Total thyroidectomy

A thyroidectomy is surgery to take out your thyroid gland. This gland is shaped like a butterfly. It lies across the windpipe (trachea). The gland makes hormones that control how your body makes and uses energy (metabolism). A doctor removes the gland when it gets too big, does not work right, or has a tumor. Most tumors that grow in this gland are benign. This means they are not cancer.

The doctor will take out the thyroid through a cut (incision) in the front of your neck. You will likely have a tube, called a drain, in your neck to let fluid out of the cut. The drain is most often taken out before you go home.

You may go home on the same day. Or you may stay one or more nights in the hospital. You may return to work or your normal routine in 1 to 2 weeks. This depends on whether you need more treatment and how you feel. It may also depend on the kind of work you do.

Your doctor will check your incision in about a week. You may need to take thyroid medicine. If you have thyroid cancer, you may need to have radioactive iodine therapy. Your doctor will talk to you about what happens next.

Surgery for hyperthyroidism is called thyroidectomy. It removes part or all of the thyroid gland. Doctors rarely use this surgery to treat hyperthyroidism. It's riskier than other treatments.

You may need surgery if:

• Your thyroid gland is so big that it's hard for you to swallow or breathe.
• You have thyroid cancer.
• Your doctor suspects that you have thyroid cancer.
• You had serious side effects from taking antithyroid medicines, and radioactive iodine isn't an option for you.
• You have a large goiter that radioactive iodine treatment didn't shrink.
• You have a single, large thyroid nodule that makes too much thyroid hormone, and radioactive iodine didn't help with the nodule.

Your doctor will have you take antithyroid medicines if you have any surgery for the condition.

After surgery, your doctor will check your thyroid hormone levels regularly. That's because you could get hypothyroidism (too little thyroid hormone).

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover. When you lie down, put two or three pillows under your head to keep it raised.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• 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.
• You may take a shower, unless you still have a drain near your incision. Pat the incision dry. If you have a drain, follow your doctor's instructions to care for it.

Diet

• If it is painful to swallow, start out with cold drinks, flavored ice pops, and ice cream. Next, try soft foods like pudding, yogurt, canned or cooked fruit, scrambled eggs, and mashed potatoes. Avoid eating hard or scratchy foods like chips or raw vegetables. Avoid orange or tomato juice and other acidic foods that can sting the throat.
• If you cough right after drinking, try drinking thicker liquids, such as a smoothie.
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• Your doctor may prescribe calcium to prevent problems after surgery from low calcium. Not having enough calcium can cause symptoms such as tingling around your mouth or in your hands and feet.
• Your doctor may have prescribed antibiotics. Take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• If your doctor told you how to care for your incision, follow your doctor's instructions. If you did not get instructions, follow this general advice:
  • After the first 24 to 48 hours, wash around the wound with clean water 2 times a day. Don't use hydrogen peroxide or alcohol, which can slow healing.
• You may have a drain near your incision. Your doctor will tell you how to take care of it.