Pre- and Post-Operative
Brain Tumor Surgery Guide
Thank you for choosing the Brain Tumor Center at Atlantic Brain and Spine for your neurosurgical care.
With over 60 years of delivering best-in-class treatments, we are here to support you and your loved ones every step of the way. To assist you, we’ve compiled answers to common questions about your upcoming surgery. Please review this information and don’t hesitate to reach out with any additional questions or concerns.
In Preparation for Your Surgery
How do I schedule my surgery?
Approximately two to five business days after you and your surgeon decide to move forward with surgery, you will receive a phone call from a Surgical Scheduling Representative to begin the scheduling process. In addition to scheduling your surgery, together, you will arrange for pre-admission testing.
Your Surgical Scheduling Representative will also provide you with his/her direct phone extension in case you have additional questions or need to make any adjustments to your surgery schedule. All faxes pertaining to your surgical scheduling should be sent to 973.455.7426.
Do I need to see any other doctor before my surgery?
You generally will need to see your primary care doctor to have your medical clearance physical performed within 30 days of your surgery. Pre-admission testing will be done at the facility where you are scheduled to have surgery. Your Surgical Scheduling Representative will contact you regarding your pre-admission testing and medical clearance appointment.
Do I need to identify a contact person – my “patient coach” – before my surgery?
Yes! Please designate one person to serve as your contact person and “coach” throughout your hospital stay and two to three weeks after your surgery. Your coach will support you through this process. He or she should be present on your discharge day when you receive final post-operative instructions and information from your care team.
How do I manage my medications before surgery?
Aspirin or other blood-thinning medications
(e.g. Aspirin, Plavix/Clopidogrel, Coumadin/Warfarin,
Pradaxa/Dabigatran, Xarelto/Rivaroxaban or Eliquis/Apixaban)
You will need to stop taking these medications at least seven days before your surgery date. Your surgeon and your primary care provider will need to work together for optimal management of blood-thinning medications.
Diabetes medication
Please do not take your diabetes medication the morning of surgery. Make sure to speak with your primary care provider about managing your medication prior to your surgery.
Medication for high blood pressure, seizures or cardiac conditions
Please continue to take these medications as prescribed by your doctor – until the day of your surgery. That day, take your morning dose as you normally would with only a sip of water.
Non-steroidal anti-inflammatory drugs (NSAIDs)
(e.g. Aspirin, Ecotrin, Bayer, Excedrin, Advil, Ibuprofen, Aleve, Motrin,
Celebrex, Meloxicam)
Stop taking these medications at least seven days before
your surgery. Discuss the management of these medicines with your nurse before your surgery as these can interfere with your procedure.
Herbal supplements
(e.g. Echinacea, St. John’s Wort, Ephedra, Valerian, Feverfew, Vitamin E, Fish Oil, Vitamin C [large doses above the RDA], Garlic, Gingko Biloba, Ginger, Ginseng)
Please restrict herbal supplements for three weeks prior to your surgery.
Multivitamin
You may continue taking your multivitamins as regularly scheduled through your surgery date.
Is there any special skin preparation before surgery?
If your doctor has prescribed an antiseptic skin cleanser liquid – such as Hibiclens – wash with it the evening prior to surgery and again the morning of your surgery. Do not wash your face or genital area with Hibiclens. Wash these areas with your regular soap. Follow any additional instructions provided.
When is the last time I can eat or drink before surgery?
Do not eat anything after midnight the night before surgery. You may have sips of water ONLY as needed to take medications on the morning of surgery. Do not drink any other liquids.
I am a smoker. Do I need to stop smoking prior to my surgery?
If you smoke cigarettes, you must stop smoking at least three weeks prior to having surgery. Research indicates that smoking can delay or even prevent the body from healing. Additionally, inhalation of smoke irritates the breathing passages and may lead to respiratory problems during and after surgery.
The Day Prior to and the Day of Your Surgery
What do I do if I feel sick the day before or day of my surgery?
If you suspect you are becoming ill or may have an infection, please call your Surgical Scheduling Representative or Atlantic Brain and Spine nurse immediately to discuss this as your surgery may need to be postponed.
