The Adrenal Glands

The adrenals are two small, wedge-shaped glands. They rest on top of each kidney. The outer layer is called the adrenal cortex. They produce hormones such as cortisol.

These hormones affect salt and water balance in the body. They also effect the body's response to stress. They affect metabolism, the immune system, blood pressure and sexual development as well as function.

The inner layer is called the adrenal medulla (muh-duh-luh). This produces epinephrine (eh-puh-neh-frun), also called adrenaline. This hormone increases blood pressure and heart rate when the body is stressed.

Tumors in the adrenal glands can be cancerous or cause too much hormone in the body. This can cause high blood pressure, increased heart rate, excess sweating, and weakness.

Surgery

General anesthesia is used. An IV or inhaled medicines are given to put you in a deep sleep. Medicines are given to stop your muscles from working for a short period.
A breathing tube is used to help you breath. Most people do very well with general anesthesia. It is considered very safe. The most common side effect is a mild sore throat and some nausea. There are medicines that can help prevent or reduce the nausea.

Most people have their adrenal gland taken out through small wounds in their belly or back (with a laparoscope). Some will require a 3-9-inch incision (open approach) to remove the gland.

You will stay in the hospital overnight. Most people go home the next day. Wear loose, comfortable clothing.

After Surgery

You may have aching in your shoulders from the gas put in your abdomen during surgery. For relief, lie flat and put several pillows under your hips. Stay in this position for 5-15 minutes. The gas pain will go away. A heating pad to your shoulder may also help.
Your throat may be sore when you swallow. This is normal and can last 1-2 days.

Going Home

Wound Care

Keep the wound clean and dry. Look at your wound daily, check for signs of an infection:

• Spreading redness or swelling.

• Foul-smelling drainage or pus.

• A fever (more than 101 F by mouth) or chills.
  

Use ice at the incision sites, 20 minutes on 20 minutes off.

There may be bruising at the incision site. The incisions are closed with dissolvable stitches. The skin is closed with glue. The glue is waterproof. If you have Steri-strips (pieces of tape) covering the incision, leave the tape on until your follow up visit. Curled tape edges may be trimmed with small scissors.

Pain Control

Expect that your incision(s) will be tender. You will have prescription pain pills to use at home. You may take Tylenol® instead of the pain pills. You can also take ibuprofen or naproxen (Aleve ®).

Narcotic pain pills can be constipating. To prevent this problem, you may want to take a stool softener each day you use narcotic pain pills. Use them until you have your first bowel movement after surgery. You may want to start with Peri-Colace®, follow the package directions.

Adrenal gland surgery can cause a drop in cortisol, it is important to take any hormone replacement medicines that is prescribed.

Diet

You can eat your normal diet when you get home.
Drink plenty of fluids. Eat high fiber foods. If you have not had a bowel movement in 3 days, please call us.

Shower

You can and should shower after 2 days. Avoid soaking or scrubbing the incision(s) until they are well healed. No swimming or soaking in water for 2 weeks.

Driving

Do not drive for at least 1 week after surgery. Do not drive if you are taking narcotic pain pills.

Work

Plan to take 1 week off from work to recover. If you need an open operation, you may need a longer time to recover (up to 4-6 weeks).

Exercise

• Do not lift more than 10 pounds for at least 2 weeks after surgery.

• If you have laparoscopic wounds, you will be limited for 1-2 weeks. If you have a 3–9-inch wound, you will be limited for 4-6 weeks.

• Walking is okay and encouraged.

• No heavy activity. This includes pulling, pushing, and twisting until cleared by your doctor.

• Sexual activity may be resumed when you feel ready. This may not be for 2-3 weeks after your surgery.
  

When to Call

• Pain that does not get better with medicines.

• Signs of infection.

• Any other symptoms that concern you.
  

Who to Call

Call 608-242-2888. This is a 24-hour number. Ask the operator to transfer you to the doctor on call for endocrine surgery.

Toll free at: 1-800-323-8942.

If you are a patient receiving care at UnityPoint – Meriter, Swedish American or a health system outside of UW Health, please use the phone numbers provided in your discharge instructions for any questions or concerns.