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Pre & Post Op Instructions

Center for Neuro Spine in Akron and Canton, OH

General Pre-Operative Instructions-Before Surgery

The following are general instructions and are NOT a substitution for the discussion that you will have had with your surgeon on your specific plan of care. The following instructions should be used as guidelines only.

  • You should arrive at the hospital 2 (two) hours prior to your surgery time. Be sure to read your surgery booklet to find out where to check in upon arrival to the hospital.
  • REMEMBER: Do not eat or drink anything by mouth after midnight the night before your surgery. This includes all foods and liquids (including water). Do not drink any liquids the morning of your surgery. Exception: You may take any oral medications that you feel necessary with a very tiny sip of water. If you are diabetic, take only one half (1/2) of your normal morning dose.
  • Do not take any blood thinners, aspirin, other anti-inflammatory medications and herbal supplements for at least 7 (seven) days prior to surgery. These include: Coumadin, Plavix, Warfarin, Aggrenox, Lovenox, Aspirin, Motrin, Aleve, Advil, Ibuprofen, Excedrin, Relafen, Bextra, Mobic, Celebrex, Daypro, Vioxx, etc. Tylenol is allowed.

If you develop a new illness such as a cold or infection, please notify the office as soon as possible. It may be necessary to reschedule your surgery for when you are healthy. Please read your surgery pamphlet and post-operative instructions that are placed inside your pamphlet. Your post-operative appointment (after surgery) is written on the bottom of your post-operative instructions. Please contact the office if you are unable to keep this appointment.

Please note, if you had imaging studies done at a facility other than the location of your surgery, it is very important that you remember to bring these studies on discs with you to your surgery. Failure to do so may result in your procedure being rescheduled. If you are unsure if you need to bring your studies on the day of your procedure, please call your doctor’s patient care coordinator at (330) 665-4100 (select appropriate extension).

Should you have any other clinical questions prior to your surgery, please call the Nurse phone line at (330) 665-4100 ext. 320.

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General Post-Operative Instructions

  • Observe the incision for signs of infections daily.
    • Increasing redness
    • Warmth
    • Drainage
    • Fever over 101-degree F
    • Swelling at incision site
    • CALL OUR OFFICE WITH ANY SIGNS OF INFECTION
  • Remove the bandage and keep the incision open to air on post-operative day 3. You may shower after 3 days, unless otherwise indicated. Allow the soapy water to gently run across the incision. Pat dry. Please do not submerge your incision in water. Sutures/Staples are to be removed approximately 12-14 days after surgery at your first post-op visist. Attempt to keep the incision area are free from excessive strain or force until well healed.
  • Avoid strenuous activity, driving an automobile, or operating any power equipment until you are no longer taking narcotic pain medications and are comfortable and well rested. Please keep in mind all specific instructions you were given related to activity, such as lifting restrictions
  • Should you experience new leg pain and/or swelling, redness, or warmth, please go to the nearest emergency room. This could be indicative of a blood clot.
  • Pain medication refills are at the doctor’s discretion and will only be given after a procedure for up to 60 days. Requests for refills should be called in to the office between 8:30 am and 3:30 pm on business days. Narcotic medication prescriptions must be picked up at the office. In accordance with federal law, these prescriptions may not be called into the pharmacy, and require a physical copy. Prescriptions must be picked up by 5:00 pm. Prescription pain medications should be taken only as needed. Over-the-counter Tylenol (acetaminophen) may be taken for minor pain.
  • The use of pain medications may cause constipation. Over-the-counter laxatives may be used (Colace, Ex-Lax, Milk of Magnesia, etc.).
  • For emergencies on the weekends, or after 5:00 pm weekdays, report to the Emergency Room, call your primary care physician or call our answering service at (330) 665-4100.

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Craniotomy Post-Operative Instructions

