About Your Ventriculoperitoneal (VP) Shunt Surgery

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Time to Read: About 35 minutes

This guide will help you get ready for your ventriculoperitoneal (ven-TRIH-kyoo-LOH-PAYR-ih-toh-NEE-ul) shunt surgery at MSK. It will also help you know what to expect as you recover.

Use this guide as a source of information in the days leading up to your surgery. Bring it with you on the day of your surgery. You and your care team will use it as you learn more about your recovery.

About your VP shunt surgery

A VP shunt is used to drain extra cerebrospinal fluid (CSF) from your brain. CSF is the fluid that surrounds your brain and spinal cord. It’s made in the ventricles (hollow spaces) inside your brain.

CSF protects your brain and spinal cord by acting as a cushion. However, when you have too much of it, it puts pressure on your brain and skull. Extra CSF fluid can be caused by different things, such as a brain tumor, or it can be present when you’re born. This extra fluid also makes your ventricles grow bigger (see Figure 1). This is called hydrocephalus (hy-dro-ceph-a-lus).

Figure 1. Brain without and with hydrocephalus

Figure 1. Brain without (left) and with (right) hydrocephalus

Hydrocephalus

The most common symptoms of hydrocephalus include:

  • Headache.
  • Fatigue (feeling more tired or weak than usual), drowsiness (not able to stay awake or focus), or both.
  • Nausea (feeling like you’re going to throw up) and vomiting (throwing up).
  • Irritability (feeling angrier than usual).
  • Problems with thinking and memory, such as confusion.
  • Trouble with balance and walking.
  • Not being able to control when you urinate (pee).

VP shunt

To help drain the extra CSF from your brain, a VP shunt will be placed into your head. The VP shunt works by taking the fluid out of your brain and moving it into your abdomen (belly), where it’s absorbed by your body. This lowers the pressure and swelling in your brain.

Figure 2. VP shunt

Figure 2. VP shunt

A VP shunt has 3 parts (see Figure 2):

  • A one-way valve with a reservoir.
  • A short catheter (thin, flexible tube).
  • A long catheter.

The valve controls the flow of CSF fluid. It’s attached on one end to the short catheter so it can drain the fluid away from your brain. The short catheter can be placed in the front, back, or side of your head.

The reservoir collects a small amount of CSF which your doctor can use to sample your CSF for tests if needed.

The long catheter is attached to the other end of the valve. The long catheter is placed under your skin, behind your ear, down your neck, and into your abdomen (belly).

As the VP shunt drains extra CSF and lessens the pressure in your brain, it may ease some of your symptoms. Some symptoms will stop right after the VP shunt is inserted. Others will go away more slowly, sometimes over a few weeks.

The amount of fluid that’s drained by your VP shunt depends on the shunt’s settings. If you have a nonprogrammable VP shunt, your doctor will program the shunt’s settings in advance, and they can’t be changed. If you have a programmable VP shunt, the settings can be changed by your doctor if needed. Your doctor will decide which type of VP shunt is best for you.

VP shunt surgery

Your VP shunt surgery will take place in the operating room while you’re asleep. The surgery will take about 1 hour.

Once you’re asleep, the doctor will shave off some hair near the area where they will make the incision (surgical cut) on your head. Your entire head won’t be shaved.

Your doctor will make 3 small incisions: 1 in your head, 1 in your neck, and 1 in your abdomen. These incisions will help guide the catheter so it can be placed correctly. The doctor will close the incisions with stitches or staples.

You won’t be able to see the catheter because it will be under your skin. However, you may be able to feel the shunt catheter along your neck.

Once all the parts of the shunt are connected, it will start draining the excess CSF as needed to reduce the pressure in your brain.

Getting ready for your surgery

This section will help you get ready for your surgery. Read it when your surgery is scheduled. Refer to it as your surgery gets closer. It has important information about what to do to get ready.

As you read this section, write down questions to ask your healthcare provider.

Getting ready for your surgery

You and your care team will work together to get ready for your surgery. Help us keep you safe by telling us if any of these things apply to you, even if you’re not sure.

  • I take an anticoagulant (blood thinner), such as:
    These are examples of medicines. There are others.

    Be sure your healthcare provider knows all the medicines you’re taking.
    • Aspirin
    • Heparin
    • Warfarin (Jantoven®, Coumadin®)
    • Clopidogrel (Plavix®)
    • Enoxaparin (Lovenox®)
    • Dabigatran (Pradaxa®)
    • Apixaban (Eliquis®)
    • Rivaroxaban (Xarelto®)
  • I take an SGLT2 inhibitor, such as:
    • Canagliflozin (Invokana®)
    • Dapagliflozin (Farxiga®)
    • Empagliflozin (Jardiance®)
    • Ertugliflozin (Steglatro®)
  • I take prescription medicine(s), including patches and creams. A prescription medicine is one you can only get with a prescription from your healthcare provider.
  • I take over-the-counter medicine(s), including patches and creams. An over-the-counter medicine is one you can buy without a prescription.
  • I take dietary supplements, such as herbs, vitamins, minerals, or natural or home remedies.
  • I have a pacemaker, automatic implantable cardioverter-defibrillator (AICD), or other heart device.
  • I have sleep apnea.
  • I have had a problem with anesthesia (A-nes-THEE-zhuh) in the past. Anesthesia is medicine to make you sleep during a surgery or procedure.
  • I’m allergic to certain medicines or materials, including latex.
  • I’m not willing to receive a blood transfusion.
  • I drink alcohol.
  • I smoke or use an electronic smoking device, such as a vape pen or e-cigarette.
  • I use recreational drugs, such as marijuana.

