Bechara Y. Ghorayeb, MD.  1140 Business Center Drive, Suite 560.  Houston, TX 77043.  Tel: (713) 464 2614
www.ghorayeb.com

Post-Op Instructions for Parathyroidectomy
Minimally-Invasive Video-Assisted Parathyroidectomy (MIVAP)
Minimally-Invasive Parathyroid Surgery (MIRP)

Diet
Patients who have received general anesthesia may experience nausea and occasionally, vomiting.  It is therefore preferable to eat a bland light meal or a liquid diet on the first day after the surgery.  Regular diet may be resumed the next day. Also, pain pills may cause nausea if taken on an empty stomach. It is preferable to take those pills with a piece of toast or some food.

Activity and Wound Care
Elevate the head as much as possible. Sit in a recliner or use two or three pillows when sleeping. Head elevation reduces bruising and swelling. Occasionally, you may notice that the bruises or swelling have migrated to other places (usually lower regions).

Wounds are sealed with Dermabond acrylic coating:
The wound is usually left exposed and sealed with a clear acrylic compound called Dermabond.  This compound protects the wound and allows you to take a shower without covering it.  Do not apply antibiotic ointment over the acrylic.  The Dermabond acrylic coat will peel off in 10 - 15 days.

Methylene Blue
In very rare instances, methylene blue may be used to localize the parathyroids. These patients would notice a bluish green discoloration of their urine for a few days after the operation. 

Medications
An antibiotic is usually prescribed for seven to ten days following the surgery. You may also receive a prescription for painkillers in the form of codeine or hydrocodone. These products cause somnolence, drowsiness and constipation. Occasionally, Phenergan suppositories may be necessary for nausea or vomiting.

Low Calcium (Hypocalcemia)
Occasionally, following the removal of a parathyroid adenoma, a transient drop of blood calcium levels may occur. This condition is called hypocalcemia.  This would cause patients to experience numbness or tingling around the mouth, in the fingertips and toes. Muscle cramps may also occur.  Hypocalcemia is best treated with over-the-counter calcium tablets in the form of calcium carbonate (Tums, Rolaids, OsCal, Caltrate) or calcium citrate (Citracal). If you experience these symptoms, start taking over-the-counter calcium supplements and make an appointment with your endocrinologist or primary physician for a calcium blood test.

Follow-up
Please schedule an appointment to be seen in the office:  PHONE: (713) 464 2614
We are unable to refill your medications on weekends or after hours.
We do not refill painkillers over the phone. For prescription refills, please call during office hours:
Monday-Thursday: 9:00 am - 4:30 pm and Friday: 9:00 am - 3:30 pm 

For more information and pictures, please visit Dr. Ghorayeb's website: http://www.ghorayeb.com