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Post-OP | After Brain Surgery

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It’s finally over! All of your fears seem to be forgotten. You slowly wake up, look around, and kind of pinch yourself to see if you are still all there. Just as this happens you may begin to notice the headache that will gradually fade over the next few days. Your surgeon will soon walk in and ask you to say “Hello.” The relief on his (or her) face might be followed quickly by a phrase like “Well, brain surgery wasn’t so bad, was it?” A quick neurologic examination follows and your surgeon shares a quiet moment or two with you.

The next twenty-four hours will be spent in either the recovery room or in an intensive care unit. Usually a postoperative CAT scan will also be performed during this time, and nurses will stand by you, repeating the neurologic examination every hour or so, while administering the usual post-operative medications. These usually include pain medications (not too much, because they all want to see you bright and alert), steroids, antibiotics and anticonvulsants. You will usually be allowed to drink after a few hours, and “advance” your diet with each subsequent meal.

If all is well, you will return to a regular room the following morning. Depending upon the circumstances, a physical therapist will visit you and begin to work with you. Over the next couple of days, you will increase your activity until you are ready to go home. During that time you may be seen by various ancillary physicians, such as interns, residents, psychiatrists, radiation oncologists, internists, neurologists, and possibly oncologists. They will all confer with your neurosurgeon and come up with a game plan prior to your discharge.

Remember, hospitals are quite a lot like the army. The place is full of “hurry up and wait” scenarios. Physicians and staff all have something slightly different to say. This is sure to create a certain amount of confusion. Your frightened family and friends are nearby; most of them are too afraid to speak directly to you about anything for fear of saying the “wrong” thing.

The only captain of the ship is your neurosurgeon. You should speak only to him (or her) directly if you have any serious questions or fears. Keep his business card at your bedside at all times. When in doubt, don’t be afraid to call him. Beware of the “all knowing” intern or family member. More importantly, understand the stress that your family and friends are under during this time. Beware of the game children play called “telephone;” never accept anything that your doctor has said by way of one, two, three or more intermediaries. Neurosurgeons tend to be straightforward, kind, and simple in their explanations. We rarely pull punches. We want your trust completely.

If you are convinced that something is wrong and your neurosurgeon tells you that everything is okay, believe him and take a deep breath. If he tells you that there is a serious problem, believe him and try to concentrate on the logic of the next steps that will get you through the problem.

In medicine, persistence pays; emotional reactions do not. Almost every problem can be resolved, if only the patient and physician remain level headed, logical and persistent, no matter how many steps it takes.

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