Instructions for Surgery

Introduction

 Thank you for selecting the Northern California Neurosurgery Medical Group, Inc. for your surgery.  This discusses cervical (neck) and lumbar (low back) surgeries.  It provides limited information regarding blocks and carpal tunnel surgeries. 

For minor surgeries (blocks and carpal tunnels), you will not have complex needs.  You will still have a pre-operative visit and cannot eat or drink after midnight, but you will not need to rearrange your house or need a lot of help after surgery.

Before Surgery

Before spine surgery, prepare things at home:

1)  place your telephone next to your bed;

2)  if you do the cooking, prepare a week of meals in advance and freeze them;

3)  select someone to do your chores;

4)  pick someone to change your dressing;

5)  place frequently used items at waist level to minimize bending;

6)  remove things which may cause you to trip;

7)  if your bedroom is upstairs, and your bathroom is downstairs, consider moving downstairs for a few days;

8)  select someone to drive you to appointments for a few weeks; and,

9)  pick someone to drive your children to school.

Equipment and Supply needs

If you need a brace, have this fitted before surgery.  Bring it to the hospital with you. Other equipment will be arranged by the hospital. 

Planning your trip home after surgery

Whoever picks you up at the hospital will have to help you out of the car at home. If the hospital is more than 20 minutes from your home, pick a place to stop, get out of the car,  and stretch.  Do not drive yourself home.

Your medication use before surgery

Bring all medications, including over the counter and herbal medicines, to your pre-operative office visit and when you come to the hospital for your surgery.

Smoking

If you smoke, stop or cut back. Smoking irritates your lungs and increases the risks during surgery. 

Your primary and/or family doctor

If you have not seen your family doctor recently, or do not have a family doctor, talk to our office.  We have a wonderful, in house, primary care doctor.

Pre-operative testing

We will arrange for your pre-surgery testing.  Your evaluation will include a thorough history, examination and perhaps blood tests or x-rays.

The evening before surgery

Do not eat or drink anything after midnight the day before your surgery. If you take medications, take your evening and morning pills with a small sip of water.

What you need to bring to the hospital or surgery center, and what you should not bring

Remove all jewelry and piercings before you come. Do not bring valuables. 

Select loose fitting, comfortable clothing that is easy to remove for after surgery. Pull-on shirts are sometimes difficult to get on. Wear a shirt that buttons down the front. If you will be wearing a back brace, buy oversized sweat clothes. The hospital will give you with a gown but you may want your own pajamas.

What to expect at the hospital

The morning of surgery

Report two hours early.  Your driver can drop you off and then go to park.

Try not to bring more than two visitors. They will be shown to a waiting room after you leave for surgery. You will be asked to undress, and be given a gown. An intravenous line (I. V.) will be placed in your arm.

When ready, you will be taken to the surgery room.  An anesthesiologist will give you medications to let you sleep through surgery. He or she will remain with you constantly.

After surgery, you will go the recovery room. You will be there for about one hour. Your surgeon will go to talk with your family.  Families and friends should remain in the lobby until after the surgeon arrives.  

Care at the hospital

From recovery, you will be taken to your room.   Expect to do deep breathing exercises, leg exercises, and to walk within a few hours of your surgery. 

Shortly after arriving to your room, your family will be allowed to visit with you. You will be tired and the number of visitors should be limited.

You will be asked to rate your pain on a scale between 0 and 10.  Zero is no pain and 10 would be the worst pain imaginable. If your pain is severe you will get more medication. You may have a catheter in the bladder and if so may feel some pressure or fullness.

The morning after surgery the doctor will see you and determine if you are ready to go home.  To go home:

1)  your pain must be well controlled with pain pills;

2)  you have to be able to urinate without a catheter;

3)  you have to be able to eat and drink;

4)  you must be able to walk with minimal or no assistance;

5)  there must be no drainage from your incision;

6)  you have to be able to get in and out of bed by yourself; and,

7)  you need to understand all your instructions.

What to expect at the surgery center

The morning of surgery

On the day of surgery, report to the lobby one hour before your case is scheduled.  Your driver can park and walk in with you, the lot is small.

It is best not to bring more than one or two visitors with you. You will be asked to change into a dressing gown for surgery. An intravenous line (I. V.) will be placed in your arm.

An anesthesiologist will give you medications to let you sleep through surgery. He or she will remain with you constantly.

After surgery, you will go the recovery room. You will remain there for approximately one to three hours.  

Care at the surgery center

You will go home directly from the recovery room in most cases.  To go home, you must meet the following criteria:

1)  your pain must be well controlled with pain pills;

2)  you have to be able to urinate without a catheter;

3)  you have to be able to eat and drink;

4)  you must be able to walk with no assistance;

5)  there must be no drainage from your incision;

6)  you have to be able to get in and out of bed by yourself; and,

7)  you need to understand all of the nurse’s instructions for your recovery.

After Discharge from HOSPITAL or SURGERY CENTER

Activity and limitations

Most of all it is important to take care of yourself following your surgery:

1)  follow your doctor’s instructions;

2)  take enough pain medicine;

3)  keep your incision clean;

4)  you can shower after two days but take the bandage off before and pat the incision dry and put on a new dressing after the shower;

5)  if you have had neck surgery don’t bend the neck too much and take the collar off when showering;

6)  do not ever scrub the incision;

7)  do not drive a car or use any dangerous equipment;

8)  do not lift anything heavier than 10 pounds, or a gallon of milk; and,

9)  you may have sex after your surgery if you are careful.

When to call the doctor

Call the doctor for:

1)  fever greater than 101 degrees;

2)  uncontrolled pain;

3)  if you have swelling, tightness or drainage at your incision;

4)  if you have numbness or tingling in your arms or legs;

5)  if you have severe nausea, vomiting, diarrhea, or constipation;

6)  if you have burning, pain or difficulty when urinating;

7) If you have difficulty breathing or swallowing; and,

8)  if you have any questions.

Your after surgery medications

It is important to take your medications as prescribed.  Don't wait too long to take your pain pills.  Do not drive a car.  When you get out of bed, sit on the side of the bed for a minute to make sure you do not become dizzy.  Hold on to stair rails on the stairs.  If you are constipated use a laxative.  If your doctor has given you an antibiotic, take all of it.