Neurosurgery Care Guide

Your Care Guide
for Neurosurgery
When do I call my surgeon?
When do I call 911?
Call if you have any of these symptoms:
Call 911 if you experience any of these
symptoms:
• Severe pain that is not relieved by
pain medication
• Extreme leg swelling, redness or
tenderness that does not go away
• Chest pain
• Shortness of breath
• Unable to walk after a fall
• Fever of 101˚F (38˚C) or higher
• Separation of stitches or staples
• Drainage or pus around your incision site
• Nausea and vomiting that does not stop
• Loss of bladder or bowel control
Regular clinic hours
Monday through Friday, 8 a.m. to 5 p.m.
Request medication refills as soon as possible. Medication refills may take up to 24 hours to
be approved.
Welcome
Thank you for choosing Park Nicollet for your neurosurgical care.
Your health and well-being is our top priority and is at the forefront of everything we do. We
believe outstanding healthcare is delivered when we merge the science and intellect of medicine with
the compassion, spirit and humanity of our hearts. We refer to this as “Head + Heart, Together.”
You may have questions about what to expect during your experience with Park Nicollet
Neurosurgery. This care guide provides the information you may need throughout your
preparation, surgery and follow-up care. Read this care guide before your surgery to help prepare
you and your family members for your hospital stay and recovery.
Visit parknicollet.com/neurosurgery for more information. Watch our video, Welcome to Park
Nicollet Neurosurgery.
You can also watch the video by scanning the
QR code at the right. Use a QR app on your
smartphone or tablet.
Thank you again for allowing us to partner with you and your family in your care to get you back
to everything you love.
The Park Nicollet Neurosurgery Team
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Important Telephone Numbers—Neurosurgery
Neurosurgery Clinic—Main Line
952-993-2079
Call to schedule or change appointments, or if you have other questions about your visit.
Neurosurgery Clinic—Nursing
Handout
Call the telephone number on the handout provided if you have questions about your surgical
procedure, medications or symptoms.
After-Hours Emergency Line
952-993-3123
• If you need immediate help after regular clinic hours, call this number to page the on-call
neurosurgery clinician.
• If you are having chest pain, shortness of breath or are unable to walk after a fall, call 911.
• If you have a nonurgent question, call Neurosurgery Clinic—Nursing and leave a message.
A nurse will return your call during clinic hours.
Surgery Coordinator 952-993-7309
The surgery coordinator can help you with the following:
• Insurance prior authorization
• Surgery scheduling
• Pre-operative exam scheduling
• Follow-up appointment scheduling
• Questions about the day of surgery
Diagnostic Scheduler 952-993-7320
The diagnostic scheduler can help you with scheduling tests such as magnetic resonance imaging
(MRI) or computed tomography (CT) scan and scheduling epidural steroid injections.
Clinic Manager, Ginny W. Ogle
Call to provide feedback on a visit or report a concern about your care.
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952-993-7342
Important Telephone Numbers—Patient Accounts
and Services
www.parknicollet.com/Patient-Accounts-Services
Methodist Hospital Patient Relations
952-993-5541
Call to provide feedback on a visit or report a concern about your care.
Patient Financial Services
952-993-7672
Call if you have questions about billing or financial resources.
Park Nicollet Advance Care Planning Help Line
952-993-0190
Advance Care Planning is the process of coming to understand, reflect on, discuss and plan for
a time when you may not be able to make your own medical decisions. Call if you have questions
about completing a Healthcare Directive or a Living Will or to appoint a healthcare agent.
Visit parknicollet.com/healthcaredirectives for more information.
