Motherhood and Dr. Elizabeth Tigges, D.O.

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Enough with the Anti-Robot Rhetoric!

Posted on 04/09/2020 at 9:00 AM

The following is a letter to the editor of General Surgery News from our very own David Coster, MD, FACS, FASMBS. This letter has been reprinted here with the express consent of the author. The original letter can be found here.


As a surgeon and early adopter of robotic surgery some 10 years ago, I am having an increasing problem in tolerating the rhetoric of the invented controversy over “laparoscopic” versus robotic surgery. In our hospital, robotics is used around the clock and on weekends as needed. All OR staff know how to do the setup, and it is used judiciously for appropriate cases, of which we have now done thousands in general surgery.

"Robotic surgery “is” laparoscopic surgery, but with a better set of instruments. So what is the basis of any argument against using a better tool?"

The robot is a laparoscopic technology that allows the surgeon to control each instrument; there is no longer any need for a “camera operator” or an assistant to hold something. There is no reason to expect that robotic laparoscopic surgery would be any “better” than regular laparoscopic surgery in regard to the usual outcomes. It doesn’t have to be; it only has to be as good.

Where robotic surgery “is” better—and demonstrably so—is in cases that could otherwise not be done by minimally invasive techniques, that is, the most complex types of surgery that one could only hope to perform laparoscopically and those procedures that eventually are converted from regular laparoscopic to open because the laparoscopic technology does not offer the range necessary to complete the case successfully. Here there is a clear advantage to robotic surgery, but no one is bothering to talk about it. 

You cannot tell me that successfully avoiding open surgery is of no benefit to the patient. In my practice, I do a lot of complex procedures in patients who have had many other operations, and it is in this patient population that the robotic approach really shines. In addition, robotics offers advantages for the surgeon in every possible way: visibility, exposure, technique, ease of use and comfort for the operator. Since when does the surgeon experience not count as a “measurable outcome” for comparison? Being better for the surgeon is no small thing, as this has never occurred in the past with any new technologies. One can see things better, and often things that would have gone unnoticed with regular laparoscopy; one can manipulate better and perform the operation with more finesse and less tissue damage; one can be more certain of the quality of their work when using robotic technology.

Robotic laparoscopic surgery is still laparoscopic surgery, but with a better tool. It’s time for surgeons to stop setting the bar at whether or not patient outcomes are better, as all they have to be is the same. Why? Because the process for the surgeon, for once, is better. No longer does one have to suffer to complete a laparoscopic operation; rather, it can be completed with ease, aplomb and a certainty of perfection that was previously not possible.

"Those who think robotic surgery is going to go away are wrong." 

Many of us do nearly all of our procedures these days robotically, and we have a much nicer day as a result. The costs will go down as the approach becomes the norm, as it inevitably will. As with the controversy of laparoscopy versus open surgery in the 80s and 90s, this controversy of laparoscopy versus robotic laparoscopy is tied to the fear of being left behind. I would suggest a healthier approach to robotics is simply to add it to your skill set so you have it when you need it for difficult cases where such technology is not just a perk but a requirement.

David Coster, MD, FACS, FASMBS
Grinnell, Iowa

Wash the (Freaking) Bottles!

Posted on 03/20/2020 at 10:00 AM

This entry is from a new series of blogs by our very own OB/GYN, Dr. Elizabeth Tigges. In this series, we explore the adventures (and misadventures) that mothers share from the perspective of a mom and OB/GYN.

This series was originally posted to her personal blog, "Obstetrics and Momecology". This is a blog by a mom, for moms and those who love them. If you enjoy this content and would like to see more, please feel free to subscribe to the blog to receive updates of new posts.


When we had our first child... 

...Cody [my husband] and I found our new roles as parents about as foreign as eating fried beetles. We also found our understanding of what needs to be done to propel a house forward and function as a unit was misguided and ill-understood.

Our general personalities didn’t help the scenario. I’m a “get things done right now” kind of lady. Cody is a “why do today what can wait until tomorrow” kind of man. This resulted in too many arguments to count. And a lot of resentment on my part.

Balancing responsibilities at work and at home.

We both were working full time but even that for us is very different. I work full days every day I’m at the hospital/clinic.  Cody has weeks of “service” where he is responsible for the Unit of 15-20+ extremely sick or dying children. His work horrifies me.

