Postoperative Instructions for Total thyroidectomy

1. Activity
   • Most patients are able to return to a full-time work within 1-2 weeks, howeverthis may vary according to your job.
   • Do not drive a car until you are able to turn the neck side to side, which may take 1-2 weeks.
   • Do not drive while you are taking pain medicines.
2. Diet
   • You may have temporary throat discomfort or difficulty swallowing. This is due to the surgery around your larynx (voice box) and eosophagus (swallowing tube).  These symptoms will gradually improve over the course of several weeks.
   • You may be able to return to your usual diet in a couple of days.
3. Incision Care 
   • Please leave the dressing in place on your incision and allow it to fall off on its own. If it has not fallen off in 7-10 days, you may remove it yourself.
   • You may shower after surgery but please do not swim or soak in a tub for at least 2 weeks. After you are done showering, just pat your incision dry. If it is draining clear fluid, you can cover it with a dry dressing (such as gauze).
   • Mild swelling at the incision site will go away in 4-6 weeks. The pink line will slowly fade to white during the next 6-12 months.
   • Use a sunscreen or wear a scarf for protection if in the sun for the first 6 months to a year as the sun can darken your scar.
   • You may begin to use a moisturizing cream or oil (Bio Oil or Vitamin E cream) along the incision after 2 weeks.
4. Common Problems
   • Numbness of the skin under the chin or above the incision is normal and should go away in a few weeks.
   • Your incision may feel itchy while it heals. Avoid rubbing or scratching if possible.
   • Your voice may be hoarse or weak. Pitch or tone may change. You may have difficulty singing. This usually goes back to normal over 6 weeks to 6 months.
5. Thyroid and Pain Medications
• You will require lifelong thyroid supplementation following surgery. Take your thyroid medication (thyroxine) as prescribed when you go home. These medications are identical to the hormone made by the thyroid.
• Thyroid medication should be taken on an empty stomach.
• Thyroxine tablets should be kept in their original container and stored out of sunlight in a cool dry place (often they are stored in a fridge).
• A temporary drop in you calcium may occur after surgery requiring calcium medication on discharge. Blood tests will be used to guide these medication which are normally stopped after 3-4 weeks.Calcium and thyroid hormone should be taken 1-2 hours apart.
• We will supply you with a prescription for a mild pain medication. You are not required to take it. If you do take it, please do not drive or drink alcohol as these in combination may make you drowsy. Most patients do not need strong pain medicine by the time you leave the hospital.
6. When to Call a Doctor
   • For any non-urgent questions, please contact my office on 9158 2453.
   • Go to the Emergency Department if you have fever, shortness of breath, difficulty breathing, numbness or tingling in your fingers, hands, or mouth, muscle spasms, or if you notice signs of wound infection (redness, tenderness around the incision).
7. Follow up
   • Follow up is normally scheduled at 2 weeks following surgery in the office. This should be booked by the hospital on discharge. If there are any concerns regarding follow up please contact the office on 9158 2453.