Dr Adam Wells
  (08) 7127 2359

I’ve been diagnosed with a brain tumour. What do I do now?

• Brain tumours are very common and many do not need surgical intervention. Unfortunately however a large number of newly diagnosed brain tumours are malignant in nature, including cerebral metastases (secondary tumours that have travelled to the brain from another part of the body) or glioblastomas (aggressive primary brain tumours). Malignant tumours frequently need surgical resection, followed by radiation therapy and chemotherapy. If you have been diagnosed with a malignant brain tumour please contact Dr Wells on (08) 7127 2359 for an urgent appointment.

 

If I have had brain tumour surgery will I need chemotherapy and/or radiation therapy?

• For malignant or aggressive brain tumours most patients will need a course of radiation therapy and chemotherapy after they have recovered from their brain surgery. Radiation therapy is usually once per day, Monday to Friday, for up to 6 weeks; chemotherapy is most commonly an oral tablet taken daily for one week every month for up to 12 months. If your tumour is a type that needs radiation therapy and/or chemotherapy Dr Wells has a close network of skilled oncology doctors that he refers to for adjuvant treatment.

• If you have a benign brain tumour such as a meningioma then most commonly surgical resection is all that is required for cure, however you may still need ongoing post-operative surveillance imaging in the future to ensure it does not come back.

 

I have developed very bad sciatica and can barely walk. Do I need surgery?

• You might, but the good news is that in most cases acute disc prolapses that cause sciatica frequently repair themselves within about 8 weeks. Some people benefit from a percutaneous cortisone injection (a nerve root block) to help with pain control. Only a small number of people will ultimately need surgery; Dr Wells can discuss this with you at your appointment.

 

What is the wait time for an appointment?

• For non-urgent appointments most patients can be seen within 4-6 weeks after we receive a referral from your General Practitioner. If you need an urgent appointment this can usually happen within a week of receiving a referral, such as for a newly diagnosed brain tumour.

• Dr Wells has online access to all of the major radiology companies in South Australia, including Jones and Partners, Benson Radiology, Radiology SA, Fowler Simmons Radiology and South Australian Medical Imaging (SAMI). He can bring up your scans on his widescreen monitor in the rooms during your consultation, so you do not need to bring your current x-rays, CT or MRI scans with you at the time of your appointment.

 

I live in the country. Does Dr Wells offer telehealth consultations?

• Yes. If you live far away from Adelaide we can offer a telehealth consultation for both your initial consultation and for follow up consultations. At some point however it would be advantageous for a face to face consultation to occur in order for Dr Wells to perform an appropriate physical examination.

 

Does Dr Wells perform minimally invasive (keyhole) surgery?

• Yes. Dr Wells was trained in Cambridge University the technique of performing minimally invasive tubular retraction lumbar spine surgery, also known as keyhole surgery. At present most health funds do not cover the additional expense associated with hiring the equipment required for keyhole surgery, therefore if you would like to explore this option please ask and we can obtain a quote for any additional costs that this procedure would involve.

 

What is a craniotomy?

• A craniotomy is an operation in which a part of the skull is removed to gain access to the brain, usually in order to resect a brain tumour or evacuate an intracranial haematoma (blood clot) or infection. Some brain operations can be performed without performing a craniotomy, for instance if a needle biopsy of a brain tumour is being performed only a small window of access is required, this is called a burr hole and is only about the size of a 5c coin.

 

Do I need a spinal fusion?

• It depends. Most lumbar spine surgery can be performed by simply decompressing nerves and nerve roots from a posterior approach without fusing the bones, but some conditions may need an interbody fusion to properly treat the changes in your spine. Dr Wells will discuss this with you at the time of your appointment. Cervical spine problems causing spinal cord or nerve root compression are usually best treated by an anterior approach through a small incision at the front of the neck, and this is generally completed by fusing the cervical vertebrae. Again, Dr Wells will discuss this with you.

 

What is the wait time for surgery?

• For patients with private health insurance not very long at all. Dr Wells operates most Thursdays at St Andrew’s Private Hospital, and can generally accommodate surgical dates to your preference.

 

Is surgery expensive?

• Health insurance premiums continue to rise but unfortunately many private funds are not passing these fees on in the form of rebates for providers, which makes it increasingly difficult to maintain quality surgical services. As a member of the Australian Medical Association Dr Wells practices within the fee structure that the AMA recommends which incorporates a co-payment for surgery, however if you are a pensioner or on a restricted budget please talk to reception staff about how we can help to minimise these out of pocket costs. For patients not covered by private health insurance Dr Wells also operates at the Royal Adelaide Hospital and your GP can refer you to the RAH as a public patient.

 

I’m very worried about having an operation. Will Dr Wells discuss my concerns with me?

