Post-operative Care

Ear
Post-operative care following the insertion of Middle Ear Ventilation Tubes (Grommets)

The insertion of middle ear ventilation tubes (Grommets) is a day care procedure. Therefore, after the procedure – which is approximately after 3-4 hours, your child will be in a good shape to go along with you to home.
After the procedure, it is usually normal to notice the discharge of blood stained fluid from the ear of your child. You may notice it for 24 hours after the procedure – and therefore, should not get worried about it as it can be simply wiped away with the help of a cotton ball.

Post-surgery, the patient is given antibiotic eardrops and the regimen will continue up to four to five days. Two to three drops are put in each ear two to three times a day beginning from the evening of the day of surgery. The dosage and the commencement of the therapy will depend on the amount and nature of the fluid seen in the middle ear at the time of surgery.

Make your child comfortable and ask him or her to lie down on the side. And then, to open up the ear canal, gently pull the ear upwards and backwards. Press the dropper to put the drops into the ear canal, and then – to allow the drops to move down the ear canal, gently press and release repeatedly the tragus (a small flap of cartilage in front of the ear canal). This process should be done for approximately 30 seconds. Remember! It is normal for your child to feel an unusual or abnormal taste in his or her mouth because it indicates that the medicine is moving down the Eustachian tube. If drops need to be put in both the ears then – after putting the drops in each ear, allow your child to be in the same sidewise position for about a minute or so – and then, turn him or her to the other side and do it for the other ear as well.
Store the drops in your refrigerator.

Are grommets effective in restoring hearing?

Grommets are very effective in restoring hearing in children who are suffering from hearing loss due to middle ear fluid and often you may notice that, even before leaving the hospital, your child’s hearing has improved.

How to relieve pain after grommets insertion?

CROCIN is prescribed to relieve pain if your child experiences pain after the insertion of grommet. Following surgery, on the same day or a day after, your child can go to school, day care or preschool. You can allow them for sports, but not for swimming, until the grommets have fallen off.
Your child will undergo a hearing assessment following grommet insertion.

Precautions when Grommets are in

Protection of ear from water: Your child may require some sort of protection from water as long as he or she has grommets in. Therefore, utmost care must be taken to protect them. While bathing or when your child takes a bath ensure that he or she keeps their head out of water.
If you want to wash the hair of your child, you can use insulated ear plugs that do not allow water inside the ear. To make insulated cotton plug, apply some Vaseline or wax all over a small cotton ball and use this ball to plug the ear. Then after, you can wash the hair of your child by using water.

Swimming precautions

You can allow your child to swim, go underwater or jump into a swimming pool after grommets are in place for over a week provided you have set in place adequate protective measures in the form of insulated ear plugs that do not allow water inside the ears while grommets are in.
Additional protection in the form of two-layered protection may be required – first layer is an earplug and the next is swimming headband or swimming cap. You can use silicon earplugs or Bluetac as well.
In addition to the above mentioned precautions, your child may not require any other additional restrictions on activities with grommets in place. There is also no restriction for your child to travel by plane as grommets actually help your child by performing equalization of pressure for the ear. Your child can also play contact sports after three days of grommet insertion.

Ear infection following grommets insertion

There might be a possibility of developing ear infection following the insertion of grommets. Owing to the infection, the child may develop ear discharge or earache. If you notice any such symptoms, seek immediate medical help and reach to the hospital or clinic. If I am available, I will take care of your child – if not,then one of my colleagues may take care of your child. The ear is cleaned and then appropriate antibiotics eardrops are put into the ear. In general with antibiotic eardropsear infections with grommets tend to settle quite rapidly.

Follow up

The follow up appointment after the insertion of grommets – which means, the first post-operative appointment will be after one month and the next appointment will be after four months and will continue until the grommets will leave the eardrums – which may be after a period of eight to twelve months approximately. The grommets are small green or blue tubes.If they dropped off the eardrums, they may be seen in the outer part of the ear canal.And can be easily removed by using tweezers. And, at times, the grommets come out of your child’s ear and can be found on the pillow. Therefore, it is natural for the grommets to come out of the ear canal.

