Preparing for Oculoplastic Surgery: Blood Thinner Review, Smoking Pause and Photos for Planning

A retired schoolteacher sits in an exam chair, holding a folded sheet of paper. On it, in careful handwriting, is every tablet and capsule she takes: a pill for her heart rhythm, a low-strength anti-inflammatory for her knees, fish oil because a friend swore by it. The surgeon reads it slowly, then asks about the fish oil first. That small moment, not the operation itself, is where preparing for eyelid surgery really begins.

Eyelid surgery is common, brief and done under local anesthesia in many cases, which is exactly why people underestimate the homework. The lids are thin, richly supplied with blood vessels, and sit next to an organ that does not tolerate swelling well. Small choices in the month before, about medicines, cigarettes and even a few photographs, shape how the following fortnight feels.

This explainer walks through what the surgical team is actually checking, why each step exists, and what the mainstream evidence does and does not support. Every decision stays with the people treating you.

What happens during eyelid surgery, and why the prep matters more than people expect

Blepharoplasty is the medical term for surgery that removes or repositions excess skin, muscle and fat from the upper or lower eyelids. An oculoplastic surgeon is a surgeon trained specifically in the structures around the eye: lids, tear drainage, brows and orbit. The procedure itself is short by surgical standards. The Mayo Clinic describes it as typically done in an outpatient setting, often with numbing injections plus medicine to help you relax, though general anesthesia is used for some people.

For the upper lid, the incision hides in the natural crease. For the lower lid, it runs just under the lashes or, when only fat needs work, on the inside of the lid where no visible scar forms. Skin is trimmed, fat is removed or redistributed, and fine sutures close the wound. Some people have a related operation for ptosis, which means a drooping upper lid caused by a weak or stretched lifting muscle rather than by extra skin.

Here is why preparation carries so much weight. The eyelid has one of the richest blood supplies of any skin in the body, which is good for healing but means bleeding is the most consequential early complication. A collection of blood behind the eye, called a retrobulbar hemorrhage, is rare, but it can threaten vision. Everything the team asks you to do in the weeks before, from reviewing blood thinners to stopping smoking, is aimed at reducing bleeding, protecting the eye surface and giving thin tissue the best chance to knit cleanly.

That framing helps when instructions feel fussy. The surgeon is not being cautious for its own sake; the anatomy simply leaves little room for error.

Who eyelid surgery is usually for, and who is asked to wait

Two broad groups arrive at this operation. The first has a functional problem: upper lid skin that hangs low enough to block part of the upper or outer field of vision, heavy lids that tire by evening, or a lid so lax it lifts the lashes into the line of sight. The second seeks a cosmetic change, wanting lids that look less tired or puffy. The steps of preparation are the same for both, though functional cases usually involve extra documentation, which is one reason planning photographs matter.

MedlinePlus lists the health factors a surgeon weighs before agreeing to operate. Thyroid eye disease, Graves disease, dry eye, high blood pressure, diabetes, glaucoma and heart disease do not automatically rule surgery out, but each changes the risk calculation and may need the condition to be stable first. Dry eye deserves a special mention: the operation temporarily reduces how completely the lids close, so someone already struggling with a dry surface may be asked to treat that first or to accept a more conservative plan.

Who is typically asked to wait?

• People who cannot safely pause an anticoagulant, until their cardiologist or hematologist and the surgeon agree on a plan together.
• Active smokers who want the full benefit of a smoking pause, since the evidence points to four or more weeks as the window where complication rates fall.
• Anyone with an active eye infection, a recent eye operation, or unstable blood pressure or blood sugar.
• Those whose expectations do not match what lid surgery can change; a heavy brow, for example, may need a different operation altogether.

Waiting is not a refusal. In most of these situations it is a scheduling decision, made so the day itself is safer and the result more predictable.

Why the blood thinner review comes first when preparing for eyelid surgery

Blood thinners is an umbrella term for two different drug families. Anticoagulants, such as warfarin and the newer agents apixaban, rivaroxaban and dabigatran, slow the chemical cascade that turns liquid blood into a clot. Antiplatelets, such as aspirin and clopidogrel, make the tiny blood cells called platelets less sticky, so they are slower to plug a cut vessel. Both are prescribed for serious reasons: atrial fibrillation, artificial heart valves, previous strokes, stents, deep vein clots.

