After Pituitary Surgery Instructions

Vanderbilt Pituitary Center
1215 21st Avenue South #8210
MCE South Tower
Nashville, TN 37232
Phone: 615-343-8332 Fax: 615-343-8346
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Pituitary Surgery Discharge Instructions
The instructions will help you take care of yourself at home until your next appointment. Following them will help you to feel better and keep you safe. Your doctors may change the instructions to fit your particular needs.

Activity restrictions
• Do no blow your nose. You may sniff if necessary.
• No swimming
• Do not use Q-tips or other objects to clean your nostrils.
• Do no fly in an un-pressurized airplane
• Do no bend over. Bend at the knees to pick up something from the floor.
• Do not rub or pick at your nose.
• Do no drive until approval given by your eye doctor or other doctor.

It is OK to do these things:
• You may use saline nasal spray as recommended by the ear, nose, and throat surgeon.
• You may lightly dab nose with a soft handkerchief or tissue
• You may ride in a car as a passenger

Exercise/lifting
For the first 4 to 6 weeks after surgery, do not lift anything heavier than 5 pounds or do any kind of heavy exercise. The best exercise after surgery is walking. You should begin walking short distances immediately after surgery and gradually increase the distance. This will allow you to increase your overall strength and endurance. Wear comfortable, low-heeled shoes and stay on flat, even surfaces. You may climb stairs as soon as you feel like it. Be sure to use the handrail.

Travel
Your physician will tell you when it is safe to begin driving You may ride as a passenger. If you will be riding in a car or flying in an airplane for long distances, plan to stop every hour or 1 ˝ hours to stretch and walk around for a few minutes.

Returning to work
The type of work you do and the demands of your job will determine when you are able to return to work. Your doctor will discuss this with you during your follow-up appointment 4 to 8 weeks after surgery.

Medications
You will be given a prescription for Prednisone 5 mg tablets - Take 1 tablet every morning
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Take the prednisone with a small snack daily until you are instructed to stop by either the nurse or physician. The medication will be stopped only when your cortisol levels indicate it is safe to do so. ON THE MORNING OF YOUR FOLLOW-UP VISIT AFTER SURGERY, DO NOT TAKE THE PREDNISONE DOSE. Bring that morning's dose with you to the clinic so you may take it after your blood testing is complete.

You can expect some pain after surgery until the inflammation and sensitivity of the nerves has decreased. As you heal, you should need less pain medicine. The prescription is usually not refilled. Call your doctor if you still have considerable pain when you have taken all your pain medicine.

Constipation is a side effect of taking pain medicine. You may need to increase the fiber in your diet and take a stool softener or laxative that you can buy without a prescription.

Fluids
Ž ŽPay attention to how much fluid you drink and how much you urinate. Drink fluid to quench your thirst but do not drink excessively out of habit, unless you are thirsty. Dry mouth and thirst are different drink enough to relieve the dry mouth and if still thirsty, continue to take in fluids until the thirst is quenched. If you develop increased headache, dizziness, nausea, confusion, severe fatigue, excessive thirst or urination, or other concerning symptoms, go to the blood lab and have your blood drawn with a provided requisition. You will be given several requisitions for laboratory testing. The blood tests will need to be drawn only if there is a concern after surgery. If you do have blood testing, be sure to speak with a nurse or physician from the Pituitary Center later that day for guidance about fluid intake and any necessary medication.

Sometimes after surgery, patients develop a syndrome called DI (diabetes insipidus) which causes too much urine output and increased thirst. Contact us if you have these symptoms. You may need to start a medication called ddAVP (it is provided as either a nasal spray or a pill). If you take this medication, take it only as directed. Do not take your next dose until you start to urinate excessively again. After you take the medication, drink only to quench your thirst, do not over-drink.

Before surgery, you should find a local blood draw lab write down its name, phone number, and fax number so that it is convenient after surgery if we need to send you for testing.
Laboratory name and city________________Phone number ______________Fax number___________

Follow-up appointments
You will have a follow-up appointment at the Vanderbilt Pituitary Center 6 to 8 weeks after surgery. Be sure that this appointment is scheduled by calling 615-343-8332 after your surgery.

Important
Contact your endocrine physician if you experience any of these symptoms:
• Fever with a temperature higher than 101.5 degrees. Take 10 mg of prednisone until your fever subsides.
• Excessive thirst and urination.
• Nausea, vomiting, confusion, lightheadedness, inability to stay awake.
• Vomiting within 4 hours after taking your steroid medication --> take another dose -- > if you vomit again within 4 hours, go to a local emergency department for an injection of steroid medication.
Contact your neurosurgeon for emergencies OR if you experience any of these symptoms:
• In the next 2 weeks, fever with a temperature higher than 101.5 degrees.
• Yellowish-green, blood or clear, watery fluid dripping from your nose or in the back of your throat
• Worsening headache that is not relieved with pain medication
• Stiff, painful neck Ž
• Worsening of your vision
Contact the Pituitary Center by calling 615-343-8332. This phone is also answered at night and on the weekend for emergency calls.