{"id":465,"date":"2019-10-23T15:53:21","date_gmt":"2019-10-23T22:53:21","guid":{"rendered":"https:\/\/entsalem.fm1.dev\/surgery\/post-surgery\/parathyroidectomy\/"},"modified":"2020-06-30T15:11:15","modified_gmt":"2020-06-30T22:11:15","slug":"parathyroidectomy","status":"publish","type":"page","link":"https:\/\/entsalem.com\/surgery\/post-surgery\/parathyroidectomy\/","title":{"rendered":"Parathyroidectomy"},"content":{"rendered":"\n
Incision<\/strong>: Please keep the incision dry until the stitches are removed, then gently wash the incision with soap and water 2-3 times a day as needed. After washing, please apply a thin film of an antibacterial ointment (e.g. Polysporin). Please avoid any activity that pulls across the incision such as shaving across the incision for at least 2 weeks; the rest of the face may be shaved. The stitches will be removed 1-2 weeks after surgery.<\/p>\n\n\n\n Drain:<\/strong> Some patients are discharged with a thin drain tube and oval collecting reservoir called a grenade. Please empty the grenade and record the amount of fluid whenever the grenade looks half full or at least 2 times a day. Discard the fluid down a sink or toilet; do not save it.<\/p>\n\n\n\n Head of Bed<\/strong>: Please elevate the head of your bed 30-45 degrees or sleep in a recliner at 30-45 degrees for the first 3-4 days to decrease swelling. The skin above the incision may look swollen after lying down for a few hours. Elevating the head is crucial when both sides of the neck have been dissected to avoid a swollen, puffy neck.<\/p>\n\n\n\n Bleeding and Bruising:<\/strong> Oozing from the skin may occur that causes a slow drip of blood. Simply apply 15-20 lbs. of gentle pressure to the wound with a clean paper towel or wash cloth for 15-20 min. If the swelling is raised an inch higher than the surrounding area, call (503) 581-1567<\/a> for instructions. You may change any dressing as needed.<\/p>\n\n\n\n Fever<\/strong>:<\/strong> A low-grade temperature of 100 degrees and even an occasional elevated temperature above 101.5 degrees are common. Should you have a temperature of 101 degrees or higher, take a deep breath and cough (once or twice) every 15-30 minutes and increase your fluid intake. Deep breathing and coughing opens the lungs and reverses a common cause of elevated temperature. If your elevated temperature persists 1-2 hours, call our office for further instructions. Please measure your temperature. Patients will often think they have an increased temperature because they feel warm.<\/p>\n\n\n\n Nausea and Vomiting<\/strong>:<\/strong> Nausea and vomiting are common during the first 24 hours after surgery. Narcotic medication may increase the nausea and vomiting. Please try to reduce the narcotic pain medicine as much as possible, either by reducing the amount given or lengthening the time between doses. One may try to skip one dose of narcotic and use just a full dose of plain acetaminophen (e.g. Tylenol) or ibuprofen (e.g. Motrin). The patient may also try to eat some simple, non-fatty food with the next dose of narcotics. If nausea and vomiting is excessive or persistent, call our office for further instructions.<\/p>\n\n\n\n Pain Management<\/strong>: <\/strong>A realistic goal is to reduce the patient\u2019s pain to a manageable level, not to eliminate the pain. One cannot predict a patient\u2019s pain level or the necessary dose of pain medicine, as they must approach each patient in a stepwise fashion for pain management. Specifically, when acetaminophen and\/or ibuprofen do not lower the pain enough, then start with a lower dose of narcotic, and increase the dose if pain remains uncontrolled, or decrease the dose if the medication\u2019s side effects are too severe. Close monitoring of each patient for side effects of each medication is essential.<\/p>\n\n\n\n Constipation<\/strong>: <\/strong>Isolated constipation may be caused by narcotics, lack of fiber in your diet or high calcium levels. If you experience constipation or abdominal cramping, try to reduce the narcotics, increase fiber in your diet, stop any calcium supplements or calcitriol and call our office in the morning for an order for a calcium blood level check.<\/p>\n\n\n\n Diet:<\/strong> Please start with a non-fatty, soft diet after surgery. You can gradually advance to your normal diet over a week.<\/p>\n\n\n\n Activity:<\/strong> Please avoid any activity that raises your blood pressure for one week, e.g. heavy lifting, strenuous exercise, etc. Please walk every 2 hours while awake to avoid leg clots.<\/p>\n\n\n\n Hypocalcemia: <\/strong>The patient may experience a low calcium level after surgery. Symptoms may include numbness (especially around the mouth) or abnormal muscle cramping. You may need to take vitamin D and calcium carbonate (e.g. OsCal D) or calcium carbonate (e.g. TUMS) along with a synthetic vitamin D (e.g. calcitriol) tablet after surgery. If you have numbness of face, hands, or feet, take 2 OsCal D tablets. If the symptoms do not resolve in 2 hours, call either our office or your endocrinologist. If no response, go Salem Emergency room and ask for an ionized calcium level and have the ER MD call us with the result. Call our office at (503) 581-1567<\/a> or your endocrinologist if you have questions.<\/p>\n\n\n\n Hypercalcemia<\/strong>: <\/strong>May cause constipation, abdominal cramping, muscle weakness, or extreme fatigue. If these occur, stop all calcium tablets, vitamin D (Oscal D), calcitriol (e.g. Tums), then call the office or go to the Salem Hospital Emergency Room for an ionized calcium check.<\/p>\n\n\n\n INSTRUCTIONS REGARDING POST-OP CALCIUM AND VITAMIN D<\/strong><\/p>\n\n\n\nTO AVOID RUNNING OUT OF A NARCOTIC MEDICATION:<\/h4>\n\n\n\n