The tension is obvious. A surgeon working in tissue as vascular as the eyelid wants blood that clots promptly. The cardiologist who prescribed the medicine wants it to keep working. Neither should win alone, and the guidance from the American Heart Association is unambiguous: never stop or adjust a prescribed anticoagulant without talking to the clinician who prescribed it. Stopping warfarin abruptly, for instance, can raise the risk of a clot forming in the days around the procedure.

What the review actually looks like is a conversation between teams. The surgeon states how much bleeding risk the planned operation carries and how long the medicine would ideally be out of the system. The prescribing clinician weighs how dangerous a short pause would be for you specifically. Options range from continuing the medicine unchanged, to a short planned pause, to temporarily substituting an injectable agent. Each path has a typical timeline that depends on how quickly a given drug clears the body, which is why warfarin plans and apixaban plans look different.

Your role is simpler than it sounds: bring an accurate list, including anything you take only occasionally, and let the two clinicians talk to each other. The MedlinePlus page on blood thinners is a good plain-language primer to read before that appointment, but the decision is theirs to make with you, not yours to make alone.

Which medicines and supplements usually go on the pre-op review list

The prescription anticoagulants get the attention, but the list the surgeon wants to see is longer, and the entries people forget are the ones that surprise them. Many over-the-counter products thin the blood modestly, and a modest effect in a thin eyelid can mean a larger bruise or a slower first night.

Category	Typical examples (generic)	Why the team asks about it	Who decides
Anticoagulants	Warfarin, apixaban, rivaroxaban, dabigatran	Directly slow clot formation; each clears the body at a different rate	Prescriber and surgeon together
Antiplatelets	Aspirin, clopidogrel	Reduce platelet stickiness; effect lasts for the life of the platelet, not just hours	Prescriber and surgeon together
Anti-inflammatory painkillers	Ibuprofen, naproxen	Also reduce platelet function; often taken casually for aches	Surgical team advises an alternative for pain
Supplements	Fish oil, vitamin E, ginkgo, garlic extracts, high-dose ginger	Mayo Clinic lists these among products that may increase bleeding	Surgical team, after reviewing the full list
Hormones and others	Estrogen-containing medicines, some herbal blends	Can affect clotting or interact with anesthesia	Surgical team and prescriber

Two details deserve emphasis. First, the surgeon asks about supplements because so many people do not think of them as medicine. Fish oil in particular is common among the age group most likely to seek lid surgery. Second, none of this is an instruction to stop anything. The table exists so that the list you bring is complete; what happens next is a clinical decision, and the timelines involved depend on the specific product.

A practical habit that clinicians appreciate: photograph the labels of everything you take, prescription and otherwise, and bring the photos to the consultation. Names, not colors or shapes, are what the team needs.

Why a smoking pause matters so much for eyelid healing

The eyelid heals through a chain of events that all depend on oxygen reaching the wound edge: small vessels dilate, immune cells arrive, new collagen is laid down, the skin edge seals. Smoking interferes at almost every link. Nicotine narrows blood vessels; carbon monoxide occupies the spots on red blood cells that should be carrying oxygen; and the combined effect is a wound edge that is, quite literally, starved.

The World Health Organization has summarized the surgical evidence plainly: people who smoke are at higher risk of postoperative complications, including poor wound healing and infection, and patients who quit around four weeks or more before surgery have a lower risk of complications and better outcomes at six months. The same WHO summary notes that every additional tobacco-free week after that four-week point improves health outcomes by roughly 19 percent, because it gives more time for blood flow and lung function to recover.

Why does this matter more in the eyelid than elsewhere? The incisions sit in visible skin with very little margin. A wound that separates slightly or heals with a wider, darker scar on the abdomen may go unnoticed; on the lid it is seen every time someone looks at you. Lower lid surgery adds a second concern: a healing lid that scars tightly can pull away from the eye, a problem called ectropion, and impaired blood supply makes that more likely.

What about nicotine patches, gum or vaping? The honest answer is that the evidence is thinner. Nicotine replacement removes carbon monoxide and the thousands of combustion chemicals, which is clearly better than smoking, but nicotine itself still constricts vessels. Many surgical teams ask for a pause from all nicotine sources before lid surgery on that basis. Ask your team what they want and why; if quitting is hard, say so, because support is part of good preparation, not a separate project.

