The lead up to brain surgery can be a stressful time. It is recommended that you ask your neurosurgeon any questions you have, no matter how trivial you think they are. The greater your knowledge of the procedure, the less frightening it will seem.
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Having a better understanding will also reduce any fears of the unknown and help you to feel more in control of the situation. Write your questions down before any appointments with the consultant, and take a family member or friend with you for support. Making nice plans with friends and family throughout the weeks leading up to surgery may help to relieve the anxiety which you may be experiencing.
Advance directives and living wills
While the chances of serious complications are low for most neurosurgeries, all surgeries carry some risk. Make sure to have discussions with your family members about your wishes in the event of something unexpected happening, or if you are unable to make decisions for yourself.
Patients undergoing any type of surgery should consider completing a Living Will and nominating a power of attorney before surgery.
Preparing for post-surgery
In the weeks leading up to surgery, you should consider putting in place practical coping strategies to help aid your recovery post-operation, such as:
- Prepare and freezing nutritious meals
- Make necessary adjustments to your bedroom and bathroom
- Get ahead on household chores
- Collect any books, magazines, and movies you may want to read or watch post-surgery
- Arrange any cover you need at work and create a return to work plan with your management
- Plan for any childcare needed
- Arrange travel to and from surgery
Pre-operative medical checks and appointments
In the week before surgery, you will meet with your treatment team. Here you will be briefed on the operative procedure, the benefits, and risks of surgery, and what to expect post surgery.
You may be required to undergo health tests and checks to make sure you are ‘medically fit’ for surgery. It is important to make sure your physician is fully informed of your medical history and knows of any medications you may be taking. The tests carried out vary considerably depending on your medical history, but may include:
- Blood pressure tests, pulse, and temperature
- Blood tests to check for hormone levels and chemical markers
- An angiogram of your blood vessels and blood flow
- An Electrocardiogram (ECG) & echocardiogram to ensure your heart is healthy
- Lung function tests & chest x-ray
- Neuropsychologic examinations if your condition is affecting your cognition
These checks help to identify and optimally treat any underlying medical conditions which could cause further risk from surgery.
You may be asked to stop taking certain medication a week or more prior to surgery (such as anticoagulants like warfarin, or antiplatelet drugs like aspirin). You may also be asked to take certain medications in the week before your surgery (such as steroid agents which reduce swelling in the brain, or anti-seizure medication).
Preoperative imaging tests
Several imaging tests may be conducted leading up to your surgery. These include:
- CT scans
- Magnetic resonance Imaging (MRI)
- Diffusion Tensor Imaging (DIT)
These images provide a 3-dimensional map of your brain structure and function. This helps guide the neurosurgeon to plan the procedure and avoid any areas of the brain associated with important functions.
Your neurosurgeon may place fiducial markers to pinpoint certain areas of your scalp for surgical incision. The fiducials are small stickers which are painlessly placed on your scalp pre-surgery. It is important not to move the fiducials once they are placed.
Packing a bag
You may wish to pack the following items to improve the comfort of your stay in hospital:
- Any insurance documentation
- Day clothes
- Clean underwear
- Dressing gown and slippers
- A small towel
- Reading material
- Some loose change
- Any medication you need
- Glasses or contact lenses
- A notebook and pen
- An address book with any important phone numbers
- Phones, tablets, laptops and MP3 players if permitted
It is important to remove any body piercings before your operation. This helps to minimize the spread of harmful bacteria throughout the hospital. You must also remove all makeup and nail polish so that the surgical team can see your skin and nails to monitor your circulation. Many hospitals also require you to shower or bathe before surgery.
Your doctor may ask you to not eat or drink anything for a period of time before the operation. This is crucial as you need an empty stomach during surgery, to ensure that you do not vomit while under anesthetic.