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April 2019 Issue

What is investment?

Never take financial advice from a doctor – we are notoriously bad with money.
I do, however, have a good understanding of investment, but don’t take my word for it. I came across this post on Instagram, and it resonated with me:

Usain Bolt has won 9 gold medals in the last 3 Olympics, and he has run less than two minutes on the track. Usain Bolt ran for less than 115 seconds in total in his three Olympics and made $119 million dollars. That is more than $1 million dollars for each second he ran.

But for those two minutes, he trained for 20+ years.

That is investment!

All too often, we focus on the result, but forget the work required to get there.

In this newsletter we share a couple of investment ideas.

I have previously published an article explaining my reasons for refusing to perform any surgical or non-surgical procedure without proper consultation. And while skin care treatments may seem non-invasive, Amori will not perform any of these before a proper Advanced Skin Analysis was done.

This newsletter will re-run that article as a reminder. The rest of the newsletter will focus on identifying the ideal candidate for surgery – both cosmetic and otherwise, the ideal candidate for non-surgical procedures, why it is important to disclose absolutely all medicines and herbal supplements you use prior to surgery, and the impact medicines and herbal supplements have on the health and ageing of your skin and on skin care treatments. I also include a handy list which you can use to record all your medicines and supplements. Carry this on you in case of an emergency and remember to bring it with you to your consultation.

Invest in a proper consultation

Many patients are averse to proper consultation prior to surgery or treatments. The reason being “it is just something small, will take about 5 minutes”. It is often these patients who are surprised when they suffer a complication or when their wounds won’t heal.

The purpose of the consultation is not only to write down your name, establish your problem, and deciding to operate, inject or treat. During a consultation, we also establish a relationship of trust, we determine whether you trust us to take care of you, and it gives us the opportunity to determine whether we should treat you.

We like to get to know you better, so we ask many questions about your personal life – whether you are married and have children; how old your children are and where they live; what you do for a living. We treat a person and the more we know and understand you, the better we can treat you. If you have no support from family and friends after a large surgery, we need to consider whether it is appropriate to perform surgery. If you have a demanding job, we need to make decisions based on that, to ensure that you can get back to work as soon as possible. If the surgical procedure, non-surgical procedure or skin care treatments are going to influence your daily life, we need to know this and prepare you for it or plan the timing of our planned procedures and treatments accordingly.

We also take a detailed medical history. This medical history includes your family’s medical history, because certain diseases occur in certain families. Your past medical history tells us a lot about you, how well you will cope with the proposed surgery or treatment, and which complications we could expect. As part of your medical history, we need to know whether you have any allergies – if we use medication or products you are allergic to, you could die; if you are allergic to certain plasters, your post-operative recovery could be extremely uncomfortable.

Most importantly, we also need to know which medications you use – not only those prescribed by your general practitioner or other specialists you visit, but also those you buy over the counter, and which homeopathic supplements, vitamins and other supplements you use.

Certain medications and supplements need to be discontinued before surgery, such as those containing aspirin, Omega 3 and 6, Evening Primrose oil, Krill oil and Cod Liver oil, as these medications increase your risk of bleeding with subsequent complications and bruising during and after surgery. Patients scheduled for so-called “minimally invasive” treatments, such as Botox and fillers, need to discontinue these as well, otherwise they run the risk of extensive bruising – a not so “minimally invasive” complication.

Many medications and supplements are an essential part of your well-being but have a severe impact on the quality of your healing. This will impact on your recovery time, even after skin care treatments.

Please do not forget to disclose your “organic” or “health shop” purchases – please understand that “herbal medicine” or “homeopathic medicine” or “natural medicine” is just that: medicine. Although you firmly believe these are “natural”, they still have an impact on your health and could cause complications or unexpected drug interactions.

There are many more questions we ask, but by now you should understand that we are very thorough during our first consultation, and will not consider treating you or performing surgery, non-surgical procedures or skin care treatments unless we have had an extensive consultation with you.

During the rest of our consultation, we still need to discuss the reason you came to see us. You need to know how the surgery is performed, or the treatment done and what you can expect immediately thereafter. You need to know what outcome you may reasonably expect, which complications and risks there are. You need to know how soon after the proposed surgery or treatment you can attend work or major social events, what to do if there is a complication, how quickly you can expect to see results or recover, when you can drive, when you can gym.

Only after we have discussed all of this, can you make an informed decision about whether you would like to proceed. And, so can we, because we cannot proceed with surgery or treatments if we are not comfortable with performing the procedure or treatment either.

Are you an ideal candidate for surgery, non-surgical procedures or skin care treatments?

Ideal candidates for any type of surgery, non-surgical procedure or skin care treatment should be healthy, have reasonable expectations about the outcome of the surgery and know the risks of the surgery, procedure or treatment they will undergo.

It is essential that we prepare you adequately and plan for all eventualities during your recovery. This might include helping you to reach your ideal weight, temporarily discontinuing certain medications or supplements, helping you to stop smoking, prescribing specific medication to ensure that we limit complications, informing your primary physician of the need for the surgery, procedure or treatment, and involving him/her in your care.

