Vagus nerve stimulation therapy: patient discharge information

Name of ward discharged from : . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Date of discharge : . . . . / . . . . / . . . .

Signature of nurse giving information: . . . . . . . . . . . . . . . . . . . . .

Name in block letters: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

You have been discharged from Addenbrooke's Hospital following surgical implantation of a vagus nerve stimulator (VNS) on . . . . . . . . . . . . . . under the care of Mr Morris, Consultant Surgeon. The following information may be of help after your discharge from hospital.

Will I be in pain following my operation for VNS?

As you are aware, you have two wound sites following this operation, one on the left side of your neck and the other on the left side of your chest. Both wound sites contain stitches with a dressing. These areas will be sore and uncomfortable, but should not cause you severe pain. Any ‘over the counter’ painkillers will be effective if you wish to treat the discomfort. Alternatively, you can ask your doctor prior to discharge, your GP or local chemist for advice.

What should I avoid doing to prevent any problems with the wound site?

Avoid lifting any heavy objects or physical work such as digging for the first couple of weeks.

What should I expect with my dressings?

There are no dressings to be removed. The incisions have a skin glue on them which will wash off at seven to 10 days. The incisions can be gently washed (during a shower or bath) after three days. It is normal for a little discharge of reddish fluid to occur after an operation. If you feel the ooze is increasing, please contact a member of the epilepsy surgery team at Addenbrooke's Hospital (contact details can be found at the back of the leaflet).

What should I expect with my wounds/scars?

The skin around both operation areas will be bruised, reddish in colour and swollen for several weeks. The scars will appear very red and swollen initially but will, for most people, gradually fade in colour and size depending upon your healing process. In some cases, the chest scar may remain red, thick and become raised. It is normal to see or feel the neck electrode if you move your neck in a specific position. You will also feel the VNS generator under your chest scar and it is normal for the generator to appear as a bump under your scar. The generator may also move slightly under your skin.

What should I do about the stitches?

The stitches are dissolvable and will have dissolved between seven and 10 days following surgery.

What should I do if I think the wound area is infected?

Occasionally a wound may become infected, if this happens, you may feel hot with or without a high temperature. One or both wounds may feel tight or hot and may produce a discharge with an offensive smell. If this occurs, you should contact a member of the epilepsy surgery team at Addenbrooke's Hospital. A course of oral antibiotics may be required and the wound will be reassessed, cleaned and redressed. Very rarely will the VNS need to be removed due to infection.

When will the VNS be switched on?

The VNS is usually switched on two to four weeks after the device has been implanted. You should receive an appointment to attend the VNS clinic in neuro outpatients at Addenbrooke’s Hospital.

What should I do about my epilepsy drugs?

You should continue taking your medication as usual. You should not stop any of medication or reduce the dose.

What information will I be given on discharge from hospital?

When you get discharged, you will be given a discharge letter, which you should give to your GP or another doctor/ health professional should you experience any problems.

How do you switch the VNS on?

The VNS is switched on using a hand held computer and wand – please see the pictures below. It is a simple and painless process. The occasional patient feels a tickle at the back of their throat and coughs a little. The magnet kit and information booklet will be fully explained to you and demonstrated during your outpatient appointment which should last approximately 30 minutes, so you have plenty of time to ask questions.

What should I do if I have a problem following my discharge from hospital or if I do not receive an outpatient appointment?

If you have a problem, or would like to ask a question or wish to book or rebook a VNS outpatient appointment, please contact:

• Erica Chisanga, epilepsy nurse consultant: 01223 217992
• Mr Robert Morris, consultant neurosurgeon, via his secretary on telephone: 01223245151 extension 4263 or via nurse practitioner (Samantha Oswald) bleep 154-680
• Dr M Manford, consultant neurologist, via his secretary: 01223 216759

If you need urgent advice out of hours, please contact the nurse in charge of the ward from where you were discharged.

Ward: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .