One of the most important things to do after you have had thyroid surgery is to keep the wound clean and dry. Follow your doctor’s instructions for wound care and bathing following your surgery. Doing so may help prevent your wound from becoming infected and it may also help the wound to heal faster.  Do not immerse the wound in water until it is fully healed. For example, do not go swimming or submerge the wound while taking a bath. Immediately following surgery, you may have a small drain tube exiting the skin of the neck near the thyroid incision site; it will help keep fluid from building up in your neck, fluid that could lead to infection and additional pain. Your doctor should remove the drain tube prior to your discharge from the hospital once any drainage is clear and sparse. The morning after your surgery, you can take a shower and allow water and mild soap to run over your wound. Do not scrub the wound or put pressure on it with high pressure water or your fingers. Just allow some water to run over the incision site and cleanse it. Your doctor may instruct you to keep the wound covered with some light gauze held on with tape. In this case, you may need to change your bandage once per day to keep the wound clean. Be gentle when you remove the old gauze as it may stick to your skin. If it is stuck, use about a teaspoon of hydrogen peroxide or saline to moisten the gauze and make it easier to remove the bandage. Then use some cotton balls dipped in hydrogen peroxide or saline to gently clean away any dried blood on your skin before replacing the bandage. Surgical site infection in thyroid surgery is very rare as it is considered a “clean case,” with minimal chances of contamination. However, it is important to observe the wound after surgery for signs of infection and talk to your doctor right away if you notice any of these signs. Signs that a wound may be infected include:  Redness, warmth or swelling at the site. Fever greater than 100.5°F (38°C) Drainage or opening of the wound
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One-sentence summary -- Keep the wound clean and dry. Cleanse the incision area the day after surgery. Change your bandage as needed. Watch for signs of infection.


Many people who have an autonomic dysfunction also suffer from depression and anxiety. If you are experiencing impotence or difficulty with sexual arousal, you may have relationship issues with your partner. Talking to a counselor or therapist can help you work through this issues and get professional support. Talk to your doctor about support groups for autonomic dysfunctions in your area. If there is not a specific group near you, you can look for a support group for your underlying condition, such as a diabetes support group or a sexual difficulties support group. It can be helpful to talk to others who understand what you are going through and are dealing with many of the same struggles as you. You may also learn some coping mechanisms from the support group to make life with an autonomic dysfunction easier. Lean on those closest to you to create a support system for yourself. Be willing to ask for and accept help when it is needed. Try not to shut yourself off from your family and friends and focus on maintaining a positive attitude to tackle any challenges or struggles you are facing due to your disorder.
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One-sentence summary -- Talk to a counselor or therapist about your condition. Join a support group. Reach out to family and friends.


Probably the most important action you can take to help alleviate the pain from OSD is to stop playing the sport or doing the activity that is contributing most to the problem. Sports that involve a lot of jumping, such as basketball and volleyball, are particularly bad for OSD.  The amount of rest needed varies widely and depends on the person, but expect anywhere from a few weeks to a few months before a significant reduction in pain and swelling is noticed. Pain with OSD can be sporadic or nearly constant; it usually occurs in just one knee, but sometimes develops in both. The application of ice is an effective treatment for essentially all acute musculoskeletal injuries, including OSD. Cold therapy should be applied to the inflamed bump (tibial tuberosity) just below your kneecap for 20 minutes every two to three hours for a couple of days, then reduce the frequency as the pain and swelling subside.  Always wrap ice or frozen gel packs in a thin towel in order to prevent frostbite on your skin. If you don't have any ice or gel packs, then use a frozen bag of peas from your freezer. While resting and applying ice to your knee, consider also using a special knee brace or kneecap immobilizer while having to walk in order to take the stress off your patellar tendon.  Knee braces can be found at stores that sell rehabilitation and medical supplies — ask a physical therapist, physician, or chiropractor for more info. Alternatively, you can try a patellar tendon strap, which fits around your leg just below your kneecap. It can support your kneecap's tendon during physical activity and distribute some of the force away from the tibial tuberosity.  Complete inactivity is not necessary with OSD, but consider switching to other fun activities that don't involve jumping or running, such as swimming, rowing or golf. Non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen, naproxen or aspirin can be short-term solutions to help you deal with the pain and inflammation of OSD. Alternatively, you can try over-the-counter analgesics (painkillers) such as acetaminophen (Tylenol). These medications can be hard on your stomach, kidneys and liver, so it's best not to use them for more than 2 weeks at a stretch. Check with your doctor before taking any medications.  Keep in mind that NSAIDs do not shorten the course of OSD.  Steroids such as cortisone have powerful anti-inflammatory properties, but injections should not be given to adolescents with OSD due to the risk factors —  mainly, potential tendon weakening, local muscle atrophy and reduced immune system function. Once the acute knee pain has settled down, start doing some quadriceps stretching. One of the causes of OSD is repetitive quadriceps contractions (from too much jumping, for example) and also overly tight quadricep tendons. As such, learning how to stretch this muscle group may help reduce the tension and inflammation in the area where the kneecap's tendon attaches to the upper shinbone (tibia).  To stretch your quadriceps while standing, bend your leg behind you so your knee is bent, your heel about at the level of your butt. Grab your ankle and pull your foot toward your body until you feel a nice stretch in your lower thigh and knee. Hold for about 30 seconds and repeat three to five times daily until you notice reduced symptoms. Stretches for the hamstrings, which are also commonly tight, may also be performed. Bending over at the waist and trying to touch your toes is a good basic hamstring stretch.
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One-sentence summary --
Rest and avoid pain-inducing activities. Apply ice to your knee. Use a knee brace or patellar immobilizer. Take anti-inflammatories or painkillers. Stretch your quadriceps.