Hearing assessment following grommets insertion may be done early after the insertion has been done. Following that the assessment may not be done frequently until the grommet has left the eardrum if the kid is improving well and showing progress with his or her speech development along with their reading ability augmentation.

Post-operative care following Ear and Mastoid Surgery

Following ear and mastoid surgery, it is recommended not to blow the nose and follow the instructions of the doctor. Accumulation of secretions or post-nasal drainage would be possible if the patient has cold. Therefore, the patient should take care to ensure that the secretions are drawn back into the throat and are ejected through the mouth.
The next precaution is to ensure that ears are not bulged out by closing and holding the nose and blowing air into the air through the Eustachian tube. If the patient feels like sneezing, then he or she should perform it by making the mouth open.

The next important precaution is to ensure that water does not enter into the ear until the doctor says that it is healed. The patient is therefore advised to take precautions to protect the ear from water – especially while bathing, washing hair and splashing water on the head and face. The patient can use insulated ear plugs that do not allow water inside the ear. To make insulated cotton plug, apply some Vaseline or wax all over a small cotton ball and use this ball to plug the ear. Then after, the hair can be washed by using water.

The patient should not go swimming or to the pool until the doctor allows him or her to do so. Furthermore, the incisions behind the ears should be kept dry for at least two to three weeks.
Another important precaution is to ensure that the patient does not catch cold and to make this possible he or she needs to take all sorts of precautions ranging from avoiding bad weather to managing stress and fatigue. In spite of all precautions, if the patient catches cold or flu, it should immediately be reported to the doctor to ensure that all possible means of controlling the condition are being taken. The doctor will take every possible measure to curtail the infection and to prevent complications that might affect the patient’s hearing.

Cautions

There could be a possibility of popping, pulsing, clicking and rhythmic sounds – along with the feeling of fullness in the ear – and also, it is not surprising to notice sharp shooting pain occasionally. Sometimes, the patient may feel as if they have fluid in the ear.

There might be a possibility of less intense dizziness or slight dizziness associated with head movements. It is considered as insignificant unless it persists and makes the patient uncomfortable.
Improvement in hearing immediately after surgery is rarely possible because swelling in the ear tissue and packing in the ear canal could even cause temporary worsening of hearing. However, improvement in hearing may be possible within six to eight months of the surgery – but optimum improvement is possible only after four to six months.

Yellowish, watery and bloody fluid discharge may occur during the healing period. During this time, the cotton plug placed in the outer ear can be changed if possible – but it would be better the lesser it is done. If you wish to put a ball of cotton or cotton plug in the outer canal of the ear to prevent the flow of discharge onto the pillow at night– you can do so, after the packing is out.

Pain after ear or mastoid surgery

The patient may experience dull and mild intermittent pain for up to two to three weeks after the surgery– which should not be considered as unusual. Pain while chewing & pain above and below the ear may also occur. However, persistent pain, and the pain which is not alleviated in spite of taking the prescribed pain relievers should not be ignored and the patient should seek medical help. There may be numbness in the outer part of the upper ear if the incision is behind the ear.

Resumption of activities after tympanoplasty and mastoidectomy

The patient can take up activities after two to three days following a tympanoplasty and following a mastoidectomy; the activities can be resumed after a week. As far as travel is concerned, the patient can go on as there are no limitations. The patient can use chewing gum to induce swallowing if they experience difficulty while going through altitude changes.

Follow-up
After the surgery, the patient can plan follow-up appointment with the doctor after two weeks.

Nose
Care of the nose following Septoplasty and /or Turbinoplasty surgery

As with any other surgical procedure, it is common to have a feeling of unease after septoplasty or turbinoplasty surgery; and therefore, for the patient it is common to stay in the hospital for one night. The patient is placed on intravenous antibiotics during that night after the surgery and might feel at unease or uncomfortable due to the placement of a nasal pack on either side of the nose. The placement of nasal pack causes blockage of nose – owing to which, the patient will have to breathe through the mouth.However, the nasal packs are removed a couple of hours before the planned discharge – which might be around 24 hours after the surgery. The removal process could be uncomfortable for some patients, but the patient is made comfortable. Prior to the discharge, the patient is seen and the case is reviewed by the doctor.

