Dis­charge Instruc­tions After Brain Tumour Surgery (2006)

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Con­tents

I. Dis­charge instruc­tions After Brain Tumour Surgery
II. Care At Home Fol­low­ing Surgery
III. Return to Work
IV. Addi­tional Resources & Information


I. Dis­charge instruc­tions After Brain Tumour Surgery

ImageThis pam­phlet was devel­oped to give you infor­ma­tion about:

  • Your care at home after your brain tumour surgery, and
  • Con­tact­ing health care providers if you have questions/​concerns

It is impor­tant for you to feel con­fi­dent and com­fort­able while you recover at home, please let us know if we can help.

Who to call with your ques­tions or concerns:

Day time: Mon­day to Fri­day
Brain Tumour Clinic: (514)3985937

Clin­i­cal Nurse Specialsts:

Catherine-​Anne Miller Maria Hamaki­o­tis
clinic: (514) 3985937 clinic: (514) 3985937
office: (514) 3981966 office: (514) 3986644, local 089817

After 4:30 pm (16h30)
EMER­GEN­CIES ONLY
Neu­ro­surgery Res­i­dent: dial (514)-9341934 local 53333 and ask “locat­ing” to have the Neu­ro­surgery Res­i­dent on Call paged. Emer­gen­cies only please.
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Care At Home Fol­low­ing Surgery

Pain /​Dis­com­fort
Image You may have pain after your oper­a­tion. Aceta­minophen (Tylenol™) may be taken every 4 hours as needed. Extra strength or reg­u­lar is fine.

If aceta­minophen (Tylenol™) does not reduce the pain, ask your doc­tor for a pre­scrip­tion for a stronger pain reliever.

You will expe­ri­ence some numb­ness or tin­gling in the area of the oper­a­tive site or inci­sion. This is nor­mal and it may take a few months for this to go away.

Leg Swelling or Pain
You may have pain and swelling in a vein (phlebitis). This can hap­pen in the calves of your legs after surgery because you have not been able to be active. If you have pain and swelling and /​or red­ness in one or both legs, con­tact your fam­ily doc­tor or come to the emer­gency room for treat­ment if necessary.

We encour­age you to be as active as pos­si­ble to pre­vent this problem.

Change In Func­tion
If you develop any change in arm or leg func­tion, speech abil­ity, or level of alert­ness, PLEASE CALL US IMME­DI­ATELY. Image

Fever
A slight fever dur­ing the first few days after an oper­a­tion is nor­mal. Any fever that con­tin­ues or is higher than 38.0 degrees Cel­sius (100.4 degrees Fahren­heit) should be reported to us.

If you develop a fever and have pain when uri­nat­ing, check with you fam­ily doc­tor since this may mean that you have an infec­tion in your uri­nary tract.

Fatigue /​Appetite
You may feel tired and may not feel like eat­ing much after your surgery. It is impor­tant that you drink 6 to 8 glasses of liq­uids per day. It may be eas­ier to eat 5 or 6 small meals of healthy foods through­out the day. Good nutri­tion is impor­tant for heal­ing the wound and get­ting your strength back.

You may need rest breaks, naps, or relax­ation exer­cises through­out the day espe­cially after com­pany or exercising.

We encour­age you to exer­cise. An exam­ple would be tak­ing short daily walks for 1020 min­utes a day. (See Activ­ity Restric­tions After Brain Tumour Surgery)

Nau­sea and Vom­it­ing
It is com­mon to feel weak and a bit nau­se­ated after surgery. You may actu­ally vomit.

Gravol, or other sim­i­lar med­ica­tions may be used to con­trol vomiting.

A pre­scrip­tion is not required to pur­chase Gravol and your phar­ma­cist can help you choose the dosage that is appro­pri­ate for you. Gravol may be taken by mouth or by suppository.

Fre­quent small drinks, Pop­si­cles, and Freezies can help you keep up your body fluid lev­els when you are nau­se­ated or vomiting.

Con­sti­pa­tion
Con­sti­pa­tion can some­times be a prob­lem after surgery. Pain med­ica­tions that con­tain codeine can make this prob­lem worse. If pos­si­ble try to avoid these. Increas­ing your activ­ity level as much as you are able is impor­tant as well as eat­ing foods such as bran, prunes and fresh fruits and vegetables.

Image Activ­ity Restric­tions After Brain Tumour Surgery
Please do not par­tic­i­pate in con­tact sports, swim­ming or div­ing, until your neu­ro­sur­geon has exam­ined you at the 68 week follow-​up appointment.

Ask your neu­ro­sur­geon about dri­ving a motor vehi­cle or rid­ing a bicy­cle (with a hel­met) after your operation.