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Contents Page
Welcome. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Important Telephone Numbers—Neurosurgery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Important Telephone Numbers—Patient Accounts and Services. . . . . . . . . . . . . . . . . . . . . . . . . . 3
Preparing for Surgery
Planning Ahead for Surgery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Checklist for planning ahead. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Stop smoking and using tobacco products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Schedule your surgery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Complete your pre-operative physical exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Complete the Pre-admitting Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Pre-admitting Form. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Check your health insurance coverage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Prepare a Healthcare Directive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Plan ahead for recovery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Preparing for Your Surgery Day. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Follow eating and drinking guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Prepare your skin. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Decide who may wait with you. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Manage your medications before surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Pack for the hospital. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Understand your role in a safe surgery experience. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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14
15
FAQs (frequently asked questions) about Surgical Site Infections. . . . . . . . . . . . . . . . . . . . . . . . . . 16
Your Surgery
Your Surgery Day. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Directions and parking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Checking in. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
In the pre-operative area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Getting anesthesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
After surgery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
In the Hospital. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
How do I manage my pain?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
How do I prevent falls? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
What can I do to promote a rapid recovery? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
What about preventing complications?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
My Notes and Questions for My Care Team. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Your Recovery
When will I leave the hospital? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
What medications do I stop taking? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
What about acetaminophen (Tylenol)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
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Preparing for Surgery
Preparing for Surgery
Page
Planning Ahead for Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Checklist for planning ahead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Stop smoking and using tobacco products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Schedule your surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Complete your pre-operative physical exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Complete the Pre-admitting Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Pre-admitting Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Check your health insurance coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Prepare a Healthcare Directive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Plan ahead for recovery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Preparing for Your Surgery Day . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Follow eating and drinking guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Prepare your skin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Decide who may wait with you . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Manage your medications before surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Pack for the hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Understand your role in a safe surgery experience . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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15
FAQs (frequently asked questions) about Surgical Site Infections . . . . . . . . . . . . . . . . . . . . 16
5
Planning Ahead
for Surgery
You may have a lot of questions as you
prepare for surgery. This section of the care
guide lets you know what to expect before
your surgery. Follow all instructions carefully.
As an involved and informed member of
your healthcare team, you will be better
prepared to help the process go smoothly,
make your recovery easier and avoid having
your surgery delayed or canceled.
Take an active role by asking questions,
addressing any fears or anxiety you may
have and following these preparation
instructions. We encourage you to share
this information with any family members,
caregivers or friends who will be with you
for surgery.
Checklist for
planning ahead
oStop smoking and using tobacco
products
o Schedule your surgery
oComplete your pre-operative
physical exam
o Complete the Pre-admitting Form
o Check your health insurance coverage
o Prepare a Healthcare Directive
o Plan ahead for recovery
Stop smoking and using
tobacco products
If you smoke or use tobacco products, stop
now. Nicotine decreases the ability of blood
vessels to carry oxygen and nutrients to your
spine. Nicotine has been shown to cause
delayed healing and poor surgical outcomes.
Nicotine also can raise your risk for infection
and scarring after surgery.
For help quitting smoking or using other
tobacco products, talk to your primary
care provider. You also can visit quitplan.com
or call QUITPLAN Services at
888-354-PLAN (7526).
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Schedule your surgery
After you meet with your surgeon, the
surgery coordinator will schedule your
surgery with you.
• Leave the entire day of your surgery open.
The schedule may change due to
emergencies or other scheduling issues.
• Please contact the surgery coordinator at
952-993-7309 as soon as possible if you
need to cancel or change the date or time
of your surgery. The surgery coordinator
also can answer any questions you may
have about insurance coverage, prior
authorization or scheduling issues.
• Watch the Day of Surgery video at
parknicollet.com/neurosurgery.
• A nurse in the Pre-Procedure Assessment
Department will call you the day before
surgery to confirm arrival and surgery
times, review medications and provide final
instructions.
Your day of surgery
Visit parknicollet.com/neurosurgery to watch
the Day of Surgery video. The video and this
care guide help you prepare for your surgery.
Scan the QR code to watch the video on your
smartphone or tablet.
8
Complete your
pre-operative physical exam
Schedule a pre-operative physical exam with
your primary care clinician within 30 days of
your scheduled surgery. During this exam,
your primary care clinician checks to make
sure you are ready for your surgery. Our
surgery coordinator can help you set up
this appointment.
Ask your clinician to print a list of your
medications during your pre-operative
appointment. Bring this medication list
with you to the hospital on the day of
your surgery.
If you do not have this exam, your surgery
may be cancelled. If you do not have a
primary care clinician, our surgery
coordinator can help you find one.