Depending on the nature of the activities or job work the patient is accustomed to do, the recovery and returning to work period may vary following nasal surgery – for a patient who does normal activities or work, the doctor may advisetaking rest for at least three to four days prior to resuming the work, but for those who do the work that involves lifting of heavy objects and straining activities, the doctor may advise taking rest for up to a week prior to resuming the work.

The usage of endotracheal tube by the anaesthesiologist during the surgery may cause sore throat for a few days after the surgery – which is common following the surgery; therefore, it should not be a cause for concern for the patient.

It is common to have congested nose for up to a week following the surgery; however, with the systematic douching of the nose, the congestion will ease. In this regard, Dr.Singh will give necessary instructions at the time of discharge. The patient is instructed to be on oral antibiotics for up to five days following the surgery. The other prescriptions may include nasal decongestants and nasal wash or douche if the patient has undergone septoplasty operation. Such prescriptions are available at a local chemist. The patient is instructed to use them three to four times in a day for up to 10 days.
Small sutures are used inside the nose in a septoplasty surgery; they will dissolve on their own. Nasal saline spray is prescribed to the patient. One such spray is FESS spray – which is available as over-the-counter medicine at any chemist shop. The patient is advised to use this spray as frequently as they are willing to use – but it is better to use six sprays thrice daily for each side of the nose.
The patient may feel congestion of the nose or blocked nose for a couple of weeks – which is normal after the surgery. Crusting and bloodstained mucus discharge from the nosemay also be noticed.
The top lip may feel numb for a few days – and therefore, it is useful to sleep a little head up for the first week or so after surgery by putting the head on a couple of pillows.
The patient should take utmost care and precautions; and therefore, must not blow their nose for up to two weeks following the surgery. In addition, the patient is also advised not to lift heavy objects and avoid the activities that involve moving and lifting heavy items or indulge in exercise for up to two weeks. The post-operative appointment may commence after the first week of surgery and during the consultation the doctor will examine the nose and if deems necessary would clean the nose. Up on the advice of the doctor, the patient can resume blowing the nose thereafter – if they need to do so.
The main cause for concern following the surgery is bleeding which can happen anytime after the surgery during the first two weeks in particular. The bleeding might get aggravated by exercise or heavy activities, such as lifting and by the activities that put pressure on the face. In such cases aspirin must be avoided as it may induce bleeding – instead ibuprofen and paracetamol may be prescribed.

How to stop a nosebleed?

If the patient gets nose bleed, they should stop the work they are doing and sit up in the chair. Keep the head in slightly forward direction and do not tilt it. Tilting head may cause the blood to flow through the throat into the stomach and promptvomiting – which could make the condition worst. If any blood gathers in the mouth, spit it out rather than swallowing it. Gently place an ice bag or cool compress over the bridge of the nose to cool the area.Cooling the nose and surrounding area like cheeks will help constrict the blood vessels and help stop bleeding. Press the soft part of the nose gently by your forefinger and thumbwith tissues under. This should stop the bleeding. If bleeding does not stop, then spray a medicated nasal spray, such as Otrivin once in each side of the nose; this may help stop the nosebleed. When bleeding stops, don’t start doing strenuous activities and try to avoid such activities as much as possible. Thereafter, use Otrivin nasal spray once in each nostril every eight hours for up to three days. In spite of all these measures if the bleeding persists and becomes extreme, then the patient should be taken to the emergency department. Emergency physicians will contact Dr Pradeep Singh for further course of action.

Care of the Nose following Functional Endoscopic Sinus Surgery (FESS)

There might be a very rare chance of a patient developing bleeding into the eye socket following a sinus surgery. This could lead to complications related with vision and affect the vision in the long run if not dealt with aggressively in time. However, it may happen in the rarest of the rare case (less than 1% of the cases). Therefore, the surgeon will examine the eyes of the patient after surgery.

