Frequently Asked Questions
1. What does the pre operative visit involve?
Patients are most often referred to Dr. Nakaji because a referring physician believes intracranial brain surgery might be needed. The determination of whether or not you require brain surgery is decided during your pre-operative visit with Dr. Nakaji. During this visit, Dr. Nakaji will review your medical history, conduct a physical exam, and review the x-ray images, MRI and CT scans, and other diagnostic exams you provided the office prior to your visit.
There are a multitude of conditions that do not require surgery and may only require close monitoring and surveillance imaging. However, if surgery is recommended, the procedure, alternatives, risks and benefits will be discussed with you. You and your loved ones will ultimately make the decision whether or not have the surgery based upon the information Dr. Nakaji and his staff provide you. Regardless of your decision, our staff is available to provide you with as much information and assistance as possible.
2. How do I prepare for brain surgery?
If you decide that surgery is the best option for you, Dr. Nakaji will explain the surgical procedure to you and answer any specific questions you have regarding your surgery and care. After your pre-operative office visit, you will be mailed a surgical packet that contains The Barrow Neurological Institute Patient Surgical Guide. This packet includes general information about undergoing a surgical procedure at The Barrow Neurological Institute. If you think of new questions after the pre-operative visit, please contact Dr. Nakaji’s office and they will try their best to answer your specific questions.
Depending on what type of surgery you will be undergoing, you may be asked to stop certain medications prior to your surgery. Discontinuation of medication varies by patient and procedure and will be case specific. Do NOT stop taking medications unless you are directed to do so. In certain circumstances, we may need the input from your cardiologist prior to stopping medications. It is recommended that you inquire about stopping medications during your office visit with Dr. Nakaji.
The night before your surgery, you should have nothing to eat or drink after midnight. You may also be asked to shower or wash your hair with a specific antibacterial soap both the night prior to surgery and the morning of surgery. If this soap is recommended for you, please take care to avoid your eyes, ears, nose and mouth.
3. Will I stay overnight in the hospital on the night prior to my surgery?
Most surgical procedures do not dictate that you spend the night in the hospital prior to your surgery. However, there are certain intracranial vascular surgeries that may require interventions one or two days prior to your actual surgery date that may necessitate a night stay in the hospital prior to your operation.
4. How long after surgery will it be before I am awake?
The period of time to be fully awake after general anesthesia varies by patient and the type and amount of anesthesia that is required for your case. Although most patients will be awake soon after surgery, many patients may not remember the first day.
5. What happens after I am discharged after surgery?
Before you are discharged from the hospital, Dr. Nakaji’s office will schedule your first visit back to see Dr. Nakaji after surgery. By prearranging this visit while you are still in the hospital, it allows you to focus on recovering from surgery, instead of trying to make appointments with our office.
A large number of Dr. Nakaji’s patients go home within 24 hours of brain surgery! Generally speaking, when you are up walking, able to use the restroom without difficulty and have control of your pain, you will be able to safely go home from the hospital. When you are discharged from the hospital, you will be given detailed discharge instructions as well as phone numbers to contact our office in the event that you do have questions when you are at home. The exceptional nurses, therapists and case managers at St. Joseph’s Hospital and Medical Center will make sure you have all of the equipment necessary for a safe and comfortable discharge to home.
6. How will I feel after surgery?
Your post operative recovery depends a great deal on what type of surgery you have undergone. Dr. Nakaji specialty is “minimally invasive” neurosurgery, that is, using the smallest and least invasive incision needed to safely perform the procedure. Dr. Nakaji’s believes that his minimally invasive surgical skills allows his patient’s a faster and less painful recovery time, with significantly less scaring. Still, surgery in general involves at least some pain and therefore you will be discharged to home with the necessary medication to control the discomfort.
7. When can I return to work and normal activity after surgery?
Your return to normal activity will also depend greatly on what type of surgery was performed. In general, most patients are able to return at four to six weeks following surgery.
8. What possible problems should I look for after surgery?
Although we don’t expect complications following any surgical procedure that we perform, there are risks associated with any surgical procedure, regardless of how minor or major it may be. You will be monitored closely during your hospitalization for any complications. When you are discharged to home, we ask that you monitor for and report any signs of infection such as fever, chills, sweats or redness, swelling or drainage from your incision. In addition, we ask that you monitor for any neurological changes and immediately report any new numbness, tingling, weakness, facial droop, changes in your mental status, confusion, difficulty walking, slurred speech, visual changes and/or dizziness. While we do expect some headache and incisional discomfort after surgery, if the pain gets worse or progresses, you should contact our office to further discuss.
9. What is the referral process?
Most likely you have been seen by your primary care provider or a specialist who has referred you to our office for a neurological problem that may require surgery. We will receive the referral order and office notes from that provider. Occasionally we may also receive X ray images to review prior to you being seen in office. We will review the available records and images and will then schedule you for an office visit. We typically see patients in office on Tuesdays and Thursdays but we try to accommodate you if you need to be seen in an urgent fashion.