Neuro Discharge Instructions

Prescription Instructions:
[ ] Anticoagulants: Aspirin, NSAIDS, Plavix, Coumadin
These medications increase your risk of bleeding. Please do not take any of these medications until cleared by your Neurosurgeon. 
[ ] Anticonvulsants (anti-seizure medication): Keppra, Dilantin
You are being discharged on anti-seizure medication to decrease the chance of having a seizure following your head injury/brain surgery. Please take the medication for 7 days. If you have questions or concerns regarding this medication, please discuss them with your surgeon.
[ ] Steroids: Decadron (dexamethasone)
You are being discharged on a medication to reduce tissue swelling. It should be taken two times daily. This medication will be gradually reduced every three days over the next 1-2 weeks. If you experience worsening of your symptoms during the taper, please call your surgeon at the numbers below.
[ ] Proton pump inhibitors: Nexium, Prilosec, Protonix, or equivalent
You are being discharged on a medication to protect your stomach while you are taking high dose steroids. Once the steroids have been completed, you may stop this medication.
[ ] Narcotic pain medications: Vicodin, oxycodone, Dilaudid, Norco, Tylenol#3
You are being discharged on medications to control your post-operative pain. Please take the medication as directed and taper use as your symptoms improve. These medications may cause constipation-see diet information below. DO NOT drive while taking these medications.
[ ] Antiemetics (anti-nausea) medications: Zofran, Reglan, Scopolamine 
You are being discharged on medications to control your post-operative nausea/vomiting.  Please take the medication as directed. For scopolamine patches, remove the patch in 3 days. Wait 2-3 hours, if your symptoms worsen, fill the prescription and place another patch behind your ear for another 72 hours. If you continue to have nausea and vomiting longer than 7 days, please call the Neurosurgery office at the numbers below.

Call your surgeon for:
-Fever over 101F
-Redness, swelling, increasing pain or milky/watery drainage from your wound
-Worsening headache pain not controlled with your pain medications
-Increasing drowsiness/mental confusion
-Unsteadiness when walking/new weakness
-New visual changes
-Nausea/vomiting not controlled with anti-nausea medication
-Slurred speech
-Convulsions/seizures

Wound Care:
-Keep bandage in place until your follow up appointment with Neurosurgery. You may shower with the bandage covered with a tegaderm dressing. 
-Staples/sutures are to be removed in 2 weeks after your surgery. 

Diet:
-Resume your usual pre-op diet, as tolerated.
-Narcotic pain medication and a change in your routine may cause constipation. Drink plenty of fluids and increase your daily fiber intake. Stool softeners or mild laxatives may be used and are available over the counter. If you have questions or concerns, please call the Neurosurgery office at the numbers below.

Activity:
-You are encouraged to walk several times a day. Start slowly and gradually increase your distance. This will improve your breathing status and circulation after surgery.
-You may tire easily, so frequent rest periods may be necessary.
-Avoid loud music, TV, smartphones, tablets, or other media screens.
-No heavy lifting (nothing greater than 5lbs or a gallon of milk) or other strenuous exercise (running, jumping, shoveling, mowing, climbing up ladders,etc).
- Your surgeon will inform you at your follow-up appointment when you may resume your full activities.

Following Head Trauma:
-You may have difficulty remembering things. If so, write them down. 
-You may experience headaches, nausea/vomiting or dizziness. Take your medications as directed and taper the medication as your symptoms improve.
-These symptoms may last for several weeks to several months.
-Do Not drink alcohol until cleared by Neurosurgery.

Driving:
[ ] No driving while taking narcotic pain medications.
[ ] You may return to driving 2 weeks after surgery.
[ ] No driving until cleared by Neurosurgery.
[ ] You have had a seizure and driving is prohibited. (See state regulations). 

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