This guide will help you get ready for your surgery to have your programmable or nonprogrammable ventriculoperitoneal (VP) shunt placed at Memorial Sloan Kettering (MSK). It will also help you understand what to expect during your recovery.
Read through this guide at least once before your surgery and use it as a reference in the days leading up to your surgery.
Bring this guide with you every time you come to MSK, including the day of your surgery. You and your healthcare team will refer to it throughout your care.
About Your 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).
The most common symptoms of hydrocephalus include:
- 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)
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.
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.
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 settings on the shunt. If you have a nonprogrammable VP shunt, your doctor will program the 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.
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.Back to top
Before Your Surgery
The information in this section will help you get ready for your surgery. Read through this section when your surgery is scheduled and refer to it as your surgery date gets closer. It has important information about what you need to do before your surgery.
Write down your questions and be sure to ask your doctor or nurse.
You and your healthcare team will work together to get ready for your surgery.
Help us keep you safe during your surgery by telling us if any of the following statements apply to you, even if you aren’t sure.
- I take a blood thinner. Some examples are aspirin, heparin, warfarin (Coumadin®), clopidogrel (Plavix®), enoxaparin (Lovenox®), dabigatran (Pradaxa®), apixaban (Eliquis®), and rivaroxaban (Xarelto®). There are others, so be sure your healthcare provider knows all the medications you’re taking.
- I take prescription medications (medications prescribed by a healthcare provider), including patches and creams.
- I take over-the-counter medications (medications I buy without a prescription), including patches and creams.
- 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 (medication to make you sleep during surgery) in the past.
- I am allergic to certain medication(s) or materials, including latex.
- I am not willing to receive a blood transfusion.
- I drink alcohol.
- I smoke.
- I use recreational drugs.
About Drinking Alcohol
The amount of alcohol you drink can affect you during and after your surgery. It’s important to talk with your healthcare providers about how much alcohol you drink. This will help us plan your care.
- If you stop drinking alcohol suddenly, it can cause seizures, delirium, and death. If we know you’re at risk for these complications, we can prescribe medications to help keep them from happening.
- If you drink alcohol regularly, you may be at risk for other complications during and after your surgery. These include bleeding, infections, heart problems, and a longer hospital stay.
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. If you develop a headache, nausea (feeling like you’re going to throw up), increased anxiety, or can’t sleep after you stop drinking, tell your healthcare provider right away. These are early signs of alcohol withdrawal and can be treated.
- Tell your healthcare provider if you can’t stop drinking.
- Ask your healthcare provider questions about drinking and surgery. As always, all of your medical information will be kept confidential.
If you smoke, you can have breathing problems when you have surgery. Stopping even for a few days before surgery can help. If you smoke, your nurse will refer you to our Tobacco Treatment Program. You can also reach the program by calling 212-610-0507.
About Sleep Apnea
Sleep apnea is a common breathing disorder that causes you to stop breathing for short periods of time while sleeping. The most common type is obstructive sleep apnea (OSA). With OSA, your airway becomes completely blocked during sleep. OSA can cause serious problems during and after surgery.
Please tell us if you have sleep apnea or if you think you might have it. If you use a breathing machine (such as a CPAP machine) for sleep apnea, bring it with you the day of your surgery.
Presurgical Testing (PST)
Before your surgery, you will have an appointment for presurgical testing (PST). The date, time, and location of your PST appointment will be printed on the appointment reminder from your surgeon’s office.
You can eat and take your usual medications the day of your PST appointment.
During your appointment, you will meet with a nurse practitioner (NP) who works closely with anesthesiology staff (doctors and specialized nurses who will give you anesthesia during your surgery). Your NP will review your medical and surgical history with you. You will have tests, including an electrocardiogram (EKG) to check your heart rhythm, a chest x-ray, blood tests, and any other tests needed to plan your care. Your NP may also recommend that you see other healthcare providers.
Your NP will talk with you about which medications you should take the morning of your surgery.
It’s very helpful to bring the following things to your PST appointment:
- A list of all the medications you’re taking, including prescription and over-the-counter medications, patches, and creams.
- Results of any tests done outside of MSK, such as a cardiac stress test, echocardiogram, or carotid doppler study.
- The name(s) and telephone number(s) of your doctor(s).
