Thyroid surgery is performed for several reasons, including to remove cancerous nodules or all of the thyroid (thyroidectomy), remove only part of the thyroid (partial thyroidectomy), or to remove an overactive thyroid (thyroid lobectomy). While thyroid surgery is generally safe when performed by an experienced surgeon, there can be side effects and potential complications. It’s important to understand the possible side effects so you know what to expect during recovery.
Common Side Effects
Some of the most common side effects after thyroid surgery include:
Pain and Discomfort at Incision Site
It’s normal to have pain or soreness at the incision site for the first few days after surgery as the anesthesia wears off. This should gradually improve over the first week. Using ice packs can help reduce swelling and pain. Your doctor may prescribe pain medication as well. Call your surgeon if the pain persists beyond the first week.
Hoarse or Scratchy Voice
The nerves that control your vocal cords run very close to the thyroid, so they can sometimes be irritated or damaged during thyroid surgery. This causes hoarseness or voice changes after surgery. It may feel like you have a sore throat. The good news is that this usually resolves within a few weeks as the nerves heal. Speak softly and avoid yelling or straining your voice during recovery. Stay well hydrated.
Difficulty Swallowing
You may have pain or difficulty swallowing after surgery due to irritation of the throat muscles. This often improves quickly within the first week. Take small sips of water frequently and stick to soft foods that are easy to swallow like yogurt, soup, applesauce, etc. As your throat heals, you can gradually return to a normal diet. Call your doctor if swallowing issues persist.
Fatigue
It’s very common to feel tired and fatigued after having surgery. Your body is healing and it takes a lot of energy. Be sure to get plenty of rest and don’t overexert yourself. Take naps and go to bed early. Gradually increase activity as you start feeling better.
Low or Hoarse Voice
The thyroid helps regulate your metabolism, so removing it affects hormone levels until you start taking replacement thyroid medication. Low thyroid hormone levels after surgery can cause fatigue, weight gain, dry skin, sensitivity to cold and other hypothyroidism symptoms. Work closely with your doctor to get your thyroid hormone levels optimized.
Potential Complications
While less common, there are some potential complications to be aware of after thyroid surgery:
Bleeding
A small amount of bleeding is normal after any surgery. But excessive bleeding after thyroid surgery is possible if a blood vessel was not properly sealed. Call your surgeon immediately if you have bleeding that is quickly soaking through the bandages. Return to the emergency room for evaluation.
Infection
There is a small risk of infection after thyroid surgery, especially in the first week. Signs include increasing pain, swelling, redness, oozing pus, warmth or fever. Call your doctor immediately if you suspect an infection so that antibiotics can be prescribed.
Calcium Imbalance
The parathyroid glands, which regulate calcium levels, are located right by the thyroid. Damage to these tiny glands can lead to low calcium after surgery. Symptoms include numbness, tingling in hands and feet, muscle cramps, anxiety, fatigue, or difficulty concentrating. Your doctor will monitor your calcium levels closely after surgery and prescribe supplements if needed.
Permanent Vocal Cord Paralysis
In very rare cases, the vocal cord nerves are permanently damaged during thyroid surgery, leading to lifelong hoarseness and potential difficulties swallowing or breathing. This risk is minimized when surgery is done by an experienced high-volume thyroid surgeon.
Recovery After Thyroid Surgery
Here’s what to expect during the recovery period after thyroid surgery:
Hospital Stay
Many patients can go home the same day as surgery. Some may require an overnight hospital stay to manage pain and monitor calcium levels.
First 48 Hours
Expect significant swelling and discomfort. Use ice packs as directed to reduce swelling. Take all medications as instructed. Drink plenty of fluids. Communicate any concerns to your care team.
First Week
Swelling, bruising and some discomfort often peak 3-5 days after surgery as anesthesia wears off. Fatigue is common. Avoid vigorous activity and heavy lifting. Follow instructions about showering, changing dressings, and watching for signs of infection. Use pain meds as needed. Speak softly and avoid straining your voice. Communicate with your doctor about any lingering issues with pain, swallowing, calcium levels or medication adjustments.
2-6 Weeks After Surgery
Gradually resume light activities as energy returns. Avoid vigorous exercise temporarily, heavy lifting and movements that strain the neck. Swelling and bruising continue to improve. Relief from hoarseness or difficulty swallowing is noticeable. Thyroid hormone medication is adjusted until levels stabilize. See your doctor as directed for follow up and monitoring.
