So, You Need An Operation ...

Operating Room Picture

There are times when the fluid portion of the brain has increased to the extent that there is no more room in the skull to accommodate the extra fluid. The brain is being squeezed, there is increased pressure and symptoms are happening. Headaches, nausea, vomiting, confusion can progress to lethargy, even coma and death. The pressure needs to be relieved by a device called a shunt (What is a Shunt?) . If the symptoms are progressing slowly, you may have the surgery arranged from the doctor's office. In this case, you will be sent to the Hospital for preadmission tests. These usually include some screening blood work, possibly an EKG to check your heart and a chest x-ray. These tests will vary depending upon your medical condition. You can request to speak to the anesthesiologist (the physician putting you to sleep for the surgery) to answer any questions about that part of the surgery. At midnight, the night before your surgery, you should not eat or drink anything further until after your surgery the next day. In some cases, it may be ok to take your medications in the morning with a tiny sip of water. You should check with your surgeon ahead of time regarding this. When you arrive at the hospital, you will check in at the admissions office and then be taken to the surgery holding area. Your chart will be reviewed to be sure all the test results and information needed for your surgery are there. You will be taken from the surgery holding area to the operating room. Your family/friends may then go to the waiting area until your surgery is finished. If you had gone to the Emergency Room and needed surgery right away, you would be taken directly from the emergency room to the holding area or right to surgery. There you will go to sleep and next thing you will know is that you are waking up in the recovery room!

PACU-Post Anesthesia Care Unit

Recovery Room

When the patient's surgery is completed, he or she is taken to PACU until the patient is stable enough to go to a regular hospital room. If the patient is going to the Intensive Care Unit (ICU), many times the patient bypasses PACU and goes directly to the ICU. Here the post-operative orders are reviewed and begun.When you are stable after waking up from surgery, it is safe to transfer you to your hospital floor. Your family will be able to see you when you arrive in your room. In general, you will not feel like having many visitors and will mostly want to be left to rest. Family and friends should let you rest and visit only briefly.

Regular Hospital Room

Hospital Wing Entrance

The first day after surgery most people feel a little weak and worn out. If this is a shunt revision from a malfunctioning shunt, you may actually feel quite good. Otherwise, it takes a while to adjust to the new pressures in your brain. Each day afterwards, you usually feel better. Everyone is different and that is why there are different types of shunts and different settings. Sometimes your shunt may need adjusting for over drainage or under drainage. This may be done in the hospital before you are discharged home or in the office. Many shunts can now be programmed to different flow settings. A CT of the brain may be done to check if the fluid is draining too much or too little. By the 2nd post-operative day most people are going home. Fortunately, most shunt surgeries are not very painful. Usually, mild pain medications will control it.