Post-operative Instructions for Total Thyroidectomy

Please reference the following guidelines for activity following surgery:

• Please plan to be on bed rest the day of surgery
• Minimize talking and chewing
• When in bed, use a few extra pillows to elevate your head—otherwise, sit up in a comfortable chair
• Refrain from strenuous exercise for at least one to two weeks from the day of your operation
• The day after surgery, you do not need to be on bed rest—light activity is fine
• Most patients are able to return to a full-time work schedule within one to two weeks
• Do not drive a car until you are able to comfortably turn your neck

There are no dietary restrictions following total thyroidectomy surgery.

Please reference the following guidelines for incision care following surgery:

• If you have glue over your incision, do not rub it off—this will fall off on its own over time
• If you have steri-strips (small pieces of tape) over the incision, do not remove these as they will fall off on their own
• You may take a shower 24-48 hours after surgery
• If a bandage is in place over the steri-strips, please remove the outer dressing before your first shower—you do not need to replace it
• Sutures are buried and will dissolve on their own
• Mild swelling at the incision site is normal and should improve in four to six weeks following surgery; the pink line will slowly fade to white during the six to 12 months following surgery
• Use a sunscreen (SPF 30 or higher) or keep the scar covered from the sun for the first six months to a year, as the sun can darken your scar—you may start sunscreen four weeks after surgery
• Four to six weeks after surgery, you can also use a scar ointment on your incision, if you wish

Following surgery, you may experience:

• A hoarse or weak voice, changes in your pitch or tone and difficulty singing. These symptoms usually fade over six weeks to six months
• A sore throat and/or a sensation of a lump with swallowing. This is very common after surgery and will improve with time
• Numbness of the skin under the chin or above the incision is also common

Please resume your pre-operative medications following surgery.

For pain medication, in general, patients undergoing thyroid surgery do not require narcotic pain medication. Tylenol, Advil, Motrin and Ibuprofen can be taken starting the evening after surgery.

For thyroid replacement, you will be started on thyroid hormone (Synthroid or Levoxyl) after surgery. You should have an appointment to see either your primary care doctor or your endocrinologist to check your thyroid hormone levels in six weeks. The results of these tests help us determine if you need more or less thyroid hormone.

It is common for the calcium level to be low following complete removal of the thyroid and most patients will need to take extra calcium for a few days or weeks following the surgery. As a general guideline, you should take one to two tablets (each are usually 500-600 mg each) of over-the-counter calcium twice daily for a total of 1000-2000 mg per day.

If you experience numbness or tingling, your calcium level may be low and you need to increase the frequency you are taking the calcium. Please call with questions, or if symptoms of numbness or tingling persist.

If the calcium is very low, you may be sent home with a prescription dose of vitamin D (Rocaltrol/Calcitriol) and you may be instructed to take the calcium more frequently than twice a day.

If you have no symptoms of numbness or tingling after several days post-surgery, you can slowly wean and discontinue the extra calcium and vitamin D.

Learn more about calcium supplementation

You will receive a follow-up phone call one to two days after surgery for a post-operative check in and then at one to two weeks post-surgery for a review of pathology results. You should plan a follow-up visit with your primary care physician or endocrinologist four to six weeks after surgery.

Please call your surgeon if you have:

• Increased redness or swelling in the area of the incision
• Trouble swallowing or breathing
• Foul-smelling drainage from your incision
• A fever of 101.5 or greater
• Severe nausea or vomiting that does not go away
• Any urgent questions or concerns