When is the admission check-in time confirmed?
You will receive a phone call from a nurse the business day before your surgery. The nurse will confirm your check-in time at the hospital and provide you with pre-operative instructions.
What do I bring to the hospital?
- Bring a form of photo identification and your insurance card(s).
- To avoid lost or misplaced personal items, bring only essential items such as glasses, dentures and hearing aids with extra batteries. Leave your valuables – such as jewelry (including rings and watches), cash and credit cards – at home or with your family.
- Remove all piercings and jewelry prior to surgery.
- Bring your most recent imaging studies (CT, MRI or X-Rays).
- If you have sleep apnea and use CPAP equipment, please bring your device with you.
When do I meet the anesthesiologist?
Your anesthesiologist will review the material your physician has provided. On the day of your procedure, your anesthesiologist will go over your medical history and the anesthesia plan with you in detail and answer all of your questions.
Following Your Surgery
How will I get home?
Same-Day Surgery
If you will not be spending a night in the facility, it is your responsibility to have someone accompany you at the time of discharge. You will not be allowed to drive yourself or take a taxi home from the facility following your surgery.
Overnight Stay
If you are staying overnight at the hospital, please make arrangements to have someone at the hospital before your scheduled discharge time. The discharge planning team will work with you to coordinate the ideal time to be discharged to home.
Please arrange to have your coach at home with you for at least the first 24 hours following your surgery.
Returning Home After Your Surgery
Taking care of yourself after your procedure is critically important. Following is important discharge information that will help you be comfortable and recover quickly.
What do I need to know about my diet?
If you are eating a regular diet when you are discharged from the hospital, continue eating normally when you return home. Your doctor or nurse will let you know if you need a specific regime or food consistency.
Be sure to drink plenty of fluids – especially water – so you stay hydrated. This enables your body to heal quickly.
What should I do if I’m constipated?
Even if you were having regular bowel movements prior to surgery, you are likely to experience post-operative constipation. Exposure to anesthetics and narcotics, alterations in your diet and fluid intake – as well as reduced physical activity – all contribute to this uncomfortable condition. You can help avoid constipation by eating a balanced diet including fruits, vegetables, whole grain foods and fiber – and increasing your water intake.
If you need supplements to help, consider using:
- Docusate sodium (Colace), a stool-softener that makes stool easy to pass. You can take 100 mg three times a day. If you do not have a bowel movement in three days, add #2 below.
- Milk of Magnesia, a laxative that works by pulling water into your intestines, helping your stool move along the intestinal tract. You may take one to two tablespoons every 12 hours. Remember to drink plenty of water following each dose. If you still have not had a bowel movement four days after your surgery, use #3 below.
- An enema or rectal suppository. When the stool softener + laxative combination does not alleviate your symptoms, use a suppository. This will help eliminate heavy straining, which is not good after surgery.
If you try this regimen twice without any results, please call our office at 973.993.7322.
What do I need to know about showering and taking care of my incision?
Keep your incision clean and dry at all times.
- Do not apply any medications, ointments or creams to the wound area without checking with our office.
- Avoid touching your incision with your fingers as this can increase your chance of infection.
- Do not wear hats, helmets, wigs or wraps that may place pressure on the incision or lead to excessive head sweating.
Take care of your incision.
- Your incision was closed with staples or sutures that will be removed at your post-operative clinic visit 10 to 14 days after surgery.
- You may shower 72 hours after surgery, but do not soak the incision in a bathtub or pool for six weeks after surgery.
- You may wash the incision site gently with shampoo and rinse it with water.
- Pat the wound dry with a clean towel.
- You may find a shower chair – which can be purchased at most drugstores – helpful.
Avoid having your hair colored or permed for four weeks after surgery.
What about physical activity?
It’s important you get out of bed and move as soon as possible after surgery. But, be careful! When you are doing something for the first time after your surgery – such as taking a walk, going to the mailbox and the like – be sure to use the buddy system and have someone with you.
Here are some more tips:
- Be sure to get up and move around. Do not sit longer than one hour at a time for the first two weeks. This will help you avoid problems such as developing blood clots or pneumonia.