After having undergone sinus surgery, you may notice that your nose has been blocked on one side or both the sides depending on whether dressing was placed in the nose. The nursing staff will check you regularly in the recovery room and in the ward. The stay for you in the hospital would be around one day after the surgery and Dr Singh will see you the next day after the surgery. Any dressing in the nose will be removed. The process of removing a nasal dressing is little painful, but you would feel pain only for a brief period of time. The nose might bleed for eight to ten minutes after the removal of dressing – which is common. The patient may be asked to stay in the hospital for about an hour or so after getting their dressing removed to make sure that the bleeding is no more and they are fit to go home.

The doctor will prescribe oral antibiotics to the patient, which they would continue for about five days. The patient may also be advised to take an oral corticosteroid tablet, such as prednisone for another five days. Furthermore, the patient must irrigate their nose with a saline solution – which they can buy over-the-counter at a chemist and use it on a regular basis. (FESS post-operative hypertonic solution, Neilmed sinus rinse, Nasowash nasal rinse)

The patient can use this solution to irrigate his or her nose each side thrice daily starting on the day they return home. While irrigating the nose, the solution is allowed to enter the nose and once the solution is instilled, it will flow out back with blood streaks and some discharge from the nose. This is quite normal and should not be worried about.
Following septoplasty or turbinoplasty the patient may experience pain, which can be controlled with ibuprofen or Crocin. However, the patient is advised not to take any non-steroidal anti-inflammatory medicines as they are capable of augmenting bleeding and making the condition worst.

Patients can plan resumption of work after taking rest for about three to four days after sinus surgery– provided their work doesn’t involve heavy physical activities, labour or lifting heavy objects. Post-operative consultations with the doctor can be scheduled every week and can continue up to three weeks.

Once the patient consults Dr Singh, he will examine and inspect the nose. The patient should take precautions (should not blow their nose) from the time they left the hospital until they meet the doctor for the first time after the surgery.At the time of that appointment the nose will be inspected and cleaned. It is common if the nose seems to be blocked or congested for up to a few weeks after the sinus surgery. When the nose is blown, it is common to find old and fresh blood clot to come out from it.

Often patients will have had surgery to the nasal septum and/or the inferior turbinates at the same time as having endoscopic sinus surgery.

Bleeding after sinus surgery:The main cause for concern following sinus surgery is bleeding which can happen anytime after the surgery during the first two weeks in particular. The bleeding might get aggravated by exercise or heavy activities, such as lifting and by the activities that put pressure on the face. Therefore, these activities must be avoided for at least two to three weeks after surgery. In addition, it is also better for the patient to avoid travelling by an aeroplane or to a location which is far away from the hospital for up to three weeks owing to the risk of bleeding.
If the bleeding is less intense, then it can be settled down by spraying nasal decongestant spray, but for more severe or significant bleeding, the patient must seek immediate medical care or rushed to the emergency room of the hospital.

Throat
Tonsillectomy and adenotonsillectomy: Post-operative care

After tonsillectomy, it is usually common to find a white slough inside the throat on either side where tonsils used to be present. When you examine your child and find such slough, then it is not to be worried about and should be considered as just a normal healing process. The slough may be seen for a few weeks following the surgery. Even the uvula (flap) – the tissue that is seen dangling at the back of the throat looks inflamed – swollen and bruised, which will settle down over a period of time. The other findings may include yellowish appearance of the inflamed area, which is surrounded by red edges with some smell – which is nothing to be worried about.

Earache and throat pain following tonsillectomy

Earache and throat pain may be experienced by the patient after tonsillectomy. Earache may be due to the pain brought up by the throat to the ears. Following tonsillectomy, particularly after the first three to four days, the throat pain may become worst and may be slightly severe for up to 10 days after the procedure – especially in adults, and then gradually settles down day by day.

