Post-Thyroidectomy Discharge Instructions

What is a Thyroidectomy?

The Thyroid gland is a gland located in the front of your neck; it helps regulate your body's metabolism. Thyroidectomy is performed to remove either all or part of your thyroid gland. Surgery is performed in case of:

• An overactive thyroid that produces too much hormone
• A large thyroid gland called a goiter, that may cause breathing or swallowing problems
• Thyroid cancer
• Small growths or lumps, also known as nodules, in the thyroid gland

What do you need to know about your surgery after you go home?

• Wash your hands before and after touching your neck wound.
• Keep your wound dry and clean. Dry the wound site well after bathing by patting with a dry towel, not rubbing.
• Sleep with your head and neck slightly raised on two pillows for a week after the surgery. This will help reduce any neck swelling.
• You might notice bruising around the incision site or upper chest, as well as slight swelling behind the scar when you are upright. The scar may become pink and hard. It will disappear within three to four months.
• You will also notice some numbness of the skin of your neck. This will gradually improve over time.
• If you are prescribed medications that replace your thyroid hormone, take them as ordered by your doctor on an empty stomach 30-60 minutes before breakfast daily.
  - If you miss your dose by a few hours, take it as soon as you remember.
  - If you miss your dose by a day, take the next dose.
  - DO NOT double the dose or take more than one dose per day.
  - If you have high blood sugar (diabetes), you will need to watch your blood sugar closely.
  - While on this medication, inform your doctor before taking any other medication to prevent interactions with other medications.
  - You may crush the tablet and mix with 5 or 10 mL of water.

• In about 10% of patients who have a full removal of the thyroid gland, other glands in the body, such as theparathyroid glands, do not function properly right away. This might cause the blood calcium level to drop below normal (hypocalcaemia) for a short period of time. Take Calcium and Vitamin D supplements, only if ordered by your doctor.
• The main complaint following thyroid surgery is discomfort with swallowing. The pain might be bothersome for a few days,but you will still be able to eat normally.
• You may feel like you have mucus in your throat, similar to when you have a cold. This is usually because there was a tube near your throat while you were asleep. You will notice that if you cough, very little mucus will come up. The mucus should clear up within four to five days.
• Your voice may be different for a short period with changes in volume and clarity (hoarseness). These changes are quite common. Generally, it will be better in the mornings and get a little worse towards the end of the day. This can last for variable periods of time, but should clear in four to six months at most.

What are some complicati ons that you might experience after your surgery?

• Bleeding
• Infection
• Scarring
• Injury to the parathyroid glands near the thyroid (this causes low calcium levels)
• Trouble with breathing
• Voice changes or permanent hoarseness (this is rare)
• Too much thyroid hormone released (this is rare)

When do you need to call your doctor or nurse?

Call your doctor or nurse if you experience:

• Signs and symptoms of a wound infection - fever of 38°C or higher, chills, redness, warmth, yellowish or greenish discharge from the wound site, severe pain, or a bad smell from the wound.
• Symptoms of bleeding - severe neck pain and swelling, light-headedness, difficulty breathing or swallowing.
• Symptoms of hypocalcaemia - numbness around lips, fingers, muscle trembling/cramps, problems moving the lips or opening and closing the mouth.

These symptoms appear between 24 and 48 hours after surgery. It is rare for them to appear after 72 hours.Low blood calcium does not occur if only half the thyroid is removed.

Who do you need to follow-up with after your surgery

• Make sure that you have a follow-up appointment with your surgeon to check on your wound.
• Make sure that you have a follow-up appointment with your Endocrinologist to conduct periodic blood tests to monitor and adjust the thyroid hormone treatment.

How do you contact your physician or nurse?

If you have any questions or concerns, please call 800 8 CCAD (2223).