Why the surgeon takes photos for planning, and what they show

People are sometimes surprised, even slightly embarrassed, when the consultation ends with a camera. The photographs are not decoration for a file. The Mayo Clinic notes that your eyes will be photographed from different angles as part of planning, and those images do several jobs at once.

The first is measurement. Lids are asymmetric in almost everyone; one crease sits a millimeter higher, one brow rests a touch lower. On a still, evenly lit image the surgeon can compare sides, note where the natural crease actually falls, and see how much the brow is compensating by lifting. That last point matters: a brow that has been hitching itself upward for years to clear heavy lids can drop after surgery, and anticipating that changes the plan.

The second job is documentation of function. When lid surgery is being considered for a visual problem rather than appearance, most systems ask for photographs showing the lid margin encroaching on the pupil, alongside a visual field test with the lids taped up and down. Standardized photos, taken straight on with the head level and no makeup, make that record credible.

The third job is honesty. Side-by-side images help you and the surgeon talk about the same face. A shadow you attribute to eyelid skin may turn out to be a hollow under the eye or a heavy brow, neither of which lid surgery addresses. Seeing that before consenting is better than discovering it afterward.

Photographs are part of your medical record and protected accordingly. You can ask how they are stored, who can see them and whether they will ever be used for teaching or publication. Consent for clinical use and consent for any other use are separate questions, and you are entitled to say yes to one and no to the other.

What not to do before blepharoplasty: the practical list

The question people type most often is blunt: what should I not do before eyelid surgery? The list below draws on the preoperative guidance published by the Mayo Clinic and the NHS, translated into ordinary habits. Every item is a prompt to check with your team, not a substitute for their written instructions.

• Do not start or stop any prescribed medicine on your own, especially anything for your heart, blood pressure or clotting. Bring the list; let the clinicians decide.
• Do not treat supplements as harmless. Fish oil, vitamin E, ginkgo and garlic extracts belong on the review list, and the team will tell you what to do with them.
• Do not reach for ibuprofen or naproxen for aches in the run-up unless the team has cleared it; these reduce platelet function.
• Do not smoke or use nicotine in the weeks before, ideally four or more, if you want the wound-healing benefit the WHO evidence describes.
• Do not drink heavily in the days before. Alcohol dilates vessels and can worsen bruising and swelling.
• Do not wear contact lenses on the day, or eye makeup, false lashes or lash extensions; the Mayo Clinic notes lenses are typically avoided for around two weeks afterward as well.
• Do not arrive without a ride home. Even with local anesthesia, sedation and blurred, swollen lids make driving unsafe.
• Do not skip the fasting instructions if sedation or general anesthesia is planned.
• Do not book a flight, an important event or a long drive for the following week without asking first.

One item is not a prohibition but an addition: buy the cold compresses, clean gauze, artificial tears and any prescribed ointment before the day, and set them up next to a chair where you can sit propped up. Preparing the room is as much a part of preparing for eyelid surgery as preparing the body.

What to bring to the consultation, and what the surgeon will check

The consultation is where the three themes of this article, blood thinners, smoking and photographs, actually get handled, so it pays to arrive organized. Bring the medicine and supplement list, your glasses or a current lens prescription, any previous eye records, and a short written note of what bothers you about your lids and what you hope will change. Vague hopes lead to vague plans.

Expect a proper eye examination, not just a look at the skin. The Mayo Clinic describes testing of vision, including peripheral vision, and an assessment of tear production. A surgeon will also gently pull the lower lid away from the eye and let it snap back; a slow return signals laxity that may need a tightening step to avoid the lid sagging afterward. The upper lid is checked for true ptosis, since fixing extra skin without addressing a weak lifting muscle leaves people disappointed.

You will be asked about dry eye symptoms, thyroid disease, high blood pressure, diabetes, previous facial surgery, allergies and bleeding tendencies, including whether you bruise easily or bled a lot after dental work. The NHS advice on any cosmetic procedure applies here: ask about the surgeon’s training, how the operation will be done, what the risks are for you specifically, and what happens if something goes wrong.

This is also the moment for the photographs and for a frank talk about expectations. A useful test: can you describe, in one sentence, what a good outcome would look like to you? If the answer involves features lid surgery does not touch, better to learn that now. Many surgeons deliberately allow a gap between consultation and operation for exactly this reason, and to let medicine plans and smoking pauses run their course.

