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The Hoeflinger Podcast
Welcome to the The Hoeflinger Podcast, where Dr. Brian Hoeflinger and Kevin Hoeflinger delve into riveting discussions about life as a neurosurgeon, the world of medicine, healthy living, fitness, and anything else that piques their curiosity. Dr. Brian Hoeflinger, MD, brings his extensive 24 years of experience as a full-time neurosurgeon to educate and inform. Get ready for engaging conversations that will broaden your understanding of the medical realm and beyond!
The Hoeflinger Podcast
#7: What Every Patient Should Know
In this episode, Dr. Hoeflinger provides invaluable insights into the entire patient healthcare journey, from the initial medical office visit to post-surgical recovery and follow-up. He offers a transparent and compassionate look at the patient journey from the perspective of a surgeon. This episode serves as an indispensable guide for patients, demystifying the complex healthcare process and empowering individuals to navigate their medical journeys with confidence.
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All right, welcome back to the Half Finger Podcast, episode seven. It's me and my dad today A little coffee. It's morning. Yeah, a little coffee. It's going to be a nice, a little bit shorter episode today. It's been a busy week, but so I thought we'd talk about what kind of what it's like for you and then, kind of from the patient's perspective, going through surgery, from what, when people have pain, what that presents as the different procedures you perform recovery and the actual yeah, the actual procedure, and then different recoveries, stuff like that.
Speaker 2:Well, I think it's so. Starting from when a patient first comes in to see me, I think the first thing you need to do is kind of adapt each patient, because I think people are nervous when they come in. They're telling you about something that's very important to them and they don't know. I think they're sitting in front of a neurosurgeon. They just don't know what to say, if they're going to say the right thing or so, I kind of guide people through it. What I do is certainly I introduce myself and might ask one question or two about themselves and how old they are, and just kind of break the ice a little bit. Then from there I'll ask them what can I help you with? Because I'm there to help them. What can I help you with? I think that opens up things nicely. And then people will start to open up and I'll ask them if they go on their own and let people talk for five minutes or so just to give me their perspective of what's happening with them. Some people don't say much. See, I kind of have to guide them. I'll say well, let me know, can you tell me where you have pain? And I'll have them show me exactly on their body where the pain is, and I'll ask them where does the pain go? I have them just pretend like they have a paintbrush and paint it down their body exactly where it goes. That gives me a really good idea as a neurosurgeon. If it's a nerve related thing, what nerve is it? Because they're telling me by painting it on their body.
Speaker 2:Then you got to know how long they've had it. And is it there all the time or does it come and go? Is it there every day? How long go did it start? Is it progressively getting worse or better? Then what kind of treatment have you done for it so far? Have you been through physical therapy? Have you been to a chiropractor? Have you been to pain management? There's other questions, but those are the main things I try to ask people just to get it started. I think as you get the interview going, people start to open up to you. They'll feel more comfortable and then they'll give you some of the other little details that maybe we need to know. That's the start of the interview.
Speaker 1:For people that are maybe intimidated coming to the office. They're not sure what to say or what to ask not just you, but just any doctor. What would your advice be there? Do you have advice for people like writing out questions in advance and then forget?
Speaker 2:I mean it's a good option if you write down questions and have them, but I think at the beginning just remember you're there to get help and the doctor's there to help you. You don't want to come in thinking that somebody doesn't want to help you or you're going to be rushed through it. If a doctor is going too fast for you, try to slow them down. Often, maybe if I have a busy day and I'm moving too fast, a patient will say can you just slow down a little bit? Can we go over things a little bit slower? And I'll respect that and I slow down a little bit.
Speaker 2:So I think you have to stand up for yourself as a patient and politely, as you can say can we just go over things a little bit slower or bring up things that you want to bring up? Because sometimes I think a surgeon has a list of things that he wants to know and that's it. And there's the things that you want to get in there, that you want to tell them, and you have to find a happy medium, because there are people who come in who will try to tell me every detail over the past five years of everything that's bothered them and obviously we don't have time to go over all that and a lot of that isn't important in the final decision. So I have to very nicely and politely say you know that that's good information, but it's not gonna help me, particularly right now and making this decision about what's going on right now.
