Dr. Ekstrom contemplating Stonehenge
By Juris Bunkis, M.D.
Dr. Ekstrom and I wound up our most delightful visit with our friends in the UK with an excursion to Stonehenge. It is difficult not to be awed by this prehistoric monument located in Wiltshire, England, which has mystified archaeologists, historians, and tourists for centuries. Comprising massive standing stones arranged in a circular pattern, this enigmatic site has posed more questions than answers.
One of the greatest mysteries surrounding Stonehenge is its purpose. Theories abound, ranging from a celestial observatory to an ancient burial ground or a place of worship. Some believe it was constructed as a monument to honor the dead, while others argue it served as a center for healing and spiritual rituals.
The method of construction itself baffles experts. How did the builders, lacking advanced tools and technology, transport and erect these colossal stones, some weighing up to 50 tons, from quarries miles away? The precision of their alignment with astronomical events, like the summer solstice, further deepens the intrigue.
Giza’s famed pyramids in Egypt were built roughly 2,500 BC. The people responsible for Stonehenge’s creation, likely from around 3000 BC, left no written records. Consequently, the monument’s true purpose and the motivations behind its construction remain shrouded in mystery. Yet, its enduring presence and magnetic draw continue to inspire awe and ignite the imagination, making Stonehenge a symbol of ancient enigma and human ingenuity.
Will I have pain after surgery and what can we do about it? Optimal Postoperative Pain Management in Cosmetic Surgery
Postoperative pain control is a crucial aspect of cosmetic surgery. Ensuring patient comfort contributes to overall satisfaction with the procedure. The short answer to the question is: it depends. Pain is subjective and post-operative pain control should be tailored to the individual. Cosmetic surgery encompasses a wide range of procedures, from facelifts and breast augmentations to liposuction and rhinoplasty. While the primary goal of these surgeries is to enhance physical appearance, managing postoperative pain is equally important to ensure a smooth recovery process.
The strategies for postoperative pain control includes a thorough assessment of the patient’s medical history, pain tolerance, and expectations. We want to identify any pre-existing pain conditions or allergies that may impact pain management choices. A multimodal approach to pain management, combining various medications and techniques to optimize pain relief is sometimes necessary. We utilize a combination of opioids, non-steroidal anti-inflammatory drugs (NSAIDs), local anesthetics, and muscle relaxants to address different aspects of pain. Local anesthesia is almost always administered to the surgical site to minimize intraoperative pain and reduce the need for postoperative pain medications. Techniques such as tumescent anesthesia and nerve blocks can provide extended pain relief. In addition, we offer a “pain pump” that can be set up to slowly deliver local anesthetics to the surgical site for several days after surgery.
Patient education about expected postoperative pain levels and recovery timelines to manage their expectations is critical and we aim to provide clear instructions both verbally and written on medication usage, including potential side effects and dosage adjustments.
After surgery, pain assessment and monitoring to evaluate the effectiveness of pain management strategies and adjusting medication regimens as needed based on the patient’s reported pain levels are often used.
Overuse of narcotics is always a concern and thus we prescribe them judiciously to mitigate the risk of dependence and adverse effects. We encourage non-opioid alternatives for pain relief whenever possible. Home care instructions to patients, including wound care, physical activity limitations, and dietary recommendations and regular follow-up are necessary. Follow-up appointments are scheduled to assess the patient’s progress and address any concerns or complications promptly. We want to ensure that pain management remains effective throughout the recovery process. Effective postoperative pain control is paramount in cosmetic surgery to enhance patient comfort, satisfaction, and overall outcomes. By adopting a multimodal approach, educating patients, and closely monitoring progress, we can optimize pain management strategies and contribute to successful cosmetic surgery outcomes. Below an post-operative pain pump is pictured.