What to Expect From Neurosurgery

Key Steps Before, During, and After Your Procedure

It’s normal to have questions when your doctor says you need neurosurgery. At Baystate Health, our neurosurgery team will work closely with you to help manage and coordinate all aspects of your care.

We want to ensure you have the best experience possible. That’s why we’ve put together this guide to key phases of the neurosurgical process. You should also refer to the Preparing for Surgery guide for basic information about having surgery at Baystate Health.

Preparing Your Home for Your Neurosurgery Recovery

Your doctor will emphasize the “no BLTs” approach after your surgery: no bending, lifting, or twisting. Go through your home and the items you use most often to eliminate any need for you to bend, lift, or twist after your procedure. You may benefit from these common bathroom aids to reduce the bending, lifting, and twisting you need to do during your regular routine:

• Raised toilet seat
• Shower chair
• Suction-cup shower handlebar

You likely will need to move items around to accommodate your movement restrictions. Make sure you can easily reach common necessities, such as:

• Deodorant
• Paper towels
• Toilet paper
• Toothpaste

You will be tired and more unsteady immediately after your neurosurgery and likely for several weeks afterward. Before your surgery, move or remove common trip hazards in your home, such as:

• Floor clutter
• Shoes
• Throw rugs and floor mats

Make sure you have food where you can reach it easily without bending, lifting, or twisting after your surgery. You won’t have a specific diet to follow after your procedure, but you may have a decreased appetite after surgery. If you’re having cervical (neck) surgery, you may want to get soft foods to eat after your surgery, such as:

• Ice cream
• Oatmeal
• Pudding
• Smoothies
• Thick soups
• Yogurt

We recommend choosing thick, soft foods such as these, rather than thin foods such as watery soups. Thick foods will be easier to swallow after your cervical neurosurgery.

One Week Before Your Neurosurgery

You will need to stop certain medications a week before your surgery date. These medications include:

• All nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin (including Excedrin), ibuprofen (Advil), and naproxen (Aleve)
• Fish oil
• Herbal supplements
• High-dose vitamins
• Vitamin E

You and your neurosurgeon will discuss your particular medications and whether you’ll need to stop them before your surgery.

The Night Before Your Neurosurgery

There are a few key preparations you must make the night before your surgery.

Washing With CHG Solution

Your neurosurgery care team will give you a bottle of chlorhexidine gluconate (CHG) wash solution. You must wash with your CHG solution before your surgery. This will reduce your risk for infection at your surgical site. Follow these steps:

 

1. Get a clean towel and washcloth, as well as your regular shampoo and soap and the CHG solution.
2. Remove all jewelry and body piercings. Tell your neurosurgeon if there’s anything you can’t remove.
3. Set aside the clean washcloth for later.
4. Use your normal shampoo and soap to wash your hair and face in the shower. Do not use the CHG solution on your head or face.
5. Rinse your shampoo and soap off completely, and thoroughly rinse your body from the neck down.
6. Wet your clean washcloth, and turn off the shower.
7. From your neck down, apply just enough CHG solution to cover your entire body (about half of the bottle). Do not use the CHG solution on your head, face, or genitals. Focus on the area of your surgery.
8. Use your clean washcloth to wash with the CHG solution. Make small circles on your skin with the washcloth, and move from your neck down to your toes. Avoid your genitals as you move down your body.
9. Do not wash with your regular soap or shave until after your neurosurgery.
10. Turn the shower back on, and let the water gently rinse the CHG solution off your body.
11. Get out of the shower, and use your clean towel to pat yourself dry.
12. Do not put on any deodorants, perfumes, powders, or lotions until after your surgery. Do not put on any jewelry.
13. Put on clean clothing or pajamas after your shower, and make sure you sleep on freshly laundered bed linens.
14. Do not allow any pets on your bed the night before your surgery.

No Food or Drink After Midnight

Starting at midnight the night before your surgery, you must not eat or drink anything, including water, ice chips, gum, etc. This is to minimize your risk for pneumonia after your surgery. Your anesthesiologist will provide instructions on how to take any necessary medications.

The Day of Your Neurosurgery

On the morning of your surgery, repeat the shower procedure from above, and put on clean, comfortable clothing. You should arrive at the Daly Building entrance of Baystate Medical Center at least an hour and a half before your scheduled surgery time.

You should leave all valuables at home. Make sure you bring these items as applicable:

• Insurance card and identification
• Dentures, hearing aids, and glasses
• Sleep apnea machine

You’ll go to the Pre-Op area on the first floor of the Daly Building. If you know you get nauseous from anesthesia, you should let the nurses know at this time. You’ll receive an intravenous (IV) line, and you’ll meet with your anesthesiologist and neurosurgeon before your surgery.

Your Neurosurgery

Most neurosurgery procedures last two to four hours, depending on the specific surgery. Your loved ones are welcome to wait for you in the waiting room on the second floor by the cafeteria. We’ll take you to the post-op area after your surgery.

