Surgery Planning

April 8, 2008

Super Nurse called yesterday but as I was on the other line, she called again today. We discussed my situation and I told her that I was feeling quite ok except for the headaches. She suggested before that I take Paracetamol against the headaches but, like last time, I told her that I don’t need (want) them. The pain is not unbearable and I like to understand (feel) the full extend of the Edema in my head. She suggested that I reduce the dose of Dexamethasone by 0.5mg in the evening (so in total 4.0mg in the morning and 3.5mg in the evening). I’ll start with this tonight and am curious whether such a small change will have any effect. Super Nurse will contact us on Thursday again.

My family have started questions about how we plan to update and involve them (if at all) before, during and after surgery. Similar questions have come from the office. Super Nurse told me about the surgery planning before (Visit to the Oncology Super Nurse) but that was from my perspective (the patient). This morning I therefore asked her again but now from the perspective of the family. I found that there is a great deal uncertain or unknown. Depending on whom you ask and when you ask them you get different answers.

With respect to the Surgery Duration the Neurosurgeon mentioned a duration of 6 hours for an Awake Craniotomy. The Anaesthetist whom we met during the Pre-Operative Screening (28-2-2008) mentioned 8 hours for a normal Craniotomy. Last time (20-3-2008) she mentioned 8 hours as well but this morning she changed her verdict: 4-6 hours. I think that it is safe to assume a duration between 4-8 hours, the shorter the better. We still have the opportunity to ask the Neurosurgeon on the 15th of April for his opinion.

The Neurosurgeon determines when I can be moved to the Recovery Room, (Dutch: Verkoever). This is a high care (post-anaesthesia care unit).  Either the Neurosurgeon or a nurse from Recovery Room will call Monling to tell her the result of surgery and any other information he cares to share. The Recovery Duration is not well defined but it seems that most agree that this will last between 1-2 hours.

The Anaesthetist determines when I can be moved from the Recovery Room to a Medium Care Unit. Monling (and my family) can visit me there but not all at the same time. The Medium Care Duration is also not defined well but the general opinion is that this lasts just one day. The Neurosurgeon will meet with Monling and my family to inform them about the result of my surgery.

After that I’m moved to the Neurosurgery Ward (2C) of the hospital. If there are no complications (problems with emotion, body paralyzed on the right side, unable to speak, no vision) will I be dismissed from the hospital in a matter of days (Regular Care Duration at most 1 week). The drain will be removed from my head in 24h and the turban will be removed after 48h. I will hear the result of the bioption no sooner than 5 days after the operation and the hole in my head should be closed in a week.

The hospital specifies however a series of scenarios where there are minor and/or major medical, physical and emotional complications. In these cases will I have to stay longer in the hospital or be transferred to a special revalidation centre before I can go home. The first major check is in 6 weeks after surgery and during that meeting also any long term expectations for recovery (taking into account the result of the biopsy that was performed during surgery). The Extended Care Duration may last up to 4 months.

On the internet I found a link to a brochure from the hospital (I have no clue why I never got this brochure, it is so useful) but unfortunately it is just in Dutch: Hersenoperatie.pdf



  1. It all sounds incredibly well organised. Not surprising, I guess, since they do these things all the time.

    First time for you, of course, but it seems you are in the best possible hands.

    Wishing you all the best for the next couple of weeks as your surgery approaches.

  2. […] Neurosurgeon gave us more information about the Surgery Duration (please refer to my post “Surgery Planning” of the 8th of April). This is the […]

  3. Dear friend,

    I apologize for not replying to you sooner. It is an extremely busy time and there is still so much I believe I should do. You’re right, this type of surgery is performed every week Thursday like clock work. The hospital claim to perform most surgery for the whole of The Netherlands which is exactly why the waiting list is this long.

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