Arteriovenous Malformation Repair: What to Expect at Home

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Your Recovery

An arteriovenous malformation repair is surgery to remove a tangled bunch of blood vessels, called an arteriovenous malformation (AVM). The doctor removed the AVM through a cut (incision) in your scalp and the bone surrounding your brain (the skull).

The incision in your scalp may be sore for about a week after surgery. You may also have numbness near the incision, or swelling and bruising around your eyes. The incision may itch as it starts to heal. Medicine and ice packs can help with headaches, pain, swelling, and itching. You may feel more tired than usual for several weeks.

You may be able to do many of your usual activities after 4 to 6 weeks. But you will probably need 2 to 6 months to fully recover.

You may need therapy to help you with speech, walking, and other activities that were affected by the AVM and surgery. Most of your healing will take place in the first year after surgery, but you can continue to improve after that.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to feel better as quickly as possible.

How can you care for yourself at home?

Activity

  • Rest when you feel tired. You may feel sleepy more often than you did before the surgery. Plan to take a nap every day. Getting enough sleep will help you recover.
  • When you sit up after lying down, bring your head up slowly. This can prevent headaches or dizziness.
  • Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
  • Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, for 2 to 4 weeks or until your doctor says it is okay.
  • For 3 weeks, avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
  • Do not play any rough or contact sports until your doctor says it is okay.
  • You can wash your hair 2 to 3 days after your surgery. But do not soak your head or swim for 2 to 3 weeks.
  • You will probably need to take at least 6 weeks off from work. It depends on the type of work you do and how you feel.

Diet

  • You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • Follow your doctor's instructions about drinking fluids.
  • You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if and when to start taking those medicines again. Make sure that you understand exactly what your doctor wants you to do.
  • You may get medicines to prevent seizures and brain swelling. Take them exactly as directed by your doctor.
  • Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor has told you not to).
    • Ask your doctor for a different pain medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

  • If you have strips of tape on the incision, leave the tape on for a week or until it falls off.
  • Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage. Change the bandage every day.
  • Keep the area clean and dry.

Ice and elevation

  • For the first 1 to 2 days, you can use ice to reduce pain, swelling, and itching. Put ice or a cold pack on your head for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
  • Try not to lie flat when you rest or sleep. You can use a wedge pillow, or put a rolled towel or foam padding under your pillow.

Rehabilitation

  • Your doctor may recommend that you work with a speech therapist or occupational therapist if the surgery affected your speech or your ability to do your daily activities.

Other instructions

  • Do not use an enema or laxative unless your doctor says it is okay.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have sudden chest pain and shortness of breath, or you cough up blood.
  • You have severe trouble breathing.
  • You have symptoms of a stroke. These may include:
    • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
    • Sudden vision changes.
    • Sudden trouble speaking.
    • Sudden confusion or trouble understanding simple statements.
    • Sudden problems with walking or balance.
    • A sudden, severe headache that is different from past headaches.
  • Your body is jerking or shaking.
  • You feel very sleepy.

Call your doctor or nurse call line now or seek immediate medical care if:

  • You fall and hit your head.
  • You have a fever with a stiff neck or a severe headache.
  • You have any sudden vision changes.
  • Your have new or worse headaches.
  • You have trouble thinking clearly.
  • You are sick to your stomach or cannot keep fluids down.
  • You have pain that does not get better after you take pain medicine.
  • You have a fever over 38°C.
  • You have loose stitches, or your incision comes open.
  • Bright red blood has soaked through the bandage over your incision.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • Swollen lymph nodes in your neck, armpits, or groin.
    • A fever.
  • Your incision leaks fluid, or fluid builds up under your scalp near the incision.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if you have any problems.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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