If you need thyroid surgery, it will be important to be well prepared. Feel free to contact your surgeon if you have any questions before or after your operation. Every surgeon does things slightly differently so be prepared for some variations. However, here are some general answers to frequently asked questions:
How long will I be hospitalized?
You will be admitted to the hospital the morning of your surgery. A bed is automatically reserved for you. Some patients may be able to go home after an 8 hours of observation period in the recovery room.
What type of anesthesia will I have? What do I do the night before my surgery?
You will most likely have your thyroid surgery with general anesthesia. You will be completely asleep and will feel no pain during your surgery. Selected patients may be able to have their surgery with intravenous sedation and local anesthetics infiltrated into the neck. In either case you will meet the anesthesiologist in person before the surgery. Because you will be getting anesthetics, it is important that you do not eat or drink anything after midnight the night before surgery. Continue to take all important medications such as heart, asthma, or blood pressure medicines - as indicated - with a small sip of water the morning of surgery. Do not take aspirin for 7-10 days prior to your surgery date. If you are a diabetic, please consult with your physician or the anesthesiologist to discuss whether you should take your diabetic medicines.
Will I have pain after the operation?
All patients will have some pain post-surgery. This pain is easily treated with medicines prescribed by your surgeon. You might have a sore throat, difficulty swallowing, or a hoarse voice after the operation. These conditions will resolve with time.
What medicines will I have to take at home after surgery?
Most patients only need pain medicines for a few days following surgery. Your surgeon will prescribe these. Because the parathyroid glands that control blood calcium levels may be somewhat dysfunctional after thyroid surgery, you may need to take calcium and vitamin D depending on your surgeon's recommendations. Some patients require calcium supplementation on a temporary basis. If the parathyroid glands continue not to function properly, you may need to take calcium and vitamin D permanently (very rarely).
Will I have to take thyroid hormone after my surgery?
If you weren't taking thyroid hormone before the operation, your surgeon may want you to start this medication after the operation. Patients, who were on thyroid hormone pills before surgery, will continue with the same dose unless told differently by their surgeon. Patients who have a total thyroidectomy (complete removal of their thyroid) will have to take this hormone for the rest of their life. During your follow-up visit, your surgeon will measure your thyroid hormone levels and adjust accordingly.
Will I have a scar?
All surgeries cause some scarring. When performed by trained endocrine surgeons, the thyroid operation will be performed using the smallest, cosmetically placed incision possible. Plastic type closures are used to minimize scarring. Ultimately the type of scar formed depends mostly on your own body. The majority of people having thyroid surgery are very pleased with the minimal scar present at 6 months after surgery.
Will I have stitches?
Your incision will be closed with stitches placed under your skin that are not visible. These stitches dissolve after a period of time and do not need to be removed. Strips (steristrips or butterfly strips) may be placed on your incision to help healing and for protection. It is best if you do not peel these off. Once these strips fall off or are removed by your surgeon, you can apply a small amount of lotion over the incision.
What do you do with the removed thyroid tissue?
The removed thyroid tissue will be handed to a pathologist to process and analyze under the microscope. The main goal will be to determine whether there are cancer cells in the removed thyroid tissue. This usually takes up to 5 working days. Your surgeon will discuss the results of your pathology with you in detail at your follow up appointment.
Will I have any restrictions after my surgery?
You will be somewhat sore and have some difficulty with full range of motion in your neck for one week post-surgery. Gradually, you will feel better everyday. Some patients may have muscle spasms in their upper back or neck. It is important to keep your neck muscles relaxed in a normal posture during your recuperation period. Most patients can return to work within 7-14 days after their surgery (depending on the physical requirements of their job). Most patients are able to start driving one week after the surgery (as long as they are no longer taking pain medication and can turn their head comfortably.) After two weeks you can return to non-strenuous exercise. You can return to all your normal activities within 3-4 weeks after surgery.
Will I lose my voice after thyroid surgery?
Your voice will undergo some temporary changes after the operation. Some patients are hoarse or have voice fatigue (their voice is "tired" at the end of the day). In most cases, changes will subside in 6-8 weeks. 1% of patients will have permanent changes or hoarseness. However, there is non-surgical treatment available to improve the voice quality.
What are the signs of low blood calcium and how will I know if I need to take extra calcium?
Some patients experience low blood calcium (hypocalcemia) after thyroid surgery. Low blood calcium occurs if the parathyroid glands (behind the thyroid gland) do not function properly. Symptoms of low blood calcium include numbness and tingling in the fingers and around the mouth. Some patients experience muscle cramps. Low blood calcium can be prevented or treated with extra calcium intake. Most surgeons will ask you to take extra calcium (usually 1000mg every 6 hours). You can take Tums, Caltrate, or Oscal for 5-14 days after surgery. If symptoms persist, contact your surgeon.
Why is the area around my scar swollen?
During the healing process it is natural to get some swelling around your incision. A healing "ridge" will form above and below your incision as your muscles heal. A small amount of bruising is normal as well. If you have any sudden swelling or have difficulty breathing, contact your surgeon immediately or go to the nearest emergency room as this can be a sign of bleeding
We hope this section has been helpful, please contact your surgeon with any further questions.