Patient to Practitioner: What Implant Removal Recovery Really Looks Like | Violet's Story

All right, welcome to the show. I have Violet, our nurse practitioner, who came to me from New York, spent a couple years with us in Austin, and now is back in the New York area like a boomerang. She came and went. Um, so Violet came to me with a facial plastics background and a lot of, uh, actually great nursing experience But we're just talking a little bit offline about breast implants, breast implant illness, explant surgery, and she let me know that that wasn't something that was discussed in the New York nurse practitioner or nursing, uh, community. So I want to give Violet an extremely warm welcome to the show so she can share her perspective on, you know, how she got to us, her experience here, uh, in Austin, and now really helping take care of our clients remotely all the time. Um, so welcome.

Yes, hi, thank you for having me today. Um, as Dr. Whitfield MD said, I did just recently move back to New York City. Um, I'm originally from Austin, Texas. We moved down there a couple years ago when I was looking, uh, for a job in Austin. I had come across a posting for his office and I saw it said something about breast implant illness, but I was searching keywords plastic surgery. In New York, I worked for a facial plastic surgeon for about 3 years and was a part of a community of tons of nurses and nurse practitioners that all worked in the New York City area and the Park Avenue area specifically. At the time, I had had implants in for 13 years. I got them when I was 20 years old and I was considering getting them out, but it was not something that people were talking about. Nobody was talking about breast implant illness, even when I talked to other nurse practitioners in the area that work for body plastic surgeons, they just said, "Yeah, I think they'll take them out." But they specifically were just putting them in. So there was definitely no one specialized in it. I had had symptoms that I didn't know were related to BII until I specifically kind of started getting started with Dr. Whitfield MD MD and learning more about what this was. I just kind of was sick, I thought, for a couple of years, which to me, I'd gone to lots of dermatologists and doctors and they eventually just told me it was genetic and that I was eventually kind of predispositioned to that. So once I got to Dr. Whitfield MD MD's office, I started learning and decided I wanted to have the surgery and was there probably about a year, I think, before I had it myself. So I got to see the before and after of a lot of the patients and kind of learn a lot more emotionally about what was going on. I, which, you know, kind of goes into how I take care of patients. I always say there was a before I had the surgery and after I had the surgery of how I treated patients. It was very by the book. You know, once I had the surgery myself and went through the full year post-op, it comes from more of a personal and emotional experience. So that's kind of where I'm at today, and I'm about to be 2 years post-op in June.

That's hard to believe it's been that long. Things move very, you know, quickly in the office and we have a very standardized routine for surgical follow-up which Violet has experienced obviously as a nurse practitioner and then as a patient. And it's, it's a very aggressive schedule of follow-up. It's in terms of, you know, seeing people initially and then trying to help them prepare. And maybe we'll start that way. So I feel, um, and from my surgical training and maybe what you've experienced in, uh, your background, there's a lack of preparation of surgical patients normally. I think there's a lot of you know, meeting someone, someone's, uh, maybe interested in having a treatment or procedure done on an area that's bothered them for a very long time. And once they decide from a patient perspective what to do, they kind of want it done yesterday. They want it done immediately. And when someone becomes aware of a chronic inflammatory process that may be associated with the implant that sets off a whole series of reactions. And sometimes people really want to get this taken care of very quickly, and it's, it's something where we're not trying to, to, to stop that as a process, so to speak. It's it's more that I'm worried that people are going too fast. They're, they're from a health-wise or health position or metabolic position or chronic inflammatory position, really not aware of how bad something is. And then when they get into it and they have a surgery, which, uh, Violet's gonna detail like her experience, and it can become not just a, uh, a body image changing type procedure, which it is, of course. But it can set off this kind of sequence of events of hormonal imbalance and fluctuation and metabolic changes and Herxheimer type reactions, which Violet got to learn all about as she came to our practice. So it's, it's not, it's not a small thing that's happening is my point. It's Surgery is, is only a small thing when it's not happening to you. Every time you have surgery, it's a very, very big deal for your body and how you respond to and cope with surgical stress and cortisol release. And the number one person of cortisol release in my practice is me. Like, I cause that every time we operate. And our whole program, if you want to think of it from that perspective, is trying to limit how much cortisol release is happening at the time of surgery by all the surgical preparation with sleep hygiene and nutrition counseling and supplemental supports and really preparing, not like the standard, like chest X-ray, EKG, blood work, and your, your health history because We hope all of that's in order because there shouldn't be a case where it's not from our perspective. But all these other things play a huge role in how someone feels after surgery. And maybe that's— I would like more people to think of it in that way so that they're not rushing but trying to really be intentional and prepare for something so that it is much smoother? Because everything we've done is to smooth out that course, and we continue to work really hard to try to perfect that front end because the back end's a nightmare if you don't work hard on the front end.