  • A small collection of fluid may develop underneath the skin near the incision. This is not uncommon, and is usually reabsorbed over several months. This swelling tends to be worse in the morning, and will fluctuate throughout the day. To keep swelling down to a minimum:
    • Sleep with head elevated on several pillows
    • Keep active and out of bed throughout the day
    • Apply ice as needed to incision for 10-15 minutes
    • Call the office if there is any leakage of watery fluid from the incision
  • Observe the incision for signs of infection daily.
    • Increasing redness
    • Drainage
    • Fever over 101-degree F
    • Swelling at the incision site
    • CALL THE OFFICE WITH ANY SIGNS OF INFECTION
  • Keep incision clean, dry, and open to air. You may shower 5 days after surgery with baby shampoo. Allow the soapy water to gently run over the incision. Gently pat dry. Do not take a bath or swim for 2 weeks. Your sutures/staples will be removed approximately 12-14 days after surgery at your post op visit.
  • Avoid lifting more than 10 pounds for about 6-8 weeks, increasing as tolerated thereafter in accordance with your doctor’s instructions.
  • Avoid strenuous activity, driving an automobile, returning to work or operating any power equipment until advised by your physician. Your doctor will give you specific instructions regarding these activities at the time of your next follow-up.
  • Pain medication refills are at the doctor’s discretion and will only be given after a procedure for up to 60 days. Requests for refills should be called in to the office between 8:30 am and 3:30 pm on business days. Narcotic medication prescriptions must be picked up at the office. In accordance with federal law, these prescriptions may not be called into the pharmacy, and require a physical copy. Prescriptions must be picked up by 5:00 pm. Prescription pain medications should be taken only as needed. Over-the-counter Tylenol (acetaminophen) may be taken for minor pain.
  • Should signs of severe headache, nausea, vomiting, lethargy (difficulty in attempting to awaken patient) or new weakness in an arm or leg occur, PLEASE TREAT THIS AS AN EMERGENCY AND PROCEED TO THE NEAREST EMERGENCY ROOM. Please keep in mind, some mild headaches are a normal part of the recovery process. However, if there are concerns after surgery you may always call the office and speak to a nurse or physician during regular business hours, afterhours see below.
  • For emergencies on the weekends, or after 5:00 pm weekdays, report to the Emergency Room, call your primary care physician or call our answering service at (330) 665-4100.

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Anterior or Posterior Cervical Surgeries Post-Operative Instructions

  • You may be instructed to wear a cervical collar (neck brace). Your surgeon will discuss this with you. If you are asked to wear a cervical collar, it must be removed to shower and when you are eating. It is normal for a cervical collar to cause muscle irritation and mild pain in the shoulders, between your shoulder blades and in the back of your head.
  • AVOID LARGE TURNING MOVEMENTS WITH YOUR HEAD
  • Avoid lifting more than 10- 20 pounds during the first 6 weeks. Your doctor will instruct you on increasing activity as tolerated.
  • Walk as much as you can tolerate. Use the railing when climbing stairs.
  • Avoid strenuous activity, driving an automobile, returning to work or operating any power equipment until advised by your physician. Your doctor will give you specific instructions regarding these activities at the time of your next follow-up
  • As long as you are instructed to wear the cervical collar, you are NOT to drive or return to work. Your doctor will instruct you on your return to work and driving status.
  • Remove the outer bandage 2 days after surgery. You may have small butterfly bandages underneath. Leave them in place. They will fall off with showering. You may begin to shower on post-operative day 3. Allow the soapy water to run across your incision, but do not scrub it. Gently pat dry. Do not take a bath or swim for 2 weeks. You may have dissolvable sutures beneath the skin that do not need to be removed. If you have visible sutures/staples, they will be removed approximately 12-14 days after surgery at your first post op visit.
  • It is possible to have a recurrence of neck/arm pain within the first month after surgery. It is also possible to have mild difficulty swallowing if your surgery was done through the front of your neck. These symptoms are related to the inflammation process and should subside with time. If you have significant trouble swallowing or breathing please call the office or go to the nearest emergency room.
  • Call the office with signs of increasing redness, swelling, drainage, or fever (101-degree F or higher). These could be signs of infection.
  • Pain medication refills are at the doctor’s discretion and will only be given after a procedure for up to 60 days. Requests for refills should be called in to the office between 8:30 am and 3:30 pm on business days. Narcotic medication prescriptions must be picked up at the office. In accordance with federal law, these prescriptions may not be called into the pharmacy, and require a physical copy. Prescriptions must be picked up by 5pm. Prescription pain medications should be taken only as needed. Over-the-counter Tylenol (acetaminophen) may be taken for minor pain.
  • The use of pain medications may cause constipation. Over-the-counter laxatives may be used (Colace, Ex-Lax, Milk of Magnesia, etc.).
  • For emergencies on the weekends, or after 5:00 pm weekdays, report to the Emergency Room, call your primary care physician or call our answering service at (330) 665-4100.

