Preparing for Surgery When You Have Parkinson’s Disease

People living with Parkinson’s disease (PD) may need surgery to treat other health conditions not related to PD.

However, research shows that people with PD are more likely to have complications following surgery. Surgery can also temporarily worsen Parkinson’s symptoms.^1,2

This does not mean people with PD should avoid the surgery they need. Understanding the issues that may occur can help you and your doctor be prepared and take steps to have the best possible outcome.^2,3

Talk to your doctor

Talking to your doctor before your surgery is an important first step. This will allow you time to ask the questions you may have. It also gives you the chance to learn more about the surgery, your options with surgery, and what to expect before, during, and after.

Drug interactions

If you take any drugs to treat a condition, there is always a risk that another drug may cause problems and interact. This is also true for the regular drugs you take for PD. Some drugs that are commonly used before and after surgery may interact with your PD drugs, so these should not be given to you.^2,3

All your doctors and nurses must know that you have PD and which drugs you take before surgery. Talk to your doctor about which drugs may be needed and how these may impact your PD symptoms.^2,3

Do I need general anesthesia?

You may want to ask your doctor if you need general anesthesia (drugs that put you to sleep) for your surgery. People with PD may have more problems with general anesthesia than others. This may be due to a variety of reasons, including:^2,3

• The need to fast (not eat or drink) for hours before surgery. This usually includes not taking your normal PD drugs, which can cause increased PD symptoms.
• Increased sleepiness after surgery. Sometimes the effects of general anesthesia last for longer than they should.
• Increased confusion after surgery. Known as post-surgical delirium, this is more common in those with PD. This may complicated or prolong your recovery, so avoiding this complication is a goal.
• Problems with swallowing after surgery. Some people with PD have problems with swallowing, and general anesthesia may make this worse. Your nurse will introduce soft foods first while recovering from your procedure to avoid complications.

This does not mean you cannot have general anesthesia if you need it. Talk to your doctor about the best option for you. Not everyone with PD will have complications related to drugs used in surgery.^2,3

Medications and hospital stays

If you take your PD drugs at certain times during the day, a hospital stay can make this challenging. The nurses may not give you these drugs at the times you need to take them. This can cause your PD symptoms to worsen.

Talk to your doctors before surgery about how to maintain your drug schedule. Ensure that your drug list and schedule are available to those taking care of you before, during, and after surgery.^4,5

You will likely resume your usual drugs after surgery. This is a decision that your doctor will make and let you know when it is safe to do so. Your PD drugs may need to be adjusted after surgery. This is usually short-term and will be determined by your symptoms and what your doctors think is best.

Considerations before surgery

Before you decide on surgery, talk to your doctor about the risks and benefits. Ask questions about whether or not the surgery is needed, what alternatives are available, and the expected outcomes.

Things to keep in mind when considering surgery:^2,3

• Talk to your doctor before surgery
• Make sure all your providers have a list of your current drug schedule
• Prepare for hurdles along the way, and be aware that some complications are more common in PD. Understanding these will help you better understand the surgery.
• Ask a loved one or friend to stay with you when possible
• Be prepared and motivated to get moving after surgery. When possible, early and frequent movement after surgery leads to fewer complications.

Planning and talking to your doctors early and often can help you have a successful surgery.