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Care after spinal surgery

No surgical recovery is pain-free. Nevertheless. Once you go home, you will gradually increase your level of daily activities. For example, increasing the amount and distance of walking you do every day will decrease pain and improve your appetite.

For at least 6 months, do not fully bend over or twist your back, and do not take part in activities such as gymnastics, contact sports (football, basketball, and hockey), skiing, or bicycle riding. Your surgeon will tell you when it’s safe to resume these activities. He will also tell you when you can start swimming.

Don’t worry if you feel tired during the first few weeks after the surgery. Remember, it takes time to fully recover from major surgery.

You will have Steri-Strips on your back covering your spinal incision (wound). The Steri-Strips will eventually fall off on their own, or you can gently remove them 10 to 14 days after the surgery. Ask your doctor or nurse about your stitches before you go home. Most stitches are self absorbing and do not have to be removed. Sometimes, staples are used instead of stitches. The staples can be removed 10 to 14 days after the surgery. Your family doctor can do this.

It’s important to monitor your wound for signs of infection, which include swelling, tenderness, redness, the incision separating or increased, or the appearance of foul smelling fluid or pus. If any of these occur, it’s important to notify your surgeon’s office.

You may start to take showers 4 or 5 days after the surgery. Don’t worry if the Steri-Strips get wet. You may want to use soap on a rope so you will not be tempted to bend over to pick up the soap. We recommend that you do not bend down to sit in a bathtub. Your doctor will tell you when it’s OK to take a tub bath. You may not eat well for a week or two after the surgery. Small meals and snacks every 2 to 3 hours will help you maintain a well balanced diet. You should eat foods from each food group every day. These groups are milk and dairy products, vegetables and fruits, meats, fish and poultry, and breads and cereals.

You may be constipated because of the pain medication and lack of physical activity. However, eating a high fibre diet (one containing whole grain breads and cereals, fresh fruit, raw vegetables, etc.) and drinking plenty of water and juices will help prevent constipation.

Reference:

http://www.aboutkidshealth.ca/En/HealthAZ/TestsAndTreatments/HomeHealthCare/Pages/Spinal-surgery-caring-for-yourself-at-home.aspx

By |Wednesday, August 2, 2017|News|0 Comments

What’s the difference between sciatica and a herniated disc?

Sciatica is pain originating in the sciatic nerve, which runs from the lower back down the back of your legs. Symptoms of sciatica include burning in the leg, pain in the back of the leg when sitting, leg weakness, shooting pain, and more. Most often, this condition is sciatica. But sometimes, it’s a herniated disc from a trauma, such as an auto accident. Disc herniations and sciatica are different things.

The sciatic nerve is a large nerve about the size of your pinky finger. It is formed by 5 nerve roots (typically): L4, L5, S1, S2, S3. These five nerve roots exit the spinal cord and outside the spinal cord come together to form this large nerve which runs down the leg to the foot. Whenever the sciatic nerve is irritated there is some characteristic pain and characteristic areas where the pain is in the leg.

However, when there is nerve pressure closer to the spinal cord caused by a damaged or herniated disc, the symptom pattern and physical examination is different. These two are not always easy to differentiate on the initial visit. They differentiate after a few visits, and sometimes advanced imaging is needed to locate the exact lesion or disc involved. MRI is the method of choice because it allows us to see all the bones, ligaments, nerves, and discs. Both the hard and soft tissue. Very key in getting an accurate diagnosis.

What difference does it make if it’s sciatica or a herniated disc?

First off, sciatica, for the most part, is very curable and with proper treatment, patients return to normal in fairly short order. However, herniated discs are often a permanent condition which can affect every area of your life. Undiagnosed, a herniated disc can become much worse and be debilitating. Once a patient understands the difference between the two, often, a large weight of worry and stress is relieved.

Reference:

What’s the difference between sciatica and a herniated disc?

By |Sunday, July 30, 2017|Blog, News|0 Comments

Brain surgery for seizures

Your doctor may recommend brain surgery to treat epilepsy if you have seizures that medications can’t control. You must have tried two or more medications without success to qualify. Brain surgery for epilepsy has a high success rate. It may significantly improve your quality of life.

Numerous types of surgery are available to treat it including:

  • resective surgery
  • multiple subpial transection
  • hemispherectomy
  • corpus callosotomy

Your doctor can help you understand the potential benefits and risks of surgical options.