6 Weeks and Beyond
Most recovery is complete by 6 weeks, aside from some lingering tightness or numbness around the incision site. Resume normal activities as tolerated while avoiding any sudden or jerky neck movements temporarily. Lifting restrictions are gradually eased. Thyroid levels stabilize with ongoing medication and monitoring. Long term, the only difference you may notice after thyroid surgery is the need for daily thyroid hormone replacement.
What to Expect at Follow Up Appointments
Here’s what usually happens at follow up appointments with your surgeon after thyroid surgery:
– Wound Check: The incision site is examined to ensure proper healing. Stitches may be removed around 1-2 weeks after surgery.
– Symptom Review: Your doctor will ask about symptoms like pain, voice changes, swallowing issues, energy levels, etc. to ensure you are recovering well.
– Neck Exam: The surgeon feels the neck to check for signs of swelling, fluid buildup, tightness or irregularities.
– Thyroid Levels: Blood work to measure thyroid hormone levels may be done to ensure the proper medication dose. Levels are closely monitored after surgery.
– Calcium Levels: Calcium may be checked periodically after surgery if there were concerns about low calcium. Supplements are adjusted accordingly.
– Medication Adjustments: Your thyroid medication is tailored based on your blood work results and clinical symptoms. The dose is gradually adjusted until levels stabilize.
– Follow Up Scans: Your doctor may order an ultrasound or other imaging to check the neck and remaining thyroid tissue. Scans help detect any early signs of recurrence.
– Voice Evaluation: If hoarseness persists, your surgeon may recommend a laryngoscopy to evaluate the vocal cords. Further voice therapy may be advised.
– Concerns and Questions: Your follow up visits are a great opportunity to communicate any worries or questions that come up during recovery. Don’t hesitate to discuss any lingering side effects or issues.
FAQs About Thyroid Surgery Recovery
Here are answers to some frequently asked questions about recovering after thyroid surgery:
How long will it take to recover after thyroid surgery?
Most people can resume their normal activities within 2-4 weeks after surgery. However, it can take up to 6 to 8 weeks to feel fully healed and like yourself again. Give yourself enough time to recover based on how your body is feeling.
How long is someone off work after a thyroidectomy?
People with desk jobs can usually return to work within 1-2 weeks, while those with more physical jobs may require 2-4 weeks off work after surgery. Your doctor will advise when it is safe to return based on your specific job duties and recovery.
When can I start exercising after thyroid surgery?
Avoid vigorous exercise for at least a few weeks after surgery to prevent neck strain and allow proper healing. Start with short walks and light activity. Gradually ease back into your normal exercise routine around 4-6 weeks post-op. Weight lifting restrictions are also gradually lifted around this time.
When can I drive after thyroid surgery?
You can typically start driving again within a few days after surgery, once you are off prescription pain medications. However, avoid extensive driving with neck strain or jerky head movements initially. Move your whole body instead of just turning your neck if checking blind spots.
How do I care for my incision after thyroid surgery?
Keep the incision clean and dry according to your surgeon’s directions. Watch for signs of infection like worsening pain, redness, pus or warmth. Avoid irritating the incision with cosmetics, perfumes, or jewelry. Tingling or numbness can persist for several weeks.
What happens if I miss a dose of thyroid medication after surgery?
Take your thyroid hormone replacement as soon as you remember if you miss a dose. Do not take extra medication. Let your doctor know if missed doses are frequent as your dosage may need to be adjusted to keep thyroid levels stable after surgery.
When can I resume a normal diet after thyroidectomy?
Initially stick to soft foods that are gentle on your throat. Progress diet as tolerated within the first week post-op. Resume normal meals around 2 weeks after surgery. Stay hydrated with water, juice, tea, broth etc. Avoid irritants like alcohol, acidic foods or spicy foods temporarily.
How will I know if my calcium is low after surgery?
Signs of low calcium include numbness or tingling, especially in the hands, feet or mouth, muscle cramps or spasms, anxiety, fatigue, cognitive issues like memory or concentration problems, or lightheadedness. Your doctor will monitor your calcium closely after surgery.
Conclusion
Thyroid surgery is very common and is often an outpatient procedure with a relatively quick recovery. However, it remains important surgery involving risks and potential complications. It is normal to have side effects like pain, swelling, fatigue and voice changes that gradually resolve over the first few weeks of recovery. Work closely with your medical team, take it easy, and communicate any concerns that arise during the healing process. With patience and proper aftercare, most people recover fully and resume their normal activities within 6-8 weeks after thyroid surgery.