Postoperative Instruction after Parathyroid Surgery
Postoperative Instructions after Parathyroid Surgery
Preoperative Instructions -- Very Important
For one week prior to surgery you should not be taking any aspirin, baby aspirin, advil, ibuprofen, vitamin E, Plavix or any medication that can increase bleeding or decrease clot formation. If you are on Coumadin or other blood thinners this will need to be stopped approximately 4-5 days before surgery and you will need to consult with your Internist and/or Cardiologist.
Please be sure to have a responsible adult accompany you the day of surgery who can drive you home or to your local destination after your procedure. No patient will be discharged unless accompanied by an adult (relative, friend or personal acquaintance).
Contacting Us Postoperatively
If you have any concerns postoperatively we encourage you to contact us any time day or night. You will be provided with Dr. Gordon's cell phone number as well as the numbers to contact the hospital. You can also email us at firstname.lastname@example.org.
When you leave the hospital you will have a small bandage over your wound. Underneath this bandage are strips that cover the wound called "steri-strips." This is what protects the wound. You can remove the covering bandage the day after surgery and leave the steri-strips in place for one week after surgery. During that week try to keep the steri-strips dry. If you do get them wet in the shower, simply pat the wound dry. One week after surgery, you should get the steri-strips very wet in the shower and this will help you to peel them off. The sutures for the wound are self-absorbing. This means that you do not need to have them removed. After the steri strips are removed you should place Bacitracin Ointment or Triple-Antibiotic ointment on the wound for another 2 weeks. Although your scar will heal just fine at this point, for decreased scar formation I then recommend using a gel called Mederma.
In some instances you may have a removable skin suture. This is removed approximately one week after surgery. If you are from out-of-town, we will provide you with instructions for your local doctor to remove this suture. If you are local, then you should be seen 1 week after surgery to remove this suture. A surgical drain is sometimes necessary depending upon the extent of the operation. If this is required, it is removed in the hospital the day following surgery.
Showers and Bathing
You can shower the next day after surgery. Try to keep the wound dry and if it gets wet, simply pat it dry. The steri-strips seal the wound, but it is important that they don't become too moist as this may lead to a wound infection. If the steristrips become persistently moist then you can remove them yourself.
The day after surgery you can resume most normal activity. We suggest that you take off at least 2-3 days after surgery from work in order to allow your body to recuperate. Avoid strenuous activity like heavy lifting and vigorous exercise for about 1 week after surgery. Elevate the head when lying down by sleeping on 2 pillows. After one week you can resume your normal routine.
You can resume a normal diet after your surgery as tolerated. Sometimes there can be nausea after anesthesia, but this is usually temporary. You are not limited in what you can eat, but it is best to avoid foods that are difficult for you to swallow or digest.
Most patients experience only mild pain or discomfort at their surgical wound site which lasts for 1-2 days. You will be given a prescription for Tylenol with Codeine or Lortab pills in case you experience moderate pain. Many patients get by with no pain medication or taking only Tylenol.
Calcium and Vitamin D Supplements
Patients with primary hyperparathyroidism should supplement with vitamin D and calcium. Approximately 600mg or one calcium pills with vitamin D should be taken daily preoperatively. Preoperatively this has shown to minimize PTH secretion, bone turnover and calcium loss.
Calcium and Vitamin D supplements should be taken pre-operatively as well as post-operatively. All patients should be taking this routinely daily postoperatively and continuously. This will help to re-build your bone calcium stores that were lost when you had the parathyroid adenoma. There are many formulations on the market of Calcium with Vitamin D. It is recommended that you take approximately 1200mg of elemental calcium or 2 calcium with Vitamin D pills a day continuously and without stop.
If a removable suture has been placed, then it will need to be removed about 1 week after parathyroid surgery. A removable suture looks blue and has a knotted tie at each end of the wound. If you are unable to visit our clinic the week following surgery your local primary care physician or a local surgeon can remove the suture. See the video below for directions on suture removal. If a dissolvable suture has been placed, then there is no need for suture removal.