When he is not on “service” he works on medical school education, writing papers, etc, and the schedule is much more relaxed and flexible. I think it needs flexibility at times when you’re caring for dying children the other week. I have a ton of empathy for him when he’s on service. But it’s hard for me to carry over that empathy when his other weeks are “easy”.

Insert my resentful thoughts and feelings.

Anger arises when I come home, and the bottles are overflowing in the sink… for the 684th time this week.A sink full of dirty bottles and empty cups (click for original blog post)

I hate washing the bottles too. And I’ve worked all day: I left the house at 5:30 AM and now I’m back at 7:30 PM. There is so much to be done around our house on any given day. And [at the time] we had one kid, one dog, and one cat.

Others most certainly have so much more. It always seemed so OBVIOUS what things needed to be done. Open your eyes and look around! But, just like it’s difficult to be in someone else’s head, it’s difficult to know what someone else wants unless they can effectively verbalize it. 

For us, insert counseling. And communication. And a commitment to help each other out. To try to see things through the other person's eyes/filter.

I learned that I literally need to spell things out sometimes. Like, “Hey, it’d be great if you could do the bath, and the laundry, and wash the sippy cups (replace bottles with sippy cups),” and on and on and on.

Also, I leave. I take a break and get away with a girlfriend every couple of months. I leave for a few days, usually 1-2. It helps us all find balance and appreciate each other

And remember…

Of course, this all feels stressful and intimidating. You’ve taken on a whole new identity and so has your partner. You don’t know who you are because you’re figuring it out. Your partner is doing the same.

Communication is of utmost importance… but it feels like: who has time for that?!

You’re busy trying to navigate this new life, breastfeed and/or figure out how much food this kid needs, when to change the diaper, how to sleep, how to process new emotions and feelings. How to stop thinking about SIDS or your child dying for some unforeseen reason. 

I generally can forget about past wrongs if someone is sorry or things change. For the love of the universe, things have finally changed.

Cody (generally speaking) does the crappy work that neither of us wants to in order to keep our home headed in the right direction. As do I. But we have found equality.

We may not do equal work every week, but our sum total is equal most of the time. I do some domestic stuff, and so does he. We try not to complain. How long did all this take us? Just over a year.  Eleanor was born in October of 2016. We got it together start of 2018. 

Be open to criticism, and cognizant of delivery

So, what did we learn? Here are ten things we’ve learned about how to make it all work:

  1. We talk about who needs what.
  2. We try to remember to remind each other how valuable we are to each other. I need to frequently be told, “thank you, you’re awesome!”
  3. I need to feel appreciated. Cody is not good at this, so we work on it. And I complain a lot in counseling and hope that he can find it in himself to say these things even though it may not feel natural to do so.
  4. I try not to nag all the time.
  5. I have to work on my tone and my approach. I have a mean, feisty side that I don’t like, and it comes out when I’m exasperated or sad or frustrated or hurt. 
  6. Eleanor’s shoes and clothes that fit do not fall out of the sky. Her swim lessons and coordination of the family weekend trips, and fun activities aren’t planned by our non-existent family organizer/travel agent. I do all these things.
  7. But I do not do garbage. I keep forgetting to empty Harriet and Harry (our robotic vacuums, named after the absurd amounts of dog hair they pick up for us).
  8. I don’t like to fix things unless they have a vagina or are pregnant. I ripped, instead of gently twisting, the fire alarm out of the ceiling in exasperation the other day. And it’s still hanging there.
  9. I hate cooking, generally speaking.
  10. We have mostly figured out who does what and for each of us that includes things we don’t like to do (again, insert washing bottles). 

 

it’s still not always obvious

I still think at times: How the F do you not see this or that, that’s literally so obvious, right in front of you, needs to be done? But now, I ask for help (also something I had to learn).

I’ve spent my whole life being taught to do things myself. Sometimes we both still find ourselves guilty of keeping score and comparing what we do, with the undertone that one of us feels like they’re doing more, and the other is sitting around eating ice cream and reading a book. The reality is that in any given week or month one of us probably does do more. But, the next week or month may be different. 

I would be lying if I didn’t tell you that our past struggles made me nervous when we were about to have our second child. I knew the bottles would start again, and so would a new identity situation. (I was right to be concerned, but take it a day at a time most days)

The puzzle pieces fly into the air and we gain a new picture and new pieces that all have to be put back together again in a new way. A way that allows both of us, and our children to be happy. To be healthy. And to work as a team.