Speaker 1:So you're the expert there and that's where your experience can come in, where Certain things like showing you where the pain goes on their body. That's way more indicative than all these different they might have been through a ton of before they get to you. They have to usually get a referral from someone or have tried other stuff.
Speaker 2:So when I think you have to be flexible as a patient a little bit. I mean, you probably have a certain mindset of what you want to gather out of this appointment, but you have to let the specialist or the doctor senior give them a little leeway, because they've been doing this for a long time and that's their job, and so they kind of know what they need to ask you to get to a point that they can help you. And so you, you have to be patient with them as much as we have to be patient with you. I think you know. So then you know, once you do that then.
Speaker 1:Well, to pause a little bit there. Well, a big issue is, too is just like there's Google out there and everything else, patients crave information and They'll go somewhere to find it, whether that be Google or YouTube, and Anything that's put on the internet, it's not necessarily accurate. So then sometimes you have to unravel.
Speaker 2:Patients come in their expectations on yeah, you gotta be, and you gotta be very, very, very careful, because when you're on the internet because and I'm saying the information is wrong but it's different, like it, you know you, you find a surgeon from Mayo Clinic who does a procedure a certain way, and then you come in to see me and I describe it a totally different way and you go, wait a minute, this is not what, how it's supposed to go, you know. So you have to realize every doctor is different, every doctor's expertise is different and we do things differently. So don't, don't go on the internet and find you know somebody who does it this way and say I Just thinking that's the way that everybody's gonna do it, because it's not, that's not gonna happen well, one quick example of that is People like doing like a lumbar fusion and stuff you can do.
Speaker 1:So many different acts lift, a lift.
Speaker 2:You can come from the front, from the side, the back. Rides and screws right or or sometimes not, rods and screws like every doctor.
Speaker 1:So that's actually something, too, and something you can tell your patients without if you don't have as much time with them. Something he started several years ago and I worked on him with is we create patient education videos for his patients of like personalized procedure videos, because there is so much information and a lot of times when you're out of medical office visit you are like you're in a foreign environment. You don't feel as comfortable. So instead of people going home and looking at YouTube themselves of some other doctor talking yeah, we made your videos of Jesse, you doing that.
Speaker 2:Because I'd rather have you listen to me about what I said in the office how I'm gonna do the procedure and getting on the internet to go hear about how somebody else does it. So so we have videos of Me speaking to our patients Specifically about the procedure they came in to have done and me explaining it to him. So even if you forgot everything during your office visit with me, it's all in the video afterwards that you can watch. We send it to your cell phone. You can watch as many times you want with your family or send it to your daughter across country or wherever. Yeah, the other thing to be careful of too, I think, is, um, I guess so many people, especially this week who came, come in. It's just the recurring theme.
Speaker 2:But you know, radiologist reads a report and it sounds horrible. And then I I go over the films with you in the office the MRI or the CAT scan and the x-rays and I'll say, maybe it doesn't look that bad. And they're saying well, how can you say that? Because radiologists, I have this and this and this wrong, and so there's always a different interpretation of how Radiologists will read a film, based upon how a surgeon will read a film. As far as surgery goes, you know I can look at certain things on an MRI and see if it's significant and do you need surgery or not. But you got to be careful about reading things, these reports, because it'll drive you crazy and then the surgeon says something totally different.
Speaker 2:So many patients come in expecting surgery because they think their report sounds horrible and their primary doctor read the report and thought you needed surgery. And then you come to me and I say you know, really it doesn't look that bad, you don't need surgery, and so it's a big. It's a big problem, I think, for patients is this disconnect, where they're coming in with an expectation and then I change that expectation. And it's only because you know I have a certain way as a surgeon looking at MRIs, to talk to you. Look at the MRI and know do I think you need surgery or not? It's not based just upon how radiologists read to report. So that's something else to be careful of when you come in for an office visit.
