After thyroid surgery

After your surgery you may be concerned about how you will feel, the possible side effects and your follow up appointments.

Your wound

Your neck wound is usually closed with stitches that are under the skin surface and dissolve over a few weeks. Sometimes surgeons use clips rather than stitches. Clips need to be removed a few weeks after the operation. You may have a sore throat, but this will improve within a few days.

When you wake up, you will have several different tubes going into your body. This can be a bit frightening. But it helps to know what they are all for. You will have:

• a drip (intravenous infusion) to give you fluids until you are drinking again
• one or more tubes (drains) coming out from your wound

Your nurse can normally take out the drip and drains within 24 hours of the surgery.

The tube coming out from the wound will be connected to a drainage bottle or bag. It is there to stop blood and fluids from collecting inside your wound and causing swelling.

Sometimes there is swelling in your neck during your operation. The surgeon may need to make a small hole in your neck (tracheostomy) to help you breathe. This is usually only for a short time until the swelling settles down.

Painkillers

It is normal to have some pain and stiffness after your operation. 

There are many different painkilling drugs you can have. It is important to tell your doctor or nurse as soon as you feel any pain. They can then find the right type and dose of painkiller for you. Painkillers work best when you take them regularly.

You will probably find it uncomfortable to swallow for a few days after your operation. It may help to have a soft diet for a while. You can talk to a dietician about this if you need to. Or your nurse may give you a diet sheet to take home with you.

Going home

You will be encouraged to be up and about on the first day after your surgery. Most people are in hospital for one or more nights and are then able to go home.

You may go back to the hospital or to your GP surgery every few days for a nurse to check your wound. You will have the phone number of the hospital ward and can call them if you are worried about anything.

It’s important that you don’t do too much and tire yourself out.  It may help to prepare or buy some meals in advance that you can just heat up once you are at home.

You will have some exercises to do, to help you with the stiffness in your neck. Normally, you can start these a day or two after surgery. You should keep doing them until you can move your neck and shoulder as freely as you could before. This will be within a few weeks of your operation.

Your scar

The scar after a thyroid operation is usually a horizontal line towards the bottom and front of your neck. It can be about 3 to 4 inches wide.

After your operation, the scar will be red and sore. But this usually heals well and becomes quite faint after 6 months to one year. Some people can have long term problems with a thick and red scar. Talk to your healthcare team if this is the case.

Side effects

Some possible side effects are common to nearly all operations. These include:

• numbness over the area
• infection, for example, a wound infection or chest infection
• a blood clot or risk of bleeding
• swelling in the area

Your healthcare team monitor you closely to check for these. You have treatment, such as antibiotics, if you need it.

You may have other side effects following your thyroid surgery for example:

Voice changes

After thyroid surgery some people have voice changes. Your voice may be hoarse or sound different. The thyroid gland lies close to your voice box (larynx). So surgery can damage the nerve to your voice box. This usually gets better within a few weeks.

It’s rare to have permanent changes. Your team might refer you to a voice therapist or speech therapist if you continue to have problems.

A change in thyroid hormones

If you have had your whole thyroid removed, you will need to take tablets to replace the hormones that your thyroid would normally make. This is called thyroid hormone replacement.

The thyroid hormones are thyroxine (T4) and liothyronine (T3). You need one of these hormones to keep your body metabolism working effectively. You will need to take them for the rest of your life. Without the hormones, you would feel tired, gain weight, have dry skin and hair, and feel physically and mentally lacking in energy. Your doctor or specialist nurse will talk to you about which hormones you need to take and the correct dose.

You don’t generally need to take thyroid hormones if you have had part of your gland removed. Your remaining thyroid usually makes all the hormone you need. But you have blood tests to check that it is working well.

If you have had follicular or papillary thyroid cancer, the hormones may also help to stop the cancer from coming back. They stop your body from producing another hormone called thyroid stimulating hormone (TSH). TSH encourages these types of thyroid cancer cells to grow.

A change in calcium levels

An operation on your thyroid gland could damage the nearby parathyroid glands. Or your surgeon might need to remove some of the parathyroid glands. The parathyroid glands control the levels of calcium in your blood.

Any damage could mean that these glands don’t work so well and calcium levels fall. If this happens, you will need to take calcium tablets and possibly extra vitamin D. This is usually a temporary side effect, but could be permanent in some people.

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 if you continue to have swelling in your neck after a few weeks. You may need some more exercises to help the swelling go down.

Follow up appointments

You will have follow up appointments to check your recovery. This may include blood tests to check hormone and calcium levels if you need them. Your appointments are also an opportunity to raise any concerns you have about your progress.