That's correct. So I'll kind of just talk about the pre-op, um, process and how we come to decide, like, when is the best surgical day. There are circumstances where there are patients, you know, that are in a or state where they do need to have the surgery right away. But if we had the optimal patient that could come to us, you know, we'd be doing their blood work and tests about 3 months before and can work with them. Some people have already been living this lifestyle where they're already gluten-free, they're dairy-free, they've already cleaned up the products in their home. Um, these are some of the things that we try to address. These are things that, you know, normal Western medicine might think are minuscule, but us, we We think that, you know, health starts in the home. It is the type of foods that you're putting into your body. It's the type of products that are around you. What are you using day to day? From there, after you have a, you know, consult and decide to make the journey of the surgery with us, ideally, like I said, you know, we have a couple of months to work with you because there is the Total Tox Test that we use that kind of is a little marker of what's going on inside of your body. The people have probably never had a surgeon do this on them before. It's like a little roadmap that tells us like what is kind of going on in the body and how can we prepare them best, you know, from an internal standpoint to heal from a major surgery such as this. You know, the thing I always emphasize to women is they think that this is just plastic surgery and it's elective and, oh, I should be bouncing back and recovering, but The reality is, is that this is a major chest surgery and I used to work in lung and heart transplant where they would do, you know, major muscle recovery. And this is stuff that keeps people down for weeks. And so that's one thing, you know, I'd like to shed some light on is it's, you know, an intention to, to decide to do this surgery. And, you know, once you do and you're invested with us, we're going to do our best to get you there, you know, fully prepared. Um, sorry, I lost my train of thought.

Um, just preparation and looking at the TOCS test and trying to, you know, I think what Violet has definitely, uh, probably had our eyes open to what is a very, very different, um, pre-op. So when we're looking at somebody We're trying to see through this test. It's very elucidating to me, and I had a call with our scientific officer the other day, and we haven't talked about this, but we've got over 500 toxicity tests on patients. And in an audit of those, the number one thing is, uh, environmental toxin BPA from plastics. And the number two thing is glyphosate, which is Roundup, which is sprayed on our food supply. And then the third thing is a mycotoxin. So that kind of tracks with what we normally see.

Yeah.

And there's a lot of concerns over heavy metals. Of course, we look at that. We've had patients like Lauren Bostic have all these heavy metals. We've had patients have a lot of herbicides and pesticides, like our recent patient Ashley Kurtz, who was a golfer her entire life, spent all this time on golf courses. And I think we're always kind of surprised by this. I mean, I never know what a test is going to show.

No.

And I can listen to people and I can get some ideas about what I expect. But if you had spoken to Ashley Kurtz, you would have never guessed in a million years she had a whole page full of herbicides as the, the top environmental toxins. Like, you can't know that from a provider's standpoint. So those are the things that still— I— nothing really ever surprises me anymore, but things like that are just like, wow, how can someone really wander around on a day-to-day basis coping with that kind of burden of forever chemicals is what in their body is in, in your body. And and, you know, take care of yourself, take care of your kids, take care of, you know, everybody, which is all my patients do that. And it's become like maybe in training for Violet, uh, blood work. Everybody's like focused on blood work. And so I don't really focus on that anymore because everybody's had that done so frequently and it's so often looked at that We don't really see patients with a bunch of abnormal blood work. That's not—