Are antibiotics necessary following tonsillectomy?

The wonder drugs may or may not be prescribed following the surgery. However, in the past, the antibiotics were regularly prescribed for the patients in whom tonsils were removed. Normally a five days prescription may be given as a liquid or syrup for children and for adults tablets or capsules are prescribed. Even now for some patients antibiotics are prescribed, but according to the latest research studies, antibiotics are not routinely necessary for patients in whom tonsils or adenoids have been removed.

How to overcome pain following the removal of tonsils?

Pain associated with tonsils or the pain following the removal of tonsils can be alleviated or relieved by taking ibuprofen or paracetamol kind of medications including Diclomol, Crocin and ibuprofen. Follow the instructions of your doctor regarding the dosage and frequency of usage as these medicines are capable of causing potential damage to your liver in case of over dosages. In general paracetamol over dosage is very serious and may cause liver injury and liver failure as well. These medicines can even pose threat to your kidneys as well.

Diet

A soft diet is good following tonsillectomy and it is recommended for at least a week.  During this time fluid intake is encouraged. The soft diet includes khichdi, Upma, Yoghurt, soft sandwiches, scrambled eggs, soft Idli, soft fruits, and ice cream. Salty, dried and sharp food stuff is not recommended and it should be avoided. Even the foods that require excessive chewing such as firm meat should also be avoided. Hot drinks are not permitted, but lukewarm beverages and drinks are permitted. Similarly, hard foods like dry chips, salty processed foods, and dry toasts should be avoided. Usage of honey which is warm, but not hot is helpful in soothing the inside of throat and back of the throat following the removal of tonsils. If the patient is a child, he or she should get enough fluids and calories during the early operative period – and if the child is tolerating soft ice cream, yoghurt and water following tonsillectomy, then it is fine as long as the child is meeting the fluid and calorific requirement.

Rinsing mouth and throat with warm water

It is not essential to rinse the mouth, but if you wish to do so simply use a teaspoonful of salt in a cup of boiling water and cool this until it is just warm – and then, use it to rinse the mouth.
Rarely a child may dehydrate because they refuse to drink enough following the surgery. Often they may tolerate an icy Pole and this is the first thing usually given to them after the surgery and could be tried. If you are concerned regarding a lack of fluid intake, let me know as very rarely a child may need to be readmitted to a hospital and placed on an intravenous drip.

Bleeding following Tonsillectomy

The risk of bleeding following tonsillectomy or adenoidectomy is there; therefore, for many patients it is something to be a major cause for concern. However, following the removal of adenoids the risk of bleeding is very low. There could be a possibility of small amount or streaks of blood with mucus – which should not be taken as seriously. But, if the patient spits blood, which is bright red and the quantity is somewhat more than usual and if this happens within or up to two weeks of surgery, then they must be taken to the nearest emergency department.
For up to a week after the removal of the tonsils,it is better for the patient to take rest at homeand to be at ease.  After 2 weeks,vigorous activity such as sport can be commenced.

Adenoidectomy: Post-operative Care

For adenoidectomy alone there are no restrictions upon dietary intake.The risk of bleeding following the removal of adenoids alone is very small and generally children can be kept at home for up to three days, and then are allowed to go back to school, preschool or day-care. Occasionally, after the removal of adenoids, which is after 5 to 7 days of surgery, a child may develop a bad breath – which may persist for a few days. This is a part of the normal healing response and should not be of any particular concern for the parents.
Routinely I see patients one week after the removal of tonsils or adenoids; and usually, this appointment is arranged for the patient at the time of their discharge.

Post-operative care following Uvulopalatopharyngoplasty (UPPP)

Definition
Uvulopalatopharyngoplasty is a surgical procedure that involves the removal of excess tissue from the uvula and soft palate – the area in the back of the roof of the mouth. Uvula is a small pendant fleshy lobe that is hanging down from the back of the soft palate.

Meaning of Uvulopalatophayngoplasty – The termUvulo< refers to this structure; palato refers to palate and pharyngo to the pharynx. Plasty is a surgical procedure done for repairing, restoring and replacing a body part.