Complete the
Pre-admitting Form
Complete the Pre-admitting Form on Page 9
and mail or fax it to Park Nicollet Methodist
Hospital. Follow all instructions on the form.
cut here
cut here
Pre-admitting Form
Date of surgery:________________
Complete immediately, tear from brochure and either fax to 952-993-6763 or mail by folding twice and taping both corners. If you
have any questions about filling out this form, call 952-993-5340.
Park Nicollet Methodist Hospital and Park Nicollet Clinic surgery centers
Primary MD ______________________________________ Surgeon_______________________________________
Patient information
Last name ____________________________________ First name ____________________________ MI_____
Date of birth ______________________________________ SS# __________________________________________
Home phone (
) _________________________________ Cell phone (
)_______________________________
Street address __________________________________ City/State _______________________ Zip__________
Sex: o Male o Female
Marital status: o Married o Single o Widowed o Divorced o Separated o Life Partner
Race: o Asian o Black/African Amer. o Caucasian o Hispanic/Latino o Amer. Ind./Alaskan o Multiple
Which religion and parish/synagogue would you like listed in your chart?____________________________________
Employer name ___________________________________________________ Phone (
)__________________
Street address __________________________________ City/State _______________________ Zip__________
Occupation ______________________ o Full time o Part time o Retired_____________ o Disabled________
Emergency contact/next of kin
Last name ____________________________________ First name ____________________________ MI_____
Relationship to patient_____________________ Home phone (
) ___________ Work phone (
)___________
Street address __________________________________ City/State _______________________ Zip__________
Employer name ____________ o Full time o Part time o Retired____________ o Disabled_________________
Insurance information
Is surgery due to accident/injury? o Yes o No Is surgery work related? o Yes o No
Is surgery auto accident related? o Yes o No Is surgery related to another type of injury? o Yes o No
Date of injury/accident_________________ Where did injury occur?____________________________________
How did injury occur? __________________________________________________________________________
Any of the following authorized to pay for surgery? o Black Lung Prog. o VA o Other Government Program
Primary insurance company (medical/work. comp/no fault ins.) name _________________________________
Policyholder _________________________________ Relationship to patient ___________________________
Policyholder’s date of birth ____________________________ Policyholder’s SS# ________________________
Policyholder’s employer _________________________________ Employer phone (
)__________________
Employer’s street address ______________________________ City/State _________________ Zip_______
Policy/ID#__________________________________________ Group# ___________________________________
Claim mailing address ______________________________ City/State ____________________ Zip_______
Customer service phone (
) ______________________ Precertification phone (
)____________________
Secondary insurance company name _______________________________________________________________
Policyholder ___________________________________ Relationship to patient _________________________
Policyholder’s date of birth _______________________________ Policyholder’s SS# ____________________
Policyholder’s employer _______________________________ Employer phone (
)____________________
Employer’s street address ______________________________ City/State _________________ Zip_______
Policy/ID#__________________________________________ Group# ___________________________________
Claim mailing address ______________________________ City/State ____________________ Zip_______
Customer service phone (
) ______________________ Precertification phone (
)____________________
Additional information
Do you have diabetes? o Yes o No
Do you use tobacco products? o Yes o No
9
10
fold here and tape both corners
NO POSTAGE
NECESSARY
IF MAILED
IN THE
UNITED STATES
BUSINESS REPLY MAIL
FIRST-CLASS MAIL PERMIT NO 14392 MINNEAPOLIS MN
POSTAGE WILL BE PAID BY ADDRESSEE
PARK NICOLLET METHODIST HOSPITAL
PREADMISSIONS
PO BOX 650
MINNEAPOLIS, MN 55440-9946
fold here and tape both corners
cut here
Check your health
insurance coverage
To avoid unnecessary out-of-pocket
expenses, contact your health insurance
provider to see if precertification, prior
authorization, referral or a second opinion is
required before your surgery.
If you plan to file a claim for workers’
compensation, contact the insurer who
provides the workers’ compensation
coverage (unless your clinician’s office has
informed you that your claim has been
approved).
Prepare a
Healthcare Directive
Advance care planning is the process of
coming to understand, discuss and plan for a
time when you may not be able to make your
own medical decisions.
Advance care planning for future healthcare
choices is important to do while you are
healthy and able to make your own
decisions.
No matter your age or health, writing your
wishes in a Healthcare Directive is important.
