DECATUR MEMORIAL HOSPITAL

1 DECATUR MEMORIAL HOSPITAL THYROIDECTOMY/PARATHYROIDECTOMYYou are scheduled for surgery to remove part or all of your thyroidgland (thyroidectomy) or to remove a parathyroid tumor (parathy-roidectomy). Most often, thyroid and parathyroid surgery is doneas a same day surgery using general anesthesia with dischargeseveral hours after recovery. In certain cases, your surgeon mayfeel it is best to stay overnight in the HOSPITAL . Outpatient Care CenterIt is very important that you contact the DMH Outpatient CareCenter at 217-876-5700 to schedule an appointment for pre-admission screening and testing. Pre-Operative Instructions nNo solid food after midnight, but you may have clear liquids(no cream, milk, or pop) until six hours before surgery. Do notdrink alcohol after 12 noon the day before with your physician before taking scheduled medications. nSTOP aspirin, Plavix, Coumadin (Warfarin) AT LEAST sevendays before surgery. nLeave valuables at home.

2 Remove all jewelry, body piercings,contacts, etc. Arrive as instructed by your physician s officestaff and plan to spend the day at the HOSPITAL . Bring only onefamily member or friend with you who can drive you home ORstay with you the night of surgery. And remember, you willNOT be allowed to drive yourself of SurgeryWhen you arrive at DMH, go to Registration. You will be escortedto Same Day Surgery. One care partner will be allowed to stay withyou. In the preoperative area, you will change into a patient gownand will be asked to remove jewelry, dentures and glasses. Yourbelongings will be secured in a locker and brought to you after sur-gery. Preoperative nurses will complete the admission process, takecare of any physician orders and start an IV. The anesthesiologist will review your medical and surgical his-tory, discuss the type of anesthesia planned and answer any ques-tions. You may be given a sedative through your IV as well asother medications ordered by your physician.

3 This is a sterile pro-cedure which means antibiotics are usually not necessary evenfor patients with heart valve problems, artificial valves, mitralvalve prolapse or artificial joint replacements. When your surgeon is ready, a nurse will take you to surgeryona HOSPITAL bed; your care partner will be directed to the SurgeryFamily Waiting Surgical ProcedureMost often, thyroid and parathyroid surgery are minimally inva-sive procedures. In most cases, the operation takes less than onehour. The incision is one and a half to three inches in the lowerneck region. The incision is closed using under the surface sutures,so no external stitches can be seen. A small drain with a bulbreservoir is in place for one to three SurgeryWhenyour procedure is complete, you will be taken to the PostAnesthesia Care Unit (Recovery Room) for one to two hours. Then you will be taken back to Same Day Surgery where yourcare partner will join you. The nursing staff will keep you comfort-able and provide you with nourishment.

4 Sutured near your incision will be a drain. The drain is a suctionbulb device that serves as a reservoir to collect fluid accumulatingbeneath the surface of the wound. The drain will be removed inthe physician s office within 24 72 you are not required to spend the night, you will be givenwritten discharge instructions and escorted to your car. The nextday, a Same Day Surgery nurse will call you at home to talk withyouand answer any questions. Discharge InstructionsnSome anesthetics and pain medication may cause nauseaand/or vomiting in certain individuals. Eating before taking painmedication may help. You may experience light-headednessand/or dizziness and you may feel sleepy following your sur-gery. Unless instructed otherwise by your physician, rest athome with moderate activity as tolerated. nIf you should experience excessive bleeding, difficulty breath-ing, unusual pain, persistent nausea and/or vomiting, pleasecall your physician.

5 If you are unable to contact your physician,and feel your signs and symptoms warrant attention, go to thenearest emergency for a follow-up appointment to be seen within one to threedays of wash your hands with soap and water before and afterany contact with your surgical drain to self-suction (emptied and recompressed as shownprior to discharge).nCleanse incision area with hydrogen peroxide followed byBacitracin may bathe or at homeYou can usually begin to eat and drink normally the morning afterthe procedure. You will be given oral medication for pain the firstfew days, but discomfort is usually minimal. A sore throat andhoarseness are common and may last for a week or so. Within three days, you ll visit your surgeon to have your inci-sion checked and drain removed. At first, your incision will beslightly red and raised; it will probably flatten out and fade in afew months. Following thyroid surgery, most patients are givenprescriptions for thyroid hormone replacement (Synthroid, Levoxylora generic) and calcium supplement (Oscal, Citracal), with orwithout Vitamin D (Calcitriol) in selected patients.

6 Please note: Calcium supplements should notbe taken at thesame time as thyroid hormones. Thyroid replacement medicationshould be taken first thing in the morning 30 minutes prior to tak-ing other your doctor if you notice any of these signs:nSwelling at the incision sitenBleeding at the incision sitenWarmth, fever, or tenderness (signs of infection) at incision sitenMajor voice change that lasts longer than three to four daysnTingling or cramps in the hands, feet, or especially around thelips (signs of a problem with the parathyroid glands)Drain InstructionsThe night before a scheduled office appointment, empty the drainas follows: nWash your hands. nRemove plug from bulb. nPour drainage into a specimen cup. nTightly compress bulb and reinsert plug. nMeasure and record amount of drainage. Note: If more thanone teaspoon of drainage is noted in the drain the morning ofthe appointment, call the office for further instructions. nDiscard drainage.

7 Physician Office Follow-UpnYour drain will probably be removed (a painless procedure).nNurses will give you medication usage instructions andphysician , calcium, and blood testing to North Edward Street lDecatur, Illinois MODERNMEDICINE08-420 This booklet written and produced by members of the DMH Surgical Services Team.