Identify Your Caregiver
Your caregiver plays an important role in your care. You and your caregiver will learn about your surgery from your healthcare provider. After your surgery, your caregiver should be with you when you’re given your discharge instructions so they’re able to help you care for yourself at home. Your caregiver will also need to take you home after you’re discharged from (leave) the hospital.
Complete a Health Care Proxy Form
If you haven’t already completed a Health Care Proxy form, we recommend you complete one now. A health care proxy is a legal document that identifies the person who will speak for you if you can’t communicate for yourself. The person you identify is called your health care agent. For more information about health care proxies and other advance directives, read the resource Advance Care Planning.
If you’re interested in completing a Health Care Proxy form, talk with your nurse. If you have completed one already, or if you have any other advance directives, bring them to your next appointment.
Do Breathing and Coughing Exercises
Practice taking deep breaths and coughing before your surgery. You will be given an incentive spirometer to help expand your lungs. For more information, read the resource How to Use Your Incentive Spirometer. If you have any questions, ask your nurse or respiratory therapist.
Try to do aerobic exercise every day. Examples of aerobic exercise include walking at least 1 mile (1.6 kilometers), swimming, or biking. If it’s cold outside, use stairs in your home or go to a mall or shopping center. Exercising will help your body get into its best condition for your surgery and make your recovery faster and easier.
Follow a Healthy Diet
Follow a well-balanced, healthy diet before your surgery. If you need help with your diet, talk with your doctor or nurse 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.
Stop Taking Vitamin E
If you take vitamin E, stop taking it 10 days before your surgery. Vitamin E can cause bleeding. For more information, read the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).
Buy Hibiclens® Skin Cleanser
Hibiclens is a skin cleanser that kills germs for 24 hours after you use it (see figure). Showering with Hibiclens before your surgery will help lower your risk of infection after surgery. You can buy Hibiclens at your local pharmacy without a prescription.
Stop Taking Certain Medications
If you take aspirin, ask your doctor if you should keep taking it. Aspirin and medications that contain aspirin can cause bleeding. For more information, read the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).
Stop Taking Herbal Remedies and Other Dietary Supplements
Stop taking herbal remedies and other dietary supplements 7 days before your surgery. If you take a multivitamin, ask your doctor or nurse if you should keep taking it. For more information, read the resource Herbal Remedies and Cancer Treatment.
Watch a Virtual Tour
This video will give you an idea of what to expect when you come to Memorial Hospital (MSK’s main hospital) on the day of your surgery.
Stop Taking Certain Medications
Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil®, Motrin®) and naproxen (Aleve®), 2 days before your surgery. These medications can cause bleeding. For more information, read the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).
Note the Time of Your Surgery
A staff member from the Admitting Office will call you after 2:00 pm the day before your surgery. If your surgery is scheduled for a Monday, they will call you on the Friday before. If you don’t get a call by 7:00 pm, please call 212-639-5014.
The staff member will tell you what time to arrive at the hospital for your surgery. They will also tell you where to go. This will be the following location:
Presurgical Center (PSC) on the 6th floor
1275 York Avenue (between East 67th and East 68th Streets)
New York, NY 10065
B elevator to 6th floor
Unless you are given other instructions, you can shower and wash your hair. Don’t use any hair products such as hair spray or hair gel.
The night before your surgery, shower using Hibiclens.
- Use your normal shampoo to wash your hair. Rinse your head well.
- Use your normal soap to wash your face and genital area. Rinse your body well with warm water.
- Open the Hibiclens bottle. Pour some solution into your hand or a washcloth.
- Move away from the shower stream to avoid rinsing off the Hibiclens too soon.
- Rub the Hibiclens gently over your body from your neck to your feet. Don’t put the Hibiclens on your face or genital area.
- Move back into the shower stream to rinse off the Hibiclens. Use warm water.
- Dry yourself off with a clean towel after your shower.
- Don’t put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne after your shower.
Go to bed early and get a full night’s sleep.
Instructions for eating and drinking before your surgery
Do not eat or drink after midnight.
Take Your Medications
If your doctor or NP told you to take certain medications the morning of your surgery, take only those medications with a sip of water. Depending on what medications you take and the surgery you’re having, this may be all, some, or none of your usual morning medications.
Shower With Hibiclens
Shower using Hibiclens just before you leave for the hospital. Use the Hibiclens the same way you did the night before.
Don’t put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne after your shower.
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.