Patients who suffer from high blood pressure, heart disease, diabetes, bleeding disorders or severe depression do not make ideal candidates and might have to be excluded from certain procedures, as the risks outweigh the benefits. Obese patients, patients who drink a lot of alcohol, use recreational drugs and smokers are often not ideal candidates.

This is by no means and exclusive list, but offers some guidelines:
  1. Patients using any medications that thin the blood (prescribed for patients with heart diseases or to prevent strokes, and including Omega 3 and 6, Evening Primrose Oil, Vitamin E Oil, Cod liver Oil and Krill oil) should discontinue these prior to surgery and non-surgical procedures, but not necessarily before skincare treatments. It is, however, essential to follow your physician’s guidelines in this regard.
  2. Patients on Accutane may need to delay surgery and certain non-surgical and skin care procedures.
  3. Patients who use Vitamin A and derivate skin care products need to discontinue these prior to certain surgical, non-surgical and skin care treatments.
  4. Patients who suffer from cold sores or shingles need to use preventative medication prior to certain surgical, non-surgical and skin treatment procedures.
  5. Patients suffering from certain medical conditions need to use antibiotics prior to, sometimes during and after certain surgical, non-surgical and skin treatment procedures.
  6. Patients undergoing any cosmetic surgery procedure should be close to their ideal weight (within 5 kilograms), and should have a stable weight, as weight loss after surgery can have a dramatic effect on the results of surgery.
  7. Patients with visceral fat (abdominal fat surrounding the internal organs), are not ideal candidates for either an abdominoplasty or liposuction. Visceral fat can be reduced effectively by following a correct diet, developed by a dietician, but not with surgery.

Invest in this list for you and your family

It should be clear by now that vague descriptions of the medications you use, are not useful.

The impact of non-use, over-use and mis-use of medications can have a profound impact on your health, and that of your loved ones. Medical conditions and even psychological conditions are often misdiagnosed due to the non-disclosure of medications being used.

Please make a list of everything you use and make a list of everything your loved ones use – keep this handy for your consultation with any medical professional, and especially in the case of a medical emergency. Every family member should have a list they carry in their wallet, handbag and school bag.

We have a handy list for you on our website to download, print and complete. Please see it here.

Invest in a consultation to understand the impact your medications have on your skin health and skin ageing

When Amori does an Advanced Skin Analysis consultation, her clients are often amazed that about half the consultation focuses on their prevailing medical conditions and the medications and supplements they use.

We tend to forget that the human skin is the largest organ in the body. Whatever we eat, swallow or apply, influences this organ profoundly. As the skin is my passion and plays an important role in everything that I do, I often refer my patients to Amori for a full analysis, and to prepare their skins properly before and after surgery and non-surgical treatments. Amori has agreed to share some of her knowledge with us here:

It is important for a Pastiche Skin Care Diagnostic Technician like me to understand everything that has an impact on your skin, and medication is just part of a long list of factors that influence your skin cells and skin structures. Without this information, and without taking it into consideration when I develop your skin care plan, which include treatments and products, lots of money and effort can go to waste. I see this often in my daily work, and our patients are often disillusioned about the thousands of Rands they have spent, without any effect, only because a proper consultation was never done.
One of the prerequisites of attending an Advanced Skin Analysis consultation with me, is that you must bring absolutely all your medication, over the counter medication, herbal supplements, homeopathic medications, nutritional supplements and other supplements with you to the consultation.

What follows is by no means an exhaustive list but will give you a good idea how certain medications can affect your skin. Understanding this will go a long way in assisting you in understanding your skin better, and purchasing the correct products, avoiding incorrect or ineffective products or treatments.

Medications which have an impact on the skin include steroid therapies, anti-histamine and other allergy medications, anti-cholesterol drugs, anti-coagulants, pain medication, diuretics, thyroid medication and blood pressure medication, anti-depressants, progesterone, anti-inflammatories and HRT.

Some of these medications increase cellular inflammation, leading to reactive-type skins, which age quicker, and might need powerful anti-oxidants to combat this process. Others lead to impaired barrier function, meaning that you are susceptible to skin infections, take long to heal and have a skin that bruises easier and is frail, and does not age well. Certain medications negatively impact on your skin’s ability to absorb the essential nutrients to perform its functions properly, while others impact on overhydration of the skin, leading to breakouts or acne. Medications can have an impact on the small blood vessels in the skin, and others have a direct impact on pigmentation formation, forcing you to make pigmentation management a permanent feature of your skin care routine.

I want to re-iterate once again, that “organic” or “natural” or “herbal” medications have the same impact on the skin as the prescription drug prescribed by your physician – if you are taking these to assist with a medical condition, that medical condition and the drug you take for it, will have an impact on your skin.

I invite you to book for an Advanced Skin Analysis and allow me to identify to which effect your medication and medical condition have an impact on your skin health and your skin ageing, and what you can do to manage or minimise this effect.

In celebration of Easter in April and Mother’s Day in May, we offer 20% discount if you buy any three medical grade skin care products, or book and pay for any three skin care treatments. We also offer 10% discount on all gift vouchers for medical grade skin care products or treatments. Gift vouchers are valued at R650.00; R800.00 or R1250.00.
Copyright © 2019 Dr Dehan Struwig, Plastic and Reconstructive Surgeon, All rights reserved.

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