Craniotomy

1. Diet
2. Medications
3. Activity and Restrictions
4. Wound Care
5. Medications

1. Diet

   Maintain your regular diet.

2. Medications

   You may use stool softeners, Panadol or Digesic as you need. Narcotic medication may be prescribed if you require these. Do not take aspirin, warfarin, clopidergral or other blood thinning agents unless discussed with Dr Mobbs first.

3. General Notes

   As with any major surgery, especially with the brain, you must allow your body time to recover following such a major procedure. It may take a month or more before you gain your energy levels. It is very important to obtain the extra rest you need during this recovery period in order to allow the healing process to occur. The following is a list of activities and restrictions that should be used as a guide for your recovery.

4. Activity
   
   
   • You should have a family member or friend stay with you for the first 2 weeks following your discharge
     
     
   • Get plenty of rest, i.e. Sleep in late, take naps, go to bed early
     
     
   • Avoid keeping your head flat, prop it up with extra pillows
     
     
   • You may take short walks, but avoid heat, humidity, or extreme cold. Stop if you become fatigued or if you are in pain
     
     
   • No heavy lifting, use your knees when bending
     
     
   • Your head may be washed after 5 days. Wait 2 weeks until you shampoo your hair. Avoid using hair dryers, creams or ointments on your suture line unless otherwise instructed. Cover your head in the sun
     
     
   • NO driving until Dr Mobbs or your neurologist gives you permission. It is a legal requirement than you NOT drive for at least 3 months after major brain surgery
     
     
   • Avoid cigarette, and cigar smoke
     
     
   • You may resume your regular diet
     
     
   • It is important to avoid junk food and alcoholic beverages, and maintain good nutrition

     If you are on Dilantin/Phenytoin

   • Visit your GP after discharge to get the “levels” checked
     
     
   • Too much dilantin in your blood can cause you to be dizzy, off balance, have eye problems amongst other symptoms
     
     
   • If you develop a fine, itchy rash – it may be your body reacting against the dilantin…. you must visit your GP or contact Dr Mobbs
     
     
5. Medications

   Take prescribed medications as directed.

   You may be sent home with prescriptions for the medications you have been taking in the hospital and these medications may include the following

   • Pain relief: (Panadol with codeine) these medications are used to reduce the amount of headache and wound pain that may be present after surgery
     
     
   • Antiswelling: (Steroids; Decadron, Dexamethasone, Hydrocortisone) this medication is used to decrease the amount of post-operative brain swelling that might occur following the surgery. It should be gradually tapered (lowering of dose) over time. Your doctors will discuss the dosages of these medications
     
     
   • Antacid: (Pepcid, Axid, Zantac, Prilosec) this medication is used to decrease the amount of excess stomach acid which may be caused by steroids (see above) or from the stress of surgery
     
     
   • Anti-seizure: (Dilantin, Phenobarb, Tegretol, Gabapentin, Epilem) this medication is given to almost all patients before, during and after a brain operation in order to help reduce the risk of seizure. There still is a seizure risk despite these medications and your doctor may need to adjust the dose of medication by using periodic blood tests

   Notify your doctor or go to the local emergency department if you experience any of the following

   1. Signs of infection (pus or discharge of any type)
      
      
   2. Fever or Chills
   3. Any new deficits, (i.e. Weakness, vision changes, speech or swallowing changes)
      
      
   4. Report all changes (i.e. Seizures, drowsiness, confusion, weakness, and vision changes)
      
      
   5. Call your doctor with any questions or concerns or if you are unsure about what symptoms should be examined in the emergency department

   If you develop fevers, chills, draining from your wound or have unrelenting pain despite medication, please contact the rooms and leave a message for Dr Mobbs. If you develop increasing weakness of the arms / legs or difficulty with speech - please go to your nearest emergency department or contact the Neurosurgery Registrar at Prince of Wales Hospital on (02) 9382 2222.