Caregiver Preparation Guide

Caregiver Preparation Guide

For family members and friends caring for a patient after spine or brain surgery.

Cotton O'Neil Neurosurgery and Spine Center — Stormont Vail Health

You are part of this

You probably know this already, but it is worth saying out loud: the patient's recovery depends substantially on you. Patients with a competent, calm caregiver recover faster, have fewer complications, and return to function sooner than those without. This guide gives you a practical framework.

Before surgery

Get a clear picture of what's going to happen

Talk to the patient about what they have been told. Ideally, attend the pre-op visit with them. Know:

• What operation is being done
• Expected hospital stay (outpatient, one night, several nights)
• Activity restrictions in the first weeks (lifting, bending, twisting limits)
• Medication plan at discharge
• Follow-up appointment date and any imaging that needs to be done first

If you weren't at the pre-op visit, call our office before the day of surgery to get the information you need.

Set up the home before surgery

Patients should come home to a setup that supports recovery rather than fights it. Two days before surgery, walk through:

• Bed location. A bed on the main floor is ideal for the first week or two. If the bedroom is upstairs, plan for a recliner or temporary setup downstairs.
• Bathroom access. A raised toilet seat helps for the first few weeks after spine surgery. Grab bars near the shower and toilet are worth it if not already installed.
• Trip hazards. Pick up rugs, cords, and clutter. Falls are the most common preventable post-op complication.
• Reach. Move frequently used items — phone charger, water bottle, glasses, medications, snacks — to waist-to-chest height. No bending, no overhead reaching for the first few weeks.
• Pets. If you have a small dog that jumps on the bed, plan to keep them off during recovery. Plan a routine that lets the patient avoid bending to feed or pick up a pet.

Pre-arrange help

The first one to three weeks are the hardest. Plan for someone (you, family, friend, paid help) to be present continuously for the first 48 hours, and available for the next 7–14 days.

• Meal planning. Prepare or freeze a week of meals before surgery, or arrange grocery / meal delivery.
• Transportation. The patient cannot drive while on narcotic medication. Plan for rides to follow-up appointments.
• Phone tree. Pick one or two people who will receive updates and share with the broader family. This keeps you from re-telling the same story twenty times.

The day of surgery

• Drive the patient to the hospital and stay during the operation.
• I (Dr. Tuchek) will speak with you in the consultation area as soon as the operation is over — before the patient has fully woken up. You will know how it went before they do.
• Bring a phone charger, a snack, and a book. Operations run 1–3 hours plus recovery; plan for 4–6 hours total at the hospital for inpatient cases.

Coming home

The first 48 hours

This is the hardest stretch.

• Patient will be groggy from anesthesia and pain medication. Expect drowsiness, occasional confusion, some appetite loss.
• Walking is essential. Get them up every 1–2 hours during waking hours for short walks (even just to the bathroom). Walking prevents blood clots, pneumonia, and constipation.
• Pain management. Give pain medications on schedule, not "as needed," for the first 48–72 hours. Catching pain early is much easier than chasing it after it has gotten ahead.
• Incision care. Follow the specific instructions from the surgical team. Generally: keep dry, no soaking, no antibiotic ointment unless told otherwise.
• Constipation prevention. Narcotic pain medications cause constipation reliably. Start a stool softener (Colace) immediately and add a laxative if there is no bowel movement by post-op day 2 or 3.

Days 3 through 14

• Reduce narcotic use as tolerated. Most patients can transition to Tylenol and anti-inflammatories within a few days. Less narcotic = less constipation, less grogginess, faster return to function.
• Increase walking. Goal is several short walks per day, gradually lengthening.
• No driving. Period. Until off narcotics AND cleared by surgeon.
• Watch for warning signs (see below).
• Be patient with the patient. Post-op irritability, anxiety, and low mood are common — both from the medications and from the disorientation of being out of normal life. This usually resolves over the first 2 weeks.

Weeks 2 through 6

• Follow-up visit. The first post-op visit is typically at 2 weeks for wound check and to discuss recovery.
• Activity progression per surgeon instructions. Generally: walking yes, lifting under 5–10 lb yes, bending and twisting no.
• Return to driving once off narcotics and cleared.
• Return to work depends on the type of work — desk work often by 2–3 weeks, physical work much longer.

When to call our office

Call (785) 368-0767 within business hours, or go to the emergency department after hours, if the patient experiences:

• Fever above 101.5°F
• Drainage, pus, or foul smell from the incision
• Increasing redness or swelling around the incision (a thin line of pink is normal; an expanding red area is not)
• Calf pain or one-sided leg swelling — possible blood clot
• Severe nausea or vomiting preventing hydration
• Inability to urinate for more than 8 hours despite trying
• Pain not controlled by the prescribed regimen

When to call 911

Do not wait. Do not call our office first. Call 911 if:

• Chest pain or shortness of breath
• New or worsening weakness or numbness
• Loss of bowel or bladder control (after spine surgery — emergency)
• Severe headache or neck stiffness
• Clear fluid drainage from the incision (possible CSF leak)
• Confusion or change in mental status that is not just post-op grogginess
• Severe headache after brain surgery that is new or different

Taking care of yourself

The caregiver role can be exhausting. A few things that help:

• Sleep when they sleep, especially the first week.
• Accept help. When friends ask "what can I do," give them a specific task — drop off a meal, take the dog for a walk, sit with the patient so you can grocery shop.
• Don't make big decisions tired. Post-op week one is not the time to decide whether to renovate the kitchen or move to Arizona.
• Take a real break. Two hours away from the house in week two does wonders.

What you bring matters

The patient will not remember every detail of the first week. They will remember being safe, being managed competently, and being treated with patience and warmth. That is the gift. Thank you for showing up for them.

Cotton O'Neil Neurosurgery and Spine Center — Stormont Vail Health Cotton O'Neil Kanza Park · 1st Floor · 2660 SW 3rd St · Topeka, KS 66606 · (785) 368-0767 chadtuchekmd.com

This handout provides general guidance for caregivers of patients of Dr. Chad Tuchek at Cotton O'Neil Neurosurgery and Spine Center, Stormont Vail Health. It is not individualized medical advice for any specific patient. Always follow the specific instructions provided at discharge and at follow-up. For medical emergencies, call 911.