I have found this to have its challenges and its beauty. 


About the Author:

Elizabeth Tigges, D.O. is a small-town Iowan at heart, having grown up in Southeast Iowa before graduating from Simpson College. She subsequently began her medical career at Des Moines University, followed by her residency training at Aultman Hospital in Canton, Ohio. Life took her to the University of Tennessee in Memphis where she was an Assistant Professor of OB/GYN, but the call to return home prompted her to return to Iowa in 2013. She has now made what she hopes will be her last move, enthusiastically joining Surgical Associates in April 2016, where she will provide compassionate and comprehensive care in Women’s Health to women of all ages.
 
Dr. Tigges’ unique clinical interests include pelvic and minimally invasive surgery, robotics,  preventative healthcare throughout a woman’s lifespan, evaluation and treatment of pelvic pain, and female sexual health. She recognizes, however, that while those topics may be the reason for a patient’s visit, they are only a small part of the individual. Dr. Tigges believes in recognizing the whole person and connecting with them on a personal level. This is largely because she loves getting to know patients personally, but also because she wants women to feel comfortable discussing Women’s Health issues openly and wholeheartedly.

Dr. Tigges is pumped to be living in Grinnell with her husband Cody and daughter Eleanor. Cody agrees that she has a special gift for making personal connections and says that she could form a lasting relationship with a rock. When she’s not sharing jokes and funny stories at work, she enjoys spending time with her family, traveling, hiking, running, and reading. 


Dr. Tigges' Disclaimer:

"This [blog] is meant to entertain and inform.  I share my personal experience and opinions through this web-based forum, which may or not apply to you, but which most certainly should not be interpreted as medical advice. I only provide medical advice via in-person appointments at my office or hospital."


 

Two Kids, One Day at a Time

Posted on 03/04/2020 at 9:00 AM

This entry is from a new series of blogs by our very own OB/GYN, Dr. Elizabeth Tigges. In this series, we explore the adventures (and misadventures) that mothers share from the perspective of a mom and OB/GYN.

This series was originally posted to her personal blog, "Obstetrics and Momecology". This is a blog by a mom, for moms and those who love them.


We recently went from 1 kid to 2 kids. It’s been a new kind of journey.

For those of you who never go from 0 to 1 or from 1 to 2, either by choice or by the forces of nature/God/the Universe, this is not meant to minimize your story. After all, this was also my state of being until not-so-very-long ago. It could’ve always been had the IVF not worked. That doesn’t make my previous story any less important or valuable. 

First off…MIND BLOWN.

If I thought one was busy, I laugh and laugh and laugh at that notion now. 

By all standards, I feel like “I have it all”. Healthy kids. The luxury of a willing and helpful partner. Incredible support system. Enough money. Enough time off work/maternity leave. Etc. etc. So these things most certainly make it all easier for me.

But the busyness isn’t the hardest part for me. Though I’m not minimizing that either. Because whoa! It is nuts/controlled chaos/insanity around here sometimes. 

I often feel like I’m not enough.

The hardest part is feeling like I’m not enough. Not giving enough, not being enough, not present enough.

I read in some parenting article somewhere that children want your time above all else. I think people of all ages want the same. They want your time and presence in order to feel value in the relationship.

This feels impossible at times. Though I feel confident that I’ll get there eventually, it’s hard right now.

Having more than one is mom guilt of the worst kind. There is literally no way to give of yourself equally or give the same that you did when you had one. You have to adjust to not being the Universal Amazing Mom that you once had the notion you were when you gave your one baby the love and attention you felt they needed. Even if that meant you held them constantly. And the new baby often gets put in a swing with horrible music, and screams because he wants to be held, for God’s sake!

One of my babies needs to be fed and held and can’t keep his head up. One of my babies is saying “hold me” and “I want you.”

A new mother and her two children

I haven’t yet figured out how to grow an extra arm.

I don’t know how parents find their flow and give enough to each of their babies to feel content. Plus, I’ve always said it’s important to take time for oneself too. How can I be a good mom AND have my own internal peace, which means time to work on me. Oh and the marriage, which is of utmost importance. Oh yeah…and (at the time of writing this) I haven’t gone back to work yet!

I feel like I lost something with my first child.

