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Frequently Asked Questions About Brain Surgery
The prospect of having brain surgery can be frightening. We encourage you to ask your neurosurgeon questions. Information can lessen anxiety by reducing fear of the "unknown." In addition, a better understanding of your problem can help you make more informed, and, therefore, better decisions. We will help you regain a sense of control and cope with a situation that may seem to be moving too fast.
How do I prepare for brain surgery?
- Your neurosurgeon may ask you to see your internist (or a specialist such as a cardiologist) in order to get "medically cleared" for surgery. The intent is to reduce the risk of anesthesia by identifying and optimally treating medical conditions. For patients with a history of heart problems or who may be at increased risk of a heart attack, this may involve specific tests to assess the blood flow to the heart.
- In order to reduce the risk of bleeding during or immediately following brain surgery, it is important to tell your neurosurgeon if you are taking any medications that thin the blood (anticoagulants) or if you have a natural tendency for bleeding (hemophilia). Always tell your neurosurgeon if you take aspirin (even baby aspirin) because in most cases aspirin should be stopped at least eight days prior to surgery. Other medications, including herbs, vitamins, or nonsteroidal anti-inflammatories such as Motrin, may also have to be stopped prior to surgery.
- Although the chances of a serious complication are usually low with most brain surgeries, surgery of any type carries risks. Consider having a discussion with family members about your wishes in the event something unexpected occurs and you are not able to make decisions for yourself. Ideally, all patients having surgery of any kind should have a Living Will or Advance Directive completed prior to undergoing the surgical procedure. Your primary care doctor may be a good resource for advice.
How are university hospitals different from community hospitals when it comes to surgery?
- Experience - Brain Tumor Neurosurgeons at UCLA
- A university hospital, such as Ronald Reagan UCLA Medical Center, offers the opportunity to be treated by highly-trained specialists who can offer the latest and best treatments for brain tumors. Several studies have demonstrated that patient outcomes are better if a surgeon performs a high volume of a particular operation each year.
- UCLA brain tumor neurosurgeons perform several brain tumor operations each week. In addition, due to the high volume of patients treated at UCLA Health, our nurses are highly trained in the care of neurosurgery patients.
- The Resident Team
- The resident team helps your neurosurgeon by making "rounds" twice a day — early in the morning and then later in the afternoon. The team reviews your vital signs, examines you and helps coordinate your care (ordering tests, consulting with other specialists, preparing for discharge, etc.) under the direction of your neurosurgeon. Your neurosurgeon is in charge of your care and directs that care.
- The resident team is led by the chief resident, who has nearly completed training (seven years after completing medical school). The rest of the team consists of one senior resident (fourth- or fifth-year trainee), three junior residents (second-year trainees) and two interns (first-year doctors).
- There may also be a medical student accompanying the team. Medical students only observe and do not make any decisions regarding your care. At UCLA Health, a neurosurgery resident is stationed at the hospital 24 hours a day, 365 days a year to help with your care.
- You will not be subjected to any research or investigation without your direct consent. For many patients, however, one of the reasons they are at a university hospital is to take advantage of the latest treatments being offered as part of research protocols.
- All research conducted at UCLA Health is highly scrutinized to adhere to the highest ethical and safety standards and must be approved by the UCLA Office for Protection of Human Subjects.
What happens after I am discharged from the hospital after brain surgery?
- Most patients recover quickly after brain tumor surgery and are able to leave the hospital after only a few days. Our physical and occupational therapists will evaluate you after surgery, and depending on your functional abilities, some patients might be recommended to stay at a rehabilitation hospital near their homes for a short time.
- In addition to the discharge instructions you are given, it is important to determine which doctor(s) you need to see after discharge for treatment of your brain tumor. An appointment with a radiation oncologist may be necessary so radiation therapy can begin soon after surgery. It may be beneficial to make an appointment to discuss chemotherapy with a neuro-oncologist. In most circumstances, the neuro-oncologist will be the main doctor coordinating your brain tumor care after surgery. Lastly, a follow-up appointment with your neurosurgeon may be necessary to ensure your wound is healing properly. All of these appointments will be discussed with you in advance by our navigation and care coordination teams.
What possible problems should I look for after brain surgery?
- You should call your neurosurgeon if you experience: seizure, severe headache, worsening neurological problems, fever or chills, swelling of the ankles, bleeding or bruising, severe nausea or vomiting, or skin rash.
- If your neurosurgeon's office is closed and it is an urgent matter, call the UCLA Health page operator at (310) 825-6301 and ask to have the on-call neurosurgery resident paged. If seizures continue for over one minute or there is a serious medical condition, call 911.
What should I expect during chemotherapy?
- After your diagnosis is confirmed, a treatment plan will be created specific to your diagnosis and it may include chemotherapy.
- Chemotherapy involves the use of anticancer drugs to treat cancerous cells. Chemotherapy has been used for many years and is one of the most common treatments for cancer. In most cases, chemotherapy works by interfering with the cancer cell's ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells.
- While chemotherapy can be quite effective in treating cancer, chemotherapy drugs reach all parts of the body, not just the cancer cells. Because of this, there can be many side effects during treatment. Being able to anticipate these side effects can help you and your caregivers prepare, and in some cases, prevent these symptoms from occurring. For example, if nausea or vomiting is an anticipated side effect, medications can be taken to reduce or eliminate these symptoms. Make sure to speak with your physician about the potential side effects of your particular chemotherapy treatment.
How should I care for myself during radiation therapy?
- Get plenty of rest. Many patients experience fatigue during radiation therapy, so it is important that you are well rested. If possible, ask friends and family to help run errands and prepare meals. This will help you get the rest you need to focus on fighting your cancer.
- Follow doctor's orders. In many cases, your doctor will ask you to call if you develop a fever of 101° F or higher. Be sure to read and follow your self-care instructions during treatment.
- Eat a balanced, nutritious diet. A nutritionist, nurse or physician may work with you to make sure you are consuming the vitamins and minerals you need. With certain types of radiation, you may need to change your diet to minimize side effects. You should not attempt to lose weight during radiation therapy as your treatment may require increased caloric intake. Treat radiation-exposed skin with extra care. Your radiation oncology nurse will review specific skin-care instructions with you. Some guidelines include:
- Clean the skin daily with warm water and a mild soap recommended by your nurse.
- Avoid using any lotions, perfumes or powders in the treatment area unless approved by your doctor or nurse. Try not to use products containing alcohol and perfumes.
- Avoid putting anything hot or cold on the treated skin, including heating pads and ice packs.
- Stay out of the sun. If you must spend time outdoors, wear a hat or clothing to protect your skin. After treatment, use SPF 15 or greater sunscreen.
- Seek out support. It is common to feel anxious, depressed, afraid or hopeless during cancer diagnosis and treatment. It may help to talk about your feelings with a close friend, family member, nurse, social worker or psychologist. To find a support group in your area, ask your radiation oncology nurse. There are many support groups that meet in person, over the phone or on the Internet.