Purpose of Uvulopalatopharyngoplasty – The objective of this surgical procedure is to either reduce snoring or to improve the quality of sleep by treating obstruction.

Preparation for Uvulopalatopharyngoplasty (UPPP)

The person who has been recommended to undergo Uvulopalatopharyngoplasty will be advised by his or her doctor to restrain from taking any food or water after midnight and the day leading up to the surgery. However, the patient can as usual brush their teeth, but should not swallow water. If the patient is on medication that must be taken, then he or she should discuss about such medication with the doctor or anaesthesiologist and follow the instructions given by them. The procedure may not be recommended for the patients who have recently taken medicines or who are on medication that can hinder the normal blood clotting process – such medicines may include heparin, aspirin, blood thinners and anti-inflammatory medicines.

Procedure

In this type of surgery, an instrument is placed between the upper teeth and the tongue to keep the tongue out of the way and to open the mouth wide and hold it in that position. Tonsils are removed if they are present and are separated from the muscles that cover andattach to them. After the removal of tonsils, the excess tissue from the soft palate is also removed. Electric cautery is employed to control bleeding. During this process that involves the use of electricity, blood vessels are blocked to stop bleeding. The open area is sutured and closed by using dissolvable sutures.

Post-operative Care

Following the procedure the patient must concentrate on a few things such as the food, fluids and medication. A regular dose of pain medication is important to alleviate pain and ensure smooth swallowing of food. Adequate fluid consumption is very essential and the patient must follow it as a routine. To know whether the patient is taking adequate fluid or not, it is better to observe the colour of urine – alight coloured urine indicates adequate fluid intake.

The next important aspect is food. The patient can resume >a soft food diet as and when he or she desires. The site where the surgery was performed appears white – which means the back of the throat. The place where tonsils and or uvula were used to be present shows the formation of scab that usually appears white. At this juncture, and until the throat resumes normal colour – hard food like snacks, chips and other such food items should be avoided. It is normal for a patient or child to take rest for at least a week; during the first week following the procedure, the patient may experience earache – which is considered as a normal healing process unless it is accompanied with hearing issues. Patients can resume normal activities after two weeks. If this operation is done to treat sleep apnoea, a 2–3 days stay may be required to monitor the oxygen level in the bloodstream.

The expected outcomes of Uvulopalatopharyngoplasty

The procedure will help in improving the quality of sleep and reducing snoring. The patient may feel better once the sleep quality improves. However, it is not the only procedure which is necessary for the condition.

The Possible Complications of Uvulopalatopharyngoplasty

The procedure is relatively safe – however, there might be some uncommon risks that are involved. A few of such factors we will discuss here and the rest at the time of consultation. Still if you have any concerns then you may ask those when you meet us. It is however always better that you should be aware of the possible outcomes that may include but are not limited to:
Anaesthesia complications:General anaesthesia may be associated with a very small risk and for a patient who has had a family history of problems associated with anaesthesia – the risk increases. The risks associated with anaesthesia can range from vomiting and nausea to rare life-threatening complications. Therefore, the patient undergoing the procedure should discuss with the anaesthesiologist if he or she has any questions or concerns regarding the use of anaesthetic.

Post-operative Bleeding

There might be a possibility of bleeding within seven to ten days of the surgery – which would be a minor bleeding. If bleeding occurs you should inform your doctor or surgeon.
To stop bleeding, ice cubes are mixed with water placed in a cup and a teaspoonful of salt is added to this mixture. This mixture if used for gargling should stop the bleeding. If the bleeding does not stop, you will need to return to the hospital for evaluation and treatment.
Temporarily you may notice a feeling of fluid in the back of your nose while drinking. This should only be temporary. Notify your physician if this continues.

