Its important to remember that neurosurgery is a major operation. After surgery you will need to rest for a number of days.
As a general anesthetic is used, you'll normally stay in hospital for a few days, though some hospitals may do biopsy surgery as a day case.
Following surgery, you're likely to wake up in the recovery room of the operating theatre, where there may be other patients waking from their operations. Different hospitals have different systems, some have specialist post-operative neurosurgery wards where you may be taken for observation. In others, you might wake up in a high dependency unit (HDU) or occasionally an intensive care unit (ICU).
While there, you'll have one-to-one personal care and attention.
In the first few hours, you'll have frequent neurological observations (neuro-obs). They include:
You may also be linked to a machine that controls your breathing (ventilator) to give your brain a chance to recover.
The amount of time it takes to wake up after surgery varies. Many people wake up very soon afterwards, but some people remain unconscious for a number of hours or a few days.
When you wake up after surgery, you'll have a number of tubes running in and out of your body. This unfamiliar experience can be upsetting - it can help if you know what the tubes are for.
You may be linked to the following devices:
When you wake up after surgery, you may have a dressing or bandage on your wound, but not always. If a dressing is used, this usually stays on for up to about 5–10 days after surgery.
You might have some swelling and bruising on your face.
Many factors will influence how you feel after surgery, including the type of surgery you've had, and the size and location of your tumour.
You may experience some or all of the following temporary effects:
For the first few days, one of the top priorities for your healthcare team will be ensuring that the pressure in your head doesn't increase.
Nurses will ensure that you're moving your arms and legs around enough to allow blood flow and to prevent blood clots (thrombosis) or your muscles from stiffening up. You won't be kept in bed any longer than is necessary and hospital staff are always keen for their patients to get up and get moving as soon as is safe.
You will have physiotherapy and occupational health assessments to prepare for and support your discharge from hospital.
The list of side effects may seem over whelming, but it's important to remember that such effects usually disappear fairly soon after surgery and that a team of health professionals will be taking care of you.
Your consultant should talk through your treatment plan with you, so that you know what to expect.
Due to the swelling in the brain after surgery, it's common to be given steroids. You may be prescribed a type of steroid called Dexamethasone. Steroids help to reduce the swelling and increased pressure in your head. Under the guidance of your consultant, you'll gradually be able to stop taking steroids.
Some people experience seizures (fits) after brain surgery. You may be given anti-epileptic medication. The length of time people take this for varies from person to person, but it's not uncommon to take anti-epileptics for up to a year after brain surgery. You may need to stay on them for life.
The clips or stitches will usually be removed 1-2 weeks after surgery. If you have dissolvable stitches, they don't need to be removed. Over time, in most cases, the bone flap will fuse with the surrounding skull.
If you wish to travel by plane after brain surgery, you should ask for advice from your healthcare team. Normally, you wouldn't be able to fly for a little while after neurosurgery. The Civil Aviation Authority, which is responsible for air travel safety, advises avoiding air travel for approximately 7 days following neurosurgery. This is because neurosurgery may leave gas trapped within the skull, which may expand at altitude.
Travel insurance may also be more expensive or difficult to obtain following neurosurgery. It's essential that you make sure you are fully covered to travel before you do so, to prevent incurring heavy costs if you fall ill while away. There are some specialist insurers who may insure you to travel.
If you wish to play sport after your surgery, ask for advice from your doctor. Once you've recovered from surgery, it should be fine for you to play sport, though you may need to avoid sports that involve significant physical contact between players (contact sports), such as rugby and wrestling.
Your healthcare team will be able to advise you on when you can begin playing sport again after brain surgery.
You're likely to have a brain scan a few days after surgery. This will give your healthcare team a good idea of whether any of the tumour remains and how much swelling of the brain you have.
The success of surgery is measured on the aim of the surgery and not on curing a tumour. Even if all of the visible tumour is removed, this may or may not mean that all of the actual tumour has been removed.
Surgery as a cure depends on tumour type and your individual case. Before surgery, your consultant will discuss with you what to expect from surgery and whether they are hoping to remove all or part of the tumour.
Often, surgery does not cure a tumour completely, but removing part of it can make any remaining tumour cells more responsive to other treatments, such as radiotherapy and chemotherapy.
Long-term difficulties after surgery are possible. Nerves, or the brain itself, can be damaged during surgery, affecting the functions that they control within our bodies.
The nature of these will depend on which part of the brain has been operated on, or which nerve has been affected.
The result of this damage is sometimes called a deficit and can be permanent or temporary. Such difficulties could include problems with speech and movement or problems with thought processes.
Before you have surgery, where possible, a health professional from your healthcare team will talk to you and/or your carer about what to expect and the risks involved.
It's important that you fully understand the level of risk, so you can make an informed decision about whether to agree to the surgery.
The exact level of risk depends on the exact procedure performed, but any surgery on the brain does carry risks, some of them serious. You should have been given a key worker within your healthcare team who you can contact - feel free to ask them as many questions as you wish, at any point.
If you're left with any long-term difficulties, professionals, such as speech and language therapists, physiotherapists and clinical psychologists, can work with you to improve these functions. Don't be afraid to ask for such support if you feel it's necessary.
Surgery is not always the preferred option to treat a brain tumour - it depends where in the brain the tumour is.
Sometimes, it would be too risky to operate as the tumour may be very close to, or wrapped around, an important structure in the brain. In this case, the benefits of surgery would be outweighed by the dangers.
If your consultant doesn't think surgery is appropriate for you, you may like to ask them to explain their decision.
If you're still unhappy with their decision, you could ask for a second opinion from another consultant. Your current consultant or your GP can help to arrange this.
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