Patients

New patients are asked to complete the following form and bring it with them to their first appointment.

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As you walk into our neurosurgery clinic as a new patient, you may feel a mix of emotions – nervousness, uncertainty, and hope. You will be greeted by a friendly receptionist who will gather your personal details and medical history before directing you to the waiting area. The waiting room is comfortable and well-lit, with magazines and brochures about neurological conditions and treatments. After a short wait, you are called into an examination room by a nurse who will take your vital signs and asks a few more questions about your medical history. Dr. Munshi will then take the time to listen carefully to your concerns and answer any questions you may have. Dr. Munshi performs a thorough physical and neurological exam, reviewing the patient’s MRI and CT scans, and any other diagnostic tests that may have been performed. The patient leaves the appointment feeling confident in their neurosurgeon’s expertise and with a clear understanding of their diagnosis and treatment options.

The first visit to a neurosurgery clinic can be overwhelming, but it’s important for patients to know that they are in good hands. The team at the clinic is dedicated to providing compassionate, personalized care, and making sure that patients understand their options and feel empowered to make decisions about their treatment. The patient’s first appointment sets the foundation for a strong doctor-patient relationship, which is crucial in the treatment of neurological conditions. With their neurosurgeon’s guidance, patients can start their journey towards recovery and better health.

Pre-Operative Patient Instructions:

If you have any questions that are not addressed here, please call our office at 337-234-5344.  Someone will be on call after business hours if you have a problem.  However, routine calls should be placed during normal business hours.  Prescription refills will only be processed during normal business hours on Tuesdays and Thursdays so please anticipate your medication needs and plan accordingly.

Preparing for Surgery:

• Beginning two days before surgery, each time you bathe, use Hibiclens soap to cleanse your body.  This may be purchased over the counter at any pharmacy.  You do not have to wash your hair with this soap but wash your whole body.
• Fast after midnight the night before surgery (nothing to eat or drink after midnight).  You may take your blood pressure medications with a sip of water only.
• Make arrangements to have someone with you at the hospital.
• The office will notify your insurance company of this scheduled hospital stay.  You will be required to pay any out-of-pocket or co-pay fees.

THE HOSPITAL WILL CONTACT YOU THE DAY BEFORE SURGERY TO LET YOU KNOW WHAT TIME TO ARRIVE AT THE HOSPITAL.

Medications:

• Bring ALL of your home medications with you to the hospital in the bottle that they come in.
• The morning of surgery, please take any heart or blood pressure medications as you normally would.
• DO NOT take diabetic medications, pain medications, sedatives, or blood thinners on the morning of surgery.
• Blood thinners such as Aspirin, Plavix, and Coumadin must be stopped 7-10 days before surgery.  Herbal remedies and all vitamins must also be stopped.  You MUST let your surgeon know in advance of your surgery if you are taking any type of blood thinner.

You may need to obtain clearance from your prescribing doctor to stop some medications.

Medical Clearance:

• If you have pre-existing medical conditions you may be required to obtain surgical clearance from your treating physician BEFORE proceeding with surgery.

What to Expect at the Hospital:

• On the morning of surgery you will be allowed to visit with a limited number of family/friends prior to surgery.  During surgery your family and friends will wait in the Surgery Waiting Room.  Please let your O.R. nurse know who will be in the waiting room so that your surgeon may contact them when your surgery is complete.
• Before surgery you will stay in the “holding area” where you will meet your Anesthesiologist or Anesthetist and surgery nurse.  An IV will be started and you will meet with the surgeon before going into the operating room.
• Once in the operating room you will be given medication that helps you drift off to sleep.  The O.R. team consists of a team of highly trained individuals that perform various functions to assist the surgeon.
• Following surgery you will be transported to the recovery room.  Here, you will be monitored closely by nurses until you awaken.  The recovery room stay is usually about one hour but can vary from patient to patient.
• After “recovering” you will be transported to a more spacious room where your family and friends can visit.
• Depending on what type of surgery you have, you will either be discharged home the same day or admitted for one or more nights.  The length of your stay will be discussed when you schedule your surgery.

Post-Operative Instructions

Diet:

•  No restrictions. You may return to your previous diet as tolerated. If your throat is sore from surgery you may want to try thick liquids, soups, and soft foods first.

Dressings and Incision care:

• Dressings should be left in place for a minimum of 48 hours following surgery.
• If you had carpal tunnel release, leave all bandages in place until you are seen in the office for your post-op visit. This helps ensure proper healing of your wound.
• For all other surgeries, the bandages may be removed after two days and left open to air.
• You will see steri strips under your bandages. Do not peel them off. The strips will fall off spontaneously. Any remaining strips will be removed at your post-op visit.
• If you see sutures under the dressing, these will be removed at your first post-op visit.
• Do not put any ointments, creams, or lotions on the incision unless otherwise instructed.
• Showering: If your incision is covered with a waterproof dressing you may shower immediately following surgery. If not, then you must wait until the dressing is removed (see above). Do not soak the incision in a bathtub or pool for 6 weeks.
• Wound problems are rare but can occur after any type of surgery. Watch for increased tenderness, redness, swelling, drainage, or fever. Contact our office if any of these occur.

