What is the recovery period like after DBS surgery?
How long will I stay in the hospital after the first surgery?
Patients need to stay in the hospital until their incision-related pain can be well controlled with oral pain medications, they are able to eat and drink and can walk. On average, most patients stay only one night after surgery and occasionally a second night. Patients will also receive a CT scan or MRI after the surgery to confirm the location of the electrode(s) and to check for any post-operative bleeding. This CT scan or MRI is done without the head frame.
How long is recovery? What special instructions will I receive after the surgery?
Recovery is fairly uncomplicated for most patients, but in 10% of patients they will feel sleepier and slower and possibly mildly disoriented for several days after surgery. It is essential for all patients that a plan is in place before surgery for additional help in the home during at least the first week after surgery.
In addition, you will receive instructions not to touch the surgical wounds with your hands. These instructions apply to both your 1
st stage and 2
nd stage surgeries. You will not be able to shower or get the area around the incision wet until the wound has completely healed. You will be scheduled to return to the neurosurgery clinic for a wound check and if applicable, removal of the stitches. If you see any redness, swelling, or leaking fluid, please call the neurosurgeon's office immediately as these can be early signs of infection.
When does the DBS actually get turned on?
DBS programming takes place about 3-4 weeks after your surgery. You will receive a phone call with an appointment and special instructions regarding medication.
The appointment can last anywhere from 1-3 hours, depending on if you have one or two electrodes and whether you have Parkinson's disease, dystonia or tremor. Please be prepared to bring your medications with you and someone to drive you to the appointment and back.
What follow up care is required if I have this treatment?
It is important to understand that patients who have DBS must make frequent visits to the outpatient clinic
during the first three months after surgery. These visits are needed so that doctors can "program" your stimulation so that it is just right for you. The doctor can change the strength and frequency of the electrical stimulation that your brain is receiving. These changes are then matched with adjustments in your medications until the right balance is achieved.
At first, you may be coming in as often as every two weeks for adjustments. Once stable settings are found and a new medication schedule has been established, you will not need to come in as frequently.
The initial "breaking in" period, when you require frequent adjustments, may last as long as three months. Over time, you may need additional changes as your Parkinson's disease progresses. If you live far from the hospital or have difficulty arranging transportation, this is something to carefully consider before deciding to have the surgery.
Six months after stimulation is started, we recommend you return for another follow-up visit and neuropsychological testing (if you have Parkinson's disease).
Who else will be involved in my follow up care?
In our center, programming is carried out usually by a movement disorders fellow or Dr. Ludy Shih. Six months after your surgery, a repeat neuropsychological examination will be performed by the neuropsychologist or neuropsychology fellow to determine whether there has been any change in your cognitive functioning after DBS. We also have available the expertise of various members of our interdisciplinary team, including the physical therapist, occupational therapist, speech therapist, social worker.
Do I need any follow-up testing?
We recommend that if you had neuropsychological testing prior to surgery that you have a repeat test done 6 months after surgery.
When can I go back to work?
This depends on the nature of the work and how quickly you recover from surgeries. In general, we do not recommend going back to work for at least two weeks. Most patients do not go back to work until after the DBS programming is begun, usually 3-4 weeks after surgery. Please talk with your physician about this in detail.