Patients who undergo thyroid or parathyroid surgery typically spend one night in the hospital after surgery. In some cases, they may go home the same day and in others they may require a longer hospital stay.
Typically a clear liquid diet is started immediately after surgery, and patients can rapidly progress to normal food the day of surgery in most cases. Some patients do experience post-operative nausea. Medicine is given during surgery to prevent post-operative nausea, and medication is available in the hospital on an as needed basis for patients that continue to have nausea. Some patients complain of mild discomfort when swallowing for the first few days after surgery.
Most patients do not have significant pain and report taking narcotic pain medication for only a couple of days. Patients will receive a prescription for an oral pain medication. There may be soreness in the area of the wound and also in the throat related to presence of a breathing tube during surgery. Female patients should wear a sports bra for the first 72 hours after surgery if they had robot-assisted surgery.
Patients who undergo robot-assisted surgery are encouraged to work on the range-of-motion of their upper arm and shoulder after surgery. This can be accomplished by slowly raising your arm above your head and moving your upper arm through its normal range. This should be done several times a day, starting the day after surgery. Patients do complain of soreness over the upper chest for several weeks after surgery. Working on the range-of-motion will reduce soreness and help with a quicker recovery.
Patients should avoid strenuous activity and heavy lifting for two to six weeks after surgery at the direction of your surgeon. Patients can resume driving when they are no longer taking pain medication and they have full range of motion of their neck and shoulder without discomfort in their wound. This varies by the individual, and usually is less than one week.
Drains are tubes that are placed at the end of surgery to evacuate fluid from the wound to prevent accumulation. In most cases of conventional surgery (non-robot-assisted), drains are not placed. In extensive procedures and in most robot-assisted cases, a drain is placed. They are typically removed 2-3 days after surgery by your surgeon in clinic. Patients who undergo robot-assisted surgery are encouraged to wear a tank-top to their post-operative visit to facilitate examination and drain removal.
Patients without a drain can shower the day after surgery. It is okay to get the incisions wet, but we do not recommend submerging the incisions or letting the water directly hit the incisions. It is okay to blot the incisions dry. Do not rub the incisions with a towel or wash cloth. If you have a drain and wish to shower, you should discuss this with your surgeon.
Some patients who undergo total thyroidectomy or parathyroidectomy will experience low calcium levels after surgery. Typical complaints included numbness in the lips or fingertips, and in some cases muscle cramping or aches. Most commonly, this is temporary. Your surgeon may send you home on calcium and a vitamin D supplement. In some cases, labs will need to be drawn as an outpatient to determine your calcium levels.
Patients who undergo total thyroidectomy (removal of the entire thyroid gland) will require thyroid replacement for the rest of their life. This is taken in the form of a daily pill, and due to the long half-life of thyroid hormones, it can take several months to achieve the desired level. This is typically monitored through blood tests.
The literature shows that in patients that undergo a thyroid lobectomy (removal of half of the thyroid) and have normal thyroid function prior to surgery, approximately 20% will go on to need thyroid replacement. This may not become apparent until six weeks to two years after surgery. Patients who develop symptoms of hypothyroidism (low thyroid levels) should have blood tests to determine their thyroid hormone levels. Symptoms may include, but are not limited to: weight gain, inability to lose weight, feeling cold, fatigue, coarse hair, hair loss, hoarse voice, facial swelling, joint aches, constipation, irregular menstrual cycles, decreased libido and depression.