Your Surgery Guide
If your doctor has recommended surgery for a brain tumor, you’re probably wondering what to expect and what you'll need to do. Being prepared in advance can help ease your anxiety over the procedure and make things go more smoothly for you and your family.
In the Days Before Surgery
Ask About Medications
Find out if you need to stop taking certain medications and supplements. If you’re currently being prescribed anticoagulation or blood-thinning medication, such as aspirin, warfarin or heparin, your surgeon will probably instruct you to discontinue them 5 to 7 days before a scheduled procedure to prevent excessive bleeding. You may also need to stop taking some over-the-counter drugs or nutritional supplements, such as fish oil or multivitamins.
Donate Blood Ahead of Time
You may be able to donate blood for self-use in case you need it for your surgery, and you may also choose to ask friends or family to donate for you (known as "directed donor" blood). If you wish to donate blood for yourself, in general, it is better for these donations to be done more than one week in advance of surgery so your body can make more red blood cells. If it is a friend or family member, these donations should be made well in advance to the surgery—ask your doctor for more information.
You can call the Cedars-Sinai Blood Bank at 310-423-4170 to set up an appointment for donation.
On the Night Before/Day of Surgery
Avoid Food and Drink
Your doctor will direct you not to eat or drink anything after midnight on the night before surgery. So eat something at 11 pm the night before surgery—you deserve it. Having an empty stomach will prevent you from aspirating anything (sending food into your lungs) when you're under anesthesia. You can have a sip of water in the morning, especially if we asked you take certain medications, but if you have half a glass of water, you may not be able to have surgery.
Take Your Medication
If you’ve been told to continue any medication at home before you go to the hospital, take it with just a sip of water.
Pack for the Hospital
You should bring:
- A list of medications you’re taking, including dosage and frequency. Don’t bring the medications—the hospital will supply them.
- Glasses, hearing aids, your mouth guard or dentures, a robe, slippers and anything else you’ll need to be comfortable during your hospital stay.
- Telephone number(s) of family or friends who can be contacted in an emergency.
- A copy of your advance healthcare directives (legal paperwork that states your wishes about care decisions if you can't speak for yourself).
Please leave valuable items, such as jewelry, credit cards, wallets or watches, at home. If you bring valuables with you, you’ll be asked to deposit them in our vault. You can reclaim them when you leave.
At the Hospital
Get Started in Pre-Surgery
After being admitted to the hospital, you’ll meet with doctors and nurses in the pre-op area. They’ll ask questions about your medical history and answer any questions you may have about your procedure and hospital stay. The anesthesiologist will also meet with you to explain what type of anesthesia you will have and how it will affect you.
A nurse will then start an intravenous (IV) fluid drip. This IV will continuously provide water and nutrients to your system to keep you hydrated. It also allows the team to administer different medications through one source, rather than giving you a separate injection each time a new medicine is needed.
During Your Surgery
Once the IV is in place, you'll be taken to the operating suite, where you'll be moved to the operating table and given anesthesia. After you go to sleep, a tube will be inserted through your mouth into your windpipe to help you breathe more easily.
You may also have a catheter inserted into your urethra (the duct that leads to the bladder) to allow urine to flow into a collection bag while you sleep. The catheter may remain in place after the surgery until you can move around and use the bathroom on your own.
Depending on the kind of procedure you’re having, your head may be positioned in a device which holds it steady. Once you're in position, you won't be moved again until after surgery.
In the Recovery Room
Immediately after the surgery, you'll be taken to the recovery room, where your vital functions will be monitored. Typically, your anesthesiologist and neurosurgeon will be there when you wake up. When you're well enough, family members will be allowed to visit for short periods of time.
In the Neurosurgical Intensive Care Unit
Next, if it is safer for you, you may be moved to the Neurosurgical Intensive Care Unit (ICU), where a team of doctors, nurses and support staff will take care of you. Many neurosurgical patients go to a special neurosurgical stepdown area which is not quite the ICU.
The ICU team includes an intensivist (a doctor who specializes in critical care), critical-care nurses, and residents or fellows (doctors who are receiving advanced training in neurosurgical care).
In the Inpatient Nursing Unit
In most cases, you’ll stay in the hospital for 2 to 3 days after neurosurgery. Your care team will keep you updated on your expected departure date.
This team includes:
- Case managers, who are nurses assigned to oversee your transition from intensive care through your recovery and discharge
- Physical and occupational therapists, to help strengthen your muscles, regain balance, and improve physical and everyday functioning
- Psychologists, to help you cope with the emotional and physical changes you may experience
- Registered nurses (RNs), to help with overall care during your stay
- Social workers, to help you and your family adapt to changes in your home and social life, career and financial circumstances
- Speech therapists, to help regain your cognitive, communication and swallowing skills, if needed
In most cases, you’ll stay in the hospital for 3 to 7 days after neurosurgery. Your care team will keep you updated on your expected departure date.
On Your Discharge Day
Get Ready to Go
Typically, you’ll be sent home from the hospital in the morning. The day you leave, your doctor, a resident or physician assistant will see you. This is the time to ask any questions about what to expect over the next several days, and get advice on home care. You’ll be given a detailed written plan that includes:
- Caring for your wound
- Recommended and prohibited activities
- Medication and dosage information
- Diet information
- What to do if you have a problem
The hospital doesn’t provide transportation. Here are some suggestions for getting home:
- Arrange for a friend or family member to drive you.
- Medical vans may be available through community agencies, and are generally less expensive than a taxi. Payment is required at time of service.
- Taxis are available, or you can take a car service such as Lyft or Uber, if you can be transported in a sitting position and don’t have mobility issues.
If you have a concern about getting home, contact a Cedars-Sinai Department of Neurosurgery social worker at 310-423-7900.
Transfer to Inpatient Rehab If Needed
If you’ve recovered to the point that you don’t need to stay in the hospital, but you aren’t capable of living unassisted just yet, you may be transferred to an inpatient rehabilitation facility for intensive physical and occupational therapy. The facility may feel similar to the hospital in terms of care but will typically offer a variety of services to help in your recovery. Because of this, patients often experience more rapid progress in an inpatient setting than they would at home.