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Patient Instructions

You had surgery to remove part or all of your thyroid gland. You probably spent 1 to 3 days in the hospital.

A speech pathologist may have shown you exercises to make your vocal cords stronger. A dietitian may have helped you plan meals for the first few days after your surgery.

You may have a drain and a bulb coming from your incision.

You may have some pain and soreness in your neck at first, especially when you swallow. Your voice may be a little hoarse for the first week. You will probably be able to start your everyday activities in just a few weeks.

If you had thyroid cancer, you may need to have radioactive iodine treatment soon.

Get plenty of rest when you get home. Keep your head raised while you are sleeping for the first week.

Your doctor may have prescribed a narcotic pain medicine. You may be taking over-the-counter pain medicine, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol). Take all of your pain medicines the way your doctor or nurse told you to.

Try taking your pain medicine 30 minutes before a meal to ease the pain of swallowing.

You may put a cold compress on your surgical cut for 20 minutes at a time to ease pain. Do not put the ice directly on your skin. Make sure it is wrapped in a towel. Keep the area dry.

Take good care of your drain (if you have one) and dressings (bandages).

• Use a cotton swab and hydrogen peroxide (or another solution your doctor told you to use) to clean the wound area 2 times a day until the stitches are out.
• If you have a drainage bulb, empty it 2 times a day. Keep track of the amount of fluid you empty each time. When it is only about a tablespoon, your surgeon may remove the drain.
• If you have dressings over the wound area, change them the way your doctor or nurse showed you. Keep the area dry.
• Wash the area with mild soap and water when the stitches are out. Gently pat it dry.

See also: Surgical wound care

You may be taking antibiotics to prevent infection. Make sure you take all of the medicine the way your doctor or nurse told you.

For the first few days, you will need to eat only liquids and soft foods. Pudding, Jell-O, mashed potatoes, smooth apple sauce, and liquids at room temperature are good choices.

Pain medicines can cause constipation. Eating high-fiber foods and drinking 8 to 10 glasses of water a day will help make your stools softer. See also: Constipation

You may slowly start adding your regular foods to your diet. Your doctor may suggest you see a dietitian to help you with your meals.

Give yourself some time to heal. For about a week, do not do any strenuous activities, heavy lifting, jogging, or swimming.

Slowly start your normal activities when you feel ready. Do not drive if you are taking narcotic pain medicines.

Cover your incision with clothing or very strong sunscreen when you are in the sun for the first year after surgery. This will make your scar show less.

You may need to take thyroid hormone medicine for the rest of your life to replace your natural thyroid hormone.

You may not need hormone replacement if only part of your thyroid was removed.

See your doctor for regular blood tests and to go over your symptoms. Your doctor will change your dose of hormone medicine based on your blood tests and symptoms.

You may not start thyroid hormone replacement right away, especially if you had thyroid cancer.

You will probably see your surgeon every 2 to 4 weeks while you are healing. If you have stitches or a drain, your surgeon will remove them at these visits.

You may need long-term care from an endocrinologist for regular blood tests. An endocrinologist is a doctor who diagnosis and treats problems with glands and hormones.

Call your doctor or nurse if you have:

• Increased soreness or pain around your incision
• Redness or swelling of your incision
• Bleeding from your incision
• Fever over 100.5 °F
• Chest pain or discomfort
• A weak voice
• Difficulty eating
• A lot of coughing
• Numbness or tingling in your face or lips

Total thyroidectomy - discharge; Partial thyroidectomy - discharge; Thyroidectomy - discharge; Subtotal thyroidectomy - discharge

Hanks JB, Salomone LJ. Thyroid. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds.Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 36.

Updated by: Robert A. Cowles, MD, Assistant Professor of Surgery, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.