Post-Op

You’ll wake up in our post-op area after surgery. Your loved ones can join you there. We’ll start pain medication through your IV. You should let your nurse know if you feel nauseous.

From here, we’ll move you to your hospital room.

Your Hospital Room

Most patients stay one night with us in the hospital after neurosurgery. If you think you may have trouble sleeping, we recommend bringing a “quiet kit” with you to the hospital, which may include:

• Ear plugs
• Eye mask
• Headphones

Do not get out of your hospital bed by yourself. Use the call bell to ask for help. However, we do recommend that you get out of bed and walk with help. Walking will help prevent blood clots and pneumonia and improve stiffness after your surgery.

We’ll help you walk to the bathroom after your surgery. We’ll also measure your bladder with an ultrasound to see whether your surgical anesthesia has caused you to retain any urine.

Let your nurse know if you have any of the following symptoms:

• Pain, especially if it’s different or worse than before or if your pain medication isn’t working
• Nausea
• Numbness or weakness
• Loss of bladder control
• Headaches, especially when sitting or standing

Physical Therapy

One of our physical therapists or occupational therapists will assess you after your surgery, whether it’s the same day or the morning after. This is to make sure you’re safe to go home. Once you go home, you won’t begin any physical therapy for four weeks after your surgery. We encourage you to walk when you can. You should take short, frequent walks on firm ground.

Going Home After Neurosurgery

You will not be able to drive for two weeks after surgery, so you must have someone available to drive you home from the hospital. You can be a passenger in a car, but limit your trips to one hour or less.

Once the two weeks are past, you should not drive if you have taken pain medication. Be extra careful while driving, as your reflexes will not be at their best while you are still recovering from neurosurgery.

Your Neurosurgery Recovery Process

It’s normal to feel tired or fatigued after your surgery. Take breaks often, and give yourself time to rest and heal.

You may find yourself constipated after your surgery. Many factors after neurosurgery can contribute to constipation, such as:

• Anesthesia and pain medications
• Not eating
• Not moving around

Make sure you drink plenty of water as you recover. If you need them, you can take stool softeners or laxatives to relieve constipation. Follow the manufacturer’s instructions for these medications.

Showering and Changing Your Dressing

You may shower on the third day after your surgery. This will give the surgical site time to heal after your procedure. Remove the outer dressing—likely a clear bandage with gauze—but leave the small pieces of tape holding your incision closed in place. The pieces of tape will fall away on their own later.

You should still refrain from using any ointments, lotions, or oils while you shower. Make sure you take a shower, not a bath. Your incision site should not be in any standing water, such as:

• Bathtubs
• Hot tubs
• Swimming pools

When to Get Help

It’s very likely that you will have a smooth recovery after your neurosurgery. However, there’s always a risk of complications.

Call 911 or go to the nearest emergency department right away if you notice any chest pain or shortness of breath. These are serious symptoms that you should not experience after your neurosurgery.

Call us at 413-794-5600 if you notice any of the following symptoms:

• Fever greater than 101 degrees (a low-grade fever is normal the first week after surgery)
• Inability to swallow or drink water
• Loss of control of bowel or bladder
• New headaches, especially when sitting or standing
• New numbness or weakness
• Pain that medication does not relieve

Your Pain After Neurosurgery

Unfortunately, we can’t eliminate all pain after surgery. Our goal is to get your pain down to a level you can manage. Your pain is unique to you—it won’t be the same as someone else, even if they have the same surgery as you.

You may notice that some pain and symptoms related to your neurological condition improve or are resolved immediately after your surgery. Don’t be disappointed if they aren’t, however. Not all symptoms go away immediately.

The second through fifth days following your surgery may be the most painful or challenging. This is due to the process of inflammation. Inflammation helps in the healing process, but it can irritate nerves, which can increase your pain. Having too much inflammation can make it difficult or impossible for you to do basic tasks, such as getting out of bed or even swallowing, so it’s important to carefully manage your pain and inflammation levels.

Your pain management plan likely will include pain medications. Common pain medications include:

• Percocet (contains Tylenol/acetaminophen)
• Vicodin (contains Tylenol/acetaminophen)
• Oxycodone
• Tramadol
• Muscle relaxers, such as Flexeril (cyclobenzaprine) or tizanidine (Zanaflex)

You may fill your prescriptions at your regular pharmacy, or you can have them filled in our retail pharmacy, located behind the gift shop near the Daly Building entrance. If you fill your prescriptions in our pharmacy, we’ll have them ready for you to take home before you leave the hospital. Some insurance plans only pay for a week’s worth of pain medication at a time, so you may need to call our office for a refill. If so, someone will need to pick up the paper prescription and take it to the pharmacy, rather than having it called in.

Though your pain is unique to you, there are certain symptoms or issues we frequently see based on the type of surgery involved.