WHAT TO DO ON THE DAY OF DISCHARGE

• Be sure you have plans for removing your skin sutures or staples. If you live in the Tyler area, they will probably be removed at NeuroCare Network. If you live further away, you may prefer to have your family doctor or a nurse remove them. Of course, if there is any problem such as redness or drainage, you will want to be sure and let your surgeon's nurse know.
• You will be given prescriptions for post-op pain medications before you leave the hospital.
• The nurses will give you a sheet of post-operative activity instructions. (This is usually referred to as the "Do's and Don'ts" sheet.)

6-WEEK CHECK-UP

• You will need to have a post-op office visit four to six weeks after surgery. If you don't hear from us in a few days after you get home, please call and set this up.
• If you have had a fusion, you will need to go by the hospital and get an x-ray taken before your six-week check-up.

DISCHARGE INSTRUCTIONS AFTER NECK SURGERY

• Any time the skin is punctured, infection is a risk. If treated early, infection is easier to control; if not, it can be life threatening. Infection is rare, but it can happen. By being aware of the signs of infection, you can take action quickly if it should happen to you. If in doubt, call your doctor's nurse. Mention to the switchboard operator that you have recently had surgery and your call will be handled immediately.

BE ALERT FOR THE SIGNS OF INFECTION

• Fever - even one degree.
  
• Increased pain at the incision site.
  
• Drainage that is pus-like in nature.
  
• Redness and swelling at the incision.
  
• Heat at the incision.
  
• Unpleasant odor at the incision.

Other symptoms to report immediately:
If you experience clear, watery fluid draining from your wound, or develop a headache when you are upright, you may have a spinal fluid leak. You should notify your doctor's nurse or the doctor on call right away.

TO MAXIMIZE RECOVERY:

• Watch the video "The First Six Weeks."
• Naturally, your incision area will be sore; however, if you have any drainage, pain, redness, swelling, or fever, please call the office immediately.
• Do not become alarmed if you experience the same type of pain that you had before your surgery, or even some new weakness or numbness. This usually only lasts a short time. The healing process takes time.
• You will tire easily after surgery. Plan rest periods for yourself, but start a walking program as soon as your pain allows you to do so. Have someone walk with you at first. Start slowly and increase your distance daily a little bit at a time. Wear sensible shoes and select a flat area on which to walk.
• DO NOT lift or bend unnecessarily prior to your post-op check-up. Use good body mechanics AT ALL TIMES. If you are unsure of the use of good body mechanics, discuss this with your nurse, or a physical therapist can instruct you properly. Do not bend your spine. The only exercise you should attempt is walking until you receive other instructions from your doctor. Change sitting positions frequently. Keep in mind that you must not lift more than 10 lbs. for at least 6 weeks.
• Sitting in a low chair or sofa is usually uncomfortable. Avoid unnecessary sitting, such as sitting in a car. You may not drive until you are released by the doctor to do so (usually 6 weeks). Avoid the use of a recliner; use a straight-backed chair to sit. Sleep on a firm mattress.
• Use your pain medications carefully. Many patients have been on a lot of narcotics prior to their surgery. Use pain medications only as your doctor recommends in order to avoid problems such as increased tolerance to the medication.
• Let your pain determine your activity level. If something causes increased pain, avoid that activity.
• Since you will be less active than normal, it is important to have good dietary habits. Excess weight is harmful to your back, and good nutrition promotes healing. If you are a smoker, this is an excellent time to quit. The effects of cigarette smoking (and tobacco use in general) and failed fusions are well documented. If you need assistance with stopping smoking, please discuss it with your doctor or nurse.
• You may take a shower and at that time gently wash the incision site with soap and water only. It is probably better not to take a bath, but if the only option is a bath, make it quick as the incision should not be soaked in water for prolonged periods. If for some reason you feel the site needs to be cleaned in addition to the shower, cleanse briefly with hydrogen peroxide and sterile water on a gauze pad. DO NOT PUT OILS OR OINTMENTS ON THE INCISION.
• If you have had a fusion and the graft was taken from your hip you will probably experience pain from this area, which is normal. Be sure to walk regularly as bed rest lengthens your recovery time.

HOW TO AVOID SURGERY IN THE FUTURE

• Discontinue smoking or other tobacco usage.
• Don't overdo. The absence of pain does not mean healing is complete.
• Do not take pain medications in order to do more than you should.
• Begin exercising slowly. Increase as tolerated. Avoid getting competitive with your exercise--listen to your body.
• Tune in to physical sensations and listen for messages of "overload."
• Form a partnership with your physical therapist and discuss feelings openly.
• Keep muscles of the spine strong - for the rest of your life.
• Use proper back mechanics - for the rest of your life.
• Treat osteoporosis vigorously.