose a particular type of lift. And I will typically take a picture with my iPad and draw on it for them. Then I'll insert it in their file, which goes into their Symplast EHR chart. And they can access it any time. If not, we can simply email it to them if they're having difficulties.

Dr. Robert Whitfield (01:25):
Typically, what we do for each and every patient is run an ERAS protocol. An ERAS protocol means enhanced recovery after surgery. And so what does that entail? There's medications you take the night before surgery. And you'll say, "Oh, why are we taking stuff the night before?" Because we want to avoid problems with nausea, increased pain and inflammation, and then nerve pain.

Dr. Robert Whitfield (01:47):
And so, the night before I have everybody take Zofran, which is for nausea. Gabapentin, which is to help to reduce nerve pain and make it so the anesthesia provider has an easier time getting you off to sleep. And then the Celebrex is the anti-inflammatory I prefer to use. That's to obviously decrease inflammation. Those are taken the night before. And then you bring all of your medications to the surgery center that they have.

Dr. Robert Whitfield (02:13):
We'll provide you obviously with the location that we're using for your case. And then your arrival time. I like to start really early in the morning. I've been doing it for 20 years. Typically, we start between six and seven o'clock. Your arrival time is always an hour to 90 minutes before that designated start time. The medications then, if you're going to need more of them, you'll have them with you. We also place a scopolamine patch, which is for motion sickness. Once again, we're trying to do everything preemptively. We don't like to react to situations. We want to avoid them by being proactive.

Dr. Robert Whitfield (02:48):
Here are some of the most common questions I get asked at pre-op appointments. People ask a lot about, "What should I wear prior to surgery?" Easy things to get in and out of, like a jumpsuit, a zip-down top, button-down shirts, things that you don't have to pull on and off over your head are always easy. And then comfortable or light sweatpants, comfy pants. Those are things that are warmer. Those are what we want you to wear the day of surgery.

Dr. Robert Whitfield (03:14):
People often ask, "When will they see me again after surgery?" I have the same protocol in place for each patient, regardless of its outpatient nature or in office surgical nature. I touch base with a patient via phone the day after surgery. I then see them in person at a week, one month, three months, six months, nine months and a year. Obviously, any of these appointments can be virtual if necessary.

Dr. Robert Whitfield (03:42):
What I'd like to have, if at all possible, is that one week and that three month appointment in-person. I'm always happy to see folks more frequently if needed, but that's my protocol. And then a big, big component of all of the process is making sure you have great before pictures. There can be no great after pictures, if they're not great before pictures.

Dr. Robert Whitfield (04:02):
We make sure that our backgrounds are consistent, our clothing is consistent. We provide all that for you. For my Austin-based patients or patients flying in that I can do an EEG for, we do this to evaluate brain fog. We're doing this at the preoperative appointment, our one week post-op appointment, our one month and our three month appointments. It's a very valuable tool in looking at brain fog and hopefully seeing improvements right away.

Dr. Robert Whitfield (04:30):
Other things we'll go over really are related to what to expect in the days after surgery. So the day after surgery, I will give you a phone call as early as I can that next day, if I'm not operating, just to reiterate my findings so that you understand exactly what I found. The other thing I want to do is answer any questions. Invariably, there'll be some question regarding either how they're feeling, what I expect in terms of mobility.

Dr. Robert Whitfield (04:57):
On the day after surgery, I expect everybody to get up and walk around. I would prefer that you walk. That's the best form of exercise after surgery. In fact, once you're feeling up to it, if you could walk a mile or two, whether it's on a treadmill or gently on a recumbent bike, or even seated bike, that would help you from a exercise or a cardiovascular standpoint.

Dr. Robert Whitfield (05:19):
We want everybody to honestly get the best sleep they can, eat the best they can. Diet is a huge thing for me. We're big advocates here of food sensitivity testing. We make sure that you are really understanding what works well in your system specifically. I always like to put everybody on a gluten-free, dairy-free diet and increase their protein intake to one to one and a half grams of protein per day per kilogram of body weight.

Dr. Robert Whitfield (05:47):
For really small folks, that's 100 grams. For larger folks, it could be up to 200 grams. And we discuss this and go over this because you need the amino acids protein in order to heal from any surgical procedure or anything like an infection or an inflammation, or an injury from trauma or something. So surgery, same thing. You need to have amino acids. You need to be able to absorb them. Knowing your sensitivities can help with that as well.

Dr. Robert Whitfield (06:15):
My best case scenario would be somebody who's taken our genetic testing, gotten food sensitivity testing, blood work that reveals any hormone levels that we treat holistically with supplements or with hormone replacement therapy, which we do so that patient's more prepared to have a better outcome. On our next episode, we'll talk about the day of surgery, what happens at the surgery center and what to expect there.

Speaker 1 (06:44):
Dr. Robert Whitfield is a board certified plastic surgeon located in Austin, Texas near 360 and Walsh Tarlton in Westlake. To learn more, go to drrobertwhitfield.com or follow Dr. Rob on Instagram at @drrobertwhitfield. Links to learn more about Dr. Rob's smart procedures and anything else mentioned on today's show are available in the show notes. The Holistic and Scientific podcast is a production of The Axis, theaxis.io.