no, we don't. That's absolutely right. They're within range, I would say. So I guess that's a huge difference, you know, coming from the practice that I came from before. We did surgery, we just did facial, but kind of assessing like what the healing pattern was going to look like. And, you know, for the patient that was going, that's a huge thing that we put emphasis on. That it could maybe deter some people because like you said, they want to have surgery right away. But coming to our practice, we never push someone to do surgery right away. We never push extra surgeries on them. We want them to, like, of sound mind, make this decision and kind of come to it. You know, once the surgery is, you know, started and over with, that's kind of the next part of the process that I discovered after, you know, going through the surgery myself was like that first 4 to 6 weeks of emotional just kind of healing and almost a shakeup that happened. So I know you're talking about the cortisol levels and the hormones. And again, I worked here for a year taking care of people and could never have understood the level of what that does to someone until I, you know, went through it myself. I think of myself kind of as someone who's kind of like straightforward. I'm not super emotional and crying. And the first 6 weeks were so hard for me because I was first not sleeping that great. I'm someone who pushes themselves to the limit. I don't rest. I wasn't following, in a sense, hardly any of the things that I tell people. And that kind of, you know, when you don't rest and you don't, you don't follow the protocol, it doesn't work.

And I think Violet was not being a good patient.

No, I wasn't. No, I was not. I came back to work on day 4 and they sent me home. So it is definitely something that, you know, I really talk about with people. And I think, you know, that's the special part of this practice is that like I talk to people, you know, as a nurse, but also as a patient and the importance of, you know, going back to taking care of your family and the things that you need help with. What can you prepare beforehand? Some of the emotional stuff, you know, again, is just crying days, you don't know why. You could be so happy that you have this surgery, but you just start emotionally crying or, you know, being irritable. These are, there are a lot of highs and lows. People that never take naps such as myself, you know, wanting to take a nap at 2 o'clock. And, you know, that kind of shows into you're not eating enough protein. What are you doing throughout the day? These are things that we teach the patients that again, I think I needed to learn for myself to really, you know, know why this happened. There's another thing that's really interesting to me that I had never really even, I think, talked about in the first year with patients, um, because I don't think I was asking the right questions. And that's the growth that happens, um, in the first 3 months. I, um, you know, personally think of getting the implants out as it's almost like a loss for some people. I, you know, again, was 20 when I got my implants in, So I would say I was really never really an adult without them. You know, I just, this was kind of my identity. I was 36 when I got them taken out and I, you know, didn't realize again some of the things like how I attributed my whole identity to these things, like my hair, which I was losing, having implants and how those kind of things made me feel pretty as a woman. And when that's stripped away, stripped from you, it's really like makes you very raw and eye-opening. Again, I really wanted the surgery, but it doesn't mean that you don't go through these emotions and the process of healing. So a lot of the patients that I talk to, you know, they, they deal with anger with themselves, like their, for example, me and their 20-year-old selves, like why did they do this? Um, there's a lot of processing of, you know, even deeper issues of Childhood bullying, relationships, self-confidence, you know, kind of getting to the root of why they got them in the first place. This wasn't something that I was just asking people. It just kind of naturally started coming out whenever I was talking to them. I think woman to woman also, again, just because like I understand it and, you know, some people are not supported through this process. And so there is a lot in that first 3 months of growth. And it sounds weird to say, but it's almost like turning a chapter in a woman's life is, you know, kind of coming out of this and processing all of those things and, you know, learning to self-love. And sometimes that's not in the first 3 months. You know, I work with patients throughout the whole year. It's at 1 week, 1 month, 3, 6, 9, and 12. And it is almost everyone that at that end of the year, like, they've come to a self-acceptance and happiness. But you could never have told them that at month 1 or 3. They, you know, were in a lot of sadness. So that's one of the things that I've been really proud of, um, of, you know, working with women and bringing to this practice is the realness, um, of, you know, healing in a safe place, you know, for them to have postoperatively. We have almost literally every patient that comes through here that says there is no other practice like this, there is no other safe space of, you know, a group of women that support you postoperatively. Dr. Whitfield MD is the surgeon, but he has a strong group of women that work in the office, that work virtually, that are functional practitioners that help make this journey so much more supportive and easier versus if they were going to another surgeon's office and just kind of like had a post-op and that's it. So we take a lot of pride in that.

