Neurosurgery Patient Visit

At Mount Sinai, we are committed to providing you, our patients, with the highest quality of care. When you come to the Department of Neurosurgery, you benefit from our medical excellence, provided in a carefully designed, patient-friendly environment. We look forward to taking great care of you and making your time with us as pleasant and comfortable as possible.

The Consultation

Most of our patients are referred by another doctor. Depending on your medical problem, this may be your primary care doctor, a neurologist, an ear, nose, and throat specialist, an eye doctor, or an endocrinologist.

The first step is a face-to-face meeting with your neurosurgeon to discuss your symptoms and treatment options.

To make the best use of your time with our neurosurgeon, please bring these items to the appointment:

Copies of your latest imaging (on film or a disc) and the report that goes along with it
Latest test results
Medical history
List of all medications you take regularly including prescriptions, over-the-counter medications, dietary supplements, and alternative/holistic medicines
List of your allergies
Contact information for any doctors we should communicate with (such as your primary care doctor, referring doctor, neurologist, or endocrinologist)
Your insurance card(s); we will get authorization from your insurance company
If you have acoustic neuroma, bring your hearing test results
If you have a pituitary tumor, bring the full panel of endocrine blood tests and visual field testing

Note: if you take more medications than you can remember you should always have a list of what you are currently taking on your person or in your wallet, along with emergency contact and doctor information.

Some things to discuss with your surgeon are:

Any dental problems you have
Whether your religious beliefs forbid blood transfusion
Any medications you are taking, so your doctor can tell you whether to take them the morning of the procedure
Whether you have ever had a problem with anesthesia, such as nausea
If you’ve had a bad reaction to opioid painkillers, such as codeine, Vicodin, Percocet, morphine, fentanyl, and Dilaudid
Where to go to check in on the day of the surgery

Next, if needed, we will schedule your surgery, which may be soon after this appointment. One of our nurses or physicians assistants will talk to you about what you can expect from surgery and answer any questions you may have. A surgical coordinator will work with your insurance company to get authorization approval before surgery.

Pre-testing

All of our patients require some level of medical clearance before surgery to ensure a safe procedure. We will explain exactly what type of testing you need. If you have heart or lung problems, you may need written clearance from your cardiologist or pulmonologist.

If you do your pre-testing at Mount Sinai, we can see the results immediately. If you go elsewhere, please have the testing completed within 30 days prior to surgery so that we have enough time to receive and review the results.

Preparing for Surgery

As the surgery day approaches, there are some things you should know:

If you develop a fever, cold, virus, sore throat, or other illness or injury, please call your surgeon’s office so we can determine whether we should delay the procedure.
There should be no need for you or a family member to donate blood before your surgery. If you do need a transfusion, please know that we test all blood products for a number of diseases including HIV.
You don’t need to follow a special diet for your neurosurgical procedure. A healthy, well-balanced diet should be sufficient.
Most patients must stop taking Coumadin and NSAIDs (such as ibuprofen, naprosyn, and aspirin) 7 to 10 days before the surgery. Your surgeon may ask you to stop taking other medications as well.
Do not eat or drink after midnight the night before your surgery. If your surgeon has instructed you to take any medications in the morning, you may take them with a very small sip of water. If you eat or drink anything else, we will have to postpone the surgery.
You’ll need to make sure you have a way to get home after discharge from the hospital. You can ask a family member or friend to escort and assist you, or arrange for a car service or ambulette. Please note that most insurance plans do not cover transportation.
You may require inpatient rehabilitation following surgery. Our hospital social work team coordinates sub-acute and acute rehabilitation and we arrange it together with your patient and family.

We provide hospital gowns and toiletries, but you may want to pack items that will help you feel comfortable in your hospital room. In addition, please bring:

Insurance card/information
Dentures and eyeglasses (not contact lenses)
List of medications and dosage information
Small amount of cash for newspapers or other items
List of allergies
Your credit card number (you don’t need the card)
Medications the hospital cannot provide (we will label it for in-hospital use)
Emergency contact number, preferably a cell phone number
Completed Health Care Proxy form, if you have one
Contact numbers for physicians, family, and friends

Your employer may require you to submit disability forms. We can process them after you give us signed permission to share your medical information. Your surgeon will estimate your recovery time and when you can expect to return to work. Keep in mind that these estimates may change, depending on your individual circumstances. Additionally, it can take up to a week to process disability forms, so please submit all disability forms as soon as possible.

Your Hospital Stay

Your doctor will tell you where to go to check in on the morning of your procedure. Please pick one person to be your contact so that the hospital staff can call that person when you are out of surgery. We cannot tell multiple people over the telephone because of the privacy rules of the ederal Health Insurance Portability and Accountability Act.

Your neurosurgeon will perform the operation with assistance from supervised residents and physician assistants. When the procedure is completed, you will recuperate in a recovery room before you move to your hospital bed. Once you are in your hospital bed, our staff will let your family know when they can see you.

After the procedure, you will be very tired, you might feel nauseated from the anesthesia, and you could have some pain, especially headaches and at the incision site. We will monitor your pain and give you medication if you need it. If you know that one medicine works well for you, let us know. Your hospital stay will depend on your condition.

If you have a private room, you can have a family member spend the night with you. We will provide a cot if we have one available. We cannot permit family members to stay in the intensive care unit. A personal telephone and TV are generally available for an additional fee per day. Please ask a hospital staff member to help arrange these services. We have free Wi-Fi service in most areas of our hospitals.

If your family or visitors have any questions, please do not hesitate to contact your neurosurgeon’s office.

Before we discharge you from the hospital, a physical therapist will evaluate you to see if you will need a visiting nurse or physical therapist. If you do, the visiting nurse will determine what services and equipment you need. Unfortunately, not all insurance plans cover these services, but our social worker can help you make arrangements to get the care you need.

After Discharge

Once you are at home, we encourage you start walking as soon as you can. It’s not a good idea to stay in bed for long periods of time. Usually you should avoid heavy lifting. Your surgeon will give you specific instructions.

You will meet with your surgeon for a post-operative visit. Some patients see their surgeons regularly after the procedure while others don’t go back for six months; it depends on your individual diagnosis and situation. At your post-operative visit, your surgeon will also tell you whether you can drive.

Please don’t hesitate to call your surgeon if you have a fever, redness, or discharge from the wound, increased tenderness, or wound separation. You should also call with any new symptoms that concern you, or any questions that you might have.