I loved hanging out with Eleanor and I knew in my heart this would have its emotional challenges.  I give the tubbies (baths) to Eleanor. I do art projects. I do the naptime and bedtime snuggles. But now, more of “we” or Daddy does these things. This is not bad. It’s actually good. It’s just an evolution and change. 

Eleanor has a Mom version of me that she’ll never have again. And Nelson never gets to experience that Mom version. That version of me/Mom I was really pretty content with. But my new and improved me will get there in time. If this sounds like you, whether you’re on your first or second or third, you’ll get there too.

My heart grew, and there is room for both my kids in there.

I was worried it wouldn’t. Thankfully, I have a great counselor/therapist that was able to show me an alternative perspective recently. She proposed that I was choosing to look at it from an angle of loss. Which it is. But I have also gained a lot. And the gains are so much much bigger.

Didn’t I love having siblings? Didn’t my own family grow up to feel amazing once I had brothers? Did I ever recall feeling like my mom didn’t love me as much or care about me as much? No! of course not!

 I feel like in my own life, it’s often how I choose to see it. If I choose my brain waves to focus on how full of love and life our home is, was and will be, then that’s mostly how I’ll see it. My perspective matters and influences how I see my/our little universe. Our house feels abundant and peaceful.

Well, peace is maybe a stretch. At naptime…for 20 to 40 minutes. Maybe content is a better word. 

And in line with one of my favorite pieces of advice….One Day At a Time.

 


About the Author:

Elizabeth Tigges, D.O. is a small-town Iowan at heart, having grown up in Southeast Iowa before graduating from Simpson College. She subsequently began her medical career at Des Moines University, followed by her residency training at Aultman Hospital in Canton, Ohio. Life took her to the University of Tennessee in Memphis where she was an Assistant Professor of OB/GYN, but the call to return home prompted her to return to Iowa in 2013. She has now made what she hopes will be her last move, enthusiastically joining Surgical Associates in April 2016, where she will provide compassionate and comprehensive care in Women’s Health to women of all ages.
 
Dr. Tigges’ unique clinical interests include pelvic and minimally invasive surgery, robotics,  preventative healthcare throughout a woman’s lifespan, evaluation and treatment of pelvic pain, and female sexual health. She recognizes, however, that while those topics may be the reason for a patient’s visit, they are only a small part of the individual. Dr. Tigges believes in recognizing the whole person and connecting with them on a personal level. This is largely because she loves getting to know patients personally, but also because she wants women to feel comfortable discussing Women’s Health issues openly and wholeheartedly.

Dr. Tigges is pumped to be living in Grinnell with her husband Cody and daughter Eleanor. Cody agrees that she has a special gift for making personal connections and says that she could form a lasting relationship with a rock. When she’s not sharing jokes and funny stories at work, she enjoys spending time with her family, traveling, hiking, running, and reading. 


Dr. Tigges' Disclaimer:

"This [blog] is meant to entertain and inform.  I share my personal experience and opinions through this web-based forum, which may or not apply to you, but which most certainly should not be interpreted as medical advice. I only provide medical advice via in-person appointments at my office or hospital."


 

Motherhood and Dr. Elizabeth Tigges, D.O.

Posted on 02/19/2020 at 10:22 AM

Introducing a new blog series: Obstetrics and momecology

By dr. Elizabeth Tigges

Dr. Elizabeth Tigges, D.O.This is the first entry in a new series of blogs by our very own OB/GYN, Dr. Elizabeth Tigges. In this series, we will explore the adventures (and misadventures) that mothers share from the perspective of a mom and OB/GYN.

This series was originally posted to her personal blog, "Obstetrics and Momecology". This is a blog by a mom, for mom's and those who love them.

 


The Underground World of Motherhood

I feel deeply connected to the rawness and realness of Motherhood and Womanhood. The extremes of all emotions, and the steadiness of the day-to-day. I am in complete awe of the tenacity and strength and spirit of Women. 

The day I became a mother was the day I better understood the significant contributions we add to the Universe. The Impact we have. The 100,00 balls we constantly suspend in the air to keep everything and everyone moving forward. We are brilliant, radiant, beautiful humans. 

These are 2 of my recent observations:

#1. We don’t take care of our own souls enough. Or ever.