- Don’t wear any metal objects. Remove all jewelry, including body piercings. The equipment used during your surgery can cause burns if it touches metal.
- Don’t put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne.
- Leave valuable items (such as credit cards, jewelry, and your checkbook) at home.
- Before you’re taken into the operating room, you will need to remove your hearing aids, dentures, prosthetic device(s), wig, and religious articles.
What to Bring
- Your breathing machine for sleep apnea (such as your CPAP machine), if you have one.
- Your portable music player, if you choose. However, someone will need to hold it for you when you go into surgery.
- Your incentive spirometer, if you have one.
- Your Health Care Proxy form and other advance directives, if you have completed them.
- Your cell phone and charger.
- Only the money you may want for small purchases (such as a newspaper).
- A case for your personal items (such as eyeglasses, hearing aid(s), dentures, prosthetic device(s), wig, and religious articles), if you have one.
- This guide. Your healthcare team will use this guide to teach you how to care for yourself after your surgery.
Where to Park
MSK’s parking garage is located on East 66th Street between York and First Avenues. If you have questions about prices, call 212-639-2338.
To reach the garage, turn onto East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There’s a tunnel that you can walk through that connects the garage to the hospital.
There are also other garages located on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, and East 65th Street between First and Second Avenues.
Once You’re in the Hospital
When you get to the hospital, take the B elevator to the 6th floor and check in at the desk in the PSC waiting room.
You will be asked to say and spell your name and birth date many times. This is for your safety. People with the same or a similar name may be having surgery on the same day.
Get Dressed for Surgery
When it’s time to change for surgery, you will get a hospital gown, robe, and nonskid socks to wear.
Meet With Your Nurse
You will meet with your nurse before surgery. Tell them the dose of any medications (including patches and creams) you took after midnight and the time you took them.
Your nurse may place an intravenous (IV) line into one of your veins, usually in your arm or hand. If your nurse doesn’t place the IV, your anesthesiologist will do it later once you’re in the operating room.
Meet With Your Anesthesiologist
Your anesthesiologist will:
- Review your medical history with you.
- Ask you if you’ve had any problems with anesthesia in the past, including nausea or pain.
- Talk with you about your comfort and safety during your surgery.
- Talk with you about the kind of anesthesia you will have.
- Answer your questions about your anesthesia.
Get Ready for Your Surgery
Once your nurse has seen you, 1 or 2 visitors can keep you company as you wait for your surgery to start. When it’s time for your surgery, your visitor(s) will be taken to the waiting area. Your visitors should read the resource Information for Family and Friends for the Day of Surgery.
You will either walk into the operating room or be taken in on a stretcher. A member of the operating room team will help you onto the operating bed. Compression boots will be placed 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 will fall asleep. You will also get fluids through your IV line during and after your surgery.
During Your Surgery
After you’re fully asleep, a breathing tube will be placed through your mouth and into your windpipe to help you breathe. You may also have a urinary (Foley®) catheter placed to drain urine from your bladder.
Once your surgery is finished, your incision will be closed with staples or sutures (stitches). Your incisions may be covered with a bandage. Your breathing tube is usually taken out while you’re still in the operating room.Back to top
After Your Surgery
The information in this section will tell you what to expect after your surgery, both during your hospital stay and after you leave the hospital. You will learn how to safely recover from your surgery.
Write down your questions and be sure to ask your doctor or nurse.
When you wake up after your surgery, you will be in the Post-Anesthesia Care Unit (PACU).
A nurse will be monitoring your body temperature, pulse, blood pressure, and oxygen levels. You may be getting oxygen through a thin tube that rests below your nose or a mask that covers your nose and mouth. You will also have compression boots on your lower legs.
While you’re in the PACU, your pain will be managed with medications.
Your visitors can see you briefly in the PACU, usually within 90 minutes after you arrive there. A member of the nursing staff will explain the guidelines to them.
Moving to Your Hospital Room
Once you recover from the anesthesia, you will be taken to your hospital room. The length of time you will stay in the PACU may also depend on when your hospital bed is ready for you.
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.
When you’re taken to your hospital room, you will meet one of the nurses who will care for you while you’re in the hospital. While you’re in the hospital, your nurses will teach you how to care for yourself while you’re recovering 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.
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 will get pain medication in your IV line. Once you’re able to eat normal food, you will get oral pain medication (medication you swallow).
