Meet the Team: Cristina, RN, Lead Nurse for Dr. Brahme

You are listening to The La Jolla Cosmetic Podcast.

Welcome everyone to The La Jolla Cosmetic Podcast. I'm your hostess, Monique Ramsey. My guest today is Cristina. She's one of the nurses here at La Jolla Cosmetic in the Surgery Center. So welcome Cristina.

Thank you. Thank you so much.

So how long have you been at La Jolla Cosmetic now?

I started in June, 1999 and was in the OR 14 years and have been in the clinic since.

So, OR 14 years. So you've seen a lot.

I have worked with all the doctors that we had then we have new ones now, but yes, worked with all the doctors then.

And so your role is primarily as Dr. Brahme's nurse and you're kind of our Swedish team. So you've been with Dr. Brahme though even longer?

Yes, I was in his practice about three years, right below Sharp Hospital. And then we both actually moved to Dr. Smoot's office and then I moved down to La Jolla Cosmetic, and then both Dr. Smoot and Dr. Brahme moved down to La Jolla Cosmetic.

Love it. You just came down the elevator and have been with us ever since, which is wonderful. That's so nice. So how would you describe Dr. Brahme to a prospective patient who hasn't met him yet?

I would say he's very down to earth, great listener, more listening to the patient, but their desires are and rarely says what they should do more than what would they like to do? What would they like to improve? So he is very non-intrusive and just down to earth guy.

Yeah,

Not intimidating at all.

Yeah, he's very open I feel. And he's a fun personality, but the consummate professional, so we had a patient on recently, one of our episodes, I think this last episode that dropped with the skinny B B L and she talked about how he was in the consultation and she just really felt like he listened to what her goals were and helped her achieve them with, he said, I can do your lipo, but if you really want to waist, this is what we need to do. And she got the body of her dreams and so I think it's wonderful that it has a great connection. How would you describe that teamwork of the style of the two of you together?

Well, again, he's a great listener, so I talk to the patient first. I talk about him, his background. He is a former trauma surgeon. He was on life flight for nine years. He's the head of the breast cancer center for seven years. He just has a very broad background. So we talk about that and then they tell me what they're interested in and while I go and pick him up in his office, I give a quick report on what the goal is and he picks it up from there. And we've worked so long together so I can almost tell ahead of time what he's going to say, but it just becomes a very nice conversation. Non-threatening, because this is scary things. People come in and they're concerned and they're a little bit nervous and he just brings them straight down that nothing to be worried about. We're just talking about different things that they could be entrusted in.

So let's talk a little bit about you. What made you want to be a nurse and when did you know that that was kind of your path?

Well, I was eight years old and I knew I was going to be a nurse. I had a neighbor that was a nurse and she would give me syringes for my dolls and I would give everybody in the family shots every few days just so they would feel better. And that was my goal all along. Never wanted to do anything different than that. Actually took foreign medicine to work in third world countries, but my path took me a different way. So we moved from Sweden to America instead. And so this was 1981 and I did trauma floor for the first year. Then this was in Florida, and then we moved to the west coast. And again, I started within, well, I started in dermatology first, and then through that doctor I found La Jolla Cosmetic and was interviewed and landed a great role here, been here ever since.

When you did your training, you were in Sweden?

I was in Sweden. I did trauma there nine years. And yeah, I did not want to do that anymore. It was just too taxing with the different diseases that came into play and then switched over to more of the style work, which is very, very nurturing and I love it. This changes a lot of lives.

Changes a lot of lives. Yeah. So what are the parts about aesthetic medicine and your role with Dr. Brahme that makes you feel good when you go home at the end of the day?

I think it's interpreting what the patient comes in for, make sure that they're here for the right reasons and bond with them and interpret what exactly their path can be explained to them, how it's going to be going on forward after we talk about the procedures. And I have a great connection with the patients in my opinion. They trust me and I know that they will reach out if they have any concerns at all. And then I have Dr. Brahme with me, so if I have a concern, of course I've talked to him and he's very connected with his patients, calls them himself a lot, and it's just a good team.

So what have you learned over the years when you're with patients and sort of listening to them? What have you learned?

A lot of gratefulness, a lot of, I mean, every single day patients come in and they hug the doctor and say that he's changed their lives and it's, it's amazing to watch and be part of. And I mean, we are teary-eyed, both of us at many times where it's just has made a huge impact on almost every single patient. We do bigger surgeries and smaller surgeries, but it's very fulfilling. It's just nice to be part of.

So you're part with the patients, you said you're starting with them maybe at the consultation or at the consultation, not maybe at the consultation. And then if they decide to go forward with surgery, are you the one who's normally doing the preoperative visit with them or do they meet with another nurse?

We try to keep it together where I do the pre-op, but he does have a lot of patients and not all of them fit into the Wednesdays that I do. I try to follow up after any pre-op to see if they have any additional questions. If I did not do the pre-op, just so they feel some form of cohesiveness and they just don't get lost. It is a big practice and we are a lot of nurses, but try to keep it together so they know that I'm the main contact if they have any concerns whatsoever. So I follow up even now over the weekend after surgery, I talk to them and see if there's any additional questions after.