I think that's something that is probably not, um, I mean, we don't spend a lot of time or emphasize our dedication to the patient and that approach. I talk about our team a lot and how great the team is, but we should highlight, you know, the lead practitioner on the functional team, Chelsea, is a patient who explanted with us, and so is Gina, who is on the team and explanted with us. And within, you know, the office, everybody worked extremely hard to, to care for the patients. And I don't, you know, throughout the time I took and participated, you know, in different types of practices, you know, whether it's in England where I worked at Cambridge, or whether it's at Indiana where I trained, or I taught, or here in Austin, there's not been, I would say, that amount of emphasis from an extender standpoint. Like, everybody involved in the, the care— because we have a big team that works in the office, and not everybody will understand what we're going to talk about next, but then the office is very different. Like, post-op care in an office and I can let Violet give her experience, but the way it ran when I was trained was somebody would come in for post-op appointment, they would have a brief appointment with the surgeon.

Yes.

And then the nurse would, uh, conclude the, you know, encounter with the patients, help with any instructions, if in fact there was a nurse. It could be a medical assistant or anybody at that point after the surgeon come in and done the post-op physical exam and listen to any questions and answered those, you know, for the patient, then that was it. Now, that could be a week, a month, 6 months, or a year. Invariably, it's not how we do follow-up. Now, I do follow-up a specific way, and I always have for my breast cancer reconstruction patients or my cosmetic patients. And I stopped doing breast cancer reconstruction end of 2019, but But I've always kept it the same. And it, I think it's, it helps keep a cadence for everybody. So there's not a drop-off or a communication issue. And I often say the only way you can't get ahold of us is if you're not trying to.

That's absolutely right. Yes.

So I'll let Vailey give her perspective about like plastic surgery care and follow-up with surgery patients. And she worked in a— like she told you, a transplant unit, like it's a very different situation.

So, yeah. So again, some of the things that make our practice different is that we are fully caring for you for a full year. You're getting from the medical side of the surgery, which is with me, and then you're also getting on the functional side, which is one of our 3 practitioners, Melinda, Chelsea, and Gina. So there is a lot of appointments that kind of go into it. And so when we say like, this is a commitment from the patient, you know, we're also putting a lot into it too and making sure like the goal is always success. The goal is, you know, getting them back to their baseline of health, whatever that is. Some people work with us longer than a year because they love how they feel and they wanna keep working with our functional team. You know, that's just some of the differences. In the plastic surgery community, photos are very important. So you might have paid, do like a 1 week, maybe a month, maybe a 6 month. But some practices, you know, they just kind of end it there, maybe even 3 months. There isn't a huge full year of care. So at each appointment, there's kind of milestone markers that we're hoping for. Somebody doesn't come to us at a month and, you know, where like they're cured, they look amazing. It's actually at the first appointment not even about cosmetically kind of how they look. We do a lot of explaining of what's internally happening to the body as well as like what's happening to the skin, um, as well as what's happening emotionally. So when I see someone for the 1 month, I always prepare them and say, you know, this isn't— this isn't like that we think you're gonna look, how you're gonna look today. Even at 3 months, you you know, you're gonna look better, but this is a closer to, you know, between 6 and 12 month process. And that's why it's so important to keep taking the photos and seeing these differences and changes. And that way also, if there's anything that we can catch that, you know, is hindering healing, that we can catch that early. That's very important to our practice.

Yeah, I, you know, it's often like you mentioned, there's a lot of deeper internal things that happened and led to why someone had the surgery in the first place. And patients always confide more in Violet than they ever would for me. And patients have confided very personal things, like they were sexually assaulted, um, things that you would obviously typically not communicate, you know, to a provider. Like myself. And, um, I, I think, you know, probably these deeper, like, bullying issues and traumatic issues and, um, body image issues are their core, core issues that they shouldn't be overlooked, they shouldn't be underappreciated, uh, and they cause a lot of frustration for the patients. And a lot of times we don't know what's going on. And I don't ever— Violet's been a couple years around me. She knows I don't really get high and I don't get low. And I just have to always kind of take things in stride and try to not I never know what's going on in someone's world, so I don't try to insert myself into that. I just try to listen and help wherever we can by not getting high or low about what's happening. Or because usually in my experience, and certainly with almost 30 years of operating now, everything typically, as more time elapses, as someone sleeps better, eats better, and their physiology improves, they will feel better.