Your doctor and nurse will ask you about your pain often and give you medication as needed. If your pain isn’t relieved, tell your doctor or nurse. It’s important to control your pain so you can use your incentive spirometer and move around. Controlling your pain will help you recover better.
You will be given a prescription for pain medication before you leave the hospital. Talk with your doctor or nurse about possible side effects and when you should start switching to over-the-counter pain medications.
Moving Around and Walking
Moving around and walking will help lower your risk for blood clots and pneumonia. It will also help stimulate your bowels so they start working again. Your nurse, physical therapist, or occupational therapist will help you move around if needed.
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. For more information, read the resource How to Use Your Incentive Spirometer.
- Do coughing and deep breathing exercises. A member of your care team will teach you how to do these exercises.
Eating and Drinking
You will be given 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.
To make sure your shunt is in the right place, you may have a computed tomography (CT) scan (imaging scan) of your head 1 to 2 days after your surgery. 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 11:00 am. 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.
Read the resource What You Can Do to Avoid Falling to learn about what you can do to stay safe and keep from falling at home and during your appointments at MSK.
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 medication. Some people have soreness, tightness, or muscle aches around their incision for 6 months or longer. This doesn’t mean that something is wrong.
Follow the guidelines below to help manage your pain at home.
- Take your medications as directed and as needed.
- Call your doctor if the medication prescribed for you doesn’t ease your pain.
- Don’t drive or drink alcohol while you’re taking prescription pain medication.
- As your incision heals, you will have less pain and need less pain medication. An over-the-counter pain reliever such as acetaminophen (Tylenol®) or ibuprofen (Advil®) will ease aches and discomfort.
- Follow your doctor or nurse’s instructions for stopping your prescription pain medication.
- Don’t take more acetaminophen than the amount directed on the bottle or as instructed by your doctor or nurse. Taking too much acetaminophen can harm your liver.
- Pain medication should help you resume your normal activities. Take enough medication to do your exercises comfortably. However, it’s normal for your pain to increase a little as you start to be more active.
- Keep track of when you take your pain medication. It works best 30 to 45 minutes after you take it. Taking it when your pain first begins is better than waiting for the pain to get worse.
Pain medication may cause constipation (having fewer bowel movements than what’s normal for you).
Talk with your nurse about how to manage constipation. You can also follow the guidelines below.
- Go to the bathroom at the same time every day. Your body will get used to going at that time. But, if you feel like you need to go, don’t put it off.
- Try to use the bathroom 5 to 15 minutes after meals. After breakfast is a good time to move your bowels. The reflexes in your colon are strongest at this time.
- Exercise, if you can. Walking is an excellent form of exercise.
- Drink 8 to 10 (8-ounce) glasses (2 liters) of liquids daily, if you can. Drink water, juices (such as prune juice), soups, ice cream shakes, and other drinks that don’t have caffeine. Drinks with caffeine, such as coffee and soda, pull fluid out of your body.
- Slowly increase the fiber in your diet to 25 to 35 grams per day. If you have an ostomy or have had recent bowel surgery, check with your doctor or nurse before making any changes in your diet. Foods high in fiber include:
- Whole-grain cereals and breads
- Unpeeled fruits and vegetables
- Mixed green salads
- Apricots, figs, and raisins
- Both over-the-counter and prescription medications are available to treat constipation. Try one of the following over-the-counter medications first.
- Docusate sodium (Colace®): This is a stool softener (medication that makes your bowel movements softer) that causes few side effects. Don’t take it with mineral oil.
- Polyethylene glycol (MiraLAX®): This is a laxative (medication that causes bowel movements) that causes few side effects. Take it with 8 ounces (1 cup) of a liquid.
- Senna (Senokot®): This is a stimulant laxative, which can cause cramping. It’s best to take it at bedtime.
For more information, read the resource Constipation.
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.
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 a mild shampoo, such as baby shampoo and soap during your shower. Don’t put soap directly on your incision and don’t rub the area around your incision.
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.
Eating and Drinking
You can eat all the foods you did before your surgery, unless your doctor gives you other instructions. Eating a balanced diet with lots of calories and protein will help you heal after surgery. Try to eat a good protein source (such as meat, fish, or eggs) at each meal. You should also try to eat fruits, vegetables, and whole grains.