And then that care that you're doing after surgery, so whether it's their first post-op visit or even a few weeks later, is it normally you're with the patient?

I see patients on Wednesdays by myself, and that would be suture removals, follow-up questions. And then Tuesdays and Thursdays the doctor will see them. If I have any concerns whatsoever, I will have Dr. Brahme come in with me on a Wednesday. He can usually break off from the surgery and come out and see, which is very, very rare. But if there's any concerns, I can always reach him or I can reach one of the other doctors. That's the strength of the practice. I think that there's so many doctors here and anyone and everyone of them are very willing to help out if there's any concerns.

And do you think that your experience in the operating room really helps?

Absolutely. And I've had most procedures myself. So 1999.

You've either watched them and helped in surgery or you've had them yourself?

I've had most of them myself. So I can speak from my own experience, which I do think helps. I do know what they're going to go through, and I often get confirmation afterwards they say that, oh, that was exactly the way you said it would be. And I think that makes them comfortable and not wondering is this normal or is this not normal? And if I did a pre-op and I've told them this is what you should expect, then they're much more in peace with everything, the whole recovery.

Yeah, I think that's so true that if you hear that somebody else has done it and this is normal, that's all you kind of need sometimes is that reassurance that it's just normal. And I think that open dialogue, like you say, you're calling them, you're checking in making sure they're okay. So important. I think people sometimes think, oh, I don't want to bother them. I can't imagine you would ever see a question as a bother.

Not at all. Never ever. There's no bad strange questions. Any question is obviously addressed. So probably the first time they go through anything like this. So we have to be there for the patients. Absolutely.

Do you feel like you're, I would think you're kind of almost the confidant of the patient. You're that bridge that if they're too shy to ask the doctor something, that you're the one who's going to be that link?

I think so. I think that the nurse is less scary, less threatening, less not God as the surgeon is. So they talk to me and then I relay the questions and bring it into conversation. And I think that's, now Dr. Brahme is very easy to talk to and I don't think most people find them threatening or scary at all, but if there's any questions that are sensitive, I do definitely help them out with that.

What do you think people would find most surprising? Like a little secret fact that you know about Dr. Brahme that they might not know?

Well, so the patient doesn't necessarily know exactly how this is going to work out, but we have these little napkins in the coffee room where it's different little slogans. And I would love to have one that said what a difference a day makes. And you can have a person that for different reasons, have come in and want to change up the way they look one day surgery and it can completely change their life. I think that Dr. Brahme's skills are unbelievable. He has a very good way of translating what somebody's desires are to reality. And he's very honest. He says, Nope, no, I cannot do that. And so there's an understanding from the beginning that they don't have unexpected outcomes, that they're very realistic and he brings them down to it, this is what I can do and this I cannot do. So it's always a good start.

Yeah. Sort of what's achievable. Do you think that most patients have unrealistic expectations or are most people sort of in the realm of, or are they even maybe surprised at what can be done?

I think it is a question out there for them that, I mean, I show a lot of pictures. I show the before and afters. I think they speak, I mean that's facts that they can see from what it was before and after. And most patients are pretty realistic. It's very, very important to try to find out the ones that are not, because then we have to have maybe more than one visit to clarify again, what can be done and what cannot be done with a particular situation. So I think that's where we come in and I feel I come in to really hear them out and see what their thoughts are. And maybe they bring in pictures of somebody else that they want to look like, well, that's not necessarily realistic, and then we talk about them instead. So yeah, most patients though, I do feel that they are pretty realistic.

Do you find different tools, so you mentioned before and after pictures, and I think sometimes seeing where someone else started and where they ended up, let's say it's a mommy makeover or a facelift, that he's so good at those procedures and to be able to say, okay, here's where this lady or this gentleman started, here's where they ended up, where the improvements were, even if it's not you. But are there any other tools that Dr. Brahme and you will use to help a patient to have a vision of what the final outcome could be?

I think we refer to photos a lot. I've had, like I said, most procedures, I can show scars, I can show they can see me live on where my incisions have been, how they've healed. That's not necessarily a hundred percent for everyone that's going to heal exactly like I did, but at least it's a starting point. And then we talk about if they have a little bit more olive in their skin, they may heal differently. And we show pictures of that, what that can look like. It's very, very important that they have a realistic idea of what they would show, how they're healing would be, and all, at least as best as we can explain that, I think photos are very important. And again, I show my scars and talk about my situations that I've gone through. So I don't really have any props of any other kinds. Well, we do have a lot of testimonials from patients that talk about what they've gone through, and I do love those. I think that's very generous of the patients to share that and what they've had done and how they felt it was. And we have some that necessarily don't go on camera, but they will talk to patients for us.

Yeah, I think that kind of that buddy system sometimes even just a phone call where there's patients who will say, yeah, I don't want to be on your website, but I'll tell the whole story of what it felt like.

Exactly. Now we do have many patients that are very sweet to help us with that, and it's more non-biased there. It's not like they've been coaxed into it, however you say that. But yeah, we do that. And then, no, it's probably those are the main things that the patient can go to if they want to.

