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 What the patient should do prior to going into hospital
 The length of the stay in hospital
 What happens prior to the operation
 The amount of the patient’s hair to be shaved prior to surgery
 The reason for the admission to the intensive therapy unit (ITU) immediately after

surgery
 How the patient will feel when they wake up
 How soon they may be visited.

Some patients may receive financial benefits prior to surgery and it is important to discuss
what might happen if the operation were successful and the patient became seizure free. As
with all benefits, it is incumbent on the patient to report any change in circumstances,
including improvements in their health, that might affect their right to benefits, or the amount
of benefit they receive. Thus, when considering surgery, it is important that the patient is
made aware of this and the possible responsibility they would face if the operation were to
be completely successful. The counsellor would point out that a time may come when the
patient would no longer be considered disabled and therefore not qualify for the benefit that
they may have been receiving.

It is very important to have a plan that goes beyond successful surgery and to take into
account what the patient plans to do with their life in a number of ways. The counsellor may
advise on useful organisations for the patient to contact for help with training, finding
employment and general advice on grants, courses and access to education.

Practical advice

The counsellor will also discuss such issues as care of the wound following surgery,
recuperation at home, how soon the patient may expect to resume a variety of activities and
how long the effect of the anaesthetic may be expected to take to wear off.

Other areas of discussion commonly include:

 The importance of staying on their medication
 How soon can the patient do sport or vigorous exercise after surgery
 When the patient can have sex after surgery
 Who to contact in the case of medical problems during recuperation
 When the patient will be seen again by the surgeon, neurologist and psychiatrist
 Driving and the DVLA regulations
 How soon the patient may travel following surgery
 General advice on recuperation.

It is important for the patient to realise that losing their seizures may sometimes lead to other
problems and stresses in daily life and that this is one of the reasons for continued contact
with the hospital, neurologist, psychiatrist and counsellor for some time after discharge.

Common emotional problems after surgery

Patients need to understand that it is common to see mood swings and a combination of
anxiety and depression in 2030% of people who have epilepsy surgery. This may be
distressing and cause tiredness, loss of sleep, and poor appetite and make the patient feel on
edge. Symptoms may resolve on their own in about 46 weeks, although some patients may
need antidepressant medication or counselling. About 10% of people may go on to develop