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|MVD related questions to consider...
NO MEDICAL CONCLUSIONS OR TREATMENT OPTIONS SHOULD BE BASED UPON THE INFORMATION CONTAINED ON THIS PAGE.
The proper course of treatment for any individual may vary from what is appropriate for other individuals, due to the actual condition and/or complications of that person. You should always consult your own medical team before proceeding with or deciding upon any course of treatment related to information presented on this website or elsewhere. It is understood that you need to visit with your own healthcare provider in order to reach a diagnosis for treatment.
The questions below are provided as a guide for different aspects of the MVD and are not meant to be all-inclusive or replace any questions or concerns that you may wish to address based on your own health. Although the questions are grouped by category, they are in no specific order related to each category. Feel free to customize this list to fit your own particular concerns.
QUESTIONS TO CONSIDER DISCUSSING DURING CONSULTATION RELATING TO A MICROVASCULAR DECOMPRESSION (MVD) SURGERY
I. SURGICAL CONCERNS
- Where did you receive your MVD training?
- How long have you been performing MVD’s?
- How many MVD’s have you performed?
- Of that number, how many have been specifically for HFS (or HFS and Trigeminal Neuralgia, if you suffer from both conditions)?
- What are the possible risks involved in having a MVD, and what type of complications (possibly temporary or permanent) should I be made aware of? What complications did your other patients experience?Is there anything I can do prior to the MVD to subdue or eliminate some of the possible side effects of the surgery?
- Do you utilize intra-operative monitoring which I understand can aid surgeons in protecting the hearing of the patient and increasing the likelihood that all compressions have been found and corrected during the surgery?
- Has there ever been a situation in which a patient’s MVD was started but had to be stopped prior to completion? If so, why and how soon after stopping was the MVD completed? How did this affect the ultimate outcome.
- What tests do you require prior to the MVD?
- Would you provide a list of some of your former HFS/MVD patients so that I could address some concerns with them? If that is not possible, would you be willing to share my contact information with them? (Note: Given the privacy laws we have today, if you want a surgeon to distribute your information, consider preparing an index or business card prior to your appointment and leave that with the surgeon for his/her office to distribute accordingly).
- I understand that as a teaching tool, medical students and less experienced surgeons may observe and/or participate during the surgery. If this is the case, what is your role and what will their role be during the surgery. (what parts will you perform, what parts will they perform). (i.e., do they position the patient, make the incision, drill the bone, perform the decompression, etc.)
- What material is used to decompress the vessel/nerve (i.e., Teflon fiber, balloon or muscle)? What keeps that material from slipping?
- What material do you use to fill the opening in the skull? Will there be any long-term concerns related to this material?
- Will I need a blood transfusion during/after surgery?
- Will I require oxygen during/after surgery?
- What size is the incision and where will it be located?
- How much hair is shaved?
- Will you use staples, sutures or another method to close the incision?
- Are there decisions made by the surgeon during surgery without the consent of the patient? If so, what may they be?
- There seem to be doctors who are either not familiar with the MVD or sometimes don’t recommend it except as a "last resort." Why do you feel this to be, since the MVD has been performed for more than 30 years?
- For Botox patients – how long after my last Botox injection before you recommend I have the MVD? Some surgeons recommend 9 months; is that your guideline as well? Would you please explain your reasoning in this regard?
- How does Botox affect the surgical procedure itself and also the outcome of the MVD?
- Should I prepare a Living Will, and should I bring a copy with me to the hospital?
- If my face is drooped as a result of having HFS or using Botox, is it possible for my face to be normal and symmetric again following the MVD?
- Does the length of time someone has had HFS play any role in how successful the MVD might be? For example, could someone who has had HFS for 1 year have an equally successful MVD as someone who has had it for 20 years? In my case, do you see any significant challenges or anything that would decrease the odds of a successful outcome?
- Sometimes patients have a successful MVD, only to have the spasms return after a period of time. What can cause spasms to recur after a successful MVD?
- How many of your patients have required subsequent MVD’s and why?
- Are there increased risks involved with a second (or subsequent) MVD?
- Do you believe having a MVD would be a good choice in my specific case?
II. POST-OP QUESTIONS
- How are post-op concerns such as headache, nausea, vomiting or vertigo handled after surgery?
- Some hospitals implement the use of a machine and stockings to aid in circulation (to prevent blood clots). What will be used in my case and how long should I expect this to be used during my recovery?
- Are there any post-op tests conducted, and if so, what are they?
- What are the most common post-op side effects?
- Are there danger signs post-operatively that I should look for?
- Are there any post-op problems that could require additional surgery? If so, what are they?
- What are the normal treatment options/medications used for post-op side effects?
- How long should I expect these side effects to last?
- What post-op problems would be considered permanent?
- Are there any other serious risks associated with MVD, i.e., death, heart attack, pneumonia, stroke, paralysis, etc. that I should be aware of, based on my own health factors.
- Is Tinnitus and/or ear fullness common after surgery? Is so, how long before they might disappear?
- How high is the risk of facial paralysis after MVD?
- Why does Bell’s Palsy occur after surgery in some patients? At what point might it appear, how long would it normally remain, and is there anything that I need to do about it?
- If there is no spinal fluid leak a week after the MVD, is it safe to assume it won’t be a problem?
- What is the likelihood of an infection occurring following surgery? What possible signs should I be looking for?
- Do you have patients stay in intensive care initially? If so, for how long?
- What is the normal length of stay in the hospital following MVD?
- What should I expect a typical recovery time to be?
- For those traveling out of town for the surgery, how long must they remain in the area following release from the hospital?
- Can I obtain a copy of my operative report for my own personal records? What about photographs or video captured during my procedure?
- How long after surgery before I can wash my hair?
- How soon after surgery is it safe to resume exercise? What exercises would you recommend initially?
- What restrictions should I expect and for how long?
III. ACCOMMODATIONS / TRAVEL HOME
- What hotels would you recommend in the area of the hospital? Do any of them offer discounted rates for surgery patients?
- Do the recommended hotels offer complementary transportation to and from the hospital?
- Is flying home a problem after MVD surgery, especially with the possibility of having a sudden cabin pressure change?
- Is travel by car, train or bus acceptable following surgery?