What to Expect After Parathyroid Surgery
Most patients will be eating, drinking and walking around the night of their surgery. Typically, there is not a lot of pain involved with thyroid and parathyroid surgery. Rarely narcotic pain medication will be required, but it will be available to you if needed. Most patients only need acetaminophen (Tylenol) for discomfort. You will stay overnight for observation and be discharged to home usually by 11:00 AM the morning after surgery.
The incision is closed with dissolvable sutures internally and you will not be able to see them. On the outside, the incision will also be closed with either surgical glue or surgical paper tape called steri-strips. A light bandage consisting of a gauze pad and a clear plastic covering will be placed over your incision after surgery. This bandage may be removed 48 hours after you leave the hospital.
If you have steri-strips on your incision, leave them in place until they begin to fall off naturally. If they have not fallen off in 7-10 days, you may gently remove them. If glue was used, it will appear as a white crusty white or yellow material covering the incision. You may notice tiny pieces of yellow material on your washcloth when you gently clean you incision.
The incision will be slightly raised and there may be swelling and light bruising at the incision site. This is normal for several weeks after surgery and will resolve over time. You may also feel a sensation of swelling or firmness that will also resolve over time.
It is normal to experience numbness under your chin after surgery, especially around the incision. This will get better over time. However, if you feel numbness and tingling around your mouth or in your fingertips or toes call our office.
You may experience slight oozing of a watery, reddish color of fluid a day or two after surgery. This is normal. Please call the office if the drainage is thick and yellow (like pus), or you develop a temperature over 101.5F, or if your incision becomes red and warm.
You may feel a firm ridge directly over the incision. This is normal and will soften and go away when healing is complete usually in 3-6 months. All incisions are sensitive to sunlight. The ultraviolet light of the sun and tanning booths will darken the scar area in the first year. Always use sunscreen.
You may shower the day after surgery. Try not to get the bandage totally soaked. Once the bandage is off, it is still OK to shower. Still try not to totally saturate the incision. You should not go swimming or soak in a tub or hot tub for at least a week.
You may eat whatever you choose. You may prefer softer foods and liquids initially if you have a sore throat. Advance you diet as you see fit. Some patients experience minor changes in swallowing that improve over time. You may feel there is a lump in your throat when you swallow. This sensation will decrease with time.
This is normal to experience after surgery and will often last up to 5 days after surgery. Lozenges and a softer diet may be helpful until this resolves. You may also feel like you have phlegm in your throat and need to cough. This is due to the irritation of the tube in your windpipe during surgery. It should clear up in 4-5 days.
Your voice may be hoarse or weak at first because the surgery took place near the voice box but usually recovers within weeks. Some patients also notice a change in the pitch of their voices that affects singing. Rarely these changes are permanent.
You may experience stiffness/soreness in your neck, shoulder, or back and may experience tension headaches. These may take a few days or weeks to go away completely. You should not drive until you can comfortably turn your head from side to side. It is a good idea to gently perform neck exercises to help keep it from getting stiff - looking side to side, up and down or moving your head in a small circle. You may apply a warm compress or heating pad to your shoulder and back to alleviate stiffness.
Pain Management at Home
Take NSAIDS like ibuprofen (Motrin, Advil), naproxen (Naprosyn, Aleve) or acetaminophen (Tylenol) for the first 3-5 days as needed. Take medication as directed on the medication container. To prevent acetaminophen overdose, do not take acetaminophen when you are taking the pain reliever - Percocet - that was prescribed on your discharge from the hospital. They both contain acetaminophen. If you take the Percocet or any other narcotic - DO NOT drive a car or drink alcohol.
Back to Normal Activities
Most patients return to their daily activities in a few days and work in about a week, with some limitations. Strenuous activity and heavy lifting should be avoided for at least two weeks.
Your body’s blood calcium level may fall after a total thyroidectomy or parathyroidectomy. The parathyroid glands that regulate your blood calcium levels may not function properly after surgery. This is common and usually temporary. You will receive specific instructions on hospital discharge on how much calcium you need to take. Symptoms of a too low calcium level include numbness and tingling in your hands, feet, and around your lips. Some patients experience muscle cramps. Typically you will take calcium carbonate 1250 mg one to three tablets a day. Do not take calcium carbonate within 1-2 hours of taking other medications. If any questions about drug interactions, be sure to ask the pharmacist or doctor. Some brands of calcium carbonate are Os-Cal 500 and Tums.
If you have had a thyroid operation, you may be prescribed a thyroid hormone replacement called Synthroid (levothyroxine is a generic form). You must take this medication every day and on an empty stomach. Take in AM when you first get up and wait to eat anything for 30 minutes to one hour. A blood test will be done in 6-8 weeks to ensure the dosage is correct.
You may be prescribed a Vitamin D supplement like Calcitrol (Rocaltrol) to help with calcium absorption on discharge also.
When to Notify Our Office
You should call our office at 410-328-6187 if you experience the following symptoms:
- Fever with a temperature higher than 101.5.
- Difficulty swallowing
- Increase in pain at the incision that is not relieved by pain medication.
- Increased swelling, redness, or drainage from the incision.
- Numbness or tingling of fingers, toes, or around the mouth.
- Muscle cramps
If you have trouble breathing, call 911 immediately.
Your post-operative appointment will be scheduled for 1 or 2 weeks after your surgery. Please call 410-328-6187 to make your appointment.
For more information, please contact our office at 410-328-6187.