They're gonna heal. Yeah, that's what I was gonna say. And I think a lot of people point out, you know, kind of how you and I work together. There's obviously a different dynamic being a male and a female. And, and, you know, Dr. Whitfield MD knows really what he knows. And for me, my— I've been a nurse, I was a nurse for 13 years, I've been an NP for 6 now. And so, you know, we both bring kind of different unique things to the practice, and I don't think that's something you can recreate at a lot of places. You know, it's definitely a personality thing. Of course, his comes more from the knowledge and problem solving, but being a nurse and that kind of being the core of who I am and being an empathetic person really, I think, helps people feel like there is a safe place and that it is a place they can confide to And again, like I was saying earlier, you know, they might not have support or friends that are listening to this. And again, this is kind of something of what we want to walk them through when they're coming with us, feeling that they have that place of safety.

Yeah, I'm glad you brought that up. I, I feel like we've had some, uh, really good instances lately where like there was a very, very clear indication about the support system. And we, we tried to always emphasize like, who's— who is that person? Who's that going to be? How are you going to— how are you going to have, um, not just assistance around the time of surgery, because obviously, um, It's not like everybody has a very specific set of people they can, you know, count on for that short-term around surgery. But I think, you know, we're not really alluding to this, but we're talking about like what's your network outside of that? Like what is your ongoing support? How is that going to be, um,— to a point where, how's it going to be that at, you know, 2 weeks and 6 days at the 12th hour when I'm not feeling right, who am I gonna reach out to? Now obviously everybody can reach out to us because we have this patient portal and we, we try to be extremely responsive in that, but that's not always going to be the case. And then, you know, that's Violet's alluding to that. Like, I feel like that's a really underappreciated situation here and it leads to a lot of consternation on the patient's part.

It is. You know, even asking someone to come with you, it's one of the requirements we ask people is that they have a caregiver, you know, staying the week in our, in Austin is important to us. We have, you know, Dr. Whitfield MD has been doing this surgery for way longer than I have, but the importance of, you know, staying here with someone and not going back to your normal life where, you know, you're cooking all day, you're taking care of kids all day, and you're not taking care of yourself is very important. So we do like emphasize the role of the caregiver. The other thing is preparing beforehand that person, you know, that they're going to be with you and that they're going to, you know, maybe be like confidant even if they're not the one who comes to surgery with you, like he said. We are here, you know, during business hours, of course, but having someone that is supportive is very important, you know, for the times where you emotionally might not be feeling completely like yourself or, you know, having a sad day hormonally or just, you know, about how you feel or decisions possibly that you made that kind of led you here.

Yeah, I, I feel like that, um, obviously we haven't you know, talked about it, but that is a huge component. And then, you know, not having a strong support, whether it's a spouse or a friend or loved one. And, you know, I, I try to say all the time, you know, that self-care is super important and trying to do self-work super important and trying to, from a mental standpoint, you know, cope with everything. And you've alluded to that's you know, very hard in the first or the, the shortest time after surgery, that becomes 4 to 6 weeks, I'd say, is usually the kind of the parameter. Yeah, so that's more of like you're talking about maybe, um, as hormones settle down and, and, and things of that nature. But now, like, we'll say it's 3 to 6 months 6 to 9 months out and you're someone that didn't have a lot of tissue and, and now you're coping with this big, big change from a visual standpoint in your clothing. And, uh, you know, one of our patients posted the other day that sometimes she gets a little down when she's, you know, trying certain things on, and then other times she'll get something, you know, and she said she got some sports bra thing from Amazon and fit really nice, and she was like super happy about it. But is that like— that's the ebb and flow, that it is the ebb and flow.