About drinking alcohol

It’s important to talk with your healthcare providers about how much alcohol you drink. This will help us plan your care.

If you drink alcohol regularly, you may be at risk for problems during and after your surgery. These include bleeding, infections, heart problems, and a longer hospital stay.

If you drink alcohol regularly and stop suddenly, it can cause seizures, delirium, and death. If we know you’re at risk for these problems, we can prescribe medicine to help prevent them.

Here are things you can do before your surgery to keep from having problems.

  • Be honest with your healthcare providers about how much alcohol you drink.
  • Try to stop drinking alcohol once your surgery is planned. Tell your healthcare provider right away if you:
    • Get a headache.
    • Feel nauseous (like you’re going to throw up).
    • Feel more anxious (nervous or worried) than usual.
    • Cannot sleep.

These are early signs of alcohol withdrawal and can be treated.

  • Tell your healthcare provider if you cannot stop drinking.
  • Ask your healthcare provider questions about drinking and surgery. All your medical information will be kept private, as always.

About smoking

If you smoke, you can have breathing problems when you have surgery. Stopping for even a few days before your surgery can help.

Your healthcare provider will refer you to our Tobacco Treatment Program if you smoke. You can also reach the program by calling 212-610-0507.

About sleep apnea

Sleep apnea is a common breathing problem. If you have sleep apnea, you stop breathing for short lengths of time while you’re asleep. The most common type is obstructive sleep apnea (OSA). With OSA, your airway becomes fully blocked during sleep.

OSA can cause serious problems during and after surgery. Tell us if you have or think you might have sleep apnea. If you use a breathing device, such as a CPAP machine, bring it on the day of your surgery.

Using MyMSK

MyMSK (my.mskcc.org) is your MSK patient portal. You can use it to send and read messages from your care team, view your test results, see your appointment dates and times, and more. You can also invite your caregiver to make their own account so they can see information about your care.

If you do not have a MyMSK account, you can sign up at my.mskcc.org. You can get an enrollment ID by calling 646-227-2593 or your doctor’s office.

Watch How to Enroll in MyMSK: Memorial Sloan Kettering's Patient Portal to learn more. You can also contact the MyMSK Help Desk by emailing [email protected] or calling 800-248-0593.

Within 30 days of your VP shunt surgery

Presurgical testing (PST)

You’ll have a PST appointment before your surgery. You’ll get a reminder from your surgeon’s office with the appointment date, time, and location.

You can eat and take your usual medicine(s) the day of your PST appointment.

It’s helpful to bring these things to your appointment:

  • A list of all the medicines you’re taking, including prescription and over-the-counter medicines, patches, and creams.
  • Results of any medical tests done outside of MSK in the past year, if you have them. Examples include results from a cardiac stress test, echocardiogram, or carotid doppler study.
  • The names and telephone numbers of your healthcare providers.

You’ll meet with an advance practice provider (APP) during your PST appointment. They work closely with MSK’s anesthesiology (A-nes-THEE-zee-AH-loh-jee) staff. These are doctors with special training in using anesthesia during a surgery or procedure.

Your APP will review your medical and surgical history with you. You may have tests to plan your care, such as:

  • An electrocardiogram (EKG) to check your heart rhythm.
  • A chest X-ray.
  • Blood tests.

Your APP may recommend you see other healthcare providers. They’ll also talk with you about which medicine(s) to take the morning of your surgery.

Identify your caregiver

Your caregiver has an important role in your care. Before your surgery, you and your caregiver will learn about your surgery from your healthcare providers. After your surgery, your caregiver will take you home when you’re discharged. They’ll also help you care for yourself at home.

For caregivers

‌  Caring for a person going through cancer treatment comes with many responsibilities. We offer resources and support to help you manage them. Visit www.msk.org/caregivers or read A Guide for Caregivers to learn more.

Fill out a Health Care Proxy form

If you have not already filled out a Health Care Proxy form, we recommend you do now. If you already filled one out or have any other advance directives, bring them to your next appointment.

A health care proxy is a legal document. It says who will speak for you if you cannot communicate for yourself. This person is called your health care agent.

Talk with a member of your care team if you have questions about filling out a Health Care Proxy form.

Do breathing and coughing exercises

Practice taking deep breaths and coughing before your surgery. Your healthcare provider will give you an incentive spirometer to help expand your lungs. To learn more, read How To Use Your Incentive Spirometer.

Do physical activity

Doing physical activity will help your body get into its best condition for your surgery. It will also make your recovery faster and easier.

Try to do physical activity every day. Any activity that makes your heart beat faster, such as walking, swimming, or biking, is a good choice. If it’s cold outside, use stairs in your home or go to a mall or shopping center.