Resective Surgery

Resective surgery is the most common type of surgery for treating epilepsy. If you have epilepsy, your doctor can use MRI to learn where seizures occur in your brain. Using resective surgery, they can surgically remove the part of your brain where seizures happen. They’ll likely remove an area roughly the size of a golf ball. They may also remove a brain lesion, a brain lobe, or a portion of a brain lobe.

The most common type of resective surgery is a temporal lobectomy. It’s the most successful form of surgery for epilepsy. It may reduce the number of seizures you have while limiting your risk of permanent brain damage.

Multiple subpial transection

A multiple subpial transection is a rare procedure. Surgeons only perform this surgery on people who have severe and frequent seizures. It involves cutting parts of your brain to prevent the spread of seizures. It may be more effective than resective surgery if your seizures don’t always start in the same part of your brain.

Hemispherectomy

In this procedure, a surgeon removes the outer layer of one entire side of your brain. It’s used when an entire side of your brain is damaged from seizures. The most common candidates for this type of surgery are younger children, babies born with brain damage, and older children with severe seizures.

The earlier in life you have this surgery, the better your long-term outcome will be.

Corpus callosotomy

Corpus callosotomy is different from other types of brain surgery for epilepsy because it can’t stop your seizures. Instead, its purpose is to decrease the severity of your seizures. By cutting the nerve fibers between the two sides of your brain, your surgeon can help stop seizures from spreading from one hemisphere to the other. By stopping the spread of seizures throughout your brain, they can help make your seizures less severe.

Corpus callosotomy is most often used in children who’ve bad seizures that start in one half of their brain and spread to the other.

Risks of brain surgery

Brain surgery offers potential benefits that may improve your quality of life, but it also involves serious risks. The risks may include:

  • infection
  • stroke
  • paralysis
  • speech problems
  • loss of vision
  • loss of motor skills
  • more seizures

What to expect after surgery

  • a hospital stay lasting three to four days after surgery
  • severe pain for a few days after surgery
  • moderate pain and swelling for several weeks
  • time off school or work for up to three months

You may need to continue taking antiseizure medications for at least a couple of years after your surgery.

Despite the lengthy recovery time, brain surgery can be worth it for people with epilepsy. Talk to your doctor if you think you might be a good candidate. They can help you understand the potential benefits and risks of surgery, as well as your long-term outlook.

Reference:

http://www.healthline.com/health/types-epilepsy-brain-surgery#outlook7

By |Sunday, June 18, 2017|News|0 Comments

Post scoliosis surgery care

These are general guidelines for recovery from scoliosis surgery.

At the Hospital: Immediately Following Scoliosis Surgery

Pain Management — Just after scoliosis surgery, most patients are given PCA (patient-controlled analgesia). PCA is a pump that delivers morphine or other narcotic at the press of a button by the patient. This controls pain very well for the first two to three days after surgery. Thereafter, PCA is stopped and oral pain medication is administered. At hospital discharge, a prescription for pain medication is provided. Adults may require medication at diminishing doses for weeks or months. Children are usually off medication within two weeks.

Drains — A drain prevents fluid accumulation at the incision site and is routine. Most patients have a drain in their back or side for two to three days after surgery. Drains in the side of the chest are termed ‘chest tubes’ and prevent air and fluid from accumulating around the lungs. Drains are removed when fluid drainage is small. Drain removal is not painful.

A urinary catheter (Foley) helps to keep the patient comfortable. It may be removed two or three days after surgery.

Walking — Physical therapists and nurses help the patient out of bed on the first or second day after surgery. Walking is guided by the physical therapist and is increased daily as tolerated.

Some patients may need a walker or cane early during recovery to help with balance and prevent a fall. keep their balance. Most children do not need walking aids at home.

Eating — Most patients will not begin to eat for two to three days after surgery. This is because the bowels slow down after surgery and patients have difficulty keeping food down.

Patients start on a diet slowly, first with sips of clear liquids, and move on to solid foods and a regular diet. Once home, it is important to eat well; small frequent meals are best to maintain body weight.
Hospital Discharge
Before release from the hospital, patients must:

  • Be eating a regular diet
  • Urinating normally
  • Walking, including up and down stairs
  • Have no fevers
  • Have minimal drainage at the incision site(s)

Some patients, especially adults, may benefit from a one- to three-week stay at an in-patient rehabilitation facility to improve walking and overall function.

At Home: Scoliosis Surgery Recovery
Helpful aids include an adjustable bed, shower chair, elevated toilet seat, and extended grasper are for  use at home after surgery.