A Healthcare Directive is your written plan
for future medical treatments. A Healthcare
Directive also is the document in which you
can identify someone to communicate your
wishes if you are unable to do so. This
person is your healthcare agent.
For more information on advance care
planning, call the Park Nicollet Advance Care
Planning Help Line at 952-993-0190.
Plan ahead for recovery
• Arrange to have an adult drive you to
and from the hospital. You will receive
medication that makes driving unsafe after
surgery for up to 24 hours or longer if you
are taking prescription pain medication.
• Arrange for help at home. You must have
a responsible adult stay with you for at
least 8 hours after you arrive home from
surgery. Many people find that having
someone stay overnight is helpful. If
possible, arrange for help at home with
household tasks, such as cleaning and
running errands.
• Contact appropriate community
resources for on-going help at home, if
necessary. Talk to your clinician about your
needs and for recommendations.
• Make your home safe in case you are
limited in moving around after surgery. For
example, clear hallways, remove throw rugs
and move items you need to where you
can easily reach them.
• Prepare food ahead of time. Talk to your
clinician about any restrictions you may
have for eating and drinking after surgery.
• Develop a pain management plan with
your surgeon. Talk to your surgeon about:
» What type of pain to expect and for
how long
» What type of pain relief methods may
be used
» What degree of relief these methods
provide
» What has worked well—or not so well—
for you if you have had surgery before
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Preparing for Your
Surgery Day
Follow eating and
drinking guidelines
• Do not eat anything after midnight the
night before your surgery.
• You may drink water, Gatorade, tea,
and coffee (without cream or milk) up to
4 hours before your surgery.
• You may take medications your clinician
has OK’d with a small sip of water.
• Do not drink alcohol for 24 hours before
surgery.
Prepare your skin
Do not use hair products, makeup or
perfume the day of surgery.
Your surgeon may ask you to use a skin
preparation called Hibiclens before your
surgery. If you need to use Hibiclens, follow
these instructions:
• Purchase a 4-ounce bottle of Hibiclens.
• Shower the morning of surgery.
• To shower with Hibiclens:
» Wash your hair with your regular
shampoo. Wash your face with your
regular soap or water only. Thoroughly
rinse your body with water.
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» Apply the minimum amount of Hibiclens
necessary to cover the skin. Use
Hibiclens as you would any other liquid
soap. Wash from chin downward. Keep
out of eyes, ears and mouth.
» Rinse.
» Wash a 2nd time from chin downward
using Hibiclens. Work up a lather.
» Rinse well.
» Dry with a clean towel.
» Do not apply lotions, deodorants
or powders.
» Put on clean clothes after showering.
Decide who may wait
with you
Decide which family members or friends you
want with you before your surgery. Once
your healthcare team has completed
preparations for your surgery, you may have
2 people wait with you before going into
surgery.
Depending on the type of surgery and
anesthesia you are having, people may not
be able to wait with you.
Additional family or friends must wait in the
nearby lounge. They can see you after
surgery when you are awake and
comfortable.
Manage your medications
before surgery
Your primary care clinician will give you
instructions before surgery about any
medications, supplements or vitamins you
take. Please also follow the instructions
below.
Type of medication
Instructions
Nonsteroidal anti-inflammatory drugs
(NSAIDs), such as:
• Aspirin (Bufferin, Bayer, Excedrin)
• Ibuprofen (Advil, Motrin, Nuprin)
Stop taking 1 week before surgery.
• Naproxen (Aleve)
• Celecoxib (Celebrex)
Fish oil or omega-3 supplements
Acetaminophen (Tylenol)
Stop taking 1 week before surgery.
You may take as needed for pain.
Oxycodone-acetaminophen (Percocet)
You may take as prescribed by your clinician.
Hydrocodone-acetaminophen (Vicodin)
You may take as prescribed by your clinician.
Insulin or oral medication for diabetes
Talk with your primary care clinician about
how to adjust your doses before clinician.
Anticoagulant medications, such as
• Warfarin (Coumadin)
Talk with your primary care clinician about
when to stop taking these medications.
• Enoxaparin (Lovenox)
Antiplatelet medications, such as:
• Clopidogrel bisulfate (Plavix)
Talk with your primary care clinician about
when to stop taking these medications.