Follow a healthy diet

Follow a well-balanced, healthy diet before your surgery. If you need help with your diet, talk with your healthcare provider about meeting with a clinical dietitian nutritionist.

Tell us if you’re sick

If you develop any illness before your surgery, call the doctor who scheduled your surgery. This includes a fever, cold, sore throat, or the flu.

Buy a 4% chlorhexidine gluconate (CHG) solution antiseptic skin cleanser, such as Hibiclens®

4% CHG solution is a skin cleanser that kills germs for 24 hours after you use it. Showering with it before your surgery will help lower your risk of infection after surgery. You can buy a 4% CHG solution antiseptic skin cleanser at your local pharmacy without a prescription.

7 days before your VP shunt surgery

Follow your healthcare provider’s instructions for taking aspirin

Aspirin can cause bleeding. If you take aspirin or a medicine that has aspirin, you may need to change your dose or stop taking it 7 days before your surgery. Follow your healthcare provider’s instructions. Do not stop taking aspirin unless they tell you to.

To learn more, read How To Check if a Medicine or Supplement Has Aspirin, Other NSAIDs, Vitamin E, or Fish Oil

Stop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements

Vitamin E, multivitamins, herbal remedies, and other dietary supplements can cause bleeding. Stop taking them 7 days before your surgery. If your healthcare provider gives you other instructions, follow those instead.

To learn more, read Herbal Remedies and Cancer Treatment.

2 days before your VP shunt surgery

Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs, such as ibuprofen (Advil® and Motrin®) and naproxen (Aleve®), can cause bleeding. Stop taking them 2 days before your surgery. If your healthcare provider gives you other instructions, follow those instead.

To learn more, read How To Check if a Medicine or Supplement Has Aspirin, Other NSAIDs, Vitamin E, or Fish Oil.

1 day before your VP shunt surgery

Note the time of your surgery

A staff member will call you after the day before your surgery. If your surgery is scheduled for a Monday, they’ll call you the Friday before. If you do not get a call by , call 212-639-5014.

The staff member will tell you what time to get to the hospital for your surgery. They’ll also remind you where to go.

This will be the following location:

The Presurgical Center (PSC) at Memorial Hospital on the 6th floor
1275 York Ave. (between East 67th and East 68th streets)
New York, NY 10065
Take the B elevator to the 6th floor.

Shower with a 4% CHG solution antiseptic skin cleanser, such as Hibiclens, if needed

A member of your care team may tell you to shower with a 4% CHG solution the night before your surgery. If they do, follow these instructions.

Before you go to bed the night before your surgery:

  1. Wash your hair with your usual shampoo and conditioner. Rinse your head well.
  2. Wash your face and genital (groin) area with your usual soap. Rinse your body well with warm water.
  3. Open the 4% CHG solution bottle. Pour some into your hand or a clean washcloth.
  4. Move away from the shower stream. Rub the 4% CHG solution gently over your body from your neck to your feet. Do not put it on your face or genital area.
  5. Move back into the shower stream to rinse off the 4% CHG solution. Use warm water.
  6. Dry yourself off with a clean towel.

Do not put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne after your shower.

Instructions for eating and drinking before your surgery

Instructions for drinking: 8 hours before your arrival time

8 hours before your arrival time, do not eat or drink anything except these clear liquids:

  • Water.
  • Soda.
  • Clear juices, such as lemonade, apple, and cranberry juices. Do not drink orange juice or juices with pulp.
  • Black coffee or tea (without any type of milk or creamer).
  • Sports drinks, such as Gatorade®.
  • Gelatin, such as Jell-O®.

You can keep having these until 2 hours before your arrival time.

The day of your VP shunt surgery

Take your medicines as instructed

A member of your care team will tell you which medicines to take the morning of your surgery. Take only those medicines with a sip of water. Depending on what you usually take, this may be all, some, or none of your usual morning medicines.

Shower

Shower and wash your hair with baby shampoo the morning of your surgery. Don’t use conditioner or any other hair products such as hair spray or hair gel. After showering, don’t put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne.

Things to remember

  • Wear something comfortable and loose-fitting.
  • If you wear contact lenses, wear your glasses instead. Wearing contact lenses during surgery can damage your eyes.
  • Do not wear any metal objects. Take off all jewelry, including body piercings. The tools used during your surgery can cause burns if they touch metal.
  • Leave valuable items at home.
  • If you’re menstruating (have your monthly period), use a sanitary pad, not a tampon. We’ll give you disposable underwear and a pad if you need them.

What to bring

  • Your breathing device for sleep apnea (such as your CPAP machine), if you have one.
  • Your incentive spirometer, if you have one.
  • Your Health Care Proxy form and other advance directives, if you filled them out.
  • Your cell phone and charger.
  • Only the money you may want for small purchases, such as a newspaper.
  • A case for your personal items, if you have any. Eyeglasses, hearing aids, dentures, prosthetic devices, wigs, and religious articles are examples of personal items.
  • Your portable music player, if you choose. However, someone will need to hold it for you when you go into surgery.
  • This guide. You’ll use it to learn how to care for yourself after surgery.

