Recovery of patients after Brain Surgery

at NIKISA Geriatric and Rehabilitation Hospital

Brain surgery recovery is a gradual process and can take two to three months, and sometimes even more. It eventually improves the quality of patient’s life and is worth the patience. Typically, a brain surgery procedure requires that a patient be monitored in the hospital for 7 to 15 days, depending on the type of brain surgery performed. In case of a minimally invasive brain operation, the patient can leave within 2-3 days after the procedure, depending upon overall patient health and determination of risk of subsequent complications by the doctors. It often takes some time before you can return to your normal activities after a brain surgery. To completely heal, you will need to rest amply. Each person requires a different time to recover after their surgery. The healing time depends on

1. The procedure followed to remove the brain tumour
   1. The location of the tumour
   1. The areas affected as a result of the surgery
   1. Your age and overall health at the time of surgery.

Brain surgery especially the ones caused by blood clots take more time to heal. Hospital is best equipped with men, materials and technology to ensure proper recovery of brain operated persons. Hospital stay in Brain surgery cases is very costly. Hence most of the patients are discharged within 7 to 15 days after the operation from the hospital. At the time of discharge the patient would have gained consciousness and in case Tracheotomy has been with the endotracheal tube removed. Very often that’s all.

NIKISA’s approach to rehabilitation after brain Surgery

NIKISA Post Brain Surgery Rehabilitation plan depends on the condition of the patient at the time of discharge from the acute care hospital. Patients recovering after Brain surgery are divided into one of the following two categories right at the time of admission to NIKISA Hospital.

1. Patients who require Critical care: These patients are the ones who require high degree of care. Following is the criteria used to recognise Post Brain Surgery Rehabilitation patients who require critical care;
   1. Completely immobile and are in Supine position.
   1. Discharged from acute care hospital with   cannula, Riels tube, and catheters.
   1. The acute care hospital has done Tracheostomy and tube is not removed. Wound is not yet healed.
   1. Patients possibly requiring Medical Oxygen, either continuous or on intermittent basis.
   1. Patients who require suctioning on account of Phlegm build-up

• Patients who are weak and completely bed ridden and therefore cannot communicate in an understandable manner with service providers.
• Patients who do not require critical care.
  • Patients who do not come under the above criteria.
  • Patients who can be mobilised on wheel chair or on foot with or without support.
  • Patients who are normal except for surgery related immobility of limbs and inability to speak. They are able to eat normal food and do not require high degree of medical supervision.

Treatment of Brain surgery patients  who require Critical care:

1. These patients are admitted to Critical care section till they attain a non-critical stage.
2. Critical care section is almost like an intensive care unit and has the following facilities.
   1. Patients are provided with Fowlers bed.
   1. Continues Medical oxygen supply facility is available in this section.
   1. There are duty doctors at this section on 24 X 7 basis.
   1. Patient monitors, suction facility is also available.
   1. There is a minor OT in the Critical care section to do procedures on emergency basis.
   1. Required activities like Chest physiotherapy, Suction etc are performed on bed side. 
   1. Visitor entry is also restricted.
   1. Emergency cart is readily available. Emergency medicines provided by the hospital are to be replenished by the patient’s caretakers.
   1. Medicines and other consumables can be bought from the Hospital Pharmacy or from any other pharmacy and provided to the treating doctors and nurses.
   1. The Nutritionist guides the patients and their families on dietary requirement of the patients. Patients can get their diet from their homes. External catering services are also available. 
3. At the time of recovery, the patient is continuously monitored for the following events or parameters.
   1. seizure,
   1. severe headache,
   1. worsening neurological problems,
   1.  chills,
   1. swelling of the ankles,
   1. bleeding or bruising,
   1. severe nausea or vomiting,
   1. skin rash.
   1. Blood clots in lungs
   1. drainage from your surgical scar
   1. a fever over 100°F (37.8°C)
4. Once, the patients recover from critical condition, they are shifted to wards, specially created for rehabilitation of Post Brain Surgery Rehabilitation  patients.  In case the patient turns out to be more critical, the family members will be requested to shift the patient to an acute care hospital for further acute care. 