Incision care — Patients may begin to shower one-week after surgery. Before showering, tape plastic wrap to cover the incision. Remove the tape and plastic wrap after each shower. This should be done for showers taken during the first week at home. Thereafter, shower without the plastic wrap covering the incision. For safety, it is important to be accompanied in the shower for the first two to three weeks.

If there is a dressing on the incision, change it once a day until there is no staining of the sterile gauze. Thereafter, a dressing is not needed.

Steri-Strips are usually placed across the incision(s) and will fall off on their own. Do not remove the Steri-Strips unless instructed to do so or if they are dangling.

Respiratory Function — Lung (pulmonary) function may slightly decline after scoliosis surgery. To improve breathing function steadily with time, it is helpful to perform respiratory exercises every one to two hours for the first three weeks after surgery. Respiratory exercises include deep breathing using the incentive spirometer provided at the hospital and frequent coughing. Lung function is routinely checked during regular office visits.

Activity Level — Patients are encouraged to walk. However, bending, lifting, and twisting are usually prohibited for several months or until the surgeon approves. Sports are not allowed for at least three months after surgery.

When activities are resumed, it is recommended to return gradually. Conditioning exercises such as swimming, bicycling, treadmill, or jogging are a good way to start.

After full healing, most patients will not have activity restrictions. However, certain sports activities such as gymnastics may not be practical. Activities that may be prohibited will be discussed by your surgeon and are dependent on the extent of your spinal fusion. Most patients do not feel restricted.

Medication — Usually, nonsteroidal medications, such as aspirin, Motrin, and ibuprofen are prohibited. Tylenol can be taken. Birth control pills are stopped prior to surgery as these may increase the risk of blood clot formation during the postoperative period in women.

Smoking — Smoking impairs bone from healing and hinders fusion. Patients must be committed to stop smoking two months before surgery and for a minimum of six months after surgery. Of course, it would be better just to give up the habit for a lifetime.

Transportation — Avoid frequent car rides and mass transit for six weeks after surgery. Patients can go home from the hospital by car with a pillow behind their back and seatbelt in use.

Reference:

https://www.spineuniverse.com/conditions/scoliosis/recovery-scoliosis-surgery

By |Tuesday, June 13, 2017|News|0 Comments

Seizure due to brain tumor surgery

Like any other invasive procedure, brain surgery is closely associated with many side effects. However, the likelihood of side effects increases significantly when it comes to the surgery of the brain as it is the master of all body controls. The intensity and duration of the side effects varies in accordance with the reason for the operation and the area of brain on which the operation was carried out. In some uncommon cases, people have to re-learn some or all basic skills such as reading and writing.

The malignant and benign tumors of the brain can cause substantial tissue damage. Thorough removal of all affected tissue is important to prevent the tumor from spreading further or from reccurring. Although this does save the patient’s life, removing tissue leads to complications.

Infections– Infection constitutes an unwanted effect related to brain surgery. If bacteria gain access to the brain during the procedure, chances of brain infection are high. For example, infection due to Staphylococcus Aureus can lead to meningeal inflammation. As a small hole is made in the skull, the patient stands a fair chance of acquiring a skull infection. A proper antibiotic regime is started immediately to prevent such after effects.

Bleeding– There is a possibility of post-operative intracranial bleeding in cases in which surgical eradication of a malignant or benign tumor has been carried out. This bleeding is known as a hemorrhage and it causes an increase in pressure. This spike in pressure either within or on the brain as well as the surrounding structures has the potential to reach alarmingly high levels, leading to either unconsciousness or death.

Some symptoms that suggest intracerebral bleeding include: nausea, sudden headache, vomiting and loss of sensation leading to numbness. Weakness is another important symptom. One must call for a doctor’s help immediately on noticing these symptoms.

Seizure– Seizures are caused by unusual electrical activity within the brain. Post neurosurgery, seizures are quite common and may occur either immediately, after a few months or even many years after the day of operation. If the seizure does occur soon after the completion of surgery, it is regarded as a “provoked” seizure. Some seizures are classified as ‘unprovoked’ if they continue to occur for a long time after the surgery. Patients belonging to the latter category are diagnosed as epileptic.

Seizures occur because after the removal of damaged or infected tissue, the brain makes new but different connections with the nerves. Such abnormal connections lead to unprovoked seizures which range in frequency. The good news is that many such seizures are treatable via effective anti-convulsant drugs.

Stroke– A stroke is defined as an emergency medical situation in which the blood flow in the brain experiences a sudden interruption. Blocked vessels may be a cause of stroke, especially after brain tumor removal surgery.

By |Thursday, June 8, 2017|Blog, News|0 Comments