The day of surgery: anesthesia, timing and going home

Most eyelid operations happen in an outpatient setting, and most people go home the same day. The Mayo Clinic describes the usual approach as numbing medicine injected into the lids combined with intravenous medicine to help you relax, though general anesthesia is chosen for some patients and some combined procedures. Which is right for you depends on the extent of the surgery, your health and your preference, and the anesthesia team will discuss it beforehand.

Timing varies with what is being done. Upper lids alone are quicker than upper and lower together; adding a ptosis repair or a lid-tightening step lengthens the operation. Ask for a realistic estimate for your specific plan rather than relying on a general figure.

What the sequence typically looks like:

• Markings are drawn on the lids while you sit upright, because gravity changes the skin once you lie down.
• Numbing injections are given; the sting lasts seconds and is the part people most often describe as uncomfortable.
• The surgeon removes or repositions tissue and closes with fine sutures, some of which dissolve and some of which are removed at a follow-up visit.
• Cold compresses and ointment are applied, and you spend a short time in recovery before being discharged with written instructions.

You will be asked to have an adult take you home and, ideally, stay with you the first night. Vision is blurred by ointment and swelling, and sedation lingers. Before you leave, make sure you know two things by heart: the number to call after hours and the specific signs that mean you should call it. That list appears later in this article, but the one your team gives you takes precedence.

Eyelid surgery recovery time: what the first two weeks usually look like

The most common misunderstanding about recovery is expecting it to be linear. It is not. Days two and three are typically the peak of swelling and bruising, which means many people look worse forty-eight hours after surgery than they did that evening. Knowing this in advance saves a panicked phone call.

The Mayo Clinic gives the most-quoted figures: swelling and bruising generally subside within about 10 to 14 days, and that is roughly when most people feel comfortable being seen in public. Incision lines take longer, often several months, to fade from pink to pale. The NHS offers similar ranges, noting that it can take several weeks to recover fully and that strenuous activity is usually avoided for a few weeks.

A typical, not guaranteed, arc:

• Days 1 to 3: tightness, watering, light sensitivity, blurred vision from ointment, bruising that spreads and darkens. Cold compresses and rest with the head raised are the main tools.
• Days 4 to 7: bruising shifts from purple toward yellow-green; swelling begins to ease; non-dissolving sutures are often removed around the end of this window.
• Week 2: most bruising fades; gentle walking is encouraged; contact lenses are usually still off, since the Mayo Clinic suggests waiting about two weeks.
• Weeks 3 to 6: swelling continues to settle, especially in the lower lids; heavier exercise is reintroduced with the team’s agreement.

The fastest way to recover, to answer the question people search, is not a product. It is following the plan: keeping the head elevated, using cold compresses as instructed in the first days, protecting the eyes from sun and wind with dark glasses, not rubbing, not smoking, and not bending or lifting in ways that raise pressure in the head. Sleep and patience do most of the work.

Sleeping upright after eyelid surgery: how long, and why it helps

Gravity is a quiet ally in the first days. When your head sits above your chest, fluid drains away from the lids instead of pooling in them overnight, and the morning puffiness that alarms so many people is reduced. The Mayo Clinic advises sleeping with the head raised higher than the chest for a few days after eyelid surgery; the NHS gives similar guidance about keeping the head raised in the early period.

How upright is upright? You do not need to sit bolt upright in a chair. Two or three pillows, a wedge pillow, or a reclining chair that keeps the head above the level of the heart is the usual aim. What matters is avoiding lying flat and, particularly, avoiding sleeping face down or on the side with a cheek pressed into the pillow, which can push on the healing lid.

How long depends on how quickly your swelling settles. Most teams suggest the first three to seven nights, and some people continue for a week or two simply because they wake up looking better for it. Ask your surgeon for their preferred range and treat the daily mirror check as your guide; if the lids are still noticeably puffier in the morning than in the evening, elevation is still doing useful work.

Pair elevation with cold. Clean compresses, a bag of frozen peas wrapped in a cloth, or gel packs kept in the refrigerator rather than the freezer, applied in short intervals during waking hours in the first two days, reduce both swelling and the bruise footprint. Never apply ice directly to numb skin, and never press. After the second or third day, many surgeons switch you to warm compresses, which encourage bruises to clear. Follow the timing your team gives, since it varies with the operation performed.

