
It's finally over! All of the previously
held 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 which 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 setting.
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 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 some sort of 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 constant apparent 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 sure to be under during this time. Beware of the game which 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.