After Surgery: Deep Brain Stimulation
Practical guidance on wound care, activity restrictions, what to expect before programming begins, and when to call your team.
What's Normal After Surgery
Expected Symptoms
- Soreness at incision sites (scalp and chest), bruising, and fatigue
- Swelling or bruising around the eyes — may take 1–2+ weeks to improve
- Ice packs (with a cloth barrier) may help with eye swelling if your team allows
Microlesion Effect — a Common Question
You may notice temporary improvement in tremor or Parkinson's symptoms before DBS is turned on. This happens from temporary brain swelling near the target. Symptoms often return as the swelling resolves — this is expected and does not mean the surgery didn't work. Programming will address your symptoms once healing is complete.
Incision Care
Keep Incisions Clean & Dry
- Do not apply ointments or creams unless your surgeon specifically tells you to
- No soaking (bath, pool, hot tub) until cleared — commonly at least 2 weeks
- Do not scratch your incision
Showering:
- Keep the dressing clean and dry for the first 48 hours
- After 48 hours: you may remove the dressing and leave the incision open to air (unless told otherwise)
- When showering is allowed: let water run gently over the area — do not scrub — pat dry with a clean towel
- Starting 5 days after surgery: wash your head and the incision gently with baby shampoo and water, rinse well, pat dry
Watch Closely for Infection
Call your team if you notice any of the following:
- Fever, spreading redness, warmth, or worsening swelling
- Drainage from any incision
- Wound opening or increasing pain at the incision site
Staple/suture removal: Commonly around 10–14 days. You will have a post-operative appointment with your neurosurgery team in 1–2 weeks for wound exam and suture removal. Please contact the office to confirm your appointment.
Activity & Lifting
These restrictions protect the leads, extension wire, and chest generator during healing. Your team will personalize the timeline based on your surgery and recovery.
✕ Avoid
- Heavy lifting (> 10 lbs), especially first 4–6 weeks
- Strenuous upper-body exercise
- Repetitive bending or twisting
- Anything that puts strong tension across the neck/chest where the extension wire runs
- Extreme overhead reaching on the side of the chest generator until cleared
✓ Do
- Walk daily as tolerated — increase gradually
- Sleep with your head elevated above heart level, semi-reclined or upright
- Use soft pillows to avoid pressure over your wounds
- Keep movements slow and controlled
Driving: Do not drive while taking opioid pain medication or if you feel foggy or dizzy. Return to driving depends on recovery — ask your team when it's safe.
Return to work: Timing depends on your recovery. Many patients return after initial healing and once programming begins. Your team will help you plan.
Pain Control & Medication
Important: Take your usual neurologic medications exactly as instructed by your DBS team. Do not change doses on your own.
Pain medication guidance
✓ You may take
Acetaminophen (Tylenol) 500–650 mg every 4–6 hours as needed for pain or headaches. Use prescribed pain medication only as directed.
✕ Do not take without clearance
Aspirin, ibuprofen (Advil), naproxen (Aleve), meloxicam, or any NSAIDs for at least 1 week. No blood thinners (Coumadin/warfarin, Plavix, Eliquis, Xarelto, Brilinta) unless instructed by your neurosurgical team.
Constipation is common — especially with opioids. Stay hydrated, eat fiber, and use stool softener or laxative as your team recommends.
What to Expect After Implant
DBS is usually not turned on immediately. Programming begins once healing is complete — typically 4–6 weeks after surgery.
Healing Phase (weeks 1–4)
DBS is off. Focus on wound healing, rest, and following activity restrictions. The microlesion effect may provide some temporary benefit.
Programming Begins (~4–6 weeks)
Your team starts turning on the system and adjusting settings. Programming is iterative — it may take multiple visits over weeks to months to optimize benefit.
Ongoing Optimization
Keep every follow-up appointment for wound checks and programming. Your team will also monitor battery and device function long-term.
When to Call or Go to the ER
Know When to Act
- Fever, spreading redness, warmth, worsening swelling, or drainage from any incision
- New or worsening severe headache and neck stiffness, increasing confusion, persistent vomiting
- New hardware concerns: rapidly worsening symptoms that feel "sudden," or concern that something shifted