What people often get wrong about preparing for eyelid surgery

The myths around this operation cluster in predictable places, and correcting them is part of preparing well.

It is a quick, small operation, so the prep is optional. The eyelid is thin, vascular and next to the eye. A small bleed here carries more consequence than a larger one in most other skin. Brief does not mean trivial.

I should stop my blood thinner a week before to be safe. This is the most dangerous misconception on the list. The American Heart Association is explicit that anticoagulants should never be stopped or adjusted without the prescribing clinician, because an unplanned pause can raise the risk of stroke or clot. The safe version is a plan agreed between your surgeon and your prescriber.

Supplements are natural, so they do not count. Fish oil, vitamin E, ginkgo and garlic extracts appear on mainstream lists of products that can increase bleeding. Natural describes the source, not the effect.

Cutting down on cigarettes is nearly as good as stopping. The WHO surgical evidence is built around stopping, with roughly four weeks as the threshold where complication rates fall and further gains for each additional week. Cutting down leaves carbon monoxide and nicotine in circulation.

Vaping is fine because there is no smoke. It removes combustion products, which helps, but nicotine still narrows blood vessels. The evidence on vaping specifically before surgery is limited, which is precisely why most teams ask you to pause it.

Upper eyelid surgery is very painful. Most people describe tightness, soreness and gritty, watery eyes rather than sharp pain, and the Mayo Clinic lists discomfort managed with simple pain relief among the expected aftereffects. Severe or worsening pain, by contrast, is a warning sign, not a normal part of recovery.

The result I see at two weeks is the final result. Swelling, especially in the lower lids, can take months to fully settle, and scars keep fading for up to a year.

Questions to ask your care team before you consent

A good consultation leaves you knowing what will happen, why, and what the alternatives were. The questions below are drawn from the NHS guidance on choosing cosmetic and eyelid surgery and from the practical gaps patients most often report afterward. Write down the answers; adrenaline erases memory in clinic rooms.

• Exactly which lids and which structures will you operate on, and is any of this for function rather than appearance?
• Have you spoken with the clinician who prescribes my blood thinner, and what is the agreed plan for it before and after surgery?
• Which of my supplements and over-the-counter medicines do you want reviewed, and who will tell me what to do with each?
• How long do you want me off smoking and all nicotine before and after, and can you connect me with quitting support?
• What will the planning photographs be used for, how are they stored, and will anyone outside my care see them?
• What type of anesthesia do you recommend for me, and why?
• What are the specific risks in my case, given my dry eye, thyroid, blood pressure or other history?
• What would you consider a normal amount of swelling and bruising, and what would make you want to see me urgently?
• How long should I sleep with my head raised, and when do you want me to switch from cold to warm compresses?
• When can I return to reading, screens, driving, contact lenses, exercise and work?
• What is the follow-up schedule, and how do I reach someone after hours?
• If the result is uneven or I am unhappy, what is the process for reviewing it?

One more question worth asking yourself rather than the surgeon: do I understand what this operation cannot change? Brow position, under-eye hollows, fine crinkling skin and dark circles from pigment rather than shadow are all common sources of disappointment when people expect lid surgery to address them.

When to call your doctor after eyelid surgery: the red flags

Most recoveries are uneventful, and most worries in the first week are about appearance rather than safety. A small number of signs, though, need same-day contact, and one needs emergency care. Your team’s written instructions override anything here; keep their after-hours number where you can find it without your glasses.

Seek emergency care immediately if you notice:

• Sudden, severe pain in or behind one eye, especially with a rapidly tightening, bulging lid or a sudden drop in vision. This can indicate bleeding behind the eye, a rare event the Mayo Clinic lists among serious risks, and it is time critical.
• New loss of vision, double vision that was not present before, or a large dark area in your field of view.

Call your surgical team the same day if you have:

• Bleeding from the incision that does not stop with gentle pressure through clean gauze.
• Swelling or bruising that is markedly worse on one side than the other, or that keeps increasing after the third day rather than easing.
• Increasing redness, warmth, thick discharge or a fever, which can point to infection.
• An incision that opens, or a lower lid that starts to pull away from the eye or turn outward.
• An eye that cannot close fully, or a gritty, burning surface that artificial tears do not relieve, since exposure can damage the cornea.
• Chest pain, shortness of breath, or calf pain and swelling, particularly if your anticoagulant was paused.