- Try to walk at least three times a day for 15 to 30 minutes.
- You may feel dizzy when standing. This is common the first two weeks after surgery and will resolve with time.
- Avoid getting up from a seated position too quickly – and remain standing for a few moments before starting to walk.
- Walk with assistance if you feel unsteady.
- If you have discomfort, stop what you are doing.
- Slowly increase your distance and activities each day as tolerated. Resume your normal daily activities including going up and down stairs, letting your comfort level and common sense guide your level of activity.
- Avoid heavy house cleaning, lifting over 20 pounds (a gallon of milk weighs 8.5 pounds), going to the gym, playing golf, swimming, running or mowing the lawn until you are cleared by our office during your post-operative visit.
- You may resume sexual activity when you are comfortable. Stop if it’s painful.
How long should I plan to be away from work?
Plan to be away from work for four to six weeks after surgery to allow for your recovery. If you can work from home, you may be able to work at a computer or desk sooner. However, you may find it difficult to sit for long periods of time or concentrate.
When can I drive?
You may drive two weeks after surgery provided (1) you are not taking opioid pain medications, (2) you have never had a seizure and (3) you do not have any neurological impairments such as visual problems that may affect your ability to drive. Driving will be discussed at your post-operative visit. If you have experienced a seizure before or after surgery, you must not drive at all until you discuss the plan with your surgeon and/or neurologist.
Can I smoke?
You should not smoke following surgery. Smoking has been proven to limit incision healing and may affect the outcome of your surgery.
What medications should I take?
You will be told which of your current medicines you should resume from home – as well as any new ones you should start. After surgery, you may be prescribed steroids to help reduce swelling and anticonvulsants to prevent seizures. It is very important you take these medications as directed. You do not need to take pain medication unless you need it. If you were taking blood thinners prior to surgery, ask your doctor when you should resume them.
Do not drink alcohol while taking prescription pain medications, anticonvulsants or muscle relaxants.
If you have a sore throat, you may use over-the-counter Cepacol lozenges. Follow the packaging instructions, and do not use them more than directed.
What happens next?
Prior to your discharge, your social worker and navigator will schedule your first follow-up appointment and coordinate visits with your nurse, neurosurgeon, neuro-oncologist and radiation oncologist at the Brain Tumor Center.
Once we have your final pathology report – usually one to
two weeks post-surgery – our team of specialists collaborates to design your treatment plan. The team includes experts in brain tumor surgery, radiation oncology, neuro-oncology, neuro-radiology, neurology, neuro-pathology, nutrition, physiatry and social work. Then, our multi-disciplinary neuro-oncology tumor board reviews your case, ensuring the most effective, safe and holistic plan is designed for you.
At your follow-up visit, you will meet with our multi-disciplinary team, who will evaluate your incision; adjust any pain, seizure or steroid medications as necessary; and answer any questions you may have. We will discuss your diagnosis and recommended treatment plan at this appointment.
Where can I find reliable information?
If you do research on the Internet, please be aware that much of the information published on the treatment and prognosis of brain tumors is outdated. Refer to these reliable sources of information:
The American Brain Tumor Association
abta.org
800.886.2282
The American Association of Neurological Surgeons
aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Brain-Tumors
888.566.2267
When should I call for help?
For life-threatening symptoms, call 9-1-1 immediately.
We are available 24 hours a day, 7 days a week at 973.993.7322. Call us if you are experiencing any of the following:
- A temperature of 101 degrees or higher
- Chills with shivering
- Uncontrollable pain, worsening headaches
or neck stiffness - Increasing drowsiness
- Seizures
- Change in neurological status such as increasing confusion, behavioral changes, weakness or speech difficulties
- New weakness or numbness
- Nausea and vomiting
- Inability to keep food or fluids down
- Inability to have a bowel movement
- Increased redness, soreness or swelling at the incision site
- Drainage of blood or fluid from the incision site
- Pain in your calf
Our goal is to help you feel better as quickly as possible. Please do not hesitate to contact us with any questions or concerns you have.
It is our privilege to care for you.
