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Discharge Instructions for Grave’s Disease (Pediatric)

Your child has been diagnosed with Grave’s disease. This is the result of an overactive thyroid gland, which produces too much thyroid hormone (hyperthyroidism). Hyperthyroidism may cause a variety of symptoms and may affect all body functions. Thyroid hormone is important to body growth and metabolism. If your child has too much, many of the body's processes speed up or overreact. Three options are available to treat Grave’s disease: medications, radiation, or surgery. Here's what you need to know about home care following treatment.

Medication

Your health care provider will discuss medication options with you. There are two anti-thyroid agents that may be considered. In addition to these drugs, other medications such as a beta-clocker may be used at the beginning treatment.

Anti-thyroid medications may cause side effects such as itchy skin, or more serious symptoms such as persistent nausea/vomiting, yellowing of the skin, or muscle pain. Tell your health care provider of any new symptoms so he or she may determine if the medications are causing the symptoms.

Remission of Grave's Disease can take a long time in children and is more successful if the anti-thyroid medication isn't stopped until the thyroid has returned to its normal size.

Follow these tips for taking anti-thyroid medications:

  • Never stop your child’s treatment on your own. If you do, your child’s symptoms will return.

  • Make sure your child takes his or her medication exactly as directed.

    • Have your child take his or her medication at the same time every day. Depending on your child's needs, medications may be given once, twice, or three times a day.

    • Keep the pills in a container that is labeled with the days of the week. This will help you remember whether you’ve given medication to your child each day.

  • Talk with your health care provider about prescribing ointments or artificial tears, if needed, to soothe your child’s eyes.

Other Home Care

  • Use extra pillows in bed to prop your child’s head up. Sleeping with the head elevated will reduce eyelid swelling.

  • Protect your child’s eyes from dust and drying wind. If your child is old enough, he or she can wear glasses with side guards to protect the eyes.

  • Keep a card in your wallet that lists the following:

    • Your name and contact information

    • The name of your child’s health care provider and contact information

    • The name of your child’s disease

    • The brand name and dose of your child’s medication

Health Care Visits

  • During routine visits, tell your child’s health care provider about any signs of hyperthyroidism (too much thyroid hormone), such as:

    • Restlessness

    • Rapid weight loss

    • Sweating

  • During routine visits, tell your child’s health care provider about any signs of hypothyroidism (too little thyroid hormone, which can be a side effect of treatment), such as:

    • Fatigue or sluggishness

    • Puffy hands, face, or feet

    • Hoarseness

    • Muscle pain

    • Slow pulse (less than 60 beats per minute)

Follow-Up

  • Make a follow-up appointment as directed by our staff.

  • Make and keep appointments to see your child’s health care provider and get lab work. Your child may need to be monitored for the rest of his or her life.

When to Call Your Child's Health Care Provider

Call the health care provider right away if your child has any of the following:

  • Fever:

    • In an infant under 3 months old, a rectal temperature of 100.4°F (38.0°C) or higher

    • In a child 3 to 36 months, a rectal temperature of 102°F (39.0°C) or higher

    • In a child of any age who has a temperature of 103°F (39.4°C) or higher

    • A fever that lasts more than 24-hours in a child under 2 years old, or for 3 days in a child 2 years or older

    • A seizure caused by the fever

  • Sleeplessness, anxiety, or tremors

  • Feeling sweaty and hot, even when others nearby are comfortable

  • Shortness of breath

  • Trouble focusing the eyes

  • Bulging eyes

  • Weight loss for no obvious reason

  • Rapid pulse (higher than 100 beats per minute)

  • Enlarged thyroid gland (goiter)

  • Diarrhea

 

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