“normal” healing after surgery

Posted on July 8, 2010

I am doing many preops today. The most common question I get asked is “what is normal healing after surgery?” (Corollary to this: When can I drive/exercise/go back to work/lift my baby/ have sex.)

My answer: I don’t know.

Egads.  Shouldn’t I know? Am I not the doctor? If I don’t know, then who will? How can you plan?  The answer is every patient is different.  One of my favorite stories is of two women, both age 39, who had liposuction done on the same day.  They had the same amount removed, same areas.  I couldn’t have had a better controlled trial.   Two days out when I saw them for their first preop, one came in fully dressed with make up on, with a cheery “Hi Dr. Greenberg!”  The second came in shuffling feet, barely moving, still in her pajamas. 

Same age, same surgery, same day.

Why so different?  People all respond to pain differently, to injury differently.  Some people are tougher cookies than others.  There are clearly “normal” ranges, and I will discuss those with you at your preop.  But I can never figure out who will be the outliers- the patients who a day after a major surgery seem like nothing was done to the other extreme of the ones who can’t seem to get back to their center. 

I have tried to correlate it to other factors: age, have you had kids, how many kids do you have, do you work, do you do physically challenging things like marathons, how have you responded with past surgeries.  What have I found? There isn’t a consistent correlation.  The more you swell and bruise, the more pain you tend to have.  The more you follow my instructions (Ahem. Ahem.  Yes, you patients reading this who try to sneak in that workout too early and then get puffy… I know who you are and I will bust you.) so the more you follow my instructions and take it easy, the faster you will get back to normal.  I used to think having kids was a good barometer of pain tolerance- but I’ve had three kids, and it didn’t hurt much.  I do think women who with 3 or 4 kids or women with kids who work /juggle do better just because they don’t ever slow down- they can’t. 

So what is normal? Normal is whatever you do.  There is a wide range.  At your first post op visit at two days I can tell usually what trajectory you will be on.  But unfortunately I can’t predict it ahead of time.