It’s also important to drink plenty of liquids. Choose liquids without alcohol or caffeine. Try to drink 8 to 10 (8-ounce) glasses of liquids every day.
For more tips on eating and drinking after your surgery, read the resource Eating Well During and After Your Cancer Treatment.
If you have questions about your diet, ask to see a dietitian.
Physical Activity and Exercise
When you leave the hospital, your incision will look like it’s healed on the outside, but it won’t be healed on the inside. For the first 4 to 6 weeks after your surgery:
- Don’t lift anything heavier than 10 pounds (about 4.5 kilograms).
- Don’t do any strenuous activities (such as jogging and tennis).
- Don’t play any contact sports (such as football).
Doing aerobic exercise, such as walking and stair climbing, will help you gain strength and feel better. Walk at least 2 to 3 times a day for 20 to 30 minutes. You can walk outside or indoors at your local mall or shopping center.
It’s normal to have less energy than usual after your surgery. Recovery time is different for each person. Increase your activities each day as much as you can. Always balance activity periods with rest periods. Rest is an important part of your recovery.
Ask your doctor when you can drive. Most people can start driving again 4 to 6 weeks after surgery. Don’t drive while you’re taking pain medication 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 doctor or nurse about your job and when it may be safe for you to start working again. If your job involves lots of movement or heavy lifting, you may need to stay out a little longer than if you sit at a desk.
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
After surgery for a serious illness, you may have new and upsetting feelings. Many people say they felt weepy, sad, worried, nervous, irritable, and angry at one time or another. You may find that you can’t control some of these feelings. If this happens, it’s a good idea to seek emotional support.
The first step in coping is to talk about how you feel. Family and friends can help. Your nurse, doctor, and social worker can reassure, support, and guide you. It’s always a good idea to let these professionals know how you, your family, and your friends are feeling emotionally. Many resources are available to you and your family. Whether you’re in the hospital or at home, the nurses, doctors, and social workers are here to help you and your family and friends handle the emotional aspects of your illness.
MyMSK (my.mskcc.org) is your MSK patient portal account. You can use MyMSK to send and receive messages from your healthcare team, view your test results, see your appointment dates and times, and more.
If you don’t already have a MyMSK account, you can sign up by going to my.mskcc.org. For more information about signing up for a MyMSK account, watch our video How to Enroll in the Patient Portal: MyMSK. You can also contact the MyMSK Help Desk by emailing firstname.lastname@example.org or calling 800-248-0593.
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.Back to top
Safety Precautions for Your VP Shunt
The pressure setting of some programmable VP shunts may accidentally 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.
- 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.
- Don’t use the iPad 2 if you have a Medtronic Strata® programmable VP shunt.
- Don’t use earphones or headphones without checking the shunt manufacturer’s guidelines first.
If you need to have magnetic resonance imaging (MRI), you must tell your MRI technologist that you have a programmable VP shunt before you have the procedure. 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 programmable VP shunt you have, the magnet in the MRI machine may change your shunt’s pressure setting. After your MRI, the pressure setting will need to be checked and may need to be reprogrammed by your doctor or nurse. You may need to have x-rays to find out if the pressure setting has changed.
Some types of programmable VP shunts aren’t affected by MRI. Ask your doctor or nurse if your shunt will need to be reprogrammed after an MRI. You won’t need to take any precautions if you’re having a computed tomography (CT) scan or an x-ray.
Make an appointment to reprogram your VP shunt
Before you have 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.
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 (a condition in which the tissue that covers your abdomen is inflamed) or diverticulitis (a condition in which small, bulging pouches develop in the intestines or colon) and you need emergency surgery or antibiotics..
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.Back to top
Contact your doctor or nurse if:
Call your doctor or nurse 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 vision (eyesight) (blurry vision, double vision, or loss of vision)
- 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.
On Monday through Friday from 9:00 am to 5:00 pm, contact your doctor’s office.
After 5:00 pm, during the weekend, and on holidays, call 212-639-2000 and ask to speak to the doctor on call for your doctor.Back to top
This section contains a list of support services that may help you get ready for your surgery and recover safely.
Write down your questions and be sure to ask your doctor or nurse.
Call if you have questions about anesthesia.
Blood Donor Room
Call for more information if you’re interested in donating blood or platelets.
Bobst International Center
MSK welcomes patients from around the world. If you’re an international patient, call for help arranging your care.
