Why is this procedure done?
Vagus nerve stimulation is also known as VNS. It is used to treat patients with seizures. Doctors may suggest this when other treatments are not working. In some cases, patients who have low mood that is not helped by other treatments are offered VNS. ‚
With this surgery, the doctor puts a small implant under your skin in your upper chest. It is a pulse generator and is close to the size of a stopwatch. The doctor threads a thin wire under your skin from the pulse generator to your neck. Then, the wire is attached to your vagus nerve. ‚
The implant sends out a small electrical pulse to your vagus nerve. These last about 30 seconds and happen about every 5 minutes. Doctors think this nerve affects the mood centers of your brain. ‚
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What will the results be?
Your seizures may get better and may go away fully. Your signs of low mood may get better and may go away fully. ‚
What happens before the procedure?
- Your doctor will take your history. Talk to your doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- When you need to stop eating or drinking before your treatment.
- Your doctor will do an exam and may order:
- Blood tests
- Chest x-ray
- Electrocardiogram, called an ECG
- You will not be allowed to drive right after the VNS treatment. Ask a family member or a friend to drive you home.
What happens during the procedure?
- Once you are in the operating room, the staff will put an I.V. in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery.
- Your doctor will make two cuts. The cut near your collarbone is for the wires that go to the vagus nerve. The cut in your chest is for the implant. The thin wires will be put into the vagus nerve in your neck. The wires will be tunneled under your skin down to your chest. The implant will be securely placed under the skin of your chest. The wires will be joined to the implant.
- Your doctor will close your cuts with stitches or staples and cover them with clean bandages.
- The procedure may take about 1 to 2 hours.
What happens after the procedure?
- You will go the Recovery Room after the surgery. The staff will watch you closely.
- There may be some pain at your surgery site. Tell the staff if there is pain. Your doctor may give you drugs for the pain.
- Within a few hours, the staff will help you begin to walk around.
- The doctor will give you teaching about your VNS implant, including any care needed. You will come back to the doctor to have the implant turned on.
What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
- Wear your medical alert ID.
- Always carry your implant information card. This card tells about your implant and lets other people know what to do in case of emergency.
- Talk to the doctor about how long you need to limit arm movement on the side where your implant was placed.
- Protect your chest from any blow or impact.
- Talk to your doctor about how to care for your cut site. Ask your doctor about:
- When you should change your bandages
- When you may take a bath or shower
- If you need to be careful with lifting things over 10 pounds
- When you may go back to your normal routines like work or driving
- Be sure to wash your hands before touching your wound or dressing.
What follow-up care is needed?
- Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
- You will need to come back to have the implant turned on. The doctor will slowly increase the power over time. Your doctor will want to watch your signs and how you are responding to your implant.
- Your doctor may order tests to check the electrical pulses from the implant.
- Your implant will be checked often to make sure it is working the right way.
- You may need to have the batteries of your implant replaced. This should be done before they run down. You may also need to have the wires replaced. Talk to your doctor about when you may need to have this done.
What lifestyle changes are needed?
- Avoid full contact sports such as football. These could harm the implant or may loosen the wires connected to your nerves.
- Some people have a change in voice quality during the brief electric pulse. Other sensations may include a tightening of your neck or throat muscles. You may be given a magnet to shut off the implant. You will use the magnet during a public speaking, singing, or hard exercise.
- Do not have deep heat treatment anywhere on your body, even if the implant is off. These can be risky if you have a VNS implant.
- Diagnostic ultrasounds and x-rays are safe. So are microwave ovens, appliances, and other electronic devices if they are working properly. Cell phones and MP3 players should not have any effect on your implant.
What problems could happen?
- Bleeding
- Infection
- Breakdown of your implant
- Nerve injury
- Hoarseness or voice changes
- Cough or sore throat
- Neck pain
- Problems swallowing
- Prickling or tingling of your skin
Where can I learn more?
Epilepsy Foundation ‚
http://www.epilepsyfoundation.org/aboutepilepsy/treatment/VNS/faq.cfm ‚
National Institute of Mental Health ‚
http://www.nimh.nih.gov/health/topics/brain-stimulation-therapies/brain-stimulation-therapies.shtml ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