Download Discharge Instructions

Acoustic Neuroma Center
Discharge Instructions
Barrow Neurosurgical Associates (602) 406-3181 (Drs. Porter, & Spetzler)
Arizona Otologic Associates (602) 279-5444 (Drs. Daspit & Weisskopf)
Arizona Ear Center (602) 307-9919 (Dr. Syms)
Recovery
Although specific instructions will be provided to you at the time of hospital discharge this document is
intended to give you general guidelines and prepare you for recovery.
Follow-up with your physicians
An appointment should be scheduled with the neurosurgeon or neurotologist ten to fourteen days after the
surgery to remove sutures, evaluate the surgical site and assess your recovery. Before the appointment,
write down any questions you may have to ensure that all of your concerns are addressed. Special
accommodations can be made for patients traveling from out of state. Write down any instructions that
your physician gives you such as the need for an annual check-up, future x-rays, or other time-sensitive
tests.
Activity
Patients recover at various rates from neurosurgical procedures and are encouraged to honor their physical
and emotional limitations. Resume normal daily activities after six weeks with a few exceptions.
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Avoid direct firm pressure on the incision for at least 4 weeks and do not lift greater than 5 lbs for 4
weeks.
No swimming, diving, water sports, playing in lake or stream water for 3 months until cleared by
your surgeon.
Do not blow your nose until such a time as your physician has indicated that your ear is healed. Any
accumulated secretions in the nose may be drawn back into the throat and expectorated if desired.
This is particularly important if you develop a cold.
Do not "pop" your ears by holding your nose and blowing air through the eustachian tube into the ear.
If it is necessary to sneeze, do so with your mouth open.
Do not take any unnecessary chance of catching cold. Avoid undue exposure or fatigue. Should you
catch a cold, treat it in your usual way, reporting to us if you should develop ear symptoms.
Do not drive until you are able to quickly turn your head over your right and left should without
dizziness or difficulty. Air travel is permissible two days following surgery and is preferred to
automobile or train travel for trips of over 200 miles. When changing altitude you should remain
awake, and chew gum to stimulate swallowing.
Ask your surgeon for additional specific limitations any activities involving great physical exertion.
Exercise gradually with activities such as walking rather than aggressive gym activities.
Driving is not recommended until the patient has complete awareness of their surroundings and has total
control over their motor skills. Showering is appropriate upon release by the surgical team.
Maggie Varland RN, BSB
Neuroscience Program Coordinator
Barrow Acoustic Neuroma Center
Revised 2/2007
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Medication
Prescriptions for pain control and other medications are provided at discharge. You may not feel that it is
necessary to have these prescriptions filled right away, but it is important that your medications be
available if the need arises. Discuss the possible interactions between various medications that you are
taking with your physicians. Avoid drinking alcohol, driving, and operating heavy machinery while
taking medication for pain.
Social Services
The hospital's case management department and social workers are available to help you identify needs
that you may have after discharge from the hospital. These needs may range from renting wheelchairs to
arranging home health care and outpatient therapies. Please ask to speak to one of these individuals before
the day of discharge. Remember to take all of your belongings with you and to tell your friends and
family that you have been discharged from the hospital.
Infection
Report signs and symptoms of infection to the surgeon immediately if any of the following occur: sudden
increase in swelling at the surgical site after the swelling had begun to subside, fever or chills, colored
drainage from incision, or a temp. >101 without other signs of illness. Pink skin is indicative of the
healing process where as reddened areas may be a sign of infection. Keep fingernails trimmed short to
decrease risk of incision irritation and infection from scratching as healing occurs.
Diet
Frequent small meals (4 – 6 per day) are suggested with a moderate amount of protein in each to assist in
healing process. Avoid straining hard for bowel movements for 3 months. Use stool softeners
immediately after surgery and include plenty of fluids and fiber in diet. Contact your primary care
physician to help manage constipation problems.
Wound care
 Avoid peroxide for incisions closed with absorbable sutures, as it will cause too rapid of
breakdown of suture. Clean with soap and running water.
 Keep incision free of dried blood, crusting or scabbing to decrease risk of infection and minimize
the scar.
 Begin daily hair washing with mild shampoo and conditioner (to ease the tangles) when cleared
by surgical team.
 Use caution when the combing hair. Vigorous rubbing can disrupt the sutures.
 If a nylon suture is used for the skin closure the surgeon will remove them during the postoperative visit to the clinic after hospital discharge (within ten to fourteen days following
surgery).
Normal Healing Process
You may anticipate a certain amount of pulsation, popping, clicking and other sounds in your ear, as well
as a feeling of fullness. Occasionally sharp shooting pains are not unusual. At times it may feel as if there
is liquid in the ear. Shooting pains in and around the ear are not uncommon. Pain above the ear when
chewing is also common. Unsteadiness is expected following inner ear surgery but should gradually
decrease during the first month.
Maggie Varland RN, BSB
Neuroscience Program Coordinator
Barrow Acoustic Neuroma Center
Revised 2/2007
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The following is a list of general symptoms, which are normal and may take months to disappear
completely:
 Lightheadedness
 Imbalance
 Fullness in the ear
 Headaches
 Facial weakness
 Ringing in your ear
 Dizziness
When to call your physician
Feelings of depression are temporary and common following any surgical procedure. Please contact your
physician if you have any lingering concerns about this. The following symptoms warrant a call to your
surgeon:
 Discharge from the incision after five days
 Persistent ear pain nor relieved by aspirin or Tylenol
 Symptoms of a CSF (cerebro-spinal fluid) leak including:
 Watery discharge from the nose, ear or incision, especially when bending over
 Salty taste in the back of your throat
 Symptoms of meningitis such as:
 Fever
 Stiff neck (extreme)
 Headache (extreme)
 Photophobia
 Incapacitating unsteadiness
 Signs of infection (noted above) are thought to be present
 Sutures come apart
 Confusion
 Nausea/vomiting
 If you have any questions
Patients with the Auditory Brainstem Implant (ABI):
 Unusual sensations not previously experienced in any part of your body
 New muscle twitching in any part of your body
Maggie Varland RN, BSB
Neuroscience Program Coordinator
Barrow Acoustic Neuroma Center
Revised 2/2007
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