Where to park

MSK’s parking garage is on East 66th Street between York and 1st avenues. If you have questions about prices, call 212-639-2338.

To get to the garage, turn onto East 66th Street from York Avenue. The garage is about a quarter of a block in from York Avenue. It’s on the right (north) side of the street. There’s a tunnel you can walk through that connects the garage to the hospital.

There are other parking garages on:

  • East 69th Street between 1st and 2nd avenues.
  • East 67th Street between York and 1st avenues.
  • East 65th Street between 1st and 2nd avenues.

Once you’re in the hospital

When you get to the hospital, take the B elevator to the 6th floor. Check in at the desk in the PSC waiting room.

Many staff members will ask you to say and spell your name and birth date. This is for your safety. People with the same or a similar name may be having surgery on the same day.

We’ll give you a hospital gown, robe, and nonskid socks to wear when it’s time to change for surgery.

Meet with a nurse

You’ll meet with a nurse before surgery. Tell them the dose of any medicines you took after midnight (12 a.m.) and the time you took them. Make sure to include prescription and over-the-counter medicines, patches, and creams.

Your nurse may place an intravenous (IV) line in one of your veins, usually in your arm or hand. If your nurse does not place the IV, your anesthesiologist (A-nes-THEE-zee-AH-loh-jist) will do it in the operating room.

Meet with an anesthesiologist

You’ll also meet with an anesthesiologist before surgery. They will:

  • Review your medical history with you.
  • Ask if you’ve had any problems with anesthesia in the past. This includes nausea (feeling like you’re going to throw up) or pain.
  • Talk with you about your comfort and safety during your surgery.
  • Talk with you about the kind of anesthesia you’ll get.
  • Answer questions you have about anesthesia.

Get ready for surgery

When it’s time for your surgery, you’ll take off your eyeglasses, hearing aids, dentures, prosthetic devices, wig, and religious articles.

You’ll either walk into the operating room or a staff member will bring you there on a stretcher. A member of the operating room team will help you onto the operating bed. They’ll put compression boots on your lower legs. These gently inflate and deflate to help blood flow in your legs.

Once you’re comfortable, your anesthesiologist will give you anesthesia through your IV line and you’ll fall asleep. You’ll also get fluids through your IV line during and after your surgery.

During Your Surgery

After you’re fully asleep, your care team will place a breathing tube through your mouth into your airway. It will help you breathe. They’ll also place a urinary (Foley) catheter in your bladder. It will drain your urine (pee) during your surgery.

Your surgeon will close your incisions with staples or stitches once they finish your surgery. They may also place Steri-Strips (thin pieces of surgical tape) or Dermabond® (surgical glue) over your incisions. They’ll cover your incisions with a bandage.

Your care team will usually take out your breathing tube while you’re still in the operating room.

Recovering after your surgery

This section will help you know what to expect after your surgery. You’ll learn how to safely recover from your surgery both in the hospital and at home.

As you read this section, write down questions to ask your healthcare provider.

In the Post-Anesthesia Care Unit (PACU)

You’ll be in the PACU when you wake up after your surgery. A nurse will be keeping track of your temperature, pulse, blood pressure, and oxygen levels. You may get oxygen through a tube resting below your nose or a mask over your nose and mouth. You’ll also have compression boots on your lower legs.

Pain medicine

While you’re in the PACU, you’ll get pain medicine to manage your pain.

Moving to your hospital room

You may stay in the PACU for a few hours or overnight . How long you stay depends on the type of surgery you had. A staff member will bring you to your hospital room after your stay in the PACU.

In your hospital room

The length of time you’re in the hospital after your surgery depends on your recovery. Most people stay in the hospital for 1 to 2 days.

In your hospital room, you’ll meet one of the nurses who will care for you during your stay.

Your care team will teach you how to care for yourself while you’re healing from your surgery. 

For the first few days after your surgery, your nurses will do simple tests to make sure your brain is working well.

They will do things such as:

  • Ask you questions such as where you are and what time of day it is.
  • Ask you to move your arms and legs.
  • Shine a small light into your eyes to check the response of your pupils.

Read the resource Call! Don't Fall! to learn about what you can do to stay safe and keep from falling while you’re in the hospital. You can find it in the “Educational resources” section of this guide.

Managing your pain

You may have a mild headache or feel discomfort around your incision for the first few days after your surgery. At first, you’ll get your pain medicine through your epidural catheter or IV line. Once you can eat, you’ll get oral pain medicine (pain medicine you swallow).

We will ask you about your pain often and give you medicine as needed. Tell one of your healthcare providers if your pain is not relieved. It’s important to control your pain so you can use your incentive spirometer and move around. Controlling your pain can help you recover faster.

You’ll get a prescription for pain medicine before you leave the hospital. Talk with your healthcare provider about possible side effects. Ask them when to start switching to over-the-counter pain medicine.

Moving around and walking

Moving around and walking will help lower your risk for blood clots and pneumonia (lung infection). It will also help you start passing gas and having bowel movements (pooping) again. Your nurse, physical therapist, or occupational therapist will help you move around, if needed.

