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Discharge Instructions for Graves' Disease (Pediatric)

Your child has been diagnosed with Graves' disease. This disease results from an overactive thyroid gland. The gland produces too much thyroid hormone resulting in a condition called hyperthyroidism. Hyperthyroidism may cause various symptoms and may affect all body functions. Thyroid hormone is important to body growth and metabolism. If your child has too much thyroid hormone, many of the body's processes speed up. Three options are available to treat Graves' 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 for your child. Two anti-thyroid medications may be considered. Anti-thyroid medications work by blocking the release of thyroid hormone. Other medications to control symptoms, such as a beta blocker, may also be used.

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

Remission of Graves' disease is more common in children and adolescents, although it can take a long time. Remission is more successful if the anti-thyroid medication isn't stopped until the thyroid has returned to its normal size.

Follow these tips for anti-thyroid medications:

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

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

    • Have your child take his or her medications 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 as directed.

  • Talk with your health care provider  about prescribing ointments or artificial tears, if needed, to soothe your child’s eyes, and creams or ointments to relieve itching and rough skin.

Other home care

  • If your child's eyelids are swollen on both sides, use extra pillows in bed to prop your child’s head up. Sleeping with the head elevated may 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 provider 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 doctor 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 heart rate (less than 60 beats per minute)

Follow-up care

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

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

When to seek medical care

Call 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 between 3 and 36 months of age, 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 (excessive staring or infrequent blinking)

  • Weight loss for no obvious reason

  • Rapid pulse (higher than 100 beats per minute)

  • Enlarged thyroid gland (goiter in front of the neck)

  • Diarrhea

 

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