• Of course! Dr Wells offers a very personal and individualised approach to Neurosurgery. Many patients are very anxious about the thought of surgery, and not everyone needs an operation to help manage their problems. Dr Wells is happy to discuss your concerns with you and work with you to find a management strategy that best meets your needs.

 

I have a lot of medical comorbidities or allergies. Will this affect my treatment?

• It might. Some patients have significant heart or lung conditions in which surgery carries increased risks of a complication happening. These patients may benefit from seeing a Cardiologist or General Physician pre-operatively to optimise their medical conditions as best as possible before surgery; Dr Wells can arrange this. In addition some patients benefit from an Anaesthetic review prior to surgery; again, Dr Wells will discuss this with you and arrange it if required.

 

Do I need to stop any medications before surgery?

• Some medications can interfere with blood clotting, such as Aspirin, Warfarin and Plavix, and these will need to stop before surgery. Some other medications like non-steroidal anti-inflammatories (such as Nurofen) can also interfere with bleeding and should be discontinued. Dr Wells will give you clear instructions about which medications you should stop before your surgery and which ones are safe to continue.

 

What happens during my hospital stay?

• You will either be admitted on the day prior to your surgery, or very early on the morning of your surgery. You must fast for your operation, usually from around midnight the night prior. When you arrive in the operating theatre you will be greeted by the theatre staff, and a World Health Organisation ‘Team Time Out’ will take place ensuring your correct identity, any drug allergies, and what procedure you are having, including side if appropriate. When you wake from surgery you will spend some time in the Recovery room where Dr Wells will talk to you and assess you, and Dr Wells will also contact your nominated next of kin with the results of surgery. After an appropriate amount of time in Recovery you will be taken back to the general ward or the Critical Care Unit, depending on what operation you had and/or your medical history and requirements. You can have visitors later that day. A Physiotherapist will treat you from the first post-operative day. Dr Wells will see you every day you are in hospital. You may need post-operative x-rays or scans which Dr Wells will arrange. Most people are in hospital for 2 or 3 days recovering from their surgery, however this will depend a lot on what operation you have and your personal requirements. When you leave hospital Dr Wells will write to your General Practitioner to notify them of the events of your hospital stay. In almost every case Dr Wells uses dissolvable sutures that do not need to be removed, and he will discuss with you how to care for your dressings and your wound.

 

Can I drive after surgery?

• You cannot drive after surgery, however the duration of no driving varies depending on the surgery. After spine surgery we recommend that you do not drive for 2 weeks. After a craniotomy you can not drive a motor vehicle for a minimum of 3 months, but sometimes 12 months or more. Dr Wells will discuss this with you at the time of your surgery.

 

Will I be in pain when I am discharged home after surgery?

• Most operations are associated with some degree of surgical pain. It is very important to have your pain well controlled in the immediate post-operative period before going home. You may still have an amount of pain when you are discharged from hospital but nothing that you should not be able to control, and you will also be offered oral analgesia on discharge that you can take home with you. In rare instances you may still have pain after you have completed all of your supplied discharge pain relief medications, in that instance we encourage you to see your local doctor.

 

What do I do if I get home from hospital and I have a complication?

• Surgeons are only human, and complications are an unfortunate part of surgery from which not even the best surgeon is immune. Fortunately most complications are minor, such as a superficial wound infection, and these generally settle with a course of oral antibiotics. Serious complications are uncommon but are usually apparent whilst you are an inpatient before being discharged home, and sometimes need a trip back to the operating theatre to resolve. In rare instances a serious complication may not reveal itself until after discharge. Dr Wells partakes in regular audits of his surgical practice and goes above and beyond to minimise the risks of surgery to avoid complications occurring as much as humanly possible. In the event of a complication developing Dr Wells will do everything he possibly can to help resolve it as best as possible. You will never be left to fend for yourself at any stage of your care, whether a complication develops or not.

 

I live alone. How will I cope at home after being discharged from hospital?

• Some patients live alone, or have flights of stairs at home, or there may be other reasons why discharging directly to home shortly after recovery from surgery is not appropriate. Rest assured, if you are not ready or safe to be discharged home after your surgery you won’t be. In that instance Dr Wells can arrange transfer to an inpatient rehabilitation facility such as Calvary Adelaide or Griffith Rehabilitation Hospital before you are safely discharged home.

 

Would I benefit from physiotherapy for my spine condition?

• Physiotherapy is generally extremely beneficial for your spine health. Whether you have surgery on your spine or not, I always recommend physiotherapy treatment for strengthening your core and pelvic floor, this can have an extremely positive effect on low back pain particularly. I recommend the team at Smart Health in Keswick, they have a large amount of services and are highly skilled in spine health. 

https://www.smarthealthtraining.com.au