At MSK, our chaplains are available to listen, help support family members, pray, contact community clergy or faith groups, or simply be a comforting companion and a spiritual presence. Anyone can request spiritual support, regardless of formal religious affiliation. The interfaith chapel is located near the main lobby of Memorial Hospital and is open 24 hours a day. If you have an emergency, please call the hospital operator and ask for the chaplain on call.
Many people find that counseling helps them. We provide counseling for individuals, couples, families, and groups, as well as medications to help if you feel anxious or depressed. To make an appointment, ask your healthcare provider for a referral or call the number above.
Food Pantry Program
The food pantry program provides food to people in need during their cancer treatment. For more information, talk with your healthcare provider or call the number above.
Integrative Medicine Service
Integrative Medicine Service offers many services to complement (go along with) traditional medical care, including music therapy, mind/body therapies, dance and movement therapy, yoga, and touch therapy.
Look Good Feel Better Program
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.
You can visit our library website or speak with the library reference staff to find more information about your specific cancer type. You can also visit LibGuides on MSK’s library website at libguides.mskcc.org.
Patient and Caregiver Support Program
You may find it comforting to speak with a cancer survivor or caregiver who has been through a similar treatment. Through our Patient and Caregiver Support Program, you’re able to speak with former patients and caregivers. These conversations may take place in person, over the phone, or through email.
Call if you have questions about preauthorization with your insurance company. This is also called preapproval.
Patient Representative Office
Call if you have questions about the Health Care Proxy form or if you have concerns about your care.
Perioperative Nurse Liaison
Call if you have questions about MSK releasing any information while you’re having surgery.
Private Duty Nursing Office
You may request private nurses or companions. Call for more information.
Resources for Life After Cancer (RLAC) Program
At MSK, care doesn’t end after active treatment. The RLAC Program is for patients and their families who have finished treatment. This program has many services, including seminars, workshops, support groups, counseling on life after treatment, and help with insurance and employment issues.
Sexual Health Programs
Cancer and cancer treatments can have an impact on your sexual health. MSK’s Sexual Health Programs can help you take action and address sexual health issues before, during, or after your treatment.
- Our Female Sexual Medicine and Women’s Health Program helps women who are dealing with cancer-related sexual health challenges, including premature menopause and fertility issues. For more information, or to make an appointment, call 646-888-5076.
- Our Male Sexual and Reproductive Medicine Program helps men who are dealing with cancer-related sexual health challenges, including erectile dysfunction. For more information, or to make an appointment, call 646-888-6024.
Social workers help patients, family, and friends deal with issues that are common for cancer patients. They provide individual counseling and support groups throughout the course of treatment, and can help you communicate with children and other family members. Our social workers can also help refer you to community agencies and programs, as well as financial resources if you’re eligible.
Tobacco Treatment Program
If you want to quit smoking, MSK has specialists who can help. Call for more information.
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.
American Cancer Society (ACS)
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
A resource for education, tools, and events for employees with cancer.
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
Provides support and education to people affected by cancer.
A place where men, women, and children living with cancer find social and emotional support through networking, workshops, lectures, and social activities.
Offers financial assistance to pay for copayments during treatment. Patients must have medical insurance, meet the income criteria, and be prescribed medication that’s part of the Good Days formulary.
LGBT Cancer Project
Provides support and advocacy for the LGBT community, including online support groups and a database of LGBT-friendly clinical trials.
Provides reproductive information and support to cancer patients and survivors whose medical treatments have risks associated with infertility.
National Cancer Legal Services Network
Free cancer legal advocacy program.
National LGBT Cancer Network
Provides education, training, and advocacy for LGBT cancer survivors and those at risk.
Lists Patient Assistance Programs for brand and generic name medications.
Provides prescription benefits to eligible employees and retirees of public sector employers in New York State.
Patient Advocate Foundation
Provides access to care, financial assistance, insurance assistance, job retention assistance, and access to the national underinsured resource directory.
This section contains the educational resources that were referred to throughout this guide. These resources will help you get ready for your surgery and recover safely after surgery.
Write down your questions and be sure to ask your doctor or nurse.
- Call! Don't Fall!
- Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
- Herbal Remedies and Cancer Treatment
- How to Use Your Incentive Spirometer
- Information for Family and Friends for the Day of Surgery
- What You Can Do to Avoid Falling