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Thyroidectomy/Parathyroidectomy

Diet
You may begin eating and drinking as soon as you get home from surgery. Start with a bland liquid diet such as Gatorade, tea, coffee, water, soup and crackers, or jell-o. You can increase your diet slowly to a regular diet as tolerated. Due to soreness in your neck from the surgery, you may want to avoid eating hard foods for several days.

Activity
As soon as you reach home, you may resume normal ad lib activity. You are encouraged to begin walking and resuming household activity as tolerated immediately. Going up and down stairs is also Ok. You should refrain from engaging in any strenuous activity such as running, riding a bike, heavy exercising in a gym, etc. for at least 2 weeks. You should also avoid any heavy lifting greater than 20lbs. for 2 weeks. After that, you may resume any activity as tolerated. Also avoid hyper-extending or stretching the neck during exercise, until the wound is completely healed.

Wound Care
You will have a gauze bandage on your incision. You may remove this bandage and leave the incision open to air on the day after the surgery. You may have steri-strips on your skin over the incision and underneath the bandage. If so, leave these on until they fall off on their own. The incision will most likely be closed with dissolvable sutures that are underneath the skin. You do not need to do anything about these, and they will never need to be cut out or removed. They will dissolve on their own eventually. You may shower starting 48 hours after the surgery. Running soap and clean water over the incision is Ok, but avoid submersing the incision in any dirty water such as baths, lakes, swimming pools, jacuzzis, etc. for at least 2-3 weeks. You may apply ice to the wound for 15-30 minute intervals at a time for pain or swelling, for several days after the surgery. A small amount of bleeding, redness, and swelling may be normal. If there is any excessive pain, bleeding, swelling, redness around the wound, green/white drainage, or fever, please call your surgeon immediately.

Medications
You may resume all your normal medications after surgery except for aspirin or other anticoagulants. You should wait at least 1 week after surgery before beginning aspirin or other anticoagulants. You may need to wait longer, but please consult your surgeon first. Most patients receiving a total thyroidectomy -- and the majority of patients receiving a subtotal thyroidectomy (partial removal of the gland) -- find that their thyroid becomes unable to produce enough thyroid hormone -- making them hypothyroid. When you are hypothyroid, you may need prescription thyroid replacement drugs. This may be permanent or temporary. After a parathyroidectomy, your body may become unable to regulate your calcium levels, and you may need to be on calcium supplements. This also may be permanent or temporary. This will all be discussed with you before you leave the hospital.

Pain Control
You will most likely be sent home with a prescription for narcotic pain medications. Use the narcotics as directed on the prescription. You may take less than what is indicated on the bottle, but not more. Be sure to take narcotic pain medication with food so as not to upset your stomach. You may begin to taper your narcotic medication as tolerated and discontinue them as soon as possible. As you are tapering off the narcotics, you may transition over to Ibuprofen. You should not drive or operate any mechanical equipment while on narcotic medications. Wait for at least 24 hours after discontinuing the narcotic medications before driving.

Bowel Movements
It is not unusual for patients who have been through surgery, a general anesthesia, and who are taking narcotics to become constipated. This can often be remedied by increasing your activity and making sure you stay hydrated. If this does not work, you should first try to increase you fiber intake either through diet or through supplements (Metamucil, Benefiber, etc.). You may also try to take an over-the-counter stool softner such as Colace or Sennekot. You should have a bowel movement every day, but may go 2-3 days after surgery without one. If you have not had one by two days after surgery, you may need to try an over-the-counter laxative such as Milk of Magnesia, Magnesium Citrate, Dulcolax suppositories, or a Fleets enema. If none of these measures work or if you begin to have significant abdominal pain, nausea/vomiting, or diarrhea, please contact your surgeon immediately.

Special Attention
You may also experience some hoarseness after surgery. This should be mild and resolve over a period of several days to a couple of weeks. You may also have some mild swelling in your neck with some difficulty swallowing immediately after surgery. This should improve over the first few days. If you have any significant trouble speaking, swallowing liquids or food, or breathing, please contact your surgeon immediately.

You may have a temporary inability to maintain your calcium levels. This most often will correct with time. You may be sent home with calcium supplements. If your calcium levels get too low, you may experience numbness or tingling around you mouth, face, or hands, and should contact your surgeon immediately.

Follow-Up Visit
You will be instructed as to when you should return to the office on your discharge instructions. The exact date will either be scheduled for you before you leave the surgery center, or you will be instructed to call the office to schedule this. You will usually be seen again approximately 2 weeks after the surgery. The pathology department usually takes 3-5 days to send results of your specimen to our office. If there is important information from the report to tell you before your follow-up appointment, you will be notified immediately.

Further Information
Thyroid Surgery Brochure – from thyroid.org
Thyroid Nodules Brochure – from thyroid.org
Thyroid Cancer Brochure – from thyroid.org
Thyroid Surgery and Thyroidectomy – from About.com
Recuperating After Thyroid Surgery – from About.com
Thyroid Gland – from endocrineweb
Thyroid Operations – from endocrineweb
Introduction to Parathyroid Glands – fromParathyroid.com
Standard Parathyroid Surgery – from Parathyroid.com
Minimally Invasive Parathyroid Surgery – from Parathyroid.com
Minimally Invasive Radioguided Parathyroid (MIRP) Surgery – from Parathyroid.com
Parathyroid Pictures – from Parathyroid.com
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