Before your surgery
Q: When will my surgery be?
A: During your consultation, a proposed date for your surgery may be made. Sometimes, this date will need to be changed depending on the availabilities of anaesthetic and other surgical teams involved in your operation. The date may also be changed if there are other patients with more urgent or emergency operations that may need to be performed.
If you have been placed on a waiting list, your operation date will be made known to you as soon as it has been determined, usually with several weeks’ notice.
Q: When will I come into hospital for surgery?
A: For most operations, you will be instructed to be admitted into hospital on the day of the operation. Prior to the operation, you may be required to attend a pre-admission clinic to be assessed by the anaesthetists and have preliminary tests done. Depending on the scheduled time for your operation, you will be given instructions about what time and where to come into hospital for admission by the bookings office (usually on the day before the surgery).
Q: Should I take my usual medications before surgery?
A: Your list of medications will be reviewed during your consultation. Most patients having open surgery can continue their usual medications with the exception of blood thinners, such as aspirin (Cartia, Astrix, Cardiprin), clopidogrel (Plavix, Iscover, Co-plavix), prasugrel, warfarin (coumadin), rivaroxaban (Xarelto), apixaban (Eliquis). If you are taking these medications, please inform your surgeon before surgery, and you will usually need to stop these medications about 1 week prior to surgery.
However, there are some exceptions: For some specific endovascular procedures (e.g. flow-diverting stents or stent-assisted coiling), you will be instructed to commence blood thinners (usually aspirin and clopidogrel) for at least 1 week ahead of your procedure. Also, if you have a mechanical heart valve, you may require transition to injectable blood thinning medications up to the day of surgery. These instructions will be discussed and made clear to you before surgery.
Q: What is the cost of surgery?
A: A detailed estimate of fees will be given to you before the surgery. The cost of surgery varies depending on the operation and your insurance status, and is evaluated on an individual basis.
Q: What is involved in my surgery?
A: During your consultation, you will be informed of the details of your operation, including the objectives, benefits and expectations during the immediate post-operative period. The risks and complications of the operation will also be discussed, so that you will be fully informed. If you have further questions about your operation following your consultation, you can either make another appointment or contact us via email or phone.
Most operations are performed under general anaesthesia, but some procedures may be able to be performed with sedation and local anaesthetics.
Q: Where will my recovery be within the hospital?
A: You will be monitored in the post-anaesthetic recovery area immediately after surgery for about 1 – 2 hours. After this, you may be transferred to intensive care unit, or the neurosurgical ward for further monitoring and observations. Usually, more complex surgeries, such as brain and major spine surgeries, will require at least 24 hours in intensive care unit on the first post-operative day. If you have pre-existing medical conditions, you may also require intensive care unit monitoring. Once your condition has stabilised, you will be transferred to the neurosurgical ward.
Q: How long will I be in hospital?
A: You will be given an estimate of the length of your hospital stay following your operation. Generally, this can range from day only for some minor procedures to up to 2 weeks for more major surgeries. The main factors that determine the length of your hospital stay are the type of operation, your level of pain, your mobility and whether further supports, such as in-patient rehabilitation, is required.
Q: Will I be in pain from the operation?
A: There will be pain at the surgical site, but you will be provided with sufficient pain relief so that you will be comfortable. The anaesthetic and pain management teams will be assessing you in the post-operative period to ensure that you have the best combination of pain relieving medications to manage your pain during and after discharge from hospital.
After your surgery
Q: What symptoms should I expect when I am home after surgery?
A: Before leaving hospital, you will be assessed on whether you would be able to function safely at home. In general, it is common to expect some degree of pain and discomfort at the surgical site, and many patients complain of fatigue and lethargy after major operations for several weeks. Depending on the type of surgery, you may have persistent symptoms related to the underlying condition. Sometimes you may need assistance with daily activities at home from family members and friends. If you require further additional assistance at home, this may be arranged during your hospital stay by the allied health team (physiotherapy, social work and occupational therapy).
Q: What is the follow-up after surgery?
A: You should be seen by your general practitioner (GP) about 1 week from the operation, so that they can be updated on your recent surgery, and that your wound can be inspected. If staples or sutures need to be removed, your GP can also do that at the same time. If you need further prescriptions for medications, you can request for this also from your GP.
You will have a follow-up with your surgeon at approximately 6 – 8 weeks following your surgery. A follow-up appointment will usually be made at the time of discharge from hospital.
Q: How do I look after the wound? What signs should I look out for?
A: In general, there will be a dressing on the wound when you are discharged from hospital. The dressing should be left intact and kept dry for 5 – 7 days, and then can be removed. For cranial surgery, there are usually staples or non-dissolving sutures that will be removed at 7 – 10 days (as advised by your neurosurgeon). These staples or sutures can be removed by your GP. For spinal surgery, the sutures are usually dissolvable and do not need to be removed. Showering and washing over the wound is permitted after 5 days, as long as the wound is patted dry. Be careful not to scrub at the wound.
If your wound is becoming redder, or there is discharge coming from the wound, please contact us as soon as possible. If you had cranial surgery, any new neurological symptoms or worsening headaches are concerning, and you should contact us too.
Q: What activities can I do once I have been discharged from hospital? Can I exercise?
A: Your surgeon will discuss with you what specific activities you may be permitted to do. In general, it is a good idea to “take it easy” for at least 3 – 4 weeks following neurosurgical operations. Gentle exercise would be fine, including walking, swimming and light jogging as long as it is not too painful. It is recommended that you do not lift anything heavy, including doing weights in the gym for at least 6 – 8 weeks, especially after spinal surgery.
Q: Can I drive?
A: This depends on the type of operation you have had. For spinal surgery, it is recommended that you don’t drive for at least 2 – 3 weeks, although there are no absolute restrictions. For cranial surgery, driving is not permitted for at least 6 weeks until you have been reviewed by your neurosurgeon. If you have had a seizure, you are not permitted to drive for at least 6 months.
Q: Who can I call for help if I’m concerned?
A: If you have an emergency or life-threatening condition following surgery, please contact “000” immediately for an ambulance to be transferred to the nearest hospital emergency department. The emergency department doctors can contact your neurosurgeon directly after you have been stabilised.
For any other concerns, including post-operative symptoms that are not life-threatening, you can contact our office during business hours. If the office is not contactable, you may reach out to the neurosurgical registrar on-call at Royal Prince Alfred Hospital on (02) 9515 6111.