To learn more about how walking can help you recover, read Frequently Asked Questions About Walking After Your Surgery.

To learn what you can do to stay safe and keep from falling while you’re in the hospital, read Call! Don't Fall!.

Exercising your lungs

It’s important to exercise your lungs so they expand fully. This helps prevent pneumonia.

  • Use your incentive spirometer 10 times every hour you’re awake. Read How To Use Your Incentive Spirometer to learn more.
  • Do coughing and deep breathing exercises. A member of your care team will teach you how.

Eating and drinking

You will get ice chips to eat after your surgery. You will start with a liquid diet and then you can start eating your normal foods again, as tolerated.

If you have questions about your diet, ask to see a clinical dietitian nutritionist.

Imaging scan

You may have a computed tomography (CT) scan (imaging scan) of your head 1 to 2 days after your surgery. This is to make sure your shunt is in the right place. Your nurse will give you more information about the scan before it’s done.

Caring for your incision

You will have bandages over your incision. Your doctor will take them off 1 to 2 days after your surgery. After that, you can leave them uncovered. Don’t get your incision wet, and don’t put any lotions, creams or powders on it for 5 days after your surgery.

Planning for your discharge

A physical therapist will work with you before you leave the hospital and help decide if you need help at home, such as special medical equipment or a home care nurse. If needed, your case manager will work with you to arrange for home care visits after you’re discharged from the hospital.

A caregiver should help you at home for a few days after your surgery while you recover. 

Leaving the hospital

By the time you’re ready to leave the hospital, your incision will have started to heal. Before you leave the hospital, look at your incision with your nurse and caregiver. Knowing what your incision looks like will help you notice any changes later.

On the day of your discharge, you should plan to leave the hospital around Before you leave, your doctor will write your discharge order and prescriptions. You will also get written discharge instructions. Your nurse will review these instructions with you before you leave.

If your ride isn’t at the hospital when you’re ready to be discharged, you may be able to wait in the Patient Transition Lounge. A member of your healthcare team will give you more information.

At home

Read What You Can Do to Avoid Falling to learn what you can do to keep from falling at home and during your appointments at MSK.

Your first appointment after your surgery will be 7 to 10 days after your surgery. Call your doctor’s office to schedule your appointment.

Managing your pain

People have pain or discomfort for different lengths of time. You may still have some pain when you go home and will probably be taking pain medicine. Some people have soreness, tightness, or muscle aches around their incision for 6 months or longer. This doesn’t mean something is wrong.

Follow these guidelines to help manage your pain at home.

  • Take your medicines as directed and as needed.
  • Call your healthcare provider if the medicine prescribed for you does not help your pain.
  • Do not drive or drink alcohol while you’re taking prescription pain medicine. Some prescription pain medicines can make you drowsy (very sleepy). Alcohol can make the drowsiness worse.
  • You’ll have less pain and need less pain medicine as your incision heals. An over-the-counter pain reliever will help with aches and discomfort. Acetaminophen (Tylenol®) and ibuprofen (Advil or Motrin) are examples of over-the-counter pain relievers.
    • Follow your healthcare provider’s instructions for stopping your prescription pain medicine.
    • Do not take too much of any medicine. Follow the instructions on the label or from your healthcare provider.
    • Read the labels on all the medicines you’re taking. This is very important if you’re taking acetaminophen. Acetaminophen is an ingredient in many over-the-counter and prescription medicines. Taking too much can harm your liver. Do not take more than one medicine that has acetaminophen without talking with a member of your care team.
  • Pain medicine should help you get back to your usual activities. Take enough to do your activities and exercises comfortably. You may have a little more pain as you start to be more active.
  • Keep track of when you take your pain medicine. It works best 30 to 45 minutes after you take it. Taking it when you first have pain is better than waiting for the pain to get worse.

Some prescription pain medicines, such as opioids, may cause constipation. Constipation is when you poop less often than usual, have a harder time pooping, or both.

Caring for your incisions

  • Check your incisions daily for any signs of infection, including redness, swelling, or drainage.
  • Keep your incisions clean and dry for 5 days after your surgery. Don’t shower for 5 days after your surgery. Avoid baths, hot tubs, and swimming pools until your doctor tells you it’s okay.
  • Don’t use a hair dryer, creams, ointment, or hair products on your incisions until they’re completely healed. This takes about 6 weeks.

It’s normal for the skin below your incisions to feel numb. This happens because some of your nerves were cut during your surgery. The numbness will go away over time.

Call your doctor’s office if:

  • The skin around your incisions is very red.
  • The skin around your incisions is getting more red.
  • You see drainage that looks like pus (thick and milky).

If you go home with staples or stitches in your incisions, your doctor will take them out during your first appointment after surgery. This is usually 7 to 10 days after your surgery.

Showering

Do not shower for 5 days after your surgery. You may take a sponge bath during this time, but don’t get your incision wet. Don’t use dry shampoo, creams or lotions near your incisions.

After 5 days, take a shower every day to clean your incision. If you have staples in your incision, it’s okay to get them wet.