I mean, I call it the Four Seasons, but there's four seasons. I think that's why it takes a full year of recovery, just kind of going through it. So in Texas, we only have we have two seasons. It's a little bit cold and it's very hot. But, you know, if you live other places of the country, especially in the north, you know, you go through the seasons. It is something that, you know, kind of continues and almost follows you. And that is— I know it sounds kind of silly, but I talk with clothes to women about preparing for trips, preparing for things, because I know when I went through this, I used to love certain types of clothes, especially like high-neck clothes and those kind of things, and they just didn't look the same on me anymore. And it's almost like you have to like relearn how to dress yourself. And again, it kind of goes through that processing of time and just like almost desensit— desensitization, um, of how you look and what your new body is and learning to love and accept that. I never knew, you know, that those were things that I even dealt with until until I had them removed from me and I started putting on clothes and was putting on things that I used to love, and I didn't like it anymore. It kind of highlighted things that I didn't want it, but it, you know, kind of guided me to other things.

But that's— yeah, and so that leads to, you know, whether someone has the satisfaction or regret or all these different types of thoughts or feelings that then, like, I'm certain by some of the nature of the conversations we've had and we've had with patients, is it becomes overwhelming.

It does become overwhelming. That's kind of why, you know, the Pusat program is so amazing, because one thing I always emphasize to women is, you know, they can be fixated on something for so much, but there's there's so many women that came before you that did this. You're not the anomaly. When you're going through this and you have a group of friends that all have implants, and you are the anomaly, you're the only one who's done it. It's very— I rarely have a patient that says, oh yeah, I had another friend that did this. That's not the common denominator, you know. So by reaching out to us and having us kind of like as that support system of people, we've taken care of so many people who have been through this, you know. Um, that is something that's different. You know, another thing I wanted to point out too is just to kind of go back to what we were saying about having a support system. You know, the reality is, is that not everybody has that again. So, and, and we know that. So I kind of wanted to touch on that. That doesn't exclude someone from coming to our practice. We have a lot of resources of, you know, nurses in Austin and people that can help them. We have people who travel for work and they're gone all the time. Time and they don't really have a home life, you know, so they don't have that support. There's all kinds of different people that come to us. Sometimes they stay here a little longer as well for us to, to take care of them, just to give them that TLC that they need. But someone is never really alone, you know, when they're with us. Like, we— they are— have access to us, like I said earlier, you know, throughout the day, all day, emotionally asking about clothes, just kind of asking questions about where they are. So I don't want to exclude somebody who might not have as strong of a support system as well.

Yeah, and it's good that, you know, Violet's mentioning this. Like, you're not asking me the question because I don't— and, you know, I understand the surgical aspects of it, and I'm, you know, trying to be as helpful in terms of surgical recovery. But that's all, you know, time and ideal world.

Yes.

And, and we're looking for certain milestones and things. But obviously the, the point that's being made certainly by Violet, and Violet is the head of the post-op, you know, surgical program, and then Chelsea really is the lead of the functional program post-op. And there's a ton of support within those programs for the, for the patients. And it's not— nobody's alone. You don't have to feel like that or feel, you know, isolated. That's, that's not— and we don't want anybody to feel that way. No, no.

Or excluded because of that.

Right. I mean, that's, you know, I see all these I get, uh, like, it's community, right? Everybody's trying to find, you know, a community that's going to be supportive. So within our practice, our team is supportive and continues to support patients throughout the process. So I think that's probably what I would try to convey always, is there's a strong community, you know, for the patients. And we have a private Facebook group, and we have a private group where anybody can communicate with us in terms of Dr. Rob's circle. So we're trying to always create those safe spaces, and that's outside of the, you know, the practice environment as well.

