Endocrine Surgery MSU Health Care (2024)

Surgery | Parathyroid/Thyroid Post-Operative Instructions

FOLLOW UP APPOINTMENT

Follow-up with your surgeon in 1-2 weeks for your post-operative appointment, or as previously scheduled.
Please bring your current calcium and vitamin d medications/supplements to your post-operative appointment for your surgeon to review.

SIGNS & SYMPTOMS TO WATCH FOR

Monitor for:
- Hematoma/neck swelling or worsening dysphagia, hoarseness, or paresthesia.
- Numbness or tingling around mouth or of hands/feet (Paresthesia) including numbness or tingling in your hands, around your mouth and/or on the soles of your feet or a "crawling" sensation of the skin may occur due to low blood calcium levels (hypocalcemia).
  - See chart below for dosage increases (page 2).
- Muscle cramps, dizziness or headaches may also be experienced and may be related to the hypocalcemia. It may also occur due to the need for fluids, so make sure to stay hydrated.
- Hoarseness: Your voice may go through some temporary changes with fluctuations and hoarseness. Generally, your voice will be better in the mornings and "tired" toward the end of the day. Resting your voice for a few days by speaking softly and refraining from extreme loudness or excessive laughing may help.
- Sore throat: You may experience some throat discomfort or discomfort swallowing due to the breathing tube used during your surgery. Try lozenges or warm liquids to sooth the discomfort.
- Bleeding: Slight bleeding may occur at the incision site. If you notice red blood through the paper steri-strips, a sense of increased pressure in your neck or difficulty breathing, go directly to the nearest emergency room.

CALCIUM & VITAMIN D SUPPLEMENTS

After your parathyroid/thyroid surgery, you will be prescribed to take calcium and vitamin D supplements to treat or prevent deficiency. These supplements are sometimes covered by insurance; for those who do not have this coverage, you may need to buy the supplements over the counter online or at a local pharmacy, including the MSU Health Care Pharmacy located on the first floor. Over the counter supplements may be under a different name or dosage.
Please reference below on what to look for when purchasing over the counter.
Choose one (1) of the following supplement options:

Citracal Maximum Tablets	Citracal Slow Release	Viactiv Calcium plus D soft chews
Take 4 tablets by mouth 3 times daily	Take 2 tablets by mouth 3 times daily	· Take 2 chews by mouth 3 times daily
630mg Calcium 500iu Vitamin D3	1200mg Calcium 1000iu Vitamin D3	650 mg Calcium 500iu Vitamin D3 Available online

If numbness or tingling occurs, follow these dosage increases:
If this occurs, take an additional 6 tablets of CitraCal Max and wait 1-2 hours. If symptoms improve, begin taking CitraCal Max 6 tabs three times a day. If symptoms have not improved in 1-2 hours, take an additional 6 tabs of CitraCal Max and wait another 1-2 hours. If symptoms persist, call our office 24 hours a day/365 at (517) 267-2460 (we have after hours phone service), or go to the nearest emergency department.	If this occurs, take an additional 3 tablets of CitraCal SR and wait 1-2 hours. If symptoms improve, begin taking CitraCal SR 3 tabs three times a day. If symptoms have not improved in 1-2 hours, take an additional 3 tabs of CitraCal SR and wait another 1-2 hours. If symptoms persist, call our office 24 hours a day/365 at (517) 267-2460 (we have after hours phone service), or go to the nearest emergency department.	If this occurs, take an additional 3 tablets of Viactiv and wait 1-2 hours. If symptoms improve, begin taking Viactiv 3 tabs three times a day. If symptoms have not improved in 1-2 hours, take an additional 3 tabs of Viactiv and wait another 1-2 hours. If symptoms persist, call our office 24 hours a day/365 at (517) 267-2460 (we have after hours phone service), or go to the nearest emergency department.

PLEASE NOTE:

If you are also taking Synthroid/Levothyroxine, be sure to take this medication 4 hours before or after taking calcium, iron, or antacids as these supplements will not allow your body to absorb this medication well.
In addition, you can consult with your pharmacist for options or call our office for clarification, if needed. You may need to increase or decrease dose depending on your symptoms, refer below to the signs and symptoms section for further instructions.

RESTRICTIONS