Use mild shampoo, such as baby shampoo and soap during your shower.

After you shower, pat the area dry with a clean towel and leave your incision uncovered. Don’t put any creams, lotions, or powders on your incision.

Physical activity and exercise

Your incision may look like it’s healed on the outside when you leave the hospital. It will not be healed on the inside. For the first 4 to 6 weeks after your surgery:

  • Do not lift anything heavier than 10 pounds (4.5 kilograms).
  • Do not do any high-energy activities, such as jogging and tennis.
  • Do not play any contact sports, such as football.

Doing physical activity, such as walking and stair climbing, will help you gain strength and feel better. Try to get 20 to 30 minutes of physical activity at least 2 to 3 times a day. For example, you can walk outside or indoors at your local mall or shopping center.

It’s common to have less energy than usual after surgery. Recovery time is different for everyone. Do more activity each day as much as you can. Always balance activity periods with rest periods. Rest is an important part of your recovery.

Driving

Ask your healthcare provider when you can drive. Most people can start driving again 4 to 6 weeks after surgery. Do not drive while you’re taking pain medicine that may make you drowsy.

You can ride in a car as a passenger at any time after you leave the hospital.

Going back to work

Talk with your healthcare provider about your job. They’ll tell you when it may be safe for you to start working again based on what you do. If you move around a lot or lift heavy objects, you may need to stay out a little longer. If you sit at a desk, you may be able to go back sooner.

Traveling

You can travel by bus, train or car. Don’t travel on an airplane until your doctor says it’s okay.

When traveling a long distance, don’t sit for long periods of time. Stop every 2 hours and walk around. This will help keep blood clots from forming in your legs.

Managing your feelings

You may have new and upsetting feelings after a surgery for a serious illness. Many people say they felt weepy, sad, worried, nervous, irritable, or angry at one time or another. You may find that you cannot control some of these feelings. If this happens, it’s a good idea to seek emotional support. Your healthcare provider can refer you to MSK’s Counseling Center. You can also reach them by calling 646-888-0200.

The first step in coping is to talk about how you feel. Family and friends can help. We can also reassure, support, and guide you. It’s always a good idea to let us know how you, your family, and your friends are feeling emotionally. Many resources are available to you and your family. We’re here to help you and your family and friends handle the emotional aspects of your illness. We can help no matter if you’re in the hospital or at home.

Going back to your normal activities

You can go back to doing your normal activities when your doctor tells you it’s okay. If you plan to exercise, ask your doctor if it’s safe.

You will then have regular visits with your neurologist, neurosurgeon, or both. They will check on the function of your VP shunt over time.

Safety precautions for your VP shunt

Precautions with magnets

The pressure setting of some VP shunts may accidently change if you get too close to a magnet. This depends on the VP shunt model.

Ask your doctor if you need to take precautions (safety measures) when coming into contact with magnets. Be sure to follow the VP shunt manufacturer’s guidelines for magnet precautions specific for your type of shunt. Your doctor will go over these guidelines with you.

Here are some general rules for many programmable shunts:

  • Keep all products with magnets at least 2 inches away from the valve implant site (your head).
  • Don’t use magnetic therapy pads and pillows.

Precautions with magnetic resonance imaging (MRI)

If you need to have magnetic resonance imaging (MRI), you must tell your MRI technologist that you have a VP shunt before you have the test. Your technologist will need to know the model of your shunt and its setting.

Your nurse will give you a wallet card with this information. Carry it with you at all times. You can show your technologist the wallet card.

Depending on the type of VP shunt you have, the magnet in the MRI machine may change your shunt’s pressure setting. In this case, after your MRI, the pressure setting will need to be checked and may need to be reprogrammed by your doctor or nurse practitioner. In some cases, you may need to have X-rays  In some cases, you may need to have X-rays to find out if the pressure setting has changed.

Some types of VP shunts aren’t affected by MRI. Ask your doctor or nurse if your shunt will need to be reprogrammed after an MRI. No matter what type of VP shunt you have, you won’t need to take any precautions if you’re having a computed tomography (CT) scan, positron emission tomography (PET) scan, or an X-ray. 

If your VP shunt type needs to be reprogrammed after an MRI, you must schedule an appointment with your doctor or nurse to reprogram your VP shunt after your MRI. Your shunt should be reprogrammed within 4 hours after your MRI.

Precautions for abdominal surgery

If you ever need to have abdominal surgery, you must tell your doctor so that precautions can be taken. Tell your doctor if you have peritonitis or diverticulitis and you need emergency surgery or antibiotics. Peritonitis is a condition in which the tissue that covers your abdomen is inflamed. Diverticulitis is a condition in which small, bulging pouches develop in the intestines or colon.

MedicAlert® jewelry

You should always wear a MedicAlert® bracelet or necklace that says you have hydrocephalus and a VP shunt. If you’re ever very sick or hurt and need medical help, MedicAlert jewelry will let emergency service workers know about your VP shunt.

You can purchase this type of bracelet or necklace at most drug stores. For more information, visit the MedicAlert® website at: www.medicalert.org.