Normal, by contrast, looks like this: tightness, watering, light sensitivity, mild blurring from ointment, and bruising that darkens then yellows over the first week. If you are unsure which category a symptom belongs in, call. Surgical teams would far rather reassure ten people than miss one, and a nurse can often settle the question in two minutes on the phone.

Frequently asked questions

What should you not do before blepharoplasty?

Do not start, stop or change any prescribed medicine on your own, particularly blood thinners; the surgeon and your prescriber agree a plan together. Beyond that, avoid smoking and nicotine in the weeks before, do not treat supplements like fish oil or vitamin E as harmless, skip heavy alcohol, and arrive without contact lenses, eye makeup or lash extensions, with someone to drive you home.

What are typical blepharoplasty pre op instructions?

Written instructions usually cover a medicine and supplement review, a pause from smoking and nicotine, fasting rules if sedation is planned, no lenses or eye makeup on the day, and arranging a driver and a companion for the first night. They also list the after-hours number and warning signs. Your team’s written sheet is specific to you and overrides general advice.

What is the fastest way to recover from eyelid surgery?

There is no shortcut, but following the basics consistently makes the biggest difference: head raised when resting, cold compresses in the first days as instructed, dark glasses outdoors, no rubbing, no smoking and no heavy lifting or bending. The Mayo Clinic notes swelling and bruising generally settle within about 10 to 14 days; trying to hurry that with unproven products does not help.

How long do I have to sleep upright after eyelid surgery?

Most teams suggest keeping the head raised higher than the chest for the first few nights, and the Mayo Clinic gives a similar range. Two or three pillows or a wedge is enough; you do not need to sit fully upright. If your lids are still noticeably puffier each morning after that, continuing for another week is reasonable. Ask your surgeon for their preferred timeline.

How painful is upper eyelid surgery?

Most people describe tightness, soreness and gritty, watering eyes rather than sharp pain, and discomfort is usually manageable with the simple pain relief your team recommends. The numbing injections at the start are often the most uncomfortable moment. Severe, sudden or steadily worsening pain, especially with vision change or a bulging lid, is not normal and needs urgent contact with your team.

Do I have to stop my blood thinner before eyelid surgery?

Not necessarily, and never on your own. Whether to continue, pause briefly or bridge with another agent depends on why you take it and how quickly it clears the body. The American Heart Association stresses that anticoagulants should not be stopped or adjusted without the prescribing clinician. Your surgeon and prescriber make that plan together, and your job is to bring an accurate list.

How long before eyelid surgery should I stop smoking?

The World Health Organization summarizes evidence that quitting about four weeks or more before surgery lowers the risk of complications such as poor wound healing, and that each additional smoke-free week helps further. Many surgical teams ask for a pause from all nicotine, including patches and vaping, over that period. Ask your team for their specific timeline and for quitting support.

Why does the surgeon take photos before eyelid surgery?

Standardized photographs from several angles let the surgeon measure lid crease height, brow position and asymmetry, plan how much skin to remove, and document a functional problem when heavy lids block vision. They also help you and the surgeon discuss the same features honestly. The images are part of your medical record; you can ask how they are stored and who can view them.

What is the typical eyelid surgery recovery time before returning to work?

Many people feel comfortable being seen in public once bruising and swelling have largely settled, which the Mayo Clinic places at roughly 10 to 14 days. Desk work is often possible sooner if you can tolerate screens and mild blurring, while jobs involving lifting, dust or heat usually wait longer. Contact lenses are typically avoided for about two weeks. Your surgeon will give a range for your case.

Can eyelid surgery fix my dark circles or heavy brows?

Usually not on its own. Dark circles caused by skin pigment, and heaviness that comes from a low brow rather than extra lid skin, are not changed by blepharoplasty. Hollowing under the eye may need a different approach. Planning photographs are useful precisely because they help separate lid skin from these neighboring causes before you consent, so expectations match what the operation can do.

References

• MedlinePlus: Eyelid lift
• NHS: Eyelid surgery
• World Health Organization: Smoking greatly increases risk of complications after surgery
• MedlinePlus: Blood Thinners

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.