Medication:

• Take all your medications as prescribed. You do not have to take pain medication unless it is needed.
• You may resume your previous home medications unless otherwise instructed. Please check with the surgeon or his assistant before resuming blood thinners.
• You will be given a prescription for pain medication upon discharge from the hospital. This medication should be taken as directed for post-surgical pain. Pain medication will not be given indefinitely. Patients should taper medication as tolerated. Refill requests will only be processed on Tuesdays and Thursdays during normal business hours. Please anticipate your medication needs and contact us during those times. Please contact your pharmacy for all refill requests. They will, in turn, contact our office via fax requesting your refill. This process helps to ensure that your medication will be refilled in a timely manner.
• Do not consume alcohol or drive a motor vehicle while taking narcotics, sedatives, or muscle relaxants.
• You may use throat sprays or drops for throat discomfort.

Common Issues:

• Expect soreness of the wound.
• Your symptoms may not be completely gone immediately following surgery. This is expected. Have reasonable expectations for relief and being able to resume normal activity.
• You may experience increased soreness, pain, and burning sensations following surgery. This is due to irritation of nerves and may last for several weeks following surgery. This is nothing to worry about but is a reflection of the injury to the nerves from pre-existing compression with the spine.
• Constipation is common after surgery. This can be due to a combination of things such as pain medication, anesthesia, bed rest, etc. Over the counter stool softeners such as Colace are encouraged. If bowel movements do not occur with stool softeners, try Magnesium Citrate.

Follow-up:

• You will need to be seen in our office 7-14 days following surgery. You should be given a post-op appointment date and time when your surgery is scheduled. If not, you will need to call the office the first business day following your surgery to schedule an appointment.

Activity and Expectations:

Adherence to limitations of activity after surgery is important to promote wound healing.

Following NECK Surgery:

• Keep automobile riding to a minimum and DO NOT drive until you are seen for your first post-op appointment and released to do so.
• Avoid lying on your stomach. Lie either on your back or your side.
• NO pushing, NO pulling, NO lifting for six weeks after surgery. DO NOT lift anything heavier than 10 pounds. At your post-op visits you will be guided regarding increasing your activity based upon how you are healing.
• Walking is encouraged. At first, walk short distances several times a day. Then work your way up to longer distances fewer times daily.
• If you have a brace, you must wear it at all times except when showering. You will be instructed on the weaning process from the brace at your first post-op appointment.
• Throat soreness is expected after surgery. It is rare, but if you experience any shortness of breath or difficulty breathing contact our office or go to the nearest emergency room immediately.

Following Back Surgery:

• Keep automobile riding to a minimum and DO NOT drive until you are seen for your first post-op appointment and released to do so.
• Keep sitting to a minimum (about 20 minutes at a time). Sitting in a reclining chair is ok.
• If you must sit for longer periods of time, take frequent breaks to walk and stretch your legs.
• Avoid lying on your stomach. Lie either on your back or on your side with pillows between your knees.
• NO bending, NO stooping, NO twisting for six weeks following surgery.
• DO NOT lift anything heavier than 10 pounds. At your post-op visits you will be guided regarding increasing your activity based upon how you are healing.
• Walking is encouraged. At first, walk short distances several times a day. Then work your way up to longer distances fewer times daily.
• If you have a back brace, it is not necessary to wear it while in bed or in a recliner chair. Stand or sit to put the brace on. The brace must be worn any time you are going to be up for a period of time. You may shower and go to the bathroom without the brace.

Following Brain Surgery:

• You will have incisional pain and soreness that will improve with time.
• You may have headaches and swelling for a few weeks following surgery. These will also improve with time. Pain medication and steroids will help with this.
• You may tire more easily for several months following surgery.
• You may have an increase in other symptoms due to brain swelling such as: speech, memory, concentration, motor movement, and sensation. Steroid medications will help with this as well.
• There is a risk of seizure following any type of brain surgery. You may be given a medication such as Keppra or Dilantin to help with this. You should continue to take this medication until instructed otherwise.

Following Peripheral Nerve Surgery:

• Walking is encouraged, and you may participate as much as you would like. Do not participate in any other type of exercise until after your first post-op appointment.
• Avoid lifting over 5-10 pounds.
• You should keep your hand/arm elevated for 72 hours after surgery.
• Movement is important. You should move your fingers in and out about ten times an hour while awake. This will help prevent swelling, stiffness, and scar tissue formation.
• You may return to work when you feel ready. However, you must stay within the 5 to 10-pound weight restriction.

Dr. Munshi’s office would like to hear from you. 

If you have been or are a current patient of Dr. Munshi and would like to share your experience with others, please feel free to download the forms below to share your experience and drop by or mail to our office at:
99 West Martial Avenue,  Lafayette, LA 70508.

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