YOUR SURGEON - DR. MULLAN                                        

Thank you for choosing Neurosurgical Associates, Ltd., for your surgery.  By now you should have scheduled your lumbar microdiskectomy.  Your upcoming surgery is the first step in regaining your health.  To help achieve a successful outcome, please take a few minutes to read these instructions before your surgery.  They will explain what to expect as you recover and what you need to do to help.  Bring these instructions with you to the hospital.  If someone will be helping you at home, please ask them to read this information too.

DISCHARGE

My name is Sharon Eriksen.  I am a certified neurosurgery Nurse Practitioner that works closely with Dr. Mullan.   I know that you will be eager to get home just as soon as possible after your surgery.  Before we discharge you, your vital signs (temperature, blood pressure, heart rate) must be normal, your pain should be controlled with pills rather than IV (intravenous) medications, and you must be drinking oral liquids without experiencing nausea or vomiting.  I will be checking your incision to make sure it is dry and closed.  The nurses will be making sure that you can empty your bladder and that you can walk.  If you can meet these criteria and you have a ride, you can be discharged.  I will be following you post-operatively in clinic.  We will talk physical therapy at your first visit.

REMEMBER YOUR CHECK-UP

Hi.  I am Nancy, Dr. Mullan's medical secretary.  I hope you will be feeling better soon.  When I scheduled your surgery, I also scheduled a four-week appointment following your surgery.  Your first appointment will be with Sharon Eriksen or one of our other neurosurgery nurse practitioners.   If you have any insurance or work forms for us to fill out, please bring them to your first appointment, or you may mail them directly to me at any time.  My direct phone number is 612-879-7148, if you have any questions.

MEDICATIONS TO TREAT PAIN

We will be sending you home with two medications or prescriptions to fill at your pharmacy to control your post surgical pain.  The first medication will be Toradol.  The prescribed dose is one 10 mg tablet every 6 hours for four doses only. Our second usual medication is Percocet.  The prescribed dose of Percocet is one to two tablets every 4 to 6 hours as needed.  On occasion, we may prescribe another medication other than listed above.  Please refer to the instructions on the bottles regarding how and when to take your medications.  You cannot drive or operate machinery while taking Percocet or other narcotic pain medications.  Common side effects of these drugs include drowsiness, nausea and constipation.  You should gradually take less of the Percocet as your pain decreases.   As your pain lessens, you can begin taking ibuprofen or Tylenol as needed.

MEDICATIONS TO TREAT INFLAMMATION

For most patients we prescribe dexamethasone 2 mg every 8 hours for three doses, then 1 mg every 8 hours for nine doses to help reduce the inflammation caused by your disk herniation and surgery.  Treating the inflammation should make you feel more comfortable.   Diabetic patients are not sent home with dexamethasone because it can elevate their blood sugar.

YOUR USUAL MEDICATIONS

Please resume taking your usual medications, except for blood thinners, as soon as you get home.  If you were taking a blood thinner, we will give you specific instructions about when to start the medication again.

CONSTIPATION

Constipation is normal after most surgeries and is very important to control.  Constipation is caused by immobility, pain and narcotic pain medication, such as Percocet.  To help your constipation, you should drink at least five glasses of water per day and eat lots of fruit and food high in fiber, such as cereals containing bran.  You should try to walk as much as possible and minimize the amount of Percocet you consume as your pain lessens.  You may also wish to take any of the usual remedies found at your local drug store or consult with your pharmacist.  For a severe or persistent problem, contact your primary care physician who may treat you with prescription medications or treatments.

RESTRICTIONS

It normally takes about 12 weeks for your incision and the wall of the ruptured disk to heal completely. During this time, you need to be careful with your activities.  You should infrequently lift no more than ten pounds.  You should avoid bending and twisting as much as possible.  Do not engage in impact sports, such as jogging.  Walking, standing, sitting and lying down are all fine.  Do not spend a lot of extra time lying down.  Movement is good in many ways.  Many
of our patients report walking a mile or more per day at the time of their four-week follow-up appointment.

CARE OF YOUR INCISION

Your incision will be sealed with surgical glue.  There will be layers of self-dissolving stitches holding together the deeper layers of skin.  You may take a short shower but do not take a tub bath or get into a pool until we have checked your incision.  Also, do not scrub your incision.  Look at the incision or have someone else look at it at least once per day.  If it becomes very red or swollen or begins to drain, please call us during office hours so we can speak to you about it or possibly see you in clinic.    Infections rarely occur, but if detected early can usually be treated with antibiotics.

PRESCRIPTION REFILLS

My name is Therese Doyle.  I am a certified neurosurgery Registered Nurse and work closely with Dr. Mullan and Sharon.  If you have any medical or medication questions during your recovery, I will be happy to help you.  On the day we discharge you, we prescribe enough medication to get most patients through their recovery.  If you do need a refill, please call me at 612-871-7278.  Prescriptions can be refilled by calling our office Monday through Friday from 9 a.m. to 5 p.m.  Your pharmacy requires a written prescription for Percocet and certain other narcotics.  Please plan ahead     because the approval process for narcotics can take as long as 24 (weekday) hours.   Prescriptions will not be refilled during evenings or weekends

IF YOU HAVE QUESTIONS OR PROBLEMS

From time to time, questions arise and we will be happy to assist you if you have any.  At the time of discharge, we will give you a Neurosurgical Associates Laminectomy Discharge Instruction sheet, which goes over these topics and others in more detail.  We have also given you a list of common patient questions and our answers.  If additional questions arise, please call during clinic business hours and ask for Therese or Sharon.  If they are not with other patients, they will talk with you right away.  Otherwise, they will call you back later that day.   Our phones are answered Monday through Friday, from 9 a.m. to 5 p.m.  Our phone number is 612-871-7278.  If you need urgent assistance after clinic hours or during the weekend, please call the clinic number and our answering service will page the neurosurgeon who is on call.  Our nurses are not available for paging after clinic hours.  For a life-threatening emergency, you should call 911 immediately.  Please remember, we do not fill prescriptions after clinic hours or during the weekend.

THANK YOU FOR CHOOSING NEUROSURGICAL ASSOCIATES, LTD.

My name is Bonnie Francisco.   I am the administrator for Neurosurgical Associates.  On behalf of Dr. Mullan and all the employees of Neurosurgical Associates, I would like to thank you for choosing us for your care.  If you have concerns or suggestions for improvements I want to hear from you.  Our goal is to provide you and all of our patients with the best neurosurgical care possible!