Care of your wound

• Your incision will be covered by thin paper steri-strips.  These need to stay in place for at least 1 week until your follow up appointment.

• It is ok to shower over this dressing. And pat it dry with a towel.  It is best to avoid swimming in pools, spas or the beach whilst the dressings are intact.

• If the dressings have some dry blood on them it is ok.  The blood will actually aid the healing process.  If you wish you can place another steri-strip over the original.

• If the steri-strips become dirty or begin to lift after 72hrs it is ok to replace them at this stage.  You may wish to approach your GP if unsure.

• Your wound will be a little swollen and even some mild bruising is normal.  If you develop increasing swelling, substantial bruising or difficulty breathing you should let Dr. Green know and return to either your GP or the emergency department if you are in distress (this is very rare).

Stitches

• Your wound has been closed entirely with dissolving sutures.  These will take several weeks to completely dissolve. 

• You will not need to have any stitches removed after your surgery.

Pain Relief

• It is normal to feel some pain after your surgery especially with swallowing and moving your neck in the initial 48hrs post op. 

• You will be given regular analgesia including paracetamol along with some stronger pain relief if required. 

• It is important that you are comfortable and able to move your neck freely. 

• DO NOT keep your neck stiff to avoid pain; this will only make it worse in the long run.

Return to work

• You will need to take some time off work.  However, most people can resume normal duties (light Office type work) within 1 week of surgery.

• For heavy (manual labour type work) you may require an additional week. 

• Dr. Green will happily provide a medical certificate for these times if you wish.

Driving

• You will NOT be able to drive for 48-hours post surgery as a minimum

• It is typical to not be suitable to drive for up to 1-week post surgery. 

• So safely return to driving you must be able to have full movement in your neck and are not inhibited in anyway by discomfort on moving your neck. 

• Most people can return to driving safely at the 1-week mark.

Energy levels and resuming normal activities

• It is normal to not have full energy levels after the operation. 

• You should be able to perform usual light duties within 1 week of the surgery.  Although it is quite normal to not regain full levels of energy for several weeks after an anaesthetic. 

• Regular light exercise (walking, riding etc.) is encouraged after your surgery.  A basic rule is ‘if it hurts it’s to strenuous and you should stop’.

Moving your Neck

• it is important to avoid developing a stiff neck.

• It is important that you continue to move your neck as normally as possible

• You will not damage your wound moving your head from side-side and also up and down.

• Avoid moving like a robot. Keeping your neck still will lead to stiffness, delay your ability to drive and prolong your recovery.

Follow Up

A post op appointment will be arranged for you around 1 week post your surgery.

Please check this appointment and if it is made on a day that is not suitable please call the rooms to arrange an alternative.

It is essential that you are seen within 7-10 days post surgery

Phone consultations are NOT appropriate for post operative appointments

Information specifically for Post Total Thyroidectomy

Thyroxine

• If you have undergone a total thyroidectomy you will be commenced on Thyroxine medication.  A script will be filled prior to leaving hospital. 

• Thyroxine needs to be taken every day for life. It is dangerous to stop taking the Thyroxine for long periods. 

• The dose of Thyroxine will be reviewed after undergoing a blood test approximately 1 month after starting. 

• It is likely that your GP will take over the monitoring of your Thyroxine levels and dose oncer it has stabilised

• In some circumstances you will be advised to stop your Thyroxine temporarily for further treatment.  Dr. green will advise you of this if it is necessary.

Calcium Supplements

• During your Thyroidectomy, 4 glands closely attached to the thyroid called Parathyroid glands had to be carefully preserved.  It is possible that these glands can become temporarily stunned and in rare circumstances permanently damaged.  The parathyroid glands control calcium levels in your body. 

• Prior to discharge you will undergo a blood test to check the functioning of these glands.  If the levels are low then you will commenced on either or both of Caltrate (Calcium) and Calcitriol (vitamin D) prior to discharge.  The number of tablets to take will be clearly discussed with you. 

• You will be given a Sullivan and Nicolaides blood request form to recheck the levels the day prior to your follow up appointment.  It is important that this is done to allow weaning of your calcium supplement tablets.

• Hypocalcemia (low Calcium) is a dangerous side effect if the calcium supplements are not taken as advised.  The early symptoms include Tingling and numbness around the lips and fingers/toes, especially with exercise.  This can then progress to muscle cramps in the hands, feet and jaw. 

• If you experience any of these symptoms you should either contact Dr. Green or your GP.  You will be advised to adjust your calcium supplement dose or commenced on supplements if not already taking.

• Most patients have a very comfortable postoperative period with mild discomfort only.  This is expected in most cases.  The above problems are rare but very important to let Dr. Green be aware if you experience any of these or if you have any concerns.