Post Operative Expectations

OVERVIEW

In general, thyroid surgery is well tolerated and the vast majority of patients will have a smooth recovery. However, there are some things that everyone can expect with any type of thyroid surgery.

You will experience some discomfort at the incision site as well as a raw or sore throat from the breathing tube that was inserted during surgery. Pain in the back of the neck or stiffness of the neck muscles can result from the position of the neck during surgery. Many patients will feel that there is something stuck in their throat or that they need to frequently clear their throat after surgery.

All of these are normal, expected symptoms following surgery. Ice chips, cool drinks, throat lozenges (Cepacol) or throat spray (Chloraseptic) can be beneficial for sore throat. It is recommended to avoid excessive coughing or throat clearing as these activities put extra strain on the neck and may increase the risk of bleeding. The feeling of something in the throat should clear on its own in several days time.

Some patients experience temporary hoarseness or difficulty swallowing. On rare occasions, the nerve that controls your vocal cord movements may have sustained surgical trauma, resulting in paralysis of one or more vocal cords. If the injury is mild, the nerve will recover with time and your voice will return to normal. If the injury is more severe, the paralysis may be permanent. Permanent paralysis may result in permanent hoarseness of the voice, and some may feel more short of breath if trying to speak to quickly.

Post Operative Expectations FAQs

WHAT IS THE THYROID GLAND?

The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck. The thyroid’s job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormone helps the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should.

WILL I BE ABLE TO EAT AND DRINK AFTER SURGERY?

Yes, once you have fully awakened from surgery, you will be able to gradually advance your diet. You will start with liquids and be able to advance to solid foods after that. It is recommended to avoid the use of straws with thick liquids (milkshakes, smoothies, etc), but straws are fine to use with thin liquids (water, juice, milk, soda, etc).

Some patients experience mild nausea and loss of appetite for a few days following surgery and may wish to avoid eating greasy, fatty, and oily foods or heavy meals for the first few days. Your appetite will return gradually.

HOW ACTIVE CAN I BE AFTER SURGERY?

You will be able to walk and do routine activities of everyday living. You should avoid lifting anything over 10 pounds, excessive turning or stretching of the neck, and strenuous activity for the first 2 weeks after surgery. Strenuous activity includes, but is not limited to, running, pulling, pushing, straining, lifting, or swinging (such as golf).

You will not be allowed to drive home from the hospital. Most surgeons recommend waiting at least 3-5 days before driving to ensure you have full range of motion of the neck in order to check blind spots and drive safely.

WHEN CAN I RETURN TO WORK?

Most patients can return to work 1-2 weeks following surgery. Check with your doctor prior to returning to work if you are unsure or if your job requires strenuous, manual labor.

WHAT ARE SIGNS OF AN EMERGENCY AFTER SURGERY?

While some minimal swelling, puffiness, or bruising at the incision is normal, rapid, sudden swelling of the neck that feels tight and affects your ability to breath and swallow is an emergency and requires immediate medical attention.

LOW CALCIUM

The parathyroid glands, which help the body regulate calcium levels, are next to the thyroid gland. They can be disrupted during thyroid surgery and temporarily stop functioning, leading to low calcium. Rarely, the parathyroid glands will stop functioning permanently.

Signs of low calcium include numbness and tingling around the mouth or in the fingertips/fingers/hands. Very low calcium levels can lead to muscle spasms of the hands, face, or legs. If you experience any of these symptoms, you should contact your surgeon’s office. Your doctor may give you calcium supplements to take in order to maintain normal calcium levels in your blood or to treat symptoms of low calcium. The parathyroid glands usually return to normal functioning within a few weeks or months. On rare occasions the parathyroid glands will not return to normal function, and you will need to take calcium and vitamin D supplements on a long-term basis.

THYROID HORMONE

Approximately 6 weeks following surgery, your doctor should request a blood test to evaluate your thyroid hormone level. If your thyroid hormone level is high (above the normal range), your doctor should prescribe thyroid hormone. This pill should be taken on an empty stomach with a glass of water. For most people, this is first thing they take in the morning upon awakening. Another alternative is to take the medication at bedtime. Do not have anything to eat or drink, including black coffee, for one hour. It is also important to avoid taking calcium, iron, fiber, or multivitamins within 4 hours of taking your thyroid hormone.

Surgical Management of Graves’ Disease

Further details on this and other thyroid-related topics are available in the patient thyroid
information section on the American Thyroid Association® website at www.thyroid.org.

For information on thyroid patient support organizations, please visit the
Patient Support Links section on the ATA website at www.thyroid.org