So we talked a little bit about your background and so let's talk about what you like to do when you're not working at La Jolla Cosmetic. What are your favorite things to do?

I love to hike. I like to cook a lot, lot more than I should. I sew, I knit, I read. I have a cat that I absolutely love.

What's your cat's name?

Her name is Freya. It's a Viking name and it's the queen of fertility is what it means.

But she has no kittens, I take it?

She has no kittens. She won't have any kittens, but she's adorable. And I like to travel.

Traveling. Where's a place that you haven't gotten to go yet that is on your bucket list?

So I have tickets to Turkey. So on the way I'm going to meet with a girlfriend many, many years. We're going to meet in Paris, stay a few days in Paris, and then we go on to Istanbul and we will see five cities in Turkey and we'll be gone 10, 12 days I think it is. And I'm super excited about that.

When is that coming up?

It's coming up next year, end of March. And I have asked for permission to leave.

Dr. Brahme said, okay,

Well, he doesn't know yet. <laugh>

<laugh> Well when he listens to this her might.

Through the administration, asked for the vacation time.

That will be fun. Well, he likes to travel too.

He does. And his wife is Turkish. So I will have a lot of feedback once we get closer.

Yeah. You know what I think is so fun about Dr. Brahme is he has so many outside interests and one of them is he's a musician and he can play a lot of different instruments. It's really incredible. Is there any other secrets we don't know about him?

No, I don't think so. He's extremely smart. I think he knows a little bit about anything you could ever bring up. Very, very smart guy. And he remembers everything. So he's a just pleasant guy. We do try to go and listen to him, play a few people from the clinic and it's always fun. He is a great misses. He doesn't sing a lot in the band, but he sings in the or, which is I'm sure very nice for the staff in there now.

Oh my gosh.

Every once in a while he'll be singing along. He always plays good music in the or. So I tell him he should sing in the band too, but so far he won't. So what can we say?

Well, that's neat that he sings in the or that keeps it lively. So our brand promise is where dreams become real and helping patients achieve those dreams. So tell us, Cristina, what's a dream of yours that became real?

Well, that I was allowed and able to move to America was a huge dream of mine and that I've been successful in the US that I have a great job that I've been at now 24 years, and I am not sure when I'm going to be retiring. I'm 70 now, so

Are you really?

Maybe another 20 years or so. 70. Yeah.

So you're the testament to Dr. Brahme's beautiful facial work right there. I had no idea.

Thank you. No, he is amazing. He doesn't do weird stuff. Not even my three sisters could tell that I had done anything other than I changed my hair at the same time. And they said, oh, I should always wear my hair like that. And it wasn't really the hair, it was the loose skin hanging around everywhere. And now he has a very good eye. And then the body work I've done after two children has been amazing. And it's just in general a great practice to be at and the country is great to be in.

Well, we love the fact that you chose to come here back in the eighties and that you remain here and we just love that you decided to come here to America and share your expertise medically, but I think also that personal connection that you have with patients and your experience in the OR, and your experience with probably thousands of patients over 24 years. There's got to be many, many thousands of lives that, like you said, lives that were changed. And what would you say is maybe the biggest surprise when you wanted to be a nurse at eight years old, but looking back at that career, is there anything that surprises you?

I don't think so. I've loved every year, every minute of my experience as a trauma nurse is completely different than what I do now. It was very exhilarating, very fulfilling then. And switching over to on the more sensitive side of trying to read and understand patients, prospective patients is just nice to have their trust and to just relay what their thoughts are and try to guide them correctly and through their journey here with us. And I'm friends with many of our patients through the years, and I have this little thing, I do that for Thanksgiving. I ask them for their favorite recipes and I've been collecting that through the years. So it just becomes very personal. It's been a great, great experience.

Is there any recipe that you have gotten from a patient that you love to make?

Well, there is a sponge cake. It's a lemon sponge cake where this patient, after the loaf is done, she made little holes in the loaf and then she put lemonade in there and butter and it's to die for.

Oh my gosh, that sounds so good.

It's really, really good. And yeah, there's several through the years that I make, Thanksgiving is not a holiday we have in Sweden, so it's my favorite holiday here. Lots of good food, lots of new things I can try every year. And the children are always with me, so they come up with their different recipes. It's a great, great holiday.

That's nice. It's nice to have your family around and to have those traditions. I love that. Well, thank you for coming on today. It's been a while since we've gotten to chat and it was really fun to connect again with you and have you on the podcast. And please come back anytime.

Thank you.

We've been trying to get her she's so busy. She's got all her patience and so we've been trying for now two years to get you on, so we finally did it. So I feel like I have, it's a huge accomplishment.

Well, thank you for having me.

Well thanks Cristina, and we'll see you all later. Bye.

Take a screenshot of this podcast episode with your phone and show it at your consultation or appointment or mention the promo code PODCAST to receive $25 off any service or product of $50 or more at La Jolla Cosmetic. La Jolla cosmetic is located just off the I-5 San Diego Freeway in the XiMed building on the Scripps Memorial Hospital campus. To learn more, go to lj csc.com or follow the team on Instagram at lj csc. The La Jolla Cosmetic Podcast is a production of The Axis, T H E A X I S. io.