Speaker 1:Yeah, and so I'll touch on a couple things. So some misconceptions. I think too is like surgeons always want to do surgery and Surgery is just gonna, is will, magically fix stuff. So to address a couple of those, why don't you talk about your philosophy of care? I think some people would be surprised when you tell them, like no, I don't think you should have surgery, or the trade-off sometimes you will touch on this too of when you're very old. Yeah, because I know your philosophy of care is usually surgery is the last resort, which People definitely don't have that opinion on surgeons or general conception.
Speaker 2:Well, just from my world. So I think you can pray on people. I mean, there's so many people come in and pain who will really do anything Because they want to get out of pain. So I mean you could, you could operate on people all the time if you wanted to, because the radiologist will always dictate something abnormal, right, so I can always find something report that's to justify, say, this disc looks abnormal, we should operate on it. And patients I don't think you know, I mean they, they just want to feel better. So they're gonna trust you. And that's where. That's where I think back surgery and spine surgery gets a bad rep, because you know so many people get potentially unnecessary surgery at times based upon a radiologist report. So so I think I think most surgeons are gonna be of the of the sort that they're going to. It's not our goal to operate on you. I mean, I do plenty of surgery in the end, but I I want you to come in to feel better at the end of the day. I don't want you to come in at your month visit and say I don't feel any better now. What do we do? I mean, I don't want that either. It's something you know. So I try to really pick people that I feel surgery will help and we always will try.
Speaker 2:If there's, you know, somebody has a deficit or they're becoming paralyzed or something's really significant, you may move on to surgery earlier, but it's always wise to start with a course of physical therapy. I mean, I see people all the time with Narrowing of the spinal canal and pinched nerves and you put them in the therapy and they come back six weeks later and they feel 80% better. So so therapy is always an option. A lot of people go to the chiropractor. I don't have any problems with the chiropractor as long as it's helping and it's not hurting and and it's done in moderation. So I think that's fine.
Speaker 2:Pain management can be a way around surgery, especially in somebody who is not a good surgical candidate or their elderly. You know pain shots your back can be helpful, or to your spine. But I think you know surgery typically is the last option, unless, unless somebody's been through all those things already and they have something that surgery will help with, or if somebody is just an excruciating pain, they have an obvious problem on their MRI and it's just, you know, interfering with their life on a daily basis. You can always move surgery. Yeah, up the ladder.
Speaker 1:Or we're talking about elective surgeries, obviously. Yeah, elective, so it's not, not a murder which yet so I'm just waiting like to surgery is clear.
Speaker 2:So we're talking about office visits. So if you're, if you say you have pain in your back and pain down your leg and you've had it for two months and you go see your regular doctor and Maybe you tried some therapy already and it hasn't helped or maybe not, you get an MRI it shows like you may have a pinch nerve. Then they'll send you to a neurosurgeon me to evaluate you, and so that's an elective type of thing, right, you know, you go through your regular doctor's office and then you get referred to me for me to evaluate, as opposed to, like, if I'm on trauma call or I'm on call for the week and someone comes in the emergency department, they have, you know, sudden onset of pain in their back, down their leg, they have a huge disc herniation, they've got weakness of their leg. Then that may be more, you know, emergency surgery. Or then there's trauma where you have head injuries and back injuries and from a car, accent. See, those are emergency cases. But today we're kind of talking about the office visit Electively let's.
Speaker 1:And that makes up, especially at this point in your career.
Speaker 1:Yeah, the majority, the majority of what you do and, um, it's, it's not, it's because you don't, it's not like you just treat your patients that way. Even my mom, your wife, she got back surgery early this, earlier this year. I remember the other year she wanted you to look at her films and she almost wanted you to just say like, oh, you should need surgery now and you saw like a slight issue so far, but you're like, until it worsens, it's probably not something, so it's not like. So you've practiced that.
