HOME CARE INSTRUCTIONS FOLLOWING THYROID OR PARATHYROID SURGERY:

DIET:

- Patients who have received general anesthesia may experience nausea and occasionally, vomiting.  It is therefore preferable to eat a bland light meal or a liquid diet on the first day after the surgery.  Regular diet may be resumed the next day. Also, pain pills may cause nausea if taken on an empty stomach. It is preferable to take those pills with a piece of toast or some food. It is important to maintain hydration by drinking lots of fluids after the procedure.

ACTIVITY AND WOUND CARE:

- Elevate the head as much as possible. Sit in a recliner or use two or three pillows when sleeping. Head elevation reduces bruising and swelling. Occasionally, you may notice that the bruises or swelling have migrated to other places (usually lower regions). You may have a dressing or your wound may be exposed.

- If your wound is not covered with a dressing keep the exposed wound dry.  Avoid showers for the first 48 hours.  After this you may shower, but avoid shower water directly hitting the surgical wound.  If you do get the wound wet, pat dry the area immediately after your shower. If you have been instructed to use a topical antibiotic and have not received a prescription for antibiotic ointment, use over-the-counter triple antibiotic such as Neosporin.  Apply a scanty amount on the suture line.  At times, you may not see the sutures because they have been placed inside the wound.

MEDICATIONS:

- It is important to take all medications as prescribed by your surgeon.  An antibiotic may be prescribed following the surgery. The patient also receives a prescription for narcotic pain killers. These products cause somnolence, drowsiness and constipation. Patients who take painkillers should not operate machinery, drive or make important decisions.

- Do not use aspirin for 2 weeks; it increases the possibility of bleeding.

WHAT TO EXPECT:

- For the first one to two weeks after surgery, there will be a mild to moderate amount of pain in the neck, side of the face, jaw, ear, or throat. This can be controlled with prescription pain medicine received at hospital discharge or Tylenol® (acetaminophen). Ice may be applied to the affected area to help reduce pain and swelling.

- You may have numbness, tingling and pain around the surgical site. This may last a long time but will become less noticeable with time.

- There may be discomfort during eating, and swallowing hard, crunchy foods may cause increased discomfort in the involved region.  In time, this discomfort will improve.

- Swelling in the surgical site is normal and will peak in 2-3 days.  Call our office if the incision swells excessively, becomes increasingly red and or starts to drain.

RESTRICTIONS:

- Bed rest and very light activity is the rule for the first 24 hours postoperatively. You may increase your activity level as necessary, but use common sense.

- Refrain from vigorous activity for the 10 days after surgery. Do not lift objects weighing over 8-10 pounds (roughly the weight of a gallon of milk) for a minimum of 2 weeks following surgery. 

- After surgery, you may shower below the neck. Avoid showering above the neck until at least 48 hours after surgery. We strongly discourage soaking the incision in the bathtub, swimming pool, or hot tub until you have discussed this with your physician.

- Driving is prohibited while taking prescription pain medicine. Additionally patients should not drive until for a minimum of 2 weeks (or as instructed by your physician) following surgery of the head and neck region.  Surgery in this area may cause decreased range of motion making driving unsafe.  Do not drive if you are unable to look behind your shoulder comfortably.

WHAT ARE SOME REASONS TO CONTACT YOUR DOCTOR AFTER SURGERY?

- After thyroid or parathyroid surgery, patients may rarely experience muscle spasms, twitches, or cramps in the hands, face and legs; this may be a sign of dangerously low calcium levels.  If you experience these symptoms, take 2 TUMS chewable tablets and notify our office immediately.  If this occurs after regular business hours, present to the nearest emergency room urgently.

- It is very common to have a hoarse or raspy voice immediately following surgery from the endotracheal tube (breathing tube); this will improve within the first 2-4 days after surgery.  There is a small risk of temporarily or permanent damage to the nerves that are responsible for your ability to speak.    If you notice that your voice continues to be hoarse or excessively "breathy" after surgery, notify our service of this finding.  In very rare circumstances, you may develop respiratory distress.  If you have a difficult time breathing or have excessively loud breathing (called stridor) call our clinic immediately; if this is after regular business hours or if your symptoms are severe, we strong recommend that you present to the nearest emergency department without delay.   

- Some swelling around the incision is normal. However, if is any sudden significant increase in neck swelling, apply an ice pack to the neck and call our office.  If this occurs after regular business hours, please contact our ENT on call resident.

- If you develop and shortness of breath or difficulty, breathing please present to the nearest emergency department emergently for evaluation.

- Many people will experience low-grade fevers after surgery that may persist for one to two days. Low grade fevers (less than 101 F) usually will resolve with Tylenol and fluids. If you have a high fever (greater than 101 F) that lasts longer than 24 hours without any improvement, please notify our service.

- At any time during the postop period, please call the office if you have any questions or concerns about excessive bleeding, breathing difficulty, pain, persistent fever, nausea, swelling or other concerns that seem out of the ordinary from what you have discussed with your surgeon or read in this handout.