Post-operative instructions following Thyroid Surgery for Dr. Greg Rohn and Dr. Brad Gamble of Otolaryngology Specialists of North Texas. Offices are located in Plano-Frisco and Dallas.
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Recovery from anesthesia usually occurs over several hours. Following the surgery, the patient is transported to the recovery room where they are observed for approximately an hour. They are then transferred to the postoperative medical ward, where they are usually kept overnight. During the remainder of the first day, the patient is typically groggy and tired, but progressively improves. The patient is typically discharged the following day. We usually ask patients to budget from 3-5 days off of work and activities during the first week.
The patient is typically given clear liquids either in recovery, or upon transfer to the floor. Depending on the level of grogginess, throat discomfort, and whether they have nausea, the patient’s diet is advanced to a regular diet rapidly over the first and second day. Upon return home, there are no dietary restrictions.
We typically have the patient maintain head elevation while in bed during the first week. This reduces swelling and discomfort. We suggest no heavy lifting or vigorous activity during the first week. We would request that the patient not travel out of the DFW area during the first week.
pain: The pain following thyroidectomy is typically surprisingly mild. Most patients have good pain control with Tylenol, or a mild oral narcotic pain medication for the first few days after surgery. We do ask the patient to avoid NSAID’s like Motrin, ibuprofen, Advil, Aspirin, or Aleve. It is common to have some mild throat pain for a day or two after this surgery due to the proximity of the surgical site to the throat, and the breathing tube which is in place during the surgery.
nausea: Nausea is occasionally present after a general anesthesia. If present in the hospital, the nursing staff can administer anti-nausea medications. If present after discharge, anti-nausea medications can be called in by your surgeon or their office staff.
fever: Fever is not expected after thyroid surgery. If a fever over 100 is present, please call the physician.
swelling: Typically, the lower neck does mildly swell during the first 24-48 hours, then the swelling slowly subsides over a period of 1-2 weeks. Some firmness of the region above the incision is common for several months after surgery.
numbness: Most patients have numbness of the region around the incision for a period of weeks – to-months.
tingling: If the patient had a total thyroidectomy, we ask the patient to watch for tingling in the fingers/hands, the toes/feet, or around the lips. If any of this occurs, we would ask that the patient call the surgeon for further instuctions
hoarseness: Hoarseness is not uncommon after thyroid surgery, and is usually temporary. It is most commonly caused by the breathing tube which is in place during the surgery, manipulation of the nerve to the voice box or both. If present, this typically lasts days. If there was an injury to the nerve, the voice could be weak for a longer period of time. If you have hoarseness after surgery, your surgeon will discuss the outlook and timing of recovery based on the findings during the surgery.
drains: The patient usually has a surgical drain placed in the region where the thyroid used to be. This thin tube extends out of the skin and empties into a collection apparatus. The drain is typically removed by the surgeon the am after surgery. In some cases, the output is too much to remove the drain, in which case the patient can be sent home with the drain in place. The nursing staff at the hospital will instruct the patient how to care for the drain.
incision care: The surgical incision is typically closed with absorbable sutures under the skin, steri-strips (tape affixed to the skin), or sutures on the skin. Your surgeon will update you on which method of closure was used, and how the incision is to be cared for.
Pain medication(s) as per your surgeon’s instructions. Commonly used medications include acetaminophen or prescription acetaminophen/hydrocodone. Antibiotic if prescribed by your surgeon. If you underwent a total thyroidectomy, thyroid replacement hormones will be prescribed.
A routine follow-up visit is usually made for about one week after surgery. This appointment is made by the office staff when the patient calls to set up surgery.