Speaker 2:To Emma, that was she was annoyed by that, she just wanted she just even though she she goes, are you saying there's nothing wrong with me? I mean, read my report, and there we go. And I said, cindy, I read your report. But I mean there's, it's not as bad as it sounds on your report and you know you're not quite at the point that you need should have surgery, but but but she was in pain, just not. She could still go for a walk, she just wasn't feeling, you know normal.
Speaker 2:Well it's, I think I said it progressed to the point where she really was interfering with her life. And then her we had new MRI. It was worse, and then that was the time for sure.
Speaker 1:Well, I think sometimes it's it's wanting to be heard.
Speaker 2:There's definitely I think that's a big thing in healthcare is Some people feel dismissed at different times, so you have to hear well those are the hardest offices because I can't tell you number of people come in with horrible pain and and and I can't help them and and they read their reports and they just, they think I'm not, they think I don't want to help them, they think I'm just not, you know, compensate to help them and they leave, sometimes discussed it even, you know, and I I can't do something on ethical, I'm not gonna operate on somebody if they don't need surgery. And so there are people out there who just they they're in so much pain they don't know what else to do, you know, and they want you to do anything you can do to help them. And if I can't do surgery I can't change that, yeah. And then they want to know what you can't, just you know. So you're saying you can't help me and I have to live like this.
Speaker 2:I'm not saying that, I'm just saying me, as a surgeon myself, I can't do surgery to fix you and I don't know what else to tell you to do. If you've already been through all those conservative measures, there's always a second opinion. I encourage people to get second opinions if that's what it takes and you just have to hope the next surgeon is not Unethical and does the proper thing? Well, that's that's.
Speaker 1:I think that's the issue with stuff too, is if you go to enough surgeons, eventually you can someone's. You'll find some, yeah, you'll find someone who says, okay, we can, they'll do surgery, we can do surgery on this. And the reason he's saying you can't do surgery is like there's a very, very hot, like almost like 95, 99% chance not gonna help them, and you know that.
Speaker 2:Like there's a small you mean in that, in that group of people where I don't think it's gonna help but you know there's another way to it too.
Speaker 2:I always tell people I mean I don't know at all or I'm not know it all. So I Can just tell you from my experience as a neurosurgeon for 25 years I don't think surgery is gonna help you. But that doesn't mean there's not another surgeon out there who's seen 100 people just like you and Saw MRIs like yours, and he did this procedure and it helped, you know. So sometimes you got to tap into other people's experience. I don't, I only have my experience, you know. And so there, maybe there's another surgeon who's had different experience with, with symptoms like yours, and so it doesn't hurt to go to somebody or two more people just to see if maybe they've They've seen something that I haven't, that they found that helps. So I'm not saying that ruling surgeon out a hundred percent. Yeah, I just have to realize when a surgeon says no to you about surgery, it's they're only doing it from their individual Experience basis.
Speaker 1:You know it's not and what they think is they're trying to. They're giving you their expertise and trying to do as best for you, right, but yeah, also different surgeons. Some people like their stuff that's more specialized than the stuff you typically do, so then someone would have to go somewhere else.
Speaker 2:Yeah, if there's something beyond what I normally do in my normal practice and I will firm, you know, if it's something specialized to the brain or the spine that's beyond what I normally do, then I'll refer them to you of M or Cleveland Clinic or somewhere like that, to see a specialist, even a specialized neurosurgeon, who just focuses on that specific problem.
Speaker 2:I mean yeah, there are surgeons who just focus on one specific area Of the brain or spine and then they do very complex surgery and so obviously they're more qualified than I would be, because they do that all the time and I don't do those specific surgery. So you got to know your limits as a surgeon, I think as well, which, because I think that's something too.