Women young and old have been putting everyone else first for months, years, decades, a lifetime. And we need to take some. Take some of everything. Time for ourselves. Time for the restoration of our own tired, overworked, undervalued souls. We need to take pleasure in Indulgences, simple or big. We need to not feel guilty for taking a much-needed run or an hour of CrossFit/Zumba/yoga. A long long shower (more than 6 minutes 2 days a week). A weekend with friend(s). A glass of wine. Or a bottle. Drank slowly (or quickly) with a good book.

No one will do these things for us. It’s up to me to take care of me. It’s up to you to do the same.

We need more self-love. And to get there, it’s crucial that we take care of ourselves... or we’ll be sitting on the edge of the cliff. Just one temper tantrum or petty argument with our partner away from jumping (or falling) off. 

I recently had my own moment of breakdown. I’d yelled at Eleanor [my daughter]. I said mean things. I even pushed her away from hanging on me for the 1000th time. It was mean. I was mean. I cried for the whole day.

I went to counseling (which I schedule 3 months out and go to monthly, which makes me more likely to go). I realized how vital it is to allow and accept that my best version of me is when I take the time to take care of me. I utilize my mom, my husband, and our nanny now. Even if it’s just for a 10-minute run or an hour at counseling. I have scheduled weekends with my closest girlfriend.

It’s hard to work full time. That alone is an anvil of guilt. Then, to return home from work or a weekend away and spend more time away? Yes. The answer is yes. I keep it short and simple usually. Because that’s what feels good to me. But I do it. And I remind myself that I do it because I want me to be the awesome me that I think I’m capable of. And so that my kids see that it’s mandatory that they do the same.

No one else is responsible for my happiness, except me, and kids ought to learn that early in life so they’re not depending on someone else to make them happy.

 Our longevity and health depend on us taking care of us. 

#2. We don’t support each other enough. 

I am saddened by the lack of support and nonjudgment we receive from each other. 

Women show up. We enter the arena. We get into the ring. And instead of always receiving a wild crowd of cheering, uplifting, supportive, and encouraging friends we cut each other down. We joust with our allies. 

The world of Motherhood is "underground" because we don’t openly talk about how crappy it is sometimes.

I saw my cousin's wife over the summer. They have 2 kids now and I asked how things were going. She said “good now. I didn’t like this kid for months”. And I found that honesty to be refreshing. I don’t like one or both of my kids sometimes too. They drive me bonkers. I love naps when they are peacefully asleep and I can get a minute. Of course, I love my kids more than anything in the Universe. But I have my days or moments. Sometimes I’m just surviving. And sometimes I’m even doing a crappy job at surviving.

We need reassurance that “yes, that’s happened to you too.” Sometimes I need a new day to start because I need a new beginning. Even if that starts at midnight because one of my kids won’t stay in her own bed and the other stopped sleeping through the night.

Tell me like it really is for you.

Tell each other the same. How we relate to each other is how we find common ground and validate our own self-worth. We all have insecurities. Let’s let each other see them. And thus truly see each other. Be vulnerable. We’ll be better off for it. I promise.

We all have been in a dark season. Some of us have been in many dark seasons. We all have experienced pain, sometimes excruciating pain. We all are uncertain, struggling, finding ourselves, recreating ourselves, giving up, giving in, celebrating, worrying, going crazy, misunderstood, dominating our home or our work, experiencing deep grief or despair, crushing it, spinning in circles, making change in a stagnant place, yearning, content, seeking adventure, seeking stability, making good and bad mistakes, learning, and loving life…all of the above at some point or another. 

I read a book once about “awakening” and one of the things the author challenged the reader to do was answer this question: is the person trying their best? And most of the time I think we all can say “Yes, they’re/we’re doing the best that they/we are capable of.” Because that’s what women do most often. Our very best. It’s the best we have to offer at this time. So if you, me, WE are doing our best, why do we judge? 

We intensely need each other. Brene Brown says the single most important aspect of our lives is our connection and belonging to others. If that’s the case, which I buy into, then we must absolutely must find more and better ways to be there for each other. 

We must have grace for each other’s unknowns. We must wrap each other up in blankets of compassion and empathy. 

Women are valuable beyond measure. We need to make certain that we help each other really feel that irreplaceable value. 