Treatment of Post Brain Surgery Rehabilitation  patients who do not require Critical care

1. Brain surgery patients who do not require Critical Care in the judgement of NIKISA are moved to wards created for Brain surgery recovering patients.
2. Physical facilities at the Post Brain Surgery Rehabilitation wards:
   1. All the wards are provided on Single Occupancy basis.
   1. These wards are fully equipped and have been designed keeping in mind the requirement of Brain surgery recovering patients.
   1. Corridors have been provided with rails for holding while walking.
   1. Toilets are at ground level for easy mobilization of patients both on foot and also on wheel chairs.
   1. Grab bars have been provided in bathroom and toilets.
   1. Bed required for the convenience of patient will be provided. Option of utilising Fowler beds with air bed or luxury single bed or luxury double bed is provided to the patient.
   1. Every ward is provided with attached bath rooms with hot and cold-water supply, western commode, Meals table, T V, Fridge, Nurse call facility, newspaper and Drinking water.
   1. Services of Nurses and ward boys is available on 24 X & basis.
   1. The wards are centrally air conditioned. (on account of Covid 19 restrictions AC is not being used for the present). Every ward is provided with pedestal fan.
   1. Some rehabilitation equipment are provided at ward itself depending on the requirement of the recovering patient.
3. Medical and Diet care:
   1. The patients are examined and treated by a team of doctors on a daily basis. In addition, whenever required our Specialists provide consultation to the patients.
   1. Proper nutrition and taking medication as per the prescription of nutritionist and the treating doctor respectively is of paramount importance in Post Brain Surgery Rehabilitation.  Our Nutritionist will guide the patients and their families on dietary requirement of the patients. Patients can get their diet from their homes. External catering services are also available. 
   1. Usually Post Brain Surgery Rehabilitation patients suffer from disorders like diabetes and hypertension. We monitor the vital parameters.
   1. Most Post Brain Surgery Rehabilitation patients get into a sedentary status, especially in-home settings and many develop secondary complications arising out of poor hygiene. Bed sores, urine and incontinence are very common in recovering Post Brain Surgery Rehabilitation patients; therefore, we monitor the patients for these secondary complications and take remedial actions.
   1. Secondary Injuries arising out of unexpected fall is very common in Post Brain Surgery Rehabilitation patients. When untrained personnel handle Post Brain Surgery Rehabilitation, some patients might suffer from limb and girdle fractures.   
   1. Medicines and other consumables can be bought by patient’s caretakers from the Hospital Pharmacy or from any other pharmacy and provided to the treating doctors and nurses.
4. Physiotherapy:
   1. A separate Physiotherapy section has been created to aid speedy recovery. To know more about Physiotherapy facilities available please click Physiotherapy section
   1. Physiotherapy is provided by a team of Physiotherapists.
   1. Progress in physiotherapy and rehabilitation is measured and recorded on a week to week basis.
5. Cognitive and emotional therapy:
   1. Therapy for cognitive disorders. Cognitive therapy helps the patient to get back lost cognitive abilities, such as memory, processing, problem-solving, social skills, judgment and safety awareness. Our Psychologist provides these services.
   1. Therapy for communication disorders. Speech therapy can help to regain lost abilities in speaking, listening, writing and comprehension. Our Speech therapists provide these services.
   1. Psychological evaluation and treatment. Emotional disturbance of Post Brain Surgery Rehabilitation patients will be addressed with proper counselling. Our Psychologist provides these services.

Non-Clinical Services:

1. Non clinical services towards the patients like bathing. dressing, spoon feeding. nasal feeding, toilet assistance, changing of diapers will be attended by the hospital staff.
   1. Toiletries and towels will not be provided by the hospital. But, they, can be purchased at the pharmacy.
   1. Care takers of patients can stay at the hospital at the ward assigned to the patients. Except providing a foam bed nothing else will be provided to the patient attendant.

Post Brain Surgery Rehabilitation takes time

Recovering from a Post Brain Surgery Rehabilitation can be a long and frustrating experience. It’s normal to face difficulties along the way. Dedication and willingness to work toward improvement will help you gain the most benefit.