Speaker 1:People would think like neurosurgeon, that's already very specialized. And people you know brain and spine surgeon yeah there's. They think this person knows everything. But then there's some it's. There's multiple sub specialties within neurosurgery.
Speaker 2:You know you can get way more specialized and in the end it can't be an ego game. You can't. I mean, I obviously have to have a little bit of ego to be in their certain, but you can't be egotistical because you know, in the end it's about helping you feel better as the patient and it's not about my ego that I can do a surgery. So you have to. I mean, I learned a long time ago to differentiate the two and you know I have to have to do. I always think about if it was my wife or my son and they needed this surgery and I don't do a lot of them, I'd send right off to the specialist. So you got to think of things as your own family, really, yeah.
Speaker 1:So yeah, moving on. So. So what happens?
Speaker 2:so we looked at the films in the office. After we look at the films in the office, then I'll talk to you about what I think you need to do and if it's surgery, then we sit down and go over in detail what the surgery would entail. Really, that's the time that I let people ask all the questions they want to have. A lot of people have a whole list of questions on a piece of paper, which is great, and we try to take the time to answer as many of those as I can, and then and I give them the video so they can watch all this again at home.
Speaker 1:Yeah, Um, it's just back to the office, was it too? Is when you like you said someone who would be a candidate for a good fit for surgery with, when you you don't tell people to like you From like what? I've all the times I've been there when we set up the flow so we can text out the video and other stuff. You don't say like, hey, like you gotta make a decision right now. No, you say, hey, go home, discuss this with your family, go over everything I told you, go watch the video, share that with. And that's the whole point is because you want people to be. Some people don't fully understand what they're like like doing with surgery and stuff. I mean that's another reason we made the videos so people could fully understand their surgery and be informed about their health care and be Enabled to make decisions that are best for them.
Speaker 2:Yeah, I mean I think if you ever go in and you feel rushed in the surgery, like you don't have your Questions answering, you're just being rushed in the surgery to make a decision that day.
Speaker 2:That's not how I mean, that's just not how I do. I always tell people and you know you don't have to make a decision today or right now go home and think about it. We'll give you a number to call back. If you want to come back and see me for another visit and bring your husband or wife or family, I'd be happy to go over everything again because you know you should feel comfortable with this decision. I tell them to watch the video and and I'd say 90% of those people who go home and think about it We'll call back and schedule surgery. But the wrong thing is to try to tell somebody okay, you got to make a decision right now Do you want the surgery or not? I got to get going and get another patient, so that's not what you want to happen in your visit. I wouldn't think I wouldn't want it as a patient, so I try not to do that and the other reason we talk about the videos.
Speaker 1:That's something you had thought about like right around when Brian died. Then we never you never really did something with it. And then I was in college that was something too like I do for other doctors because we get so many positive, like so much positive patient feedback on these person lines videos that they share with their family members, especially through COVID people that might not get to meet the surgeon. Yeah, so I mean I think that's, I mean that's that, that you have the whole flow with that, because then we talk about you, talk about all the other stuff too, because a lot of people the Conception there too on some patients they're like I don't want to see the surgery and stuff Like you detail the surgery, like using MRIs and everything else, and we've shown stuff like that in social.
Speaker 1:We started doing now is kind of the original idea of why, like why we started putting stuff on social media. It's like, okay, patients like these so much, let's kind of put out some other general education of you explaining MRIs to people or or stuff like that. A lot of people say you're good at talking in layman's terms and Articulate things and we know, yeah, we don't show the actual surgery.
Speaker 2:It's just about me, it's just a recreation of me talking to you in office. So I mean, I just explain an MRI that's representative years. Again, I use models to explain how we do the surgery. I'll show you sometimes what the films and a typical patients had a fusion with rods and screws would look like afterwards. So as much information that I can give you in there, I do, but it's not actually showing the blood and go or anything like that. So because some people say I didn't watch the video because I didn't want to see it, it's not of the surgery, is you?