• Cilostazol (Pletal)
13
Pack for the hospital
What to bring to the hospital
o Current insurance card and photo ID for
when you check in
o Money to pay for prescriptions and
co-pays
» Ask a family member or friend to keep
your money safe.
What to leave at home
Please do not bring valuable items to the
surgery center or hospital, such as those
listed below. Park Nicollet Methodist Hospital
and Park Nicollet Clinic are not responsible
for lost items. Have family or friends bring
you needed items during your hospital stay
when they visit.
o Wallet or purse
o List of all current medications and
dosages, including over-the-counter
medications and herbal supplements
oJewelry
o Any papers your primary care clinician
gave you at your pre-operative
appointment
o Media player
o Healthcare Directive or Living Will, if you
have one
o Eyeglasses and storage case, contact
lenses, dentures or hearing aids and
batteries, if needed
o Comfortable, loose-fitting clothing to
wear home
o Reading material
o This care guide
14
o Laptop computer or tablet
o Medications from home, unless your
clinician or nurse tells you otherwise
Understand your role in a
safe surgery experience
Patients involved in decisions about their
care are more likely to have good outcomes.
Follow these recommendations to take an
active role in your care.
• Understand the informed consent form.
Before signing, read the consent form
carefully. Confirm your name, type of
surgery and that you talked to your surgeon
and agreed to the surgery.
• Ask questions. Keep asking if you do not
understand the answers.
• Answer questions. Medical staff may ask
you the same questions numerous times.
We check and double-check with you to
make sure information is correct.
• Prevent infections. Read “FAQs
(frequently asked questions) about Surgical
Site Infections” on Page 16.
See “Patient Safety” at jointcommission.org
for more information.
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Your Surgery
Page
Your Surgery Day . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Directions and parking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Checking in . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
In the pre-operative area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Getting anesthesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
After surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19
19
19
19
20
20
In the Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
How do I manage my pain? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
How do I prevent falls? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
What can I do to promote a rapid recovery? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
What about preventing complications? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21
21
21
21
22
Your Surgery
My Notes and Questions for My Care Team . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
17
Your Surgery Day
Checking in
On the day of your surgery, we will be with
you every step of the way to help make your
surgery a success. The following information
explains what happens on the day of your
surgery. Read this section carefully and share
it with your family and friends who will be at
the hospital with you.
Enter the Heart and Vascular Center and
follow overhead signs to Surgery Center
Admitting on the 1st floor. Check in at the
Surgery Center Admitting desk to get your
parking ticket validated, a pager and
directions to the waiting area for family
and friends.
Directions and parking
Take Highway 100 to Excelsior Boulevard; go
west about ½ mile. Turn right onto the
Methodist Hospital campus. Park in the Blue
Ramp at the front of the hospital. Enter
through the Heart and Vascular Center and
follow the signs to the Surgery Center
Admitting desk on the 1st floor of Methodist
Hospital. Bring your parking ticket with you
to be validated for a reduced parking fee.
You will receive an identification bracelet,
and you may need to have some final lab
tests. After changing into hospital clothing,
you will place your clothing and belongings
N
in a Park
bag.
A nurse or nursing assistant
will
Nicollet Clinic—St. Louis Park
return the bag to you after surgery.
Louisiana Entrance
Orange
Ramp
Parking
In the
pre-operative area
Patient/
Visitor
Methodist
Hospital
Heart
and
Vascular
Center
Blue Ramp
Parking
Excelsior Blvd
3 BLOCKS
TO HWY 100
Park Center Blvd
Meadowbrook Bldg
Excelsior Entrance
Hwy 100
Louisiana Ave
Cancer
Center
3850
3800
After Parking
check-in, you will be taken to the
h St
Ramp
W 39t into hospital
pre-operative
area
to
change
Auto Club Way
Park your belongings in a
clothing and place
Nicollet
3900
garment bag. Blvd
5050
CT/MR
Center members of your
meet with different
Imaging
healthcare
team,
Distance
between Park Nicollet
Methodistincluding nurses, an
Hospital and Park Nicollet Clinic—St. Louis Park
team
and your surgeon. A nurse
not toanesthesia
scale (1.1 miles between
campuses).
will start an intravenous (IV) line, and your
surgeon will answer any remaining questions
you may have.
d
You
r Blvwill
Excelsio
Quentin Ave
3930
Central Film
Library
Valet parking is
available for a
fee at the
6500 Excelsior
Boulevard and
3931 Louisiana
Avenue entrances.
