What happens after pituitary surgery

Your key worker is a qualified endocrine nurse specialist who works closely with the ward staff and all the consultants to offer support, information and advice to you and your carers during your stay in the ward and when you are discharged.

Sara Canagon is based at Princess Royal Hospital, 01444 441881 extension 65660.

Sam Voss is based at the Royal Sussex County Hospital 01273 696955 extension 64379

Email address for all the above Nurses is uhsussex.ens@nhs.net

My key worker is:___________________________________________________________________

Hydrocortisone tablets are prescribed for all patients after pituitary surgery.

• Hydrocortisone is similar to cortisol, one of the body’s natural steroid hormones (chemical messengers).
• Without enough cortisol, you would become ill.
• Cortisol is produced by the adrenal glands in response to ‘messenger hormone’ instructions from the pituitary gland.
• After surgery, we will check whether or not your pituitary is still making these ‘messenger hormones’.

Usually after pituitary surgery we prescribe 15mg hydrocortisone to be taken first thing in the morning, and 5mg to be taken mid-afternoon, no later than 5pm. These doses of hydrocortisone can be taken on an empty stomach or with food.

For more information about hydrocortisone treatment and ‘sick day rules’ (what to do if you are ill) please read the patient information leaflet Long-term steroid hormone replacement therapy.

Your endocrine nurse specialist can also give you a copy.

To assess whether or not you will need to continue hydrocortisone treatment long-term you have been given or sent a form to have your blood taken.

• This needs to be done at your local hospital approximately one week before your follow-up clinic appointment at Hurstwood Park Hospital.
• You do not need to make an appointment but attend at 9 am. PLEASE OMIT YOUR HYDROCORTISONE ON THE MORNING OF THE TEST BUT TAKE WITH YOU TO HAVE AFTERWARDS.
• You do not need to fast, and you can take all your other medications.
• Please CONTINUE to take your hydrocortisone as usual until the results are available.

If you need further information about hydrocortisone treatment, contact your key worker.

The surgeons recommend that you wait for three months after pituitary surgery before you blow your nose or sneeze. If you have to sneeze, do so through an open mouth. Though this sounds odd, most patients manage it! This is to reduce the risk of infections going up through the surgical site.

You may get a headache after this type of operation. If your headache is severe or persistent or you are worried, please ring the Neurosurgical Ward Level 8A W at the Royal Sussex County Hospital, 01273 696955 Extension 4357 for advice.

If you have a headache associated with a fever (high temperature), a stiff neck, or a feeling that bright light bothers you, you should seek immediate medical advice from your nearest Accident and Emergency department, as this could be meningitis (an infection of the membrane lining the brain).

Feeling thirsty and passing lots of urine

If you start to pass a lot of urine (for example, if you pass the equivalent of a large cupful every hour for three hours) and/or if you feel very thirsty, contact your key worker. You should drink water if you are feeling thirsty.

Sometimes pituitary surgery affects your ability to retain water (diabetes insipidus). If this occurs, it usually settles down after a few days. However it may last longer and need hormone treatment.

Leaking clear fluid from your nose or throat

If you experience a clear fluid, like salt-water, dripping down the back of your throat or through your nose, seek immediate medical advice from your nearest Accident and Emergency department. This could be a leak of cerebrospinal fluid (the fluid that bathes the brain and spinal cord) which would need treatment.

Loss of vision

If your vision deteriorates, seek immediate medical advice from your nearest Accident and Emergency department, telling them that you recently had pituitary surgery.

Taste or smell

You may notice that your sense of taste or smell has been affected by the surgery. Although this is quite common immediately after the operation, it is usually a temporary problem which recovers with time.

Taste or smell

You may notice that your sense of taste or smell has been affected by the surgery. Although this is quite common immediately after the operation, it is usually a temporary problem which recovers with time.