CRANIOTOMY 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 Coughlan 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 fol owing your
• 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 pil ows.
• 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
• NO driving until Dr Coughlan 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
• If you develop a fine, itchy rash – it may be your body reacting against the dilantin…. you must visit
your GP or contact Dr Coughlan.
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. • Antiswel ing: (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 gradual y tapered (lowering of dose) over time. Your doctors wil 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 al patients before, during and after a brain operation in order to help reduce the risk of seizure. There stil
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: a. Signs of infection (pus or discharge of any type) b. Fever or Chills c. Any new deficits, (i.e. Weakness, vision changes, speech or swal owing changes) d. Report al changes (i.e. Seizures, drowsiness, confusion, weakness, and vision changes) e. 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 Coughlan. 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.
R e v i e w s / C o m m e n t a r i e s / A D A S t a t e m e n t s W O R K G R O U P Recommendations for Management of Diabetes During Ramadan ONIRA AL-AROUJ, MD OUSSAMA KHATIB, MD, PHD ADHIA BOUGUERRA, MD SUHAIL KISHAWI, MD OHN BUSE, MD, PHD BDULRAZZAQ AL-MADANI, MD HERIF HAFEZ, MD, FACP LY A. MISHAL, MD, FACP OHAMED HASSANEIN, FRCP ASOUD AL-MASKARI, MD, P
Deutsche Ärzte helfen in Togo Sieben Ärzte opfern Urlaub für schwierigen Einsatz – erster Bericht eines Teilnehmers veröffentlicht Kaufbeuren/Lome. Elf Tage waren sie im Einsatz für Menschen in Not. Menschen, deren Leben täglich existenziell bedroht ist von Hunger, Krankheiten und anderen Konsequenzen widriger Umstände. Sechs Ärzte aus allen Teilen Deutschland und eine Schweizer Koll