Generally patients do well after thyroid surgery. There is very little formal “recovery”. Essentially all patients are discharged from the hospital in less than 24 hours. The majority of patients having a simple thyroid lobectomy go home the same day if they live or can stay nearby. Many patients who have a total thyroidectomy go home the same day. However if you are the last case of the day you will likely spend the night and go home the next morning.
Pain Issues
Most patients are surprised how little discomfort they have post-op. Common complaints are a sore throat and discomfort with swallowing. This usually last just a few days. It is rare for anyone to be overwhelmed with discomfort. Patients receive a prescription for pain medication post-op. About 50% of patients don’t take anything other than tylenol or ibuprofen. An ice pack the first day of surgery helps some patients. It is very unusual to need pain medication beyond a week after surgery.
Activity
Patients are encouraged to be out of bed walking around the evening of surgery. The wound is covered with skin glue there are no sutures to be removed and the patient may shower the next day. The patient may resume normal activity as their comfort level allows. The patient may drive when they can comfortably and safely operate a car, frequently within 2 days. The only restrictions on activity are no exercise or athletics until the post-op visit about 2 weeks after surgery.
Return to work
If the patient has an office job that does not involve lifting, he or she may return to work when they feel well enough. Most patients miss about a week of work. If the patient has a physically demanding job, return to work is usually 2 weeks.
Wound Care
The wound is closed with skin glue. There is no need to cover the wound with a bandage. There are no sutures to be removed. The patient may shower the next day. If the wound gets wet it should be patted dry. Do not put any creams or medications on the wound. It does not need to be cleaned. Do not pick at or pull off the glue. Commonly the glue is removed at the post-op visit. We will discuss scar treatment then. We usually recommend the liberal use of sun screen on the incision for at least 6 months after surgery. No drains are used.
Medication
In general, patients should resume all medication they were taking preoperatively. We will tell the patient if any medication should be modified or discontinued. If there is any confusion, the patient should call the office. Anti-thyroid medication is usually not continued post-operatively. Beta-blockers, if started to control the symptoms of hyperthyroidism pre-op, are weaned over about 10 days. Which specific medications are given post-operatively depends on whether a thyroid lobectomy or a total thyroidectomy is performed. With a simple thyroid lobectomy usually the only new prescription will be pain medication.
After a total thyroidectomy, the patient can no longer make thyroid hormone. For normal health, this hormone is given, in pill form, by mouth as thyroid hormone replacement therapy. Typically, it is given as a single small pill taken once a day on an empty stomach. The patient will receive a prescription for this at discharge from the hospital. The dose may need to be adjusted later. The patient will receive a prescription for a vitamin D supplement. This is usually taken once a day until it is gone (usually 10-12 days). It helps with calcium absorption. The patient will go home on calcium, usually ultra-strength tums. This is started in the recovery room. Most patients take 1-2 ultra-strength tums 4 times each day(with meals and at bedtime). It is very important to take the tums with food so it will be absorbed Tums is given to prevent post-op hypocalcemia and will be discussed in detail on the risk of surgerypage. This calcium supplement should be continued until the post-op visit. A calcium level will be checked on that day and the dose of tums is adjusted as needed. The vast majority of patients are off calcium supplements within 2-3 weeks after surgery.