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Dealing With Pain As A Physician

I admit it! I was channel surfing between CSPAN and the Lehrer News Hour...

...and not so accidentally, stumbled upon one of the Kardashian sisters getting some sort of "minimally-invasive" facial rejuvenation procedure in a posh Miami medical office. The procedure was fairly routine, but what really caught my eye was the incredible amount of pain this young lady was willing to endure. I reflected back to my training in Plastic Surgery and General Surgery, and realized how little attention we paid, as a community, to pain.

I often find myself bringing up to my patients a "Postop Pain Plan", only to find them caught in a moment of bewilderment. "I thought I'm not gonna feel anything", I hear sometimes. In recent years, the increasing dumbing down of medicine and plastic surgery in pop culture media, has some people denying the existence of pain after surgery. Furthermore, of the ones that do expect some postop pain, few expect to define a specific plan for managing that pain. Albeit, they come to me with much greater concerns about their appearances, but nonetheless, the change in appearance comes at a price.

As plastic surgeons, we need to address the issue of pain in a more sincere and serious manner. We need to stop painting rosy pictures and admit to our patients that surgery is painful, that what they are asking us to do is, unfortunately and necessarily, inflict pain. We need to implement a Pain Plan. A simple, lay-term, and effective protocol addressing individual patients' postop pain control needs. We also need to document the plan and incorporate it into our informed consent plan.

As patients, we need to inquire within. Ask our surgeons about the nature of the pain, the duration, the severity. We need to request a specific plan, and decide preoperatively how to manage the pain. But most importantly, we need to stop believing everything we see and read in the lay media. We need to realize that elective surgery is surgery nonetheless. It hurts, and we ask for it. So let's treat it like the serious business it is.

Reader Comments (2)

You bring up a very important topic. Many TV/Radio commercials depict procedures such as Liposuction and breast augmentation as simple outpatient procedures with smiling, happy ladies bouncing around like they just came home from the prom. All surgery also carries some risk but that's also never disclosed. Now, why the Miami Institute would shoot a video of Ms. Kardashian writhing in pain during her "blood facial" likely ruined its appeal for perspective patients looking to have this procedure done.

We've done that procedure with the Dermapen (another device used in this video) and have never have seen such a display of pain. We also use a topical prior to procedure so I wonder if she went in without benefit of numbing...

Lastly the other issue in most TV/Radio spot is the use of price based ads for medical services. Our state boards needs to step in and outlaw the practice of any ads that mention price as a lure for perspective patients. If not what's next? Buy a heart valve and get free kidney stone treatment?

So seeing this I feel pain. haha

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