Hours of
operation are
Monday through
Friday, 7 a.m. to
6 p.m.
During the hospital admitting process,
you will sign several documents, including
a consent form. This form gives the hospital
permission to provide your treatment
and care.
19
Getting anesthesia
After surgery
• The type of anesthesia you will have is
based on your surgery, medical history,
age, personal preference and other factors.
• After surgery, you will be taken to a
recovery room, known as the Post
Anesthesia Care Unit (PACU). In the PACU,
nurses monitor you as you wake up. You
might not remember this time.
• Most neurosurgical procedures use general
anesthesia, which puts you into a deep
sleep for the entire operation. Since the
deep level of sleep may affect your
breathing, you will need a breathing tube
inserted. Side effects of general anesthesia
may include sleepiness, nausea, sore throat
and muscle aches.
• You will be carefully monitored throughout
your surgery and immediately after in the
recovery room. The occurrence of serious
problems due to anesthesia is extremely
low.
20
• Your family or friends will be able to speak
with your surgeon immediately after your
surgery.
• If you are going home the same day as
your surgery, you will be moved to the
observation area where your family or
friends can see you.
• If you are staying overnight, you will be
moved to your hospital room once you are
fully awake.
In the Hospital
How do I manage my pain?
How do I prevent falls?
Surgery is different for everyone. Rating pain
also is different for everyone. We partner
with you to create a plan for managing pain
to make you comfortable and at ease.
For your safety, follow the instructions of
hospital staff to reduce your risk of falling.
• Pain after surgery can be controlled with a
variety of safe options, such as medications
you take by mouth or that are given
through your IV.
• Methods other than medication can also
help control your pain. These include
specific positioning and support of the
surgical site, heat and cold therapy,
relaxation and positive thinking.
• You will be asked to rate your pain
throughout your hospital stay to determine
the amount of medication that is right for
your pain level. Nurses will continue to
monitor your comfort and work with you to
follow your pain management plan.
012345678910
No ModerateWorst
pain
pain
pain
Rate your pain on a scale from 0 to 10 with 0
being no pain and 10 being the worst pain
you have ever had.
• Do not get out of bed without help from a
member of your care team, even if you feel
strong enough to get out of bed by
yourself. Most beds at Methodist Hospital
are equipped with an alarm system that
alerts nursing staff if a patient gets out of
bed without help. These alarms are for
your safety.
• Keep items you need within easy reach.
• Use your call light and wait for staff to
help you if you need to get out of bed for
any reason.
What can I do to promote a
rapid recovery?
Activity
After surgery, start with mild daily activities,
such as sitting up and walking as soon as
possible. An important part of a healthy
recovery is getting up to walk several times
a day.
Being active as soon as possible after
surgery helps prevent a number of
complications. Activity promotes good blood
circulation, improves how well your lungs and
heart work and maintains muscle strength.
21
Eating, drinking and smoking
Good nutrition is an important part of your
recovery. Having an upset stomach and
constipation after surgery is common. You
may not feel like eating. Follow the general
guidelines below, unless your clinician gives
you specific instructions otherwise.
• Gradually add bland foods to your diet,
such as dry toast or crackers.
What about preventing
complications?
Blood clots
After surgery, you may be more at risk for
developing blood clots. You can help prevent
blood clots by walking and doing leg
exercises. Do these exercises 4 to 6 times
a day.
• Eat a high-fiber diet to soften bowel
movements and prevent constipation.
Foods with fiber include fruits, vegetables
and grains, such as wheat bran, corn
and rye.
• Eat foods high in protein.
• Drink lots of liquids.
• Do not smoke or use tobacco products for
2 weeks after surgery—even better, stay
smoke-free for life. Not smoking improves
healing and reduces the risk of infection or
complications in your lungs.
Ankle pumps. Bend your feet toward you
(use your ankles to flex your feet) and away
from you (point your feet). Repeat 10 times.