Speaker 1:realize people want to care about all the other stuff so much more. That's what we like. People want to know like what? What is it that? What are you seeing? That means I need surgeries like the MRIs, the symptoms and stuff, and it's obviously just a representative one, it's not their specific one, talking about what the actual Surgery you do, like so you might remove a bulging disc or something else. And then it's talking about the recovery time and what recommendations you have. Each surgeon recommends like lifting different amounts after surgery and and most surgeries you know you're gonna get better for like six months to a year after. But if you I mean you can check out the videos of any of the the surgeons we've done bit I've done videos for its AM AM Dot media and if you go to the doctors, there's a couple different types. We have orthopedic surgeon, murrow, gynecologist, couple neurosurgeons, but I've done doing that. It's some I don't know if you've never seen. I think they're still. They're pretty good for even people.
Speaker 2:Yeah, and it's important to. I think, like you know, a lot of people get online on the internet afterwards and say, well, what should I be doing after my lumbar fusion surgery? Well, again, every surgeon is different. So that's why, in my videos, I tell you, me specifically, here's what I want you to do, how to change your dressing, what the lift, what activities one you can drive and what I recommend a patient to me different than the next surgeon. So that's why I like about the videos, because it's my, it's my regimen that I'm talking to you about Specifically and that some other not you getting that information from other surgeons online.
Speaker 1:Well, and it's like us doing this here Because I realized that his expertise of knowing in medicine how that operates. And then I Come in is I? No one likes to read stuff anymore. You get these long packets for like you're like a 12 page packet and it's. You grab the pack, then you maybe set it at home somewhere, but then you have to look through and People don't like doing that as much. We're so used to watching videos, like going on, like if I, if I need to look up how to assemble like a new piece of furniture I guess because of my age and generation, I don't look at the instruction manual. I usually do like a how-to video on YouTube.
Speaker 2:What's crazy Do like I'll see. People who have been out there, you know, say they had about a back pain, they want the emergency department, and then when they come in to see me as a patient, electively they've got they'll show me why I want the emergency department. That's what they gave me. It's like 25 pages of just. I don't even know what's in it. I can't, I don't have time to look through it all and it's hard to even find what they did because there's so much extra stuff in there you don't even need, so it gets carried away. All this stuff they print out, you know, to give you to read and yeah, just all generic stuff too.
Speaker 2:It's just generic.
Speaker 1:Yeah, so after the office visit, someone has gone home. They've talked to their family. They Just decided they want to perceive a surgery. They get that scheduled. Then what? What's like actual surgery?
Speaker 2:That's usually the shortest part, right, and they're like surgery day, I mean so at some point you have to come into like a pre anesthesia visit and they kind of go over you, do an exam, tell you what to do, like you know the night before you have to scrub your back and take a certain bath and things like that, and Then obviously they have surgery, like if your first case, if it's my first case in the morning at 7 or 7 30, you know you got to be there, like it, you know, 5, 36 o'clock in the morning to the hospital and people will live two hours away. I mean I love people who are, you know, in their 70s, 80s and they had to get up at 3 30 in the morning to drive the hospital. So it's a big deal. So I always try to be on time and respect that they've gotten up early to come in and have this done. And then I always stop, always before surgery I, to talk to the patient, ask them if they have any last minute questions about the surgery. Sometimes I haven't met a family member, so family members will be there I didn't meet and I'll introduce myself and see if they have any questions, because a lot of times they weren't at the visit and they didn't watch the video and so they'll have a few questions.