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Shunt Procedures

  • A small collection of fluid may develop underneath the skin near the incision. This is not uncommon, and is usually reabsorbed in several weeks. This swelling tends to be worse in the morning and will fluctuate throughout the day. To keep the swelling down to a minimum:
    • Sleep with head elevated on several pillows.
    • Keep active and out of bed throughout the day.
  • Observe the incision for signs of infections daily.
    • Increasing redness
    • Drainage
    • Fever over 101-degree F
    • Swelling at the incision site
    • CALL THE OFFICE WITH ANY SIGNS OF INFECTION
  • Should signs of shunt malfunction occur, such as severe headache, nausea, vomiting, or lethargy (difficulty is attempting to awaken patient), please treat this as an emergency and call the office immediately or report to the closest Emergency Room.
  • Remove the bandage and keep the incision open to the air after post-operative day 3. You may shower after 5 days using baby shampoo. Allow the soapy water to gently run across the incision. Pat dry. Sutures/staples are to be removed approximately 12-14 days after surgery at your first post op visit.
  • Do not allow any non-physician to touch or pump any portion of the shunt.
  • Avoid strenuous activity, driving an automobile, returning to work or operating any power equipment until advised by your physician. Your doctor will give you specific instructions regarding these activities at the time of your next follow-up.
  • Pain medication refills are at the doctor’s discretion and will only be given after a procedure for up to 60 days. Requests for refills should be called in to the office between 8:30 am and 3:30 pm on business days. Narcotic medication prescriptions must be picked up at the office. In accordance with federal law, these prescriptions may not be called into the pharmacy, and require a physical copy. Prescriptions must be picked up by 5pm. Prescription pain medications should be taken only as needed. Over-the-counter Tylenol (acetaminophen) may be taken for minor pain.
  • For emergencies on the weekends, or after 5:00 pm weekdays, report to the Emergency Room, call your primary care physician or call our answering service at (330) 665-4100.

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Lumbar and Thoracic Surgery

  • Avoid sitting more than 30 minutes at a time. Stand or lie flat to relieve the pressure to the surgical area. Prolonged sitting can be irritating to the surgical area or increase risk of blood clots.
  • Walk as much as you can tolerate. Use the railing when climbing stairs.
  • Avoid strenuous activity, driving an automobile, returning to work or operating any power equipment until advised by your physician. Your doctor will give you specific instructions regarding these activities at the time of your next follow-up.
  • Avoid bending or twisting at the waist. Bend with your knees.
  • You may be asked to wear a rigid abdominal brace. If your physician orders one, wear the brace whenever you are walking for distances greater than 20 feet. The brace is designed to support your back when your spine is supporting the weight of your body for a prolonged period of time. Your physician will advise you when to stop wearing the brace.
  • Remove the bandage 2 days after surgery. You may shower and allow soapy water to gently run over the incision 4 days after surgery. If you have visible sutures, they will need to be removed approximately 10-12 days after surgery at your first post op visit. Some sutures may be internal and dissolve on their own.
  • It is possible to have a recurrence of back/leg pain with in the first month after surgery. This is related to the inflammation process and should subside with time. Notify your physician immediately should you develop new weakness in your legs or new bladder or bowel incontinence.
  • Monitor the incision daily. Call the office with signs of redness, swelling, drainage, fever (101-degree F or greater) or any other signs of infection.
  • Pain medication refills are at the doctor’s discretion and will only be given after a procedure for up to 60 days. Requests for refills should be called in to the office between 8:30 am and 3:30 pm on business days. Narcotic medication prescriptions must be picked up at the office. In accordance with federal law, these prescriptions may not be called into the pharmacy, and require a physical copy. Prescriptions must be picked up by 5:00 pm. Prescription pain medications should be taken only as needed. Over-the-counter Tylenol (acetaminophen) may be taken for minor pain.
  • The use of pain medications may cause constipation. Over-the-counter laxatives may be used (Colace, Ex-Lax, Milk of Magnesia, etc.).
  • For emergencies on the weekends, or after 5:00 pm weekdays, report to the Emergency Room, call your primary care physician or call our answering service at (330) 665-4100.