When to call your healthcare provider

Call your healthcare provider if you have any of the following signs and symptoms that your VP shunt isn’t working properly:

  • Vomiting with little or no nausea.
  • A constant headache that won’t go away.
  • Problems with your eyesight, such as blurry vision, double vision, or loss of vision.
  • Irritability.
  • Fatigue.
  • Loss of coordination or balance.
  • Swelling, redness, or both, of the skin that runs along the shunt path
  • Difficulty waking up or staying awake.

Call your doctor or nurse if you have signs and symptoms of a VP shunt infection. A VP shunt infection can happen when bacteria infect the tissue around your VP shunt. When the tissue is infected, it can cause your VP shunt to stop working properly and increase pressure in your brain. The signs and symptoms of a VP shunt infection include:

  • A fever of 100.4° F (38° C) or higher
  • Redness, swelling, or both, of the skin that runs along the shunt path
  • Pain around the shunt or around the shunt catheter from the head to the abdomen

These warning signs can happen quickly. If any of these symptoms develop, call your doctor or nurse immediately.

Contact information

Monday through Friday from to , call your healthcare provider’s office.

After , during the weekend, and on holidays, call 212-639-2000. Ask to speak to the person on call for your healthcare provider.

Support services

This section has a list of support services. They may help you as you get ready for your surgery and recover after your surgery.

As you read this section, write down questions to ask your healthcare provider.

MSK support services

Admitting Office
212-639-7606
Call if you have questions about your hospital admission, such as asking for a private room.

Anesthesia
212-639-6840
Call if you have questions about anesthesia.

Blood Donor Room
212-639-7643
Call for information if you’re interested in donating blood or platelets.

Bobst International Center
332-699-7968
We welcome patients from around the world and offer many services to help. If you’re an international patient, call for help arranging your care.

Counseling Center
www.msk.org/counseling
646-888-0200
Many people find that counseling helps them. Our Counseling Center offers counseling for individuals, couples, families, and groups. We can also prescribe medicine to help if you feel anxious or depressed. Ask a member of your care team for a referral or call the number above to make an appointment.

Food Pantry Program
646-888-8055
We give food to people in need during their cancer treatment. Talk with a member of your care team or call the number above to learn more.

Integrative Medicine Service
www.msk.org/integrativemedicine
Our Integrative Medicine Service offers many services to complement (go along with) traditional medical care. For example, we offer music therapy, mind/body therapies, dance and movement therapy, yoga, and touch therapy. Call 646-449-1010 to make an appointment for these services.

You can also schedule a consultation with a healthcare provider in the Integrative Medicine Service. They’ll work with you to make a plan for creating a healthy lifestyle and managing side effects. Call 646-608-8550 to make an appointment for a consultation.

MSK Library
library.mskcc.org
212-639-7439
You can visit our library website or call to talk with the library reference staff. They can help you find more information about a type of cancer. You can also visit the library’s Patient and Health Care Consumer Education Guide.

Nutrition Services
www.msk.org/nutrition
212-639-7312
Our Nutrition Service offers nutritional counseling with one of our clinical dietitian nutritionists. Your clinical dietitian nutritionist will talk with you about your eating habits. They can also give advice on what to eat during and after treatment. Ask a member of your care team for a referral or call the number above to make an appointment.

Patient and Community Education
www.msk.org/pe
Visit our patient and community education website to search for educational resources, videos, and online programs.

Patient Billing
646-227-3378
Call if you have questions about preauthorization with your insurance company. This is also called preapproval.

Patient Representative Office
212-639-7202
Call if you have questions about the Health Care Proxy form or concerns about your care.

Perioperative Nurse Liaison
212-639-5935
Call if you have questions about MSK releasing any information while you’re having surgery.

Private Duty Nurses and Companions
917-862-6373
You can request private nurses or companions to care for you in the hospital and at home. Call to learn more.

Rehabilitation Services
www.msk.org/rehabilitation
Cancers and cancer treatments can make your body feel weak, stiff, or tight. Some can cause lymphedema (swelling). Our physiatrists (rehabilitation medicine doctors), occupational therapists (OTs), and physical therapists (PTs) can help you get back to your usual activities.

  • Rehabilitation medicine doctors diagnose and treat problems that affect how you move and do activities. They can design and help coordinate your rehabilitation therapy program, either at MSK or somewhere closer to home. Call Rehabilitation Medicine (Physiatry) at 646-888-1929 to learn more.
  • An OT can help if you’re having trouble doing usual daily activities. For example, they can recommend tools to help make daily tasks easier. A PT can teach you exercises to help build strength and flexibility. Call Rehabilitation Therapy at 646-888-1900 to learn more.

Resources for Life After Cancer (RLAC) Program
646-888-8106
At MSK, care does not end after your treatment. The RLAC Program is for patients and their families who have finished treatment.

This program has many services. We offer seminars, workshops, support groups, and counseling on life after treatment. We can also help with insurance and employment issues.

Sexual Health Programs
Cancer and cancer treatments can affect your sexual health, fertility, or both. MSK’s sexual health programs can help you before, during, or after your treatment.