Speaker 2:And then from there, you know, the patient gets taken back to the operating room and anesthesia has to get you to sleep, so that takes a little bit of time, and then we have to position you on the operating table and then you know surgery itself, once you're on the operating table and you're asleep, and we clean everything up with sterile prep. You know surgery can take anywhere from an hour to five hours, just depending on what surgery I'm doing. And and then once I'm done with surgery, then I leave the room. I'll have the nurses call to put the family in a room. I'll go out immediately and talk to the family, let them know how surgery went, ask answering questions, tell them when they get to see the patient. And then, from the patient's perspective, you know anesthesia has to wake you up a little bit in the operating room, get you off the operating table, and then they'll take you into the post-recovery room where most people are there for an hour or two. If it's the same day surgery. They let you wake up, start eating, drinking, walking. You can go home in an hour to two hours to three hours. If it's stay overnight surgery, you know you'll be in recovery room for a couple hours and they get you up to your room and then and then that's where the nurses kind of take over, and the nurses will gradually help you get out of bed, hopefully later in the day, start eating, control your pain that you may be having with pain medication.
Speaker 2:Typically I'll see the patient the very next morning and I would say 90% of my patients go home the next morning, so I'll come in and see them. So the other day I had three patients in the hospital from the day before. So so Jenny, my physician assistant, I went in and we saw each patient before we went to office. The office started at 7.30. So we go to the hospital see the patients.
Speaker 2:I'll go in, talk to them, see how their day went, see how the night went. We'll look at their dressing. If it needs to be changed, we'll change it, check their strength, make sure they're doing okay and then just tell them how the day will progress. You know they're going to get you up a little bit more this morning, eat breakfast, maybe lunch, and if you're doing well, by late morning to early afternoon you can go home. Some people are ready to go right when you walk in so they'll be out of there by 8 o'clock and then I reiterate all the instructions about going home and let them know. It's all in the videos. To watch the video Plus on their discharge instructions. We write down certain things. We want you to know how to change your dressing, when to shower, when you can drive, how much to lift. So we put all that in written form plus my video, so as much information as we can give you when you leave the hospital. So you're not going home wondering what do I need to do next?
Speaker 1:Yeah, the more verified information you give that's directly from you as a source, versus we have a nursing office every day, five days a week.
Speaker 2:Who can, who's very good, and so we always say you can call her too. Any questions you have, people do call. So we try to give every avenue we can so when you have questions you're not sitting out there wondering what to do, and that's something that you should ask ahead of time. You know, after surgery what do I do, like how do I know what to do? Well, I have written instructions, kind of call somebody. I mean, it's all important stuff to know, and so we try to hit every avenue to help you after surgery.
Speaker 1:Yeah, and then. So now they've had surgery, do you want to talk about like the typical recovery, or like what's or not recovering? That's per se, but like. So you usually see people in the office like anywhere of two, six weekends.
Speaker 2:So it just depends.
Speaker 2:I know if it's a, if it's a. If it's a, you know, a neck or back surgery, typically I'll see some people at two weeks but typically I see you at a month and then I'll do a three month visit and each of those visits obviously examine you and look at your incision but also talk about how to increase your activity If you need physical therapy. I usually start that at a month and then answer any questions that you have at that visit about things that you're wondering. And so if you've had a bigger surgery or a fusion with rods and screws, I'll typically see you out to six months in a year or two. So a little extra visits for those.
Speaker 2:If you've had a brain tumor removed or you're a trauma from the hospital. It just depends, you know. I mean I usually when I have you come back in after removing a tumor, I'll have you come in two to four weeks after surgery with a follow up CAT scan to make sure there's no new changes on the head CT go over, you know, activity limitations and restrictions. If it's, if there's ongoing active treatment, if it were a brain tumor that needs to continue to be treated with radiation or chemotherapy, typically I'll see people out to three to six months as well. And then traumas. You know it's all very similar, but traumas to your back or your brain, I mean typically it just depends how you're doing. I mean, if you're doing really well, I might see a month later. If you really need close follow up, I might see a week every week for a few, you know, two to four weeks. So it just depends on the individual patient, you know.
Speaker 1:Yeah, so, but then that's just to make sure everything has went well is going well? They know everything. Yeah, everything's good, but you got to have context.