Quad sets. Press the backs of your knees
into the bed by tightening the front of your
thighs. Hold for 6 seconds and then relax.
Repeat 10 times.
Pneumonia
Too much bed rest after surgery can cause
fluid to build up in your lungs, which may
cause pneumonia. To help prevent
pneumonia, your clinician may recommend
you use an incentive spirometer or do deep
breathing exercises.
22
My Notes and Questions for My Care Team
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24
Your Recovery
Page
When will I leave the hospital? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
What medications do I stop taking? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Your Recovery
What about acetaminophen (Tylenol)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
25
Your Recovery
When will I leave
the hospital?
• Celecoxib (Celebrex)
Your clinician and care team will assess how
you are doing after surgery and determine
when you can safely leave the hospital.
• Indomethacin (Indocin)
Before going home, you need to have your
pain under control and be able to:
If you have had spinal fusion surgery,
you will need to stop these medications for
a longer period of time. Talk to your surgeon.
• Walk
• Use the restroom
• Swallow medication and food
Make sure you ask questions if you do not
understand any of your discharge
instructions. Tell your care team about any
special needs you have before you leave
the hospital.
What do I do about
my medications?
Do not take these medications until your
surgeon and primary care clinician tell you to
start them again.
Nonsteroidal anti-inflammatory drugs
Nonsteroidal anti-inflammatory drugs
(NSAIDs) may cause bleeding around the
surgical site. Do not take these medications
for 2 weeks after your surgery.
• Diclofenac sodium (Voltaren)
• Meloxicam (Mobic)
• Sulindac (Clinoril)
Aspirin
Aspirin may cause bleeding around the
surgical site. Do not take aspirin (Bufferin,
Bayer, Excedrin) for 2 weeks after your
surgery.
If you have a history of heart problems or
your clinician has prescribed aspirin for a
serious medical condition, you may be able
to start aspirin sooner. Talk to your surgeon.
Fish oil or omega-3 supplements
Do not take fish oil or omega-3 supplements
for 1 week after your surgery. These
supplements also may increase your risk
for bleeding.
• Ibuprofen (Advil, Motrin, Nuprin)
• Naproxen (Aleve)
27
Anticoagulants and antiplatelets
You and your care team will work together to
come up with a plan for safely restarting
these anticoagulant and antiplatelet
medications.
• Warfarin (Coumadin)
• Clopidogrel (Plavix)
• Dabigatran etexilate (Pradaxa)
• Prasugrel (Effient)
• Enoxaparin (Lovenox)
• Heparin
What about acetaminophen
(Tylenol)?
Acetaminophen (Tylenol) is not considered
an NSAID. Acetaminophen does not increase
your risk of bleeding. You may take
acetaminophen for mild pain.
Keep in mind you may already be taking
acetaminophen in another medication, such
as oxycodone-acetaminophen (Percocet) or
hydrocodone-acetaminophen (Norco).
Do not take more than 4,000 milligrams (mg)
of acetaminophen in 24 hours from all
sources. You may harm your liver if you
take more.
28
Your Care Guide to Neurosurgery
Copyright © 2014 Park Nicollet Institute
All rights reserved. No parts of this publication may be reproduced in any manner, mechanical or electronic, without prior permission from the
publisher except in brief quotations or summaries in articles or reviews. For additional permissions, contact Park Nicollet Institute.
At the time of publication, all facts and figures cited herein are the most current available, all telephone numbers, addresses,
website URLs are accurate and active; all publications, organizations, websites and other resources exist as described in this care
guide; and all efforts have been made to verify them. Park Nicollet Institute makes no warranty or guarantee concerning the
information and materials given out by organizations or content found at websites cited herein, and we are not responsible for
changes that occur after this book’s publication. If you find an error or believe that a resource listed herein is not as described,
please contact Park Nicollet Institute.
Park Nicollet Institute
3800 Park Nicollet Boulevard
St. Louis Park, MN 55416
952-993-3454
www.parknicollet.com/Institute
20981 (6/2014)
www.parknicollet.com/Institute 952-993-3454
St. Louis Park, MN 55416
3800 Park Nicollet Boulevard
Park Nicollet Institute