Social Work
www.msk.org/socialwork
212-639-7020
Social workers help patients, families, and friends deal with common issues for people who have cancer. They provide individual counseling and support groups throughout your treatment. They can help you communicate with children and other family members.

Our social workers can also help refer you to community agencies and programs. If you’re having trouble paying your bills, they also have information about financial resources. Call the number above to learn more.

Spiritual Care
212-639-5982
Our chaplains (spiritual counselors) are available to listen, help support family members, and pray. They can contact community clergy or faith groups, or simply be a comforting companion and a spiritual presence. Anyone can ask for spiritual support. You do not have to have a religious affiliation (connection to a religion).

MSK’s interfaith chapel is located near Memorial Hospital’s main lobby. It’s open 24 hours a day. If you have an emergency, call 212-639-2000. Ask for the chaplain on call.

Tobacco Treatment Program
www.msk.org/tobacco
212-610-0507
If you want to quit smoking, MSK has specialists who can help. Call to learn more.

Virtual Programs
www.msk.org/vp
We offer online education and support for patients and caregivers. These are live sessions where you can talk or just listen. You can learn about your diagnosis, what to expect during treatment, and how to prepare for your cancer care.

Sessions are private, free, and led by experts. Visit our website to learn more about Virtual Programs or to register.

External support services

Access-A-Ride
web.mta.info/nyct/paratran/guide.htm
877-337-2017
In New York City, the MTA offers a shared ride, door-to-door service for people with disabilities who can’t take the public bus or subway.

Air Charity Network
www.aircharitynetwork.org
877-621-7177
Provides travel to treatment centers.

American Cancer Society (ACS)
www.cancer.org
800-ACS-2345 (800-227-2345)
Offers a variety of information and services, including Hope Lodge, a free place for patients and caregivers to stay during cancer treatment.

Cancer and Careers
www.cancerandcareers.org
646-929-8032
A resource for education, tools, and events for employees with cancer.

CancerCare
www.cancercare.org
800-813-4673
275 Seventh Avenue (Between West 25th & 26th Streets)
New York, NY 10001
Provides counseling, support groups, educational workshops, publications, and financial assistance.

Cancer Support Community
www.cancersupportcommunity.org
Provides support and education to people affected by cancer.

Caregiver Action Network
www.caregiveraction.org
800-896-3650
Provides education and support for people who care for loved ones with a chronic illness or disability.

Corporate Angel Network
www.corpangelnetwork.org
866-328-1313
Offers free travel to treatment across the country using empty seats on corporate jets.

Good Days
www.mygooddays.org
877-968-7233
Offers financial assistance to pay for copayments during treatment. Patients must have medical insurance, meet the income criteria, and be prescribed medicine that’s part of the Good Days formulary.

HealthWell Foundation
www.healthwellfoundation.org
800-675-8416
Provides financial assistance to cover copayments, health care premiums, and deductibles for certain medicines and therapies.

Joe’s House
www.joeshouse.org
877-563-7468
Provides a list of places to stay near treatment centers for people with cancer and their families.

LGBT Cancer Project
www.lgbtcancer.com
Provides support and advocacy for the LGBT community, including online support groups and a database of LGBT-friendly clinical trials.

LIVESTRONG Fertility
www.livestrong.org/we-can-help/fertility-services
855-744-7777
Provides reproductive information and support to cancer patients and survivors whose medical treatments have risks associated with infertility.

Look Good Feel Better Program
www.lookgoodfeelbetter.org
800-395-LOOK (800-395-5665)
This program offers workshops to learn things you can do to help you feel better about your appearance. For more information or to sign up for a workshop, call the number above or visit the program’s website.

National Cancer Institute
www.cancer.gov
800-4-CANCER (800-422-6237)

National LGBT Cancer Network
www.cancer-network.org
Provides education, training, and advocacy for LGBT cancer survivors and those at risk.

Needy Meds
www.needymeds.org
Lists Patient Assistance Programs for brand and generic name medicines.

NYRx
www.health.ny.gov/health_care/medicaid/program/pharmacy.htm
Provides prescription benefits to eligible employees and retirees of public sector employers in New York State.

Patient Access Network (PAN) Foundation
www.panfoundation.org
866-316-7263
Gives help with copayments for patients with insurance.

Patient Advocate Foundation
www.patientadvocate.org
800-532-5274
Provides access to care, financial assistance, insurance assistance, job retention assistance, and access to the national underinsured resource directory.

Professional Prescription Advice
www.pparx.org
888-477-2669
Helps qualifying patients without prescription drug coverage get free or low-cost medicines.

Red Door Community (formerly known as Gilda’s Club)
www.reddoorcommunity.org
212-647-9700
A place where people living with cancer find social and emotional support through networking, workshops, lectures, and social activities.

RxHope
www.rxhope.com
877-267-0517
Provides assistance to help people get medicines they have trouble affording.

Triage Cancer
www.triagecancer.org
Provides legal, medical, and financial information and resources for cancer patients and their caregivers.

Educational resources

This section lists the educational resources mentioned in this guide. They will help you get ready for your surgery and recover after your surgery.

As you read these resources, write down questions to ask your healthcare provider.

Last Updated

Thursday, March 14, 2024

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