Discharge after Day Case Biopsy

Introduction

This booklet provides information and answers to questions often posed by patients following a brain tumour biopsy

Going home can feel a bit overwhelming. You and your family may have additional questions, once you have got home or may want more detailed answers. If this is the case you can contact the Clinical Nurse Specialist (CNS) Team on : 0151 556 3778 or 0151 556 3449 if you are a skull base tumour patient.

 

Going Home - The next steps

Often, when you are going home the results of your biopsy confirming the tumour type will not be available, but once received you will be contacted by your Consultant’s secretary to come to clinic to discuss the results, and what the next steps will be. They will contact you via telephone.

This can be a difficult time and if you need to talk about this the nurse specialist team and the support worker are here to help and support you.

 

Common symptoms post surgery

• Some patients recover very quickly following surgery, and others take longer.
• No two people will feel the same. Some of the most common symptoms are listed below:
• Tenderness & numbness around the wound area
• Mild headaches that should resolve with regular taking of simple pain relief like paracetamol
• Swelling/Bruising that should resolve in the days/weeks ahead. This can also be seen around the eyes and face which can appear alarming but is not cause for concern.
• Noises or whooshing sensations - During recovery you may notice some unusual sensations in your head as things are settling down. These are often described as “crackles, pops, whooshes or drips”. If you have had surgery near your ear, you my experience a dull earache.
• Tiredness & Fatigue
  This is probably the most common following surgery and regaining good energy levels can take up to 6-8 weeks.
  Allow yourself time to recover and don’t expect too much too soon.

All of these symptoms should settle over time

Red Flag Symptoms

These are the things we want you to watch out for when you get home , as they may need urgent medical attention.

• Your wound becoming red or sore or leaking any kind of fluid or pus. If it is leaking clear fluid or pus you will need to attend the Walton Centre or your local A&E so that we can assess it more thoroughly.
• A soft fluid like swelling behind or close to the scar may develop. This is a collection of brain fluid accumulating under the skin and is called a pseudo meningocele. This usually settles down on its own but please contact us for advice. We may ask you to send us a photograph for us to assess it.
• Nausea or Vomiting
• Worsening or severe headache
• Increase in number or change in seizures
• Increased drowsiness, or confusion

 

If you experience any of these symptoms overnight after being discharged then contact the SMART team via bleep on the switchboard  0151 529 3611.

 

When will the stitches/sutures/clips be taken out?

This usually happens 7-10 days after surgery.

If you are fit and well you will most likely be asked to attend your local treatment rooms or GP practice depending on your local area. Sometimes we will ask for the District Nurses to attend to you at home , but this is normally only if you have mobility or other health issues.

The ward will clarify the arrangements and dates with you before you are discharged.

Do I need to continue taking my steroids after I go home?

YES, it is important that you keep taking the prescribed dose of Dexamethasone, and you will be given specific instructions to either:

Reduce the dose over a set time until you are no longer taking any steroids or

Reduce to a specified dose until your clinic appointment.

Ensure you continue to take your stomach protection tablets whilst taking steroids.  If you are running low on either of these a repeat prescription can be obtained from your GP. You can take a copy of your TTO Prescription slip that is given to you with your medications on discharge to the practice so that they are aware of the medicines you are taking.

Do I need to keep taking my anti-seizure medication after my operation?

YES, It is very important that you continue to take this even if you haven’t experienced any further seizures. Some patients require long term anti-seizure medication, others for just a few months following surgery. This should only be stopped on advice from the medical team and should be continued unless advised differently from your consultant.

When can I wash my hair  following surgery?

You need to wait a minimum of 48hours, but once this has passed you can wash your hair and we would recommend you continue to use Hibiscrub which was given at Pre op until stitches/sutures are removed. Be careful not to rub around the wound area, if water runs on the wound this is fine, and can be just patted dry with a clean towel. If there has been leakage from the wound or a previous surgery you may be advised to wait a little longer. In some cases if dissolvable sutures/stitches are used you may be advised not to wash your hair for 5-7 days.

Useful Contacts

Appointments :

For follow up with your consultant please ring the secretary

Mr Brodbelt/Chavredakis 0151 556 3345

Mr Lawson/Jenkinson 0151 556 3346

Mr Zakaria 0151 556 3336

Mr Olubajo 0151 556 3337

Mr Farah 0151 556 3351

Miss Gilkes 0151 556 3347

Mr Yousaf 0151 556 3350

For Scan appointments call Radiology on  0151 556 3681

 

Who can I turn to for help and Support

Clinical Nurse Specialist Teams at Walton

Neuro-Oncology 0151 556 3778 or bleep via switch 0151 529 3611 bleep 5391

E-mail: Wcft.neurooncologynurses@nhs.net

Skull Base  0151 556 3449 or bleep via switch 0151 529 3611 bleep 5342

E-mail: Wcft.skullbasenurses@nhs.net