Thyroidectomy
If you are having thyroid surgery, known as a thyroidectomy, to remove all or part of your thyroid gland it’s important to know what to expect as you recover.
Side effects, such as neck pain and stiffness or sore throat, are common after surgery. Complications are rare but can be serious and even potentially life-threatening if they do occur.
What are the side effects of thyroid surgery and how to take care?
There are a number of short-term side effects that people may experience after thyroid surgery. Most of these will be temporary, but some may persist.1
Neck pain and neck stiffness
The neck is put in an extended position during surgery, and many people avoid moving their necks afterward. This can lead to neck pain and stiffness. Using pain medication after surgery may reduce discomfort, making it easier for you to keep moving your neck so that you have less stiffness later on. Applying a warm compress may also help.
Many surgeons recommend doing gentle stretching and range-of-motion exercises to reduce stiffness. Before doing these, however, make sure to ask your surgeon about their appropriateness for you, any additional exercises they believe might be helpful, how often you should perform them, and whether there are any exercises you should avoid. Recommended exercises may include:
- Gently turn your head to the right, then roll your head so that you are looking at the floor, then gently roll your head to the left.
- Gently tilt your head to the right and then to the left.
- Rotate both shoulders forward in a circular motion.
- Slowly raise your arms overhead, and then slowly lower them back down against your body.
Sore throat after thyroid surgery
Thyroid surgery is often done under general anesthesia with a breathing tube placed in the windpipe, or trachea, to breathe for you. This can lead to a sore throat and the sensation of a lump—like something is stuck in your throat—with swallowing.
Using an over-the-counter (OTC) numbing throat spray, such as Chloraseptic, or numbing lozenges, such as Cepacol, can help with the discomfort until you are healed.2
Difficulty in swallowing
Dysphagia, or swallowing problems, are common after thyroid surgery, though they usually don’t last long, often resolving within two weeks. Eating soft foods for the first few days can be helpful. Examples include foods with sauces or gravy, cooked vegetables, and casseroles.
What is the noise and sound problems and what is the solution?
After surgery, your voice may be hoarse or whispery, and it may feel tiring to talk. This is very common and expected during the first week or two after surgery
Symptoms usually improve in the first few weeks but may persist up to six months after surgery. While there is no specific treatment for this hoarseness, it’s helpful for your loved ones to be aware of the problem so that you don’t feel the need to talk loudly or more often than is comfortable. If the nerve was injured, more severe symptoms may be noted after surgery.
Performing surgery with a nerve stimulator device can prevent damage to the vocal nerves during the operation. Dr. Seyed Ahmad Fanaei use this device in Thyroidectomy surgeries.
How is nausea or vomiting after thyroid surgery and what is the solution?
Nausea and vomiting after thyroidectomy were the norm at one time, and people may be concerned if they talk with others who had this procedure in the past.
Fortunately, if nausea does develop, there are treatments that can alleviate your symptoms, and the use of medications such as dexamethasone has greatly reduced vomiting.
What is transient hypoparathyroidism and how is it treated?
Transient (temporary) hypoparathyroidism can happen after thyroid surgery. Hypoparathyroidism is when you have too little parathyroid hormone, which can lead to low calcium levels.
The four parathyroid glands lie on the back of the thyroid gland and are sometimes injured or removed during surgery. These glands are responsible for controlling the body’s calcium levels. They secrete parathyroid hormone that helps your kidneys and bones to maintain the balance of calcium and phosphorous. Roughly 5% of people may have temporary symptoms of a low calcium level, known as hypocalcemia, for at least a few weeks after thyroid surgery. It may last for up to six months.
Since it’s common for the parathyroid glands to function poorly after a thyroidectomy, you may be sent home with calcium and vitamin D supplements. If you are not given calcium, it’s important to be aware of the symptoms of hypocalcemia. They commonly include:
- Numbness around the mouth
- Tingling in the fingers
- Muscle spasms or cramps
Hypothyroidism and its solution
If you have a total thyroidectomy, or the entire thyroid gland is removed, you will require prescription thyroid replacement therapy after their procedure. This is because you’ll no longer have a gland to make thyroid hormone and will experience symptoms of hypothyroidism, or an underactive thyroid, without replacement therapy.
If your healthcare provider prescribes thyroid replacement therapy, be sure to have a conversation with them before leaving the hospital about when to start the medication, which medication you need, and at what dosage. It’s also important to talk about how to properly take your medication, as food and many drugs and supplements can interfere with absorption.
In general, after thyroid surgery, you should observe the following precautions:
- Rest when you feel tired.
- Try to walk each day.
- Avoid strenuous physical activity and lifting heavy objects for 3 weeks after surgery or until your doctor says it is okay.
- Do not over-extend your neck backwards for 2 weeks after surgery.
- Ask your doctor when you can drive again.
References
https://www.mayoclinic.org/tests-procedures/thyroidectomy/about/pac-20385195
https://www.verywellhealth.com/recuperating-after-thyroid-surgery-3233273
https://nurseslabs.com/5-thyroidectomy-nursing-care-plans/
https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zc2552