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Spinal Cord Stimulator Insertion/Revision – Occipital and Vagus Nerve Stimulator Insertion/Revision – Intrahecal Pump Insertion/Revision

 

  • Avoid sitting more than 30 minutes at a time. Stand or lie flat to relieve the pressure to the surgical area. Prolonged sitting can be irritating to the surgical area.
  • Avoid strenuous activity, driving an automobile, returning to work or operating any power equipment until advised by your physician. Your doctor will give you specific instructions regarding these activities at the time of your post op visit.
  • Walk as much as you can tolerate. Use the railing when climbing stairs.
  • Remove the bandage 2 days after surgery. You may shower and allow soapy water to gently run over the incision 4 days after surgery. If you have visible sutures/staples they will need to be removed approximately 12-14 days after surgery at your post op visit. Some sutures may be internal and dissolve on their own.
  • It is possible to have a recurrence of back/leg pain with in the first month after surgery. This is related to the inflammation process and should subside with time. Notify your physician immediately should you develop new weakness in your legs or new bladder or bowel incontinence.
  • Remove the bandage 2 days after surgery. You may shower and allow soapy water to gently run over the incision 4 days after surgery. If you have visible sutures, they will need to be removed approximately 10-12 days after surgery at your first post op visit. Some sutures may be internal and dissolve on their own.
  • It is possible to have a recurrence of back/leg pain with in the first month after surgery. This is related to the inflammation process and should subside with time. Notify your physician immediately should you develop new weakness in your legs or new bladder or bowel incontinence.
  • Monitor the incision daily. Call the office with signs of redness, swelling, drainage, fever (101-degree F or greater) or any other signs of infection.
  • Pain medication refills are at the doctor’s discretion and will only be given after a procedure for up to 60 days. Requests for refills should be called in to the office between 8:30 am and 3:30 pm on business days. Narcotic medication prescriptions must be picked up at the office. In accordance with federal law, these prescriptions may not be called into the pharmacy, and require a physical copy. Prescriptions must be picked up by 5pm. Prescription pain medications should be taken only as needed. Over-the-counter Tylenol (acetaminophen) may be taken for minor pain.
  • The use of pain medications may cause constipation. Over-the-counter laxatives may be used (Colace, Ex-Lax, Milk of Magnesia, etc.).
  • For emergencies on the weekends, or after 5:00 pm weekdays, report to the Emergency Room, call your primary care physician or call our answering service at (330) 665-4100.

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Transsphenoidal Resection of Pituitary Tumor

 

  • It is normal to have bloody mucous drainage from your nose. This drainage is greatest during the first 3 days following surgery. It is important to NOT blow your nose during the first 7-10 days following surgery. Clear fluid, like water dripping from a faucet, or a lot of bright red blood (such as with a nosebleed), is not normal. Please call your physician if this occurs.
  • Difficulty breathing through your nose after surgery is common. It typically takes 2 to 3 weeks before the inflammation and swelling inside the nose have subsided enough to provide a good nasal airway. If you think you have a sinus infection, please call your physician.
  • To help reduce swelling following surgery:

    Sleep with head elevated on several pillows

    o   Fatigue following surgery is normal—slowly increase your activity as tolerated

    o   Apply ice as needed to nose for 10-15 minutes

     

  • Observe for signs of infection

    o   Thick yellow/green discharge

    o   Increasing redness or drainage

    o   Fever over 101-degree F

    o   CALL THE OFFICE WITH ANY SIGNS OF INFECTION

  • You may shower any time after surgery.
  • The best way to clear your nose of mucus and dried blood is with saline (salt water) irrigations. These irrigations can be purchased from your local pharmacy. Please follow the instructions on the box.
  • Avoid lifting more than 10-20 pounds for about 6-8 weeks, increasing as tolerated thereafter in accordance with your doctor’s instructions.
  • Avoid strenuous activity, driving an automobile, returning to work or operating any power equipment until advised by your physician. Your doctor will give you specific instructions regarding these activities at the time of your next follow-up.
  • You may resume a normal diet after surgery.
  • Pain medication refills are at the doctor’s discretion and will only be given after a procedure for up to 60 days. Requests for refills should be called in to the office between 8:30 am and 3:30 pm on business days. Narcotic medication prescriptions must be picked up at the office. In accordance with federal law, these prescriptions may not be called into the pharmacy, and require a physical copy. Prescriptions must be picked up by 5pm. Prescription pain medications should be taken only as needed. Over-the-counter Tylenol (acetaminophen) may be taken for minor pain.
  • Some mild headaches are a normal part of the recovery process. However, if there are concerns after surgery you may always call the office and speak to a nurse or physician during regular business hours. For emergencies on the weekends, or after 5:00 pm weekdays, report to the Emergency Room, call your primary care physician or call our answering service at (330) 665-4100.

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