Head and Neck

Suture Line Care –Home care instructions

Clean suture line twice a day with normal saline available at any medical store.By using sterile and clean gauze or a cotton tip dipped in a normal saline solution, gently moisten the sutures and the skin around the surrounding area. Apply either Soframycin or Neosporin or Bacitracin ointment to the suture line after each cleaning – which should be done twice daily.
If redness, swelling or drainage develops, contact Dr Singh immediately.Suture lines may be exposed to water while bathing. Therefore, dry the suture line by gently patting the area with a soft, clean cloth or towel.

Post-operative care following Thyroid Surgery

Thyroid surgery is done under general anaesthesia. Following the procedure, the patient will stay in the hospital for around three to four days and the surgeon who performed the procedure will see the patient in the recovery room and also the next morning after surgery to make sure that the patient is recovering very well.

Diet
The patient can take liquids by mouth once he or she overcomes the affects of anaesthesia. Initially if the liquids are not well tolerated by the patient, he or she can take solid foods. After thyroidectomy, the patient may experience mild sore throat for up to two to three days. Sore throat does not cause any difficulty in swallowing.

Pain Control
Pain medications may be prescribed by the surgeon following thyroidectomy to control the pain as the patient may experience mild to moderate neck pain – which may last for a few days after the surgery. Therefore, the patient must take pain medication if they are prescribed by the surgeon. Ibuprofen and aspirin are not recommended as they may augment bleeding by dilating blood vessels – the risk of bleeding into the neck wound and neck tissues increases after thyroidectomy. Therefore, to prevent the risk of bleeding following the surgery, you must avoid taking these pain relieving medicines.

Activity
During the first 48 hours, the patient should sleep by keeping his or her head elevated – to ensure this they can use two pillows or if they are using a reclining chair – they can keep their head elevated by adjusting the position of their head. Heavy activities are not permitted for at least two weeks for patients who have undergone thyroidectomy. The patients are not allowed to lift heavy objects or strain themselves. It is better to avoid work for at least a week following the surgery – and two weeks if the work involves manual labour or lifting or else the work can be limited to light work for up to two weeks, and then heavy work can be resumed afterwards.

Wound Care
Swelling and mild redness is common around the wound after thyroidectomy; the inflammation and swelling will ease over the next few weeks after the surgery.If the area of the wound and surrounding area appear somewhat different and the patient is concerned about it, then he or she may ask the surgeon or nurseabout such developmentsprior to leaving the hospital.
As a precautionary measure, the patient should not wash his or her neck for up to 48 hours after the surgery. Scrubbing and scratching the wound area should be avoided for up to a week. Soaking the wound in running water should also be avoided. If the area becomes wet then pat the area dry, but try not to rub it with a towel. Nearly after one week of the surgery, the steri-strips over the incision are removed by the surgeon when the patient visits the hospital to see the doctor.

Follow‐up Appointment

The follow-up appointment should be scheduled beforehand – especially when the patient visits the hospital to seek the appointment for surgery – that is during the pre-operative visit. In case of not having fixed the appointment, the patient should contact the surgeon’s office after reaching home from the hospital. This appointment is usually sought after one to two weeks following surgery. During this visit, steri-strips are removed and the pathology report is evaluated and the patient may be asked to have the blood calcium test done to check the calcium levels.

Complications of Thyroid Surgery-
Dr Singh will discuss with you the possible complications of a Thyroid Surgery, a common but rare complication of the surgery is change of voice which may be temporary or permanent. This can be due to an injury to the nerve that supplies the vocal cords. The incidence is less than 5%
Another possible rare complication is fall in calcium levels which can happen due to compromised blood supply to 4 small glands close to the Thyroids called the Parathyroid Glands. An Endocrinologist`s opinion would be required to manage this.

Seek immediate medical help and reach to your surgeon if the patient has:

  • Throat hoarseness – which is progressive
  • Neck swelling and difficulty breathing
  • Choking or coughing when drinking liquids
  • Difficulty swallowing
  • Bleeding which is active
  • Fever greater than 1010F
  • Tingling and numbness in the fingertips or lips
  • Pus discharge (purulent discharge) from the wound
  • Muscle spasms or muscle cramps
  • Increasing redness around the wound