Speaker 2:In the office too, like you know. Obviously things can happen. I can see you one day and not going to see for a month and all of a sudden, three days later, you've got leakage from your incision or you have a bad headache or you're having increasing pain and you can't wait a month, obviously, right. So I always tell my patients. You know if something is changing, it's getting worse. You don't have to wait a month to see me. You call the office, we'll get you in, usually get you in right away, either with the nurse or my next office when I'm there, and always, always, always tell the people you know that they can call our office and the nurse can help you. If it's a significant problem that she can't handle, she'll call me and you know we always have you come in, no matter what.
Speaker 1:So yeah, the normal follow ups are just for people that are doing fine, yeah it's going smooth and just double checking everything.
Speaker 1:But but yeah, I think that breaks all that down. That's a pretty good detail for people and kind of gives the perspective, I think a lot. Most people who are patients, they see it from their side. They don't necessarily see from the doctor side. But I think one intrat like good aspect that you talked about was how you might. You have to remember we're all, everyone's a human, so like, some days you might be busy and you have. You know you've got other stuff going on in your life and all of a sudden you have 40 patients and it's it's, it's tight, and then you might go into someone and you're not trying to like not let them speak fully, but you think you kind of like can see you don't need the additional information to make a diagnosis necessarily, and so you have to.
Speaker 2:So that's a hard thing about being a surgeon you're balancing that, which I thought was important, because you don't want to piss people off, obviously, because they, they, they're there, they have feelings, they want to get all everything out that they want to say. And you know, when I cut them short a little bit it's you know, it's dicey, but it is true, I mean, I mean, but you know, my bad day shouldn't represent you having a bad day at your visit either, and so I try to always remember that and try to Well, and they, they also.
Speaker 1:They had to come check in, they had to schedule a check in and do all that, and then you come in, you know. So, for people that's just like any office medical office visit, like when you go somewhere, you, and then that someone comes in quick.
Speaker 2:But so I, you know, i- no, I just say you know, just you know, when you go to an office there's a you know, ask questions. You shouldn't be shy to ask questions, that you're right as a patient, but also listen. You know I should listen, but you should listen too because you have to kind of give the surgeon a chance to give you his perspective and, and you know, he's often looking at it much differently than than your family doctor or a radiologist would have looked at your MRI reading or your your you know, study that they're going over. I'm just talking about neurosurgery specifically.
Speaker 1:But yeah, and if there's anyone, I don't know, we talked about some, but if you are interested in like neurosurgery and kind of some of that stuff and you haven't seen him on social media the social media side, it's at doctor all spelled out, doctor half-linger and or you can just look. We put all the links in the description of this but we got a ton of videos like like short form videos and some other ones explaining different things like how does a good one, I think, is how does different nerves being affected? What does it present as like pain down the buttocks or or if it's down the front side? You know those all connect to different nerves. So I think we have a lot of good stuff there too.
Speaker 2:But kind of a short podcast day, but we thought it'd be good to just kind of go over the patient experience, like what to expect from an office visit. And then obviously it's based upon my opinion. Obviously every neurosurgeon is kind of a different style and a different way of doing things, but you know, just hopefully this may be helped if you have an upcoming office visit with a doctor.
Speaker 1:Yeah, just maybe just get you thinking about different things or just exhaling debt. Always try to try to get as much information as you can from the source, because every surgeon is going to there. There's no best approach in neurosurgery or any surgery. There's always there's different fields of thinking and then within that there's doctors or the surgeons. They've seen what works best for them. Like you usually tell people, don't lift more than like a carton of milk, weight wise, but that's you know, that's all. Someone might describe it a little bit differently or different stuff like that. So it's all you know. That's just expertise, that's your experience of what's worked well for your patients. So I think everything is pretty personalized. But thank you guys for listening and, as always, let us know if you have any topic suggestions and let us know what you think of the podcast. Thank, you.
Speaker 1:End Speaker 1.
