Once you are back home, plan to spend at least the first week concentrating on watching TV, planning further therapy sessions, and maintaining a positive attitude. After that, you should increase your activity gradually. Listen to your body’s signals. If you get tired on Day One, do less on Day Two.
Don’t be surprised at how fatigued you might feel, no matter how small your operation. It is amazing to note how well the body closes down other systems until the challenged part is back on track and in good repair. As a rule, you should give yourself at least six weeks to get “back to yourself.”
Potential problems to be aware of include:
- The incision and bone flap. Most patients complain of itching along the scalp incision, especially up until the time that the sutures (or skin staples) are removed. Keep the wound as dry and clean as you can. Call your doctor or his assistant if you develop local redness or heat in the area of the incision. Also call for any type of fever or rash. Some patients also complain of swelling beneath the skin, followed by swelling around the eye on the side of the operation, and later on the face below the operation. Remember that any fluid from the brain must travel back towards the heart, passing along the eye and face along the way. Some discoloration may also follow the fluid as it travels back to the heart.
Occasionally, the fluid may be normal cerebral spinal fluid escaping into the tissues at the operative site. Do not worry about this; it will go away.Other patients may hear a “clicking” sound at the bone flap site. This will also eventually resolve as the bone heals. It takes between 6 months and one year for complete healing to occur. If your surgeon uses a lot of “burr holes” in his flaps, and if he does not routinely fill or cover them, you might complain thay you have “bowling ball” sockets in your head. This can be particularly troublesome in patients who are bald.
- Seizures. Most patients must take anticonvulsant medication for six months to a year after their operation. Remember to have your anticonvulsant medication blood levels checked every month or so, especially at the beginning. These medications are usually stopped after a negative EEG for electrical indications of brain seizure activity. Some states do not allow driving during this period, especially if there has been a history of seizures. Ask your doctor to clear you for driving when the time comes.
- Headaches. Headaches almost always disappear within the first weeks after surgery. They should also be easily controlled with analgesics such as Tylenol. If an increasingly severe headache does develop during this time, call your neurosurgeon.
- Physical Therapy. If you have persistent neurological problems such as weakness or speech difficulties, you will more than likely be visited by a physical, occupational, or speech pathologist. Make sure that you really concentrate during these sessions, as your benefits will be directly proportional to your efforts.
- Other Medications. Most patients return home with a “tapering” dosage schedule of steroid (antiinflammatory) medications such as decadron, along with a medication to settle your stomach (e.g. Zantac). These “tapering” schedules may be a bit confusing, so be sure to confirm your schedule with the hospital nursing staff prior to discharge. After returning home, call your pharmacist for help if you need it.
- Discharge to a Rehabilitation Facility. Get ready for the next four to six weeks! Once in a while, you will meet a team of dedicated professionals who will structure a program tailored to your needs. Again, your input is important.
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