This information is of a general nature only. Any specific information provided by Dr Jonker should be adhered to if it differs from the information below.
Once you and Dr Jonker have agreed that surgical treatment is appropriate and the best approach for your care, the required arrangements will be made by our office. You will be provided with information regarding –
When all these details have been confirmed, your surgery will be booked and preparations made. You will be contacted by the hospital directly the business day before your admission. They will provide specific details about your admission including your admission time and location, and any fasting requirements.
Most patients undergoing brain surgery require a preoperative CT or MRI (as directed by Dr Jonker) which is registered on a computer in the operating theatre that acts like a type of ‘GPS’ for navigating accurately within the brain. Patients having surgery in the intraoperative MRI do not require this scan before surgery as it is done when they are under their anaesthetic.
Sometimes small stickers called fiducials are applied to the scalp prior to this scan being done. If you require these please leave them in place until your surgery (do not wash your hair). If they fall off leave them off and alert the team on your arrival at hospital.
It is extremely important that you bring all of your other scans (CTs/MRIs) with you for your surgery. If you believe that Dr Jonker’s office has these scans please contact the office on 1300 17 44 97 and arrange to pick them up prior to surgery so you can bring them on the day.
Blood thinning medications require special attention when undergoing neurosurgery, and usually need to be withheld for a period of time preoperatively. The following medications require attention:
Depending on the reason you require this medication it may simply need to be stopped, or else it may need to be replaced with blood thinner injections during the period leading up to your surgery. An exact plan should be discussed with Dr Jonker at the time of booking your surgery. Please contact the office if you believe you are on one of the above medications and are unsure what to do.
Depending on which hospital you attend it may be necessary to undergo a review by the anaesthetist (Preadmission Clinic) prior to undergoing surgery. At this clinic the instructions will be given to you concerning which medications to take with a sip of water on the morning of surgery, what time to stop eating and drinking (unless otherwise stated, stop by 12 midnight on the evening prior to surgery), and what time to attend the hospital if being admitted on the day of surgery.
For uncomplicated surgeries a patient’s hospital stay may only need to be 1-2 nights. Depending on the complexity of the surgery and whether the patient has any other neurological problems or requires rehabilitation it can be significantly longer.
Most cranial (head) wounds are closed with dissolvable sutures or, less commonly, with staples. An adhesive dressing called Hypafix is applied. Traditional bulky head bandages are not generally used by Dr Jonker.
The adhesive dressing can be removed 48 hours following surgery, and no additional head dressings need be applied from this point. The wound is left open to the air.
The wound is kept strictly dry for the first 72 hours but patients can shower if they keep their head away from the water.
After 72 hours the head wound may be wet in the shower, and the hair can be washed. Baby shampoo is recommended for the first 2 weeks postoperatively because it is mild on the wound. Care should be taken to avoid putting stress onto the wound and overly vigorous lathering should be avoided. Likewise a clean towel can be used to dry the wound but should be patted onto the scalp and not rubbed near the wound.
For the first 2 weeks the head must not be immersed in water (no swimming, or soaking the wound in a bath)
If dissolvable sutures have been used, no further action is required. If staples have been used, they are generally removed after 7-8 days (10-12 days for redo surgery). These can be removed by your local doctor (GP) using a staple remover and this is not usually painful.
Patients undergoing cranial surgery usually find that the degree of postoperative pain is quite manageable, often with panadeine forte in the first few days and then panadol or panadeine alone after this.
When taking panadeine or stronger narcotic analgesia constipation can occur so it is advisable to also take a stool softener such as Coloxyl and Senna.
Heavy analgesia is usually not required, and severe headaches should prompt further evaluation.
Patients who have a neurological deficit (things like weakness in a limb or balance problems and incoordination) will usually be referred for rehabilitation in the postoperative period.
Patients without a neurological deficit generally do not require specific physiotherapy.
After your operation strenuous exercise should be avoided for 6 weeks. Walking is good exercise and regular walking each day is recommended during the recovery period.
Sexual activity should be avoided for the first 10 days postoperatively but can be safely resumed after this.
In general additional sleep will be required following surgery. However sleep may be interfered with by the use of dexamethasone, a medication often prescribed around the time of surgery in cases of brain tumour. We therefore try and wean you off this medication as quickly as possible.
After the first 1-2 weeks it may be best to limit daytime naps in order to try and resume a more normal sleep cycle (too much sleeping in the day can interfere with night time rest).
It is important for your safety and the safety of others that you DO NOT DRIVE until specifically cleared by Dr Jonker. When you are safe to resume driving will depend on whether you have a neurological deficit, a history of seizures, and what type of tumour you have. Dr Jonker follows the guidelines published Austroads.
The first postoperative appointment is usually at 4-6 weeks after surgery. Sometimes this appointment is held after only 1-2 weeks for the purpose of discussion of your pathology results. A CT scan or MRI will often be required, if you have not received a referral for this then please check with Dr Jonker’s secretary. Depending on your condition you may require other treatment which will be organised by Dr Jonker. In the case of malignant brain tumours common additional treatments include radiotherapy and chemotherapy.