Seven Questions to Ask Before Neurosurgery

If you are considering surgery as a treatment option for your essential tremor, there are some things you will want to consider before scheduling your surgical appointment. It is vital you fully understand the possible risks and benefits of the procedure. False expectations and inaccurate information can lead to negative outcomes, so it is best to do your homework in advance.

One way to make sure your expectations are reasonable and you understand exactly what is involved is to have a frank discussion with your neurosurgeon. Having a thorough conversation well ahead of time ensures you are comfortable with your surgeon’s treatment plan, you understand what outcomes to expect, and what recovery entails for you.  

Involve your family members and loved ones and invite them to come with you to your consultation appointments. It is often best to have a second set of ears listening to the information, as it can be a lot to take in all at once. A friend or loved one might also take notes for you and help ask questions you may not have considered. Plus sometimes, it’s nice just to have an encouraging hand to hold.

Here are some questions to ask your surgeon, to help get your conversation started:

What is your experience with the procedure; what is your success rate, and what is your complication rate?

With something as delicate as brain surgery, you want to ensure your surgeon has the experience and skill to offer you the best chance of a positive outcome. A good surgeon will give you the opportunity to speak with other patients who have had the procedure and discuss what could go wrong.

Am I a candidate for deep brain stimulation, focused ultrasound, or Gamma Knife? Why or why not?

There are three different options for the surgical treatment of ET. Understanding why a procedure is or is not a good fit for you is an important part of the decision-making process.  

How much tremor control should I expect from my chosen option?

No surgical procedure will “cure” essential tremor, and each procedure has different amounts of tremor control expected. It is also good to know if the surgery you are considering can impact other areas of your body impacted by tremor, such as voice or head tremor.

What are the risks, benefits, and possible complications of this surgery?

Surgical procedures will not remove your tremor completely, forever. Being able to compare the risk factors against the possible benefits helps manage expectations and prepare you if your outcome should be less than perfect. You should ask about pain, chances of infection, physical limitations, etc.

Walk me through the procedure, including the steps I need to take to get prepared for surgery.

Will you have to shave all or a portion of your hair? Do you have to stop taking your medication? Can you drive yourself home or should someone drive you? Can you eat the day before the procedure? Are there any tests or pre-op procedures you will need to do before the actual surgery? These are all things to ask before you arrive for your surgery. Making sure you have everything done and ready on your end will help the process move efficiently. Part of being a good patient is
being prepared.

Some procedures require an overnight stay in the hospital; some may be done on an outpatient basis. It is a good idea to find out exactly how long you will need to be in the hospital, what types of follow-up services you might require, and how long it will be before you can return to your regular activities such as driving or returning to work. It’s important to follow your physician’s recovery instructions so you can return to you regular routine as quickly as possible.

How much does this surgery cost?

You should check with your insurance company in advance to ensure your physician, the facility, and the procedure is covered by your plan. If you are responsible for all or part of the costs of the procedure, be sure to find out when payment is expected. Some facilities require all payments in advance, while others will bill you for the amount not covered by your insurance.

The decision to have brain surgery is not something to be taken lightly. It is, after all, brain surgery. But for those whose symptoms are not controlled by medication(s) and whose tremor negatively impacts activities daily living such as eating, drinking, writing, grooming, etc., surgery may be the best option for tremor reduction. Developing a strong relationship with your neurosurgeon and asking some important questions is key to a positive outcome.

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2 thoughts on “Seven Questions to Ask Before Neurosurgery

  1. My husband has been approved for DBS surgery. He is 76 and has an essential tremor. We have met the neurosurgeon, Dr Hamid Shah, at Vanderbilt. How important are the number of procedures done at the hospital and the number done by the neurosurgeon? What are good markers to look for?
    Thank You

    • Some people say it’s years of experience that matter, labeling surgeons with 5 to 20 years as “experienced.” Others say having performed a specific procedure 25 to 30 times is experienced. Obviously it’s your comfort level; if your surgeon has only performed a handful of DBS procedures or never performed one, that might make you uncomfortable. Most importantly, look at your physician’s reviews from other patients online, and see how he is rated.

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