You know, another thing we didn't add on that, you know, for the last, I think, 6 months to a year, we were really trying to figure out a way to group the patients together that were kind of having surgery at the same time to make the group almost smaller, but, you know, have the women going through the healing at that time frame. And that's kind of how we started the functional groups that they do on Thursdays, you know, where they do talk about kind of what's going on through the detox. But it's also only people, you know, that are there kind of around your timeline. So you kind of see the same names always that are there. That's another thing that Chelsea, Gina, and Melinda have started that has been amazing and has led to a lot of success. There's so many, you know, groups you can join, of course, that are huge. And this isn't, you know, medicine and symptoms and going through isn't, to me, meant to be this huge public thing. For us, we— again, our whole practice is about, you know, a patient feeling safe, secure, that, you know, they're being taken care of to the best of their knowledge. And that's why we created all of these small individual groups for patients that are going through exactly what we're teaching them, not what somebody else is, you know, teaching them. Yeah, it's—

I don't, um, based on the comments we get sent either from our patients or from patients who are trying to help, maybe others who are just trying to seek out, you know, answers, there's obviously a wide variety of information being delivered to patients and Um, we've just tried to unify, you know, our message in that we want to educate and just help, you know, patients make better informed decisions. Always. That's really all I've ever tried to do, either through writing books or our show or, uh, communication, you know, just in general. So I guess from that perspective, It's just ongoing for us. What's— now I have to ask. Well, she's— Violet's already kind of highlighted some things that are, are very personal, but maybe what's a take-home point that, you know, as a patient who's experienced it, you know, maybe provide something, you know, what, what are your two cents, you know, having gone through the process and now helping others go through the process all the time, um, that you just pass on, I guess? Yeah.

Um, so I am a preparer in general, but there are things that I think you can do to set your home up for success when you come back, setting your life up for those first 6 weeks. Um, so some of the things I'll just kind of go through if I was talking to, you know, as a patient, you know, even preparing the clothing you're bringing. A lot of people like to bring a lot of looser stuff. They bring stuff that buttons up, zips, that way they don't have to, you know, do a lot of arm movements that are unnecessary. You know, before leaving your house, a lot of people prepare bringing stuff down more to like kind of their level so they're not doing a ton of reaching. If someone's under the muscle, we don't like them to, you know, reach above their shoulders for about 4 weeks. So setting yourself up for success that way. A lot of people and moms, they do a lot of freezer meals and prep things, have groceries, or somebody helping them with the groceries so they don't have to, you know, go around and pushing the cart. Um, those are just like some simple things that you might not even think of to do before, because I know for myself, like, I like to cook a lot and I like certain things, and I you know, my husband, he does not cook as much. And so I wanted to make sure I was still getting the nutrition and those kinds of things when I got home. The other thing is, you know, whatever your work schedule is, I think people really underestimate like how much they should take off. If I, if I could have an ideal world, it would be they'd have 2 weeks off, at least a week and a half. We work with a ton of people with physical jobs that have to do, you know, use their arms for nursing, Doctors, physical therapists, people who work in factories, they— we work with them very tirelessly to make sure they have the paperwork they need for time off. We help with all of those kind of things. I'm a huge advocate for giving people what they need and not letting their job, you know, kind of permit them from not having the surgery. I think that's a lot of fear with a lot of people. They're like, how am I going to do the recovery that you guys are, you know, putting so much emphasis on? So these are things that we talk about a lot beforehand, like setting, um, you up for success.

I think that's important. Um, you know, I think Violet has already, you know, shown that someone can be, you know, uh, or feel like they're really prepared, but it's really hard to prepare for something, you know, and you need help. And, um, we're obviously— you set up to help and have a strong support system for everybody. Um, I think for me personally, uh, I just want patients, no matter where they are in the process, to learn, uh, about how to, you know, take care of themselves better. Is always like, really work on your sleep, really try to concentrate on nutrition. And just doing those things are, are the ways to start. Nobody has to start by spinning a lot. And education is always obviously free. We have over 160 podcasts, a couple books, little courses, so you don't have to jump into this without a better understanding of what we're about and what we do. And certainly, you know, you can feel free to reach out and communicate with us. But well, I appreciate Violet coming on and spending time with us today. And if you want to hear this show, if you want to participate in the circle or our private Facebook group, you can go to Dr. Rob's circle.com, drrobertwhitfieldmd.com, or on Facebook, it's our explant, uh, group. So thank you for coming on, Violet. I really appreciate it.

Thank you for having me.