Useful advice for your stay in hospital
by Lynn Burton
Everything below is based on my stay as an inpatient for, first a craniovertebral decompression surgery and then, 3 years later, a revision operation. Although the surgeries were carried out by different neurosurgeons, at different hospitals, the pre- and post-op care routine was basically the same. The following information is not meant to be, or to be taken as medical advice. It is intended to give you an idea of what you may experience during a hospital stay, as a patient, for decompression surgery.
What may be useful during your stay in hospital?
Nightwear, lots of it. Hospitals are often warm and stuffy and you may want to change your nightwear daily.
Additional items may be:
The evening before, or on the morning of your surgery a member of the neurosurgical team will visit to discuss the surgery with you and ask you to sign a consent form. An anaesthetist will visit to explain what will happen when you are taken to theatre. Like many patients I slept very little the night before surgery so take a good book or film to watch. The hours will pass more quickly.
When you wake you will usually be in the Intensive Care Unit (ICU). It is usual for you to stay in the unit overnight for close neuro observations. You will be wakened at regular intervals and asked to move your arms and legs. A nurse will shine a pen torch into your eyes to check pupil reaction. A blood pressure collar will be permanently on your arm and will inflate automatically to keep a check on your blood pressure.
A nurse will be close by the bed at all times during your time in the ICU. If you are experiencing any pain this is usually managed well.
Some patients will have a urinary catheter. This is a thin tube inserted into the bladder during surgery to drain urine. This will be removed as soon as you are able to use a bedpan or get to the bathroom. Not all patients will need a catheter.
You will usually have an intravenous drip into the arm, via a cannula, to keep you hydrated. This is removed as soon as you are taking fluids normally again. If all is okay the morning after surgery you will usually be moved back to the neurosurgical ward at some point during the day.
Once on the ward the hourly neuro obs will usually continue. You will be offered regular pain relief to ensure you’re comfortable.
You may sleep a lot over the next day or so, while others will feel more alert.
It’s usual that, maybe 48 hours or so post-op, the physiotherapy team will visit, to advise on getting you moving. Some patients will be helped to get out of bed and stand for a few minutes. For others it will be another couple of days before you feel up to doing this.
One thing you must do while in bed is to flex your feet up and down and ‘draw’ circles with your feet. This helps with circulation and eases stiff legs.
During this time nursing staff will ensure that you are comfortable and fresh, with daily bed baths and your bed linen changed.
The physiotherapy team will usually visit daily, with the aim to getting you mobile and on the road to going home.
The neurosurgical team will also visit daily to check you are progressing well.
The occupational therapist may visit as your discharge date approaches to see if you may need any aids to help you when you’re home, e.g. shower stools, ‘sitting’ stools etc. If you need any of these aids they will usually be delivered to your home before you are discharged, ready for your arrival there.
Everyone recovers from their surgery differently, there are no set rules. Don’t push yourself, your body needs time to recover.
It’s important not to strain when using the toilet. Nursing staff will ask if you need anything to help. I know we don’t like talking about these sorts of matters but nursing staff know about these post op problems and it’s better to tell them than be uncomfortable.
Washing your hair
We all long for the day when we can wash our hair again. As a rule, this is best left until any skin stiches/clips have been removed and the wound is healing well. Baby shampoo is advised. Try to leave the wound area as dry as possible. If someone can help the first few times, it’s much easier.
On your discharge from hospital you will be prescribed medication to take home with you.
It may be a good idea to ask whoever is taking you home to bring a pillow to support your head on the journey home. The motion of the car may make you feel a little sick.
When you’re home your GP will usually visit, to make sure everything is okay.
You may notice, at around this time, that your neck is still stiff and uncomfortable to move. This is completely normal and it will take a while for everything to heal. Don’t force your neck round too much but just make gentle movements, turning your head from side to side at first. Then start turning your head two or three times, gently increasing a little moreevery day. Make gentle movements up and down too. Don’t force these movements and take it slowly. Please stop if any of these movements make you feel sick or dizzy.
Around day 14 post-op, stitches/clips will be removed. You may be asked to attend your GP surgery or, if you are still feeling unwell, request a home visit from the district nurse to have then removed. You may find that you need extra or fewer pillows than before surgery, to help you to get comfortable in bed.
Contact the hospital or your GP if you begin to feel unwell during your first few days at home.
Rest is so important once you’re home. You’ll need help around the house. Ladies, let someone else take over the cooking and the housework. Don’t rush things. Gents, the same things apply to you too. If you feel tired, then sleep. Rest, rest and more rest. Once again everyone is different and some may recover and be back to normal fairly quickly. For others it may take a little longer to feel normal again. Do everything at your own pace. You know how you feel. Listen to your body.
The above was my experience during my hospital stays, each patient's experience will be different.
Information checked by Mr Graham Flint, Consultant Neurosurgeon.