What is Neurovascular Pre-Surgical Testing?
Neurovascular diseases are prevalent in the general population, and the neurohospitalist has an important role to play in the preoperative planning for patients with and at risk for developing neurological disease. The neurohospitalist can provide patients and their families as well as anesthesiologists, surgeons, hospitalists, and other providers guidance in particular to the patient’s neurological disease and those he or she is at risk for. Here we present considerations and guidance for the neurohospitalist providing preoperative consultation for the neurological patient with or at risk of disturbances of consciousness, cerebrovascular and carotid disease, epilepsy, neuromuscular disease, and Parkinson disease.
Neurohospitalists play an important role in the pr-operative assessment of both patients with and those at risk for the development of neurological disease to help ensure best patient outcomes.
What You Need to Know Before Surgery
If your procedure is surgical, below are tips on how to prepare and what to expect before and after surgery.
You will need a history and physical examination within two weeks of your scheduled surgery. If you are required by your insurance company to go to your primary care physician, please schedule your own appointment and ask your doctor to fax results to our office as soon as possible. Regardless of insurance, all patients will need an appointment at the Preoperative Center in the Johns Hopkins Outpatient Center . The neurosurgeon's office will schedule your appointment for the following:
- Review of outside history and physical, if applicable
- Instructions on eating, drinking, and taking necessary medications before surgery
- A nurse or doctor will discuss anesthesia and what will happen before surgery which could include blood tests, chest X-ray, EKG, MRI or CT scan, and meetings with other doctors if you have any special medical problems
This visit will last several hours and will be scheduled one day to one week prior to surgery.
After Surgery, you may be taken to the intensive care unit, or you may have a short stay in the Recovery Room before going to the Nursing Unit. You will have IV's and a heart monitor on as well as a catheter in your bladder. A loose-fitting mask may be placed over your mouth, which will deliver oxygen. A typical hospital stay is four days after surgery.
You should not have a lot of pain. Most people just take Tylenol after the surgery. Let your nurse know if you have any pain. Your medications can be changed accordingly.
We expect that you will be out of bed eating and taking short walks the day after surgery. You will be getting IV antibiotics for four days after surgery. The nurses will keep track of what you eat and drink as well as how much you urinate.
You can bring some comfortable clothes (bathrobe, for example) to wear after surgery.
We ask that you call your neurosurgeon's office to arrange a postoperative visit with your surgeon. Your endocrinologist and otolaryngologist will most likely want to see you as well.
If you are having a non-surgical procedure, additional lab or blood tests may be required after the procedure. This testing can be done at Hopkins or at your primary care physician's office. Prior to discharge you will receive specific instructions and information about any additional testing and follow up visits.