Life after thyroid surgery

Thyroid surgery is a major operation. Most people recover in a few weeks, but the recovery time may take longer for some people. If you are worried about anything, let your doctor or nurse know. They will be happy to answer any questions. 

Recovering physically

After any operation you need time for your body to recover and your wound to heal. You should be able to go back to all the things you were doing before your thyroid operation within a few weeks.

Your neck may feel stiff and uncomfortable because of the wound and the scar. It may also feel numb. Tell the doctor or specialist nurse if you have any pain so that they can give you the right medicine to help you.

After the wound has healed, the scar may feel firm. It will soften and begin to fade within a few months. Look out for swelling and signs of infection, such as the wound oozing or feeling red and hot. Contact your doctor for advice if you become worried.

To avoid any strain on your neck wound you shouldn't lift any heavy objects for about 2 weeks after thyroid surgery.

If you are working, you will need to take some time off after your surgery. Most people are able to go back to work about 2 weeks after their operation. But this will depend on how strenuous your work is.

Physiotherapy exercises

After a few weeks, any stiffness in your neck and shoulder should be much better. The hospital physiotherapist may give you advice on how to do some gentle neck and shoulder exercises following the operation.

The exercises are to help prevent any permanent stiffness. Be sure to do them every day or as often as you have been told by the physiotherapist. If you continue to have problems, then contact your doctor or specialist nurse.

Driving

If your neck is sore and stiff, it will be difficult to turn your head from side to side safely while you are driving. It is best to avoid driving until you can turn your head without any discomfort. This may be a few weeks after your surgery.

Don't drive while taking any painkillers that may make you drowsy. The label on the medicine will tell you whether they may affect your driving.

Exercise

Try to keep as active as you can. Aim for a little exercise every day, but rest if you feel tired. As soon as you feel well enough, non contact sports such as golf or tennis should be fine. It is best to avoid swimming until your wound has healed. Contact sports such as rugby or football can be strenuous and should be avoided for at least the first month.

Possible problems

There are a number of possible problems you might have after your operation. These include:

Hoarse voice

You may have a hoarse voice after surgery if a nerve supplying your voice box is damaged during your operation. The thyroid gland lies close to your voice box (larynx). So the nerves that supply the voice box may be affected during surgery. After your surgery, you may find your:

• voice sounds a bit different
• voice may be hoarse and you may have difficulty making high pitched sounds
• singing voice may be different

Other people may not notice this as much as you do yourself. Usually, the hoarse voice gets better within a few weeks and your singing voice will recover. 

The voice changes may be permanent in some people. Your team might refer you to a voice therapist or speech therapist if you continue to have problems. It is very rare to develop more severe problems, such as permanent total loss of voice. 

A change in calcium levels

The parathyroid glands can be affected by thyroid surgery. These are small delicate glands that are right next to the thyroid gland. They help to control the level of calcium in your blood.

If the parathyroid glands are not working properly, your blood calcium levels can fall below normal. You will need to take calcium tablets and possibly extra vitamin D if this happens. 

If you have a low calcium level in your blood, you may have twitching or jerking muscles (muscle spasms). Contact your healthcare team if you have this. It is usually only temporary and the parathyroids normally start working again within 6 to 8 weeks of the operation. But low calcium levels can sometimes be permanent.

A change in thyroid hormones

If your whole thyroid gland has been removed, you will need to take tablets to replace the hormones that your thyroid would normally make. The thyroid hormones are necessary to keep your body processes going at the right rate. This is called your metabolism. Without thyroid hormones, you feel extremely tired and lacking in energy.

A tablet called thyroxine replaces the hormones. You take this tablet every day for the rest of your life. You have regular blood tests to check the hormone levels in your blood. Your doctor may change the dose of your tablet if your hormone levels are too high or too low.

If you have had part of your thyroid gland removed, the remaining gland usually makes all the hormone you need. But some people might need to take thyroxine tablets. You have blood tests to check for this.

These hormone tablets may help to stop the cancer from coming back in follicular and papillary thyroid cancer. They stop your body from producing another hormone called thyroid stimulating hormone (TSH). TSH can help these types of thyroid cancer cells to grow.

Taking thyroxine every day won't stop you from doing the daily activities you were doing before your surgery.

A change in diet

After your operation, your neck is likely to be swollen and may feel hard and numb. This is usual and will gradually get better as your wound heals. It may take a couple of weeks or more. While your neck is sore you may find that you need to eat foods that are soft and easy to swallow.

You may have painkillers to take at home to help you feel more comfortable when you swallow. Make sure that you eat slowly and have plenty to drink during and after meals.

Liquids can help to soften your food and make it easier to swallow. It may be helpful to use a blender to process solid foods. You will find that you can eat most of your favourite foods, but you may need to make a few changes. Here are some suggestions for a soft diet:

• use more sauces and gravies – moist food is easier to swallow than dry
• long, slow cooking softens meat and vegetables
• finely chop meat and vegetables in a food processor before or after cooking
• blend or process meat or vegetable casseroles or curries to make tasty soups

It is also important that you eat a nutritious diet to help with healing. If you are having trouble with eating, a dietician may help. You can ask your doctor for a referral to see the hospital dietician.

A wound infection

Wound infection is a possible complication after any surgery. To help prevent any infection once you are at home it is important to:

• leave your dressings in place until you’re told to remove them
• keep your neck wound clean and dry until it’s completely healed
• expose your neck wound to the air when possible but avoid direct sunlight
• not go swimming until your wound is completely healed
• avoid knocking or putting pressure on your wound

Here are some tips for wound healing:

• have a bath or shower but take care to avoid getting your wound wet. Make sure the neck area is dry by patting it with a clean towel afterwards for the first few weeks after surgery.
• avoid places where you might pick up infections such as colds
• eat a healthy, nutritious diet
• get plenty of fresh air and exercise

Lymphoedema

After your surgery it is normal to have some swelling close to the wound. This usually goes away after a few weeks as the wound heals.

If you had some lymph nodes in your neck removed, the swelling may continue to be there and sometimes it gets worse. This is called lymphoedema.

Tell your doctor or specialist nurse if you are worried about swelling in your neck after a few weeks. You may need some more exercises to help the swelling go down.

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