Post Thyroid Surgery Guidelines
Monitoring Your Progress
You should remain in bed for the first 24 hours after surgery. You should feel improvement every day a f t e r surgery. If you have any questions regarding your progress, call us right away. In addition, be sure to make an appointment to see your surgeon one week after your surgery.
Your incision is covered with a protective tape called Steri-strip. Apply an ice pack to the lower neck the first 24 hours. You can shower and wash your hair as usual the day after surgery, but do not soak or scrub the incision. The tape will start curling up at the edges in 3 to 4 days. Please pull the tape off 4 days after surgery. After the tape is removed, apply antibiotic ointment (Neosporin, Polysporin, or Bacitracin) to the incision twice a day for 5 days, then switch to vitamin E ointment twice a day and sunblock (SPF 35) in the morning for the next 2 months. Keeping the incision out of the sun will help it heal better and with less chance of scarring.
You might notice bruising around your incision or upper chest and slight swelling above the incision when you are upright. The swelling may remain for 3 to 4 weeks. In addition, the scar may become pink and hard. This hardening will peak at about 3 weeks and may result in some tightness or difficulty swallowing, which will disappear over the next 2 to 3 months. Firm massaging of the scar starting 2 weeks after surgery will help prevent this.
Thyroid Hormone Tablets after Surgery
If you were taking thyroid hormone tablets before your operation, continue with the same dose, unless your surgeon changes your dose. If you were not taking thyroid hormone prior to your operation, your internist or endocrinologist will prescribe these tablets following surgery.
During your postoperative visit, you may have a blood test to measure your levels of thyroid hormone and your dose of medication may be adjusted accordingly. Your thyroid hormone levels will then be measured about every 2 months until your hormone levels are stable (levels generally stabilize in 4 to 5 months).
Those patients who undergo a hemi-thyroidectomy (removal of half of the thyroid), will need to have thyroid blood tests done one month after surgery to make sure the remaining half is producing enough hormone.
The main complaint following thyroid surgery is sore throat and pain with swallowing. This pain can persist for 3 to 4 days. Tylenol can generally control this pain. Some people prefer Vicodin, but usually strong medications are not necessary.
Your voice may go through some temporary changes with fluctuations in volume and clarity (hoarseness). Generally, it will be better in the mornings and “tire” toward the end of the day. This can last for variable periods of time, but should clear in 4-6 weeks.
Because your operation was done under general anesthesia, you may feel like you have phlegm in your throat. This is usually because there was a tube in your windpipe while you were asleep that caused irritation that you perceive as phlegm. You will notice that if you cough, very little phlegm will come up. This should clear up in 4 to 5 days.
Swimming is the only major restriction. In general, your activity level depends on the amount of discomfort you experience. You can resume sports activities 4 weeks after surgery. Most patients are able to return to work within the first two weeks, and you are able to drive as soon as your head can be turned comfortably (this limitation is for driver safety).
In about 8% of patients who have their total thyroid removed, the parathyroid glands do not function properly immediately after thyroid surgery, the so- called “parathyroid shock”. This is usually temporary and causes the blood calcium level to drop below normal (hypocalcemia).
Symptoms of hypocalcemia include:
1. Numbness and tingling in your hands, soles of your feet and around your lips.
2. Some patients experience a “crawling” sensation in the skin,
3. Muscle cramps or
4. Severe headaches.
These symptoms appear between 24 and 48 hours after surgery. It is rare for them to appear after 72 hours.
Symptoms can generally be prevented by taking:
- First 14 days after surgery – 2000 mg of calcium 2 times daily (Citracal, or Oscal without vitamin D), and Rocalcitrol (special form of Vitamin D) once daily for.
- After the 14th day – reduce calcium to 2000 mg daily, and continue Rocalcitrol once daily for the next 2 weeks.
Hypocalcemia Symptom Treatment
At any point if symptoms develop, you should take an extra 2000 mg of calcium and Rocalcitrol and call your doctor as soon as possible.
It is common to have some bruising around the incision area. If bleeding occurs, you will notice immediate swelling in the neck and difficulty breathing. This is extremely rare but it is an absolute emergency. If it does occur, immediately call 911.
Contact Dr. Larian Today
If you have additional questions about healing or recovering after your minimally invasive thyroid surgery with world-renowned head and neck surgeon Babak Larian, MD, FACS, please do not hesitate to contact the CENTER for Advanced Head & Neck Surgery today to speak with a medical professional. Dr. Larian makes sure that every patient receives the optimal care and results that they deserve. For more information, please contact the CENTER today by calling 310-461-0300.