-XOXO Elizabeth 


About the Author:

Elizabeth Tigges, D.O. is a small town Iowan at heart, having grown up in Southeast Iowa before graduating from Simpson College. She subsequently began her medical career at Des Moines University, followed by her residency training at Aultman Hospital in Canton, Ohio. Life took her to the University of Tennessee in Memphis where she was an Assistant Professor of OB/GYN, but the call to return home prompted her to return to Iowa in 2013. She has now made what she hopes will be her last move, enthusiastically joining Surgical Associates in April 2016, where she will provide compassionate and comprehensive care in Women’s Health to women of all ages.
 
Dr. Tigges’ unique clinical interests include pelvic and minimally invasive surgery, robotics,  preventative healthcare throughout a woman’s lifespan, evaluation and treatment of pelvic pain, and female sexual health. She recognizes, however, that while those topics may be the reason for a patient’s visit, they are only a small part of the individual. Dr. Tigges believes in recognizing the whole person and connecting with them on a personal level. This is largely because she loves getting to know patients personally, but also because she wants women to feel comfortable discussing Women’s Health issues openly and wholeheartedly.

Dr. Tigges is pumped to be living in Grinnell with her husband Cody and daughter Eleanor. Cody agrees that she has a special gift for making personal connections and says that she could form a lasting relationship with a rock. When she’s not sharing jokes and funny stories at work, she enjoys spending time with her family, traveling, hiking, running, and reading. 


Dr. Tigges' Disclaimer:

"This [blog] is meant to entertain and inform.  I share my personal experience and opinions through this web-based forum, which may or not apply to you, but which most certainly should not be interpreted as medical advice. I only provide medical advice via in-person appointments at my office or hospital."


 

Sleep After Bariatric Surgery: What to Expect

Posted on 09/25/2018 at 10:30 AM

Black and white alarm clock.

Depending on your health pre-surgery, you may or may not have had trouble sleeping due to your weight. Not only do things like sleep apnea and restless leg syndrome affect your sleep because of your weight, your sleep schedule might have even contributed to your weight gain in the first place! This article will give you some insight into what you can expect post-surgery, and how to manipulate your sleep schedule to ensure you don’t start the same habits all over again!

What to Expect Immediately After Surgery

Much like nearly any other surgery, you may experience a disrupted sleep schedule. We encourage you to refrain from taking sleeping pills. Instead, push through the first few weeks, as there is restful sleep ahead. There are far too many risks and side-effects of taking sleeping pills. Much like its reaction to alcohol, your body’s tolerance for mood-altering drugs is not what it used to be. Especially when your diet consists solely of liquids. Additionally, it will be incredibly hard to wean yourself off of the pills once you have the potential to naturally develop a healthy sleeping pattern.

Moving Forward

Unfortunately, your sleep schedule has more than likely been unhealthy for quite some time. Below are some pointers we can offer to help you immediately after your surgery:

  • If you feel like you need to nap, then nap, and do so deliberately. Don’t distract yourself with background noise like the television. Find a quiet space and get some restful sleep. Try to keep your naps to the minimum possible time for the maximum rest. The goal is to give your body what it needs without disrupting your sleep schedule for that night.
  • Be patient with yourself. You will more than likely be sleep deprived and stressed about a multitude of different things, so don’t make this one of them. Sleep when you can and when you need to. Listen to your body. You may need to completely reset your sleeping schedule by staying awake all night and going to bed at an appropriate time the next day.
  • If you can’t sleep, don’t stay in bed. You can get up and walk around (we actually encourage you to do so!). We do recommend that you avoid television. This may seem redundant but there are studies that show a direct correlation to people who watch television to fall asleep and end up experiencing the opposite effect. Instead, do something that bores you. Whether that is reading an encyclopedia or counting random objects, your goal is to literally bore yourself to sleep.

Avoid Sleep Deprivation at all Costs!

Not getting enough sleep can directly affect how hungry you feel and can impact how your body processes the fuel you feed it. Your ability to feel full will diminish, creating the perfect storm for a feedback loop of weight gain. You will be low on energy and reach for the “easier” foods which are, more often than not, the less healthy option. Pre-surgery, this would have resulted in a few additional pounds due to the sheer fact that you had already entered this vicious cycle. We want to avoid these cycles completely post-procedure.

We want you to feel healthy so you can get you back to a vibrant, enjoyable lifestyle as soon as possible. In order to do that, you need to rest appropriately. If you experience severe insomnia or pain to the point where you can’t sleep, please contact your doctor immediately.

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