Human sex­u­al­ity is an impor­tant part of adult lives. Please do not hes­i­tate to ask a mem­ber of your health care team about resum­ing sex­ual activ­ity after your surgery.

Wound (Inci­sion) Care and Mon­i­tor­ing
Some swelling and some red­ness of the wound are nor­mal after this surgery. The swelling will some­times become worse 4 to 7 days after the surgery, after the ban­dages have come off. This swelling may be very minor, or reach the size of a fist. This is nor­mal and may take 2 to 3 weeks to improve or get bet­ter. As you become more active, the area of swelling may change as flu­ids move and are reab­sorbed. Keep­ing your head raised may reduce the swelling.

Watch your wound for signs of infec­tion such as: the wound becom­ing red­der, streak­ing or red­ness on your scalp, ooz­ing of pus from the wound or any leak­ing of fluid. Fever could be another sign that your wound is infected. If any of these things hap­pen, PLEASE CALL YOUR NEU­RO­SUR­GEON OR YOUR CLIN­I­CAL NURSE SPE­CIAL­IST IMMEDIATELY.

The wound heals best if left open to the air.

Sutures (stitches)
There are three types of sutures that may be used: sutures, self-​absorbing sutures and staples.

Self-​absorbing sutures: Self-​absorbing sutures, which absorb in 10 to 21 days, do not need to be removed. As the sutures age, they turn darker in color. Please wash your hair daily with a mild sham­poo. If the sutures have not fallen out by 14 days after the surgery rub them with a clean cloth or wash them gen­tly and they will fall out over the next few days.

Sutures and Sta­ples: If this is your first brain tumour surgery, the stitches or sta­ples should be removed approx­i­mately 7 to 10 days after your surgery. If it is not your first surgery, the stitches or sta­ples will be removed in approx­i­mately 14 days. Your neu­ro­sur­geon will inform you when to have your stitches or sta­ples removed. A spe­cial instru­ment is required to remove sta­ples. Your nurse will tell you where you can have your stitches or sta­ples removed. (Brain Tumour Clinic, the CLSC, or by your fam­ily doctor).

Clean­ing The Wound
Image You may wash your hair gen­tly with mild sham­poo and a wash­cloth start­ing 4 days after surgery. It is impor­tant to keep the scalp clean, so please wash your hair daily. It is impor­tant to wash over the wound and to allow water to run over it.

Med­ica­tions
Dex­am­etha­sone (Decadron™): You will be given a pre­scrip­tion for dex­am­etha­sone (also known as a cor­ti­cos­teroid or Decadron™) when you are dis­charged from the hos­pi­tal. Usu­ally this med­ica­tion is tapered (decreased) over a num­ber of weeks. You may find it help­ful to use the Decadron™ Taper­ing Sheet found in this book­let for help with this decrease.
Note:Decadron™ Taper­ing Sheet is avail­able through the down­load­able PDF ver­sion (page 8) on the top of this page.

Ran­i­ti­dine (also known as Zan­tac™) or other med­ica­tions (Sul­crate™ or Cime­ti­dine™) will also be pre­scribed to pre­vent the dex­am­etha­sone from irri­tat­ing your stom­ach lin­ing. When the dex­am­etha­sone is stopped, this med­ica­tion is also stopped.

If you are tak­ing anti-​convulsant (anti-​seizure) med­ica­tion, please con­tinue as prescribed.

A blood test may be requested in order to check your blood level for seizure medication.

The fol­low­ing is a list of side effects you may or may not notice, which could result from the decreas­ing dosage of Decadron™ (steroids).

  • Decreased energy level
  • Fatigue
  • Loss of appetite
  • Weight loss
  • Mild headaches (report any headaches which are not con­trolled with Tylenol™ or sim­i­lar medications)

Pre­cau­tions

  1. If you should develop severe headaches, nausea/​vomiting, seizures, numb­ness, mus­cu­lar weak­ness, paral­y­sis or loss of bowel or blad­der con­trol, you may increase your Decadron™ dosage to the last level, at which you did not have trou­ble and then call 3985937 to tell the nurse and /​or your physician.
  2. NEVER SUD­DENLY STOP TAK­ING STEROIDS WITH­OUT YOUR DOCTOR’s AUTHORIZATION
  3. Con­tinue any antacids such as Ran­i­ti­dine™, Sul­crate™ or Cime­ti­dine™, which were pre­scribed until you are com­pletely off steroids and then you may discontinue.

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III. Return to Work

Return to Work
Most patients take 68 weeks off. Your return to work may be grad­ual. You can best decide this in con­junc­tion with your doc­tor and your employer.

