DISCHARGE INSTRUCTIONS FOR THYROID OR PARATHYROID SURGERY

ACTIVITY:

· Walking around the house, climbing stairs, riding in a car or light office work is fine as soon as you feel able.
· It may not be comfortable to do hard physical activity or sports (e.g. swimming, skiing, tennis, weight lifting or contact sports) for several weeks.
· You can usually go back to a full-time work schedule in 1-2 weeks. It may take longer to return to heavy physical or other demanding work.
· Sexual activity is safe as soon as you are comfortable.
· Do NOT drive a car until you are able to turn the neck side to side, which may take 1-2 weeks.
· Do NOT drive while you are taking pain medicines.

DIET:

· You may have temporary throat discomfort or difficulty swallowing. This is due to the surgery around your larynx (voice box) and esophagus (swallowing tube).
· Drink and eat foods that can be swallowed easily, (e.g. juice, soup, gelatin, apple sauce, scrambled eggs or mashed potatoes)
· You may be able to return to your usual diet in a couple of days.
· If you had an operation for thyroid cancer, you may need to prepare for radioiodine scanning and treatment. Eat a special diet with no iodine.
· Do NOT eat iodized salt, sushi, seaweed, dairy products, commercial white bread, medications or vitamins that have iodine in them.
· If you had parathyroid surgery, you may need more calcium in your diet.
· Eat broccoli, spinach, clams, scallops, milk, yogurt, cheese, ice cream and cottage cheese.
· If you have lactose intolerance, you may need calcium pills.

INCISION CARE:

· Keep the incision dry for 24 hours after surgery. After that you may get the neck wet.
· Pat the incision dry. Do NOT scrub with soap or wash cloth for the first 10 days.
· If you have stitches to be removed, that will be done on the first or second day after surgery.
· Leave the Steri-Strips (small white adhesive strips) on your incision for 10 days. Then you may remove them.
· Mild swelling at the incision site will go away in 4-6 weeks. The pink line will slowly fade to white during the next 6-12 months.
· Avoid having too much sun or sunburns while the incision is healing. Use a sunscreen (SPF #30 or higher) or wear a scarf for protection.
· You may begin to use a moisturizing cream along the incision after 2 weeks.

COMMON PROBLEMS:

· Numbness of the skin under the chin or above the incision is normal and should go away in a few weeks.
· You may feel a lump or pressure in your throat sensation swallowing for a few days.
· Your incision may feel itchy while it heals. Avoid rubbing or scratching if possible.
· You may feel neck stiffness, tightness, a pulling feeling, mild aching, chest discomfort, headache, ear pain or congestion. Take a mild pain medicine such as Tylenol or Advil. Put heat on the area using a hot water bottle, heating pad or warm shower.
· Your voice may be hoarse or weak. Pitch or tone may change. You may have difficulty singing. This usually goes back to normal over 6 weeks to 6 months.
· After surgery, you may notice a change in your mood, emotional ups and downs, depression, irritability or fatigue and weakness. These changes in your personality will get better a time passes.

HORMONES AND MEDICATIONS:

· You may have to take Synthroid or Levoxyl when you go home. These are identical to the hormone made by the thyroid.
· Take the medication as you are instructed.
· If you are taking calcium pills (Os-Cal or Tums) or vitamin D (Rocaltrol or Calcitriol), make sure you take the medicine exactly as directed.
· If you have parathyroid surgery, you may need to eat a high calcium diet or take calcium pills for a few weeks. You may need a blood test at your follow-up visit.
· Most patients do not need strong pain medicine by the time they leave the hospital. You can take 2-3 regular Tylenol (acetaminophen) tablets or 1-2 Extra Strength tablets to relieve your pain if needed.

CALL YOUR DOCTOR IF:

· Your temperature is greater than 101F (or 38.3C).
· You have continued drainage from the incision, constant numbness in your fingers, repeated choking, difficulty breathing, severe pain or increasing swelling or redness.