DISCHARGE INSTRUCTIONS AFTER CRANIOTOMY

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*Although post-operative recovery is somewhat different for everyone, here are some helpful guidelines for the first two weeks after your surgery.

ACTIVITY: For the first week after surgery, avoid heavy lifting (over 5 lbs), bending over and excessive straining, however walking is encouraged; get plenty of rest. You should not drive or exercise until two weeks after surgery. After two weeks, you can gradually resume your normal activities including driving and exercise.

BATHING: You may shower or bathe but keep your scalp or eyebrow incision clean and dry for the first 4 days after surgery. (If you have skin staples, they will be removed 7 to 10 days after your surgery).

DRIVING: You may resume driving two weeks after surgery provided your vision is not impaired.

DIET: You may resume the type of diet you had before surgery.

WORK: You should have clearance from your doctor before going back to work. At least 2-3 weeks off after surgery is recommended before resuming work although working at a desk on a computer is often possible after 10 days to 2 weeks.

WARNING SIGNS:

Redness or drainage from the incision site.

Clear watery drainage from the incision may be cerebrospinal fluid (CSF).

Persistent headache not relieved by medication and rest. (It is normal to have some mild to moderate headaches for up to 2 weeks after surgery)

Excessive fatigue or tiredness (most patients experience some fatigue and tiredness).

Persistent chills; onset of fever (over 100∞).

Onset of stiff neck, nausea/vomiting or diarrhea.

New or increased visual problems. (Blurring, loss of peripheral vision, double vision)

Onset of excessive urination or thirst.

If any of the above symptoms occur contact Dr. Kelly’s office at 310-582-7450. On weekends, the answering service will forward the call to Dr. Kelly or one of his colleagues. If the problem is urgent, you may need to go to the Saint John’s Emergency room or your local emergency room.

MEDICATIONS: You may be given prescriptions for new medications you are to take at home and possibly for medications you have already had prescribed. You may fill these at any pharmacy. Before discharge, your nurse will review your medication dosage, schedule, and side effects. It is important to take your medications as ordered.

Possible discharge medications include:

Dexamethasone, prednisone or hydrocortisone: These steroids are normally produced by the adrenal glands and are necessary for dealing with stress and to help reduce brain swelling. Dr. Kelly and your other doctors will decide how long you need this medication – possibly weeks or longer.

DDAVP (Desmopressin acetate - hormone for salt and water balance). The pituitary gland may not produce enough of this hormone after surgery. This usually resolves within 3-4 days after surgery. Overdosing of this medication may lead to low blood sodium levels causing listlessness, headache, confusion and decreased urine output.

Sodium Chloride (salt tablets): You may be losing more salt than normal for 5-10 days after surgery and require added salt. Side effects may be upset stomach and nausea.

Anti-seizure medications: (Dilantin, Keppra, Phenobarbital, Tegretal): You may take these for only one week after surgery or if you have seizures in the past or are at ongoing risk of seizures, you may need to take these medications indefinitely.

Appointments after hospital discharge:
Post-operative sodium blood level check: This should be done on the 4th or 5th day after surgery. It can be done at Saint John’s or an outside medical lab closer to your home. Fax results to Dr. Kelly at 310-582-7495.

Follow-up with Dr. Kelly: 2-3 weeks after surgery. Please call 310-582-7450 to schedule an appointment.
For Additional Information and Information about the Patient Support Group go to:
www.neuro-endo.org or call our office at 310-582-7450

The Brain Tumor Center at Saint John’s Health Center
2200 Santa Monica Blvd.
Santa Monica, CA 90404