Com­pli­ca­tions
Image Prob­lems rarely occur after being dis­charged from the hos­pi­tal; how­ever, it is impor­tant to be aware of nor­mal and abnor­mal signs and symp­toms that might occur.

It is highly rec­om­mended that you care­fully read the Brain Tumour Patient Resource Hand­book sec­tion on com­pli­ca­tions. If you have not received a copy of this Hand­book please ask a mem­ber of your heath care team.

Please call us if you expe­ri­ence any of the fol­low­ing problems:

  • Develop a tem­per­a­ture, higher than 38 degrees Cel­sius or 100 degrees Fahrenheit
  • Leak­age from the wound
  • Notice the wound has become red, swollen or hot
  • Dizzi­ness that doesn’t go away
  • Headache (with no relief from med­ica­tion pre­scribed by your doctor)
  • Con­tin­u­ous nau­sea or vomiting
  • Dou­ble vision and /​or blurred vision
  • Drowsi­ness
  • Neck stiff­ness
  • Increased mus­cle weak­ness, dif­fi­culty walk­ing, dif­fi­culty using your arm or hand
  • Dif­fi­culty keep­ing your balance
  • Seizure
  • Speech prob­lems (slurred speech or unable to say words or make sounds)

Follow-​up Care
A follow-​up appoint­ment has been booked for you at the Brain Tumour Clinic or at your neurosurgeon’s office at the Mon­treal Neu­ro­log­i­cal Hos­pi­tal in 68 weeks time. Depend­ing on your diag­no­sis, you may also have an appoint­ment to be seen by the Radi­a­tion Oncol­ogy and/​or the Med­ical Oncol­ogy Service.

Please check in at the Admit­ting Depart­ment if you don’t have a hos­pi­tal card (green card) when you arrive at the hos­pi­tal and they will direct you to the clinic in Room 201 (sec­ond floor) or to the neurosurgeon’s office (first floor).

If you did not receive a follow-​up appoint­ment with your neu­ro­sur­geon prior to leav­ing hos­pi­tal, please call our clinic at (514)-3985937 or your neurosurgeon’s office to arrange an appoint­ment. If you don’t know the neurosurgeon’s office num­ber phone num­ber, please ask the unit co-​ordinator prior leav­ing the hospital.

Please keep any appoint­ments you have with Radi­a­tion Oncol­ogy [(514)-9348040] or Oncol­ogy [(514)-9341934 local 31588].

Please keep any appoint­ments you have arranged with other physicians.

Fam­ily Doc­tor
It is sug­gested you return to see your fam­ily doc­tor 23 weeks after your oper­a­tion to have him/​her check on your progress.
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IV. Addi­tional Resources & Information

Infor­ma­tion about InfoNEURO
Neuro-​Patient Resource Cen­tre
Mon­treal Neu­ro­log­i­cal Hosp­tial Room 354
Tel: (514) 3985358
E-​mail: infoneuro@​muhc.​mcgill.​ca
Web site: http://​infoneuro​.mcgill​.ca/

The Cen­tre is avail­able to help you find fur­ther infor­ma­tion con­cern­ing your type of brain tumour or fur­ther treat­ments that you may have. Feel free to drop into the Cen­tre before or after your return appoint­ments at the hos­pi­tal to browse through their lit­er­a­ture and books. The Librar­ian is avail­able to help you in your search.

Brain Tumour Sup­port Groups
It may be help­ful for you to meet with oth­ers who share the diag­no­sis of a brain tumour. It is impor­tant for you to know that you are not alone. Monthly brain tumour sup­port group meet­ings are held on the sec­ond Mon­day of the month at the Mon­treal Neu­ro­log­i­cal Hos­pi­tal. Call 514 3985358 or drop into the Neuro-​Patient Resource Cen­tre for fur­ther details.

If you do not live in the Mon­treal area please call the Brain Tumour Foun­da­tion of Canada to see if there is a brain tumour sup­port group near you. (1800 2655106)

Brain Tumour Foun­da­tion of Canada
Infor­ma­tion from this orga­ni­za­tion has been pro­vided to you. Along with lit­er­a­ture, and sup­port groups, they also have yearly infor­ma­tion days in dif­fer­ent cities for brain tumour patients and their fam­i­lies. They also have an online chat room where you can meet other brain tumour patients.

You may wish to visit their Web site: http://​www​.brain​tu​mour​.ca or call them for fur­ther infor­ma­tion: (519)-6427755 or 18002655106

This infor­ma­tion is for edu­ca­tional pur­poses only, and is not intended to replace the advice of a pro­fes­sional health­care prac­ti­tioner, or to sub­sti­tute for med­ical care.

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