Recovery After Thyroid Surgery
There is not much pain involved with thyroid surgery. Most patients will experience excellent pain control using over the counter medications such as acetaminophen (Tylenol) or ibuprofen to control their discomfort. Rarely is narcotic pain medication (such as hydrocodone, oxycodone, morphine) required, and usually this is in the immediate post-operative period in the recovery room.
After surgery, it is very common to have a sore throat. This is often from irritation from the breathing tube if the surgery was done using general anesthesia. Patients can usually eat and drink normally the night after the procedure. Mild hoarseness is common and should go away within one to two weeks.
The incision is usually closed with absorbable sutures and surgical tape or glue. Patients may shower the morning after surgery and get the incision wet but should not soak it in a tub or swim for about a week.
Hospital stay or outpatient surgery
Depending on the type and extent of operation performed, patients may go home the same day of surgery or stay in the hospital overnight. You surgeon will discuss this with you. Patients more likely to stay overnight are those having more extensive surgery (total thyroidectomy, lymph node dissection, etc.), if they are hyperthyroid or have other medical problems were closer observation is warranted.
What will the scar look like?
The vast majority of incisions heal very nicely and after a year are barely noticeable. If possible, the incision is made in a natural skin crease in the neck or follows the natural contour of the fine skin lines if no crease is available. In this way, the the best possible cosmetic effect is achieved. Earlier on in the healing period after surgery, the incision is often slightly raised, may take on a reddish color, and there may be slight swelling and bruising noted. A firm lump beneath the incision and area of surgery often develops in the first two weeks after surgery. This is a normal part of wound healing, and patients should not be alarmed. This lump will decrease and soften considerably over 6-8 weeks. Significant swelling the day after surgery is unusual, and the patient should call their surgeon if this is noted. It often takes up to one year for the incision to fade and take its final form, color and consistency.
When can I return to work and normal activity?
The neck muscles may feel stiff and sore for a few days. Most patients return to their daily activities in a few days and to work within a week. Strenuous activity and heavy lifting should be avoided for at least a week. During this time it is helpful to move the neck from side to side and roll the shoulders with gentle stretches to prevent stiffness. Acetminophen and ibuprofen are helpful for these symptoms, too.
Postoperative follow-up appointment
A follow-up visit with your surgeon will generally take place two to three weeks after the operation. The wound should be well healed by this time and it allows the surgeon to discuss and review the operation, expected postoperative course, as well as the pathology results.
Will I need new medications?
Thyroid hormone replacement is given immediately after a total thyroidectomy, with the dose dependent on the patient’s weight and the final diagnosis. Thyroid hormone levels are checked 6-8 weeks after surgery and adjustments to the thyroid hormone dose as needed. Thyroid hormone replacement should be taken thirty minutes to one hour away from food, drinks other than water, or other medications.
Is supplemental calcium or vitamin D necessary after thyroid surgery?
If signs of low calcium become apparent supplemental calcium and/or vitamin D may be recommended. Labs may be checked to guide the amount of these supplements to be taken. (See Complications of thyroid surgery) At many centers, calcium is routinely recommended after total thyroidectomy. Calcium is not generally recommended after thyroid lobectomy.