POST-OP THYROID INSTRUCTIONS
Thyroid surgery is major surgery and in order to recover with the least amount of problems an to reduce your chance of complications, it is advised to follow the specific instructions listed below.
After you are discharged from the hospital you will still have residual effects of anesthesia. It is never appropriate to drive home after surgery in which sedation or a general anesthetic was used or if you are taking narcotic pain medications. Mental function is decreased in all patients to some degree and no important decisions should be made within 24 hours or if the effects of oral pain medication impair judgment.
Pain is expected after surgery. Although you may have had minimally invasive thyroid surgery, your neck will be sore and pain will be worse when the neck is stretched. It is best to keep the neck in a comfortable position. As the surgical site heals, pain will resolve over the course of a week. Pan medication will be prescribed to educe pain.
Most patients may begin to drink liquids immediately after surgery. Foods may be introduced as tolerated until a regular diet is achieved. It is possible to have swelling of the esophagus after surgery due to the anesthesia breathing tube or due to swelling of the esophagus, which is near the thyroid. An early regular diet after general anesthesia may cause vomiting. Begin slow and easy.
CARE OF THE INCISION
our incision has been carefully repaired in order to maximize healing. My goal is to have the best cosmetic appearance of the scar. The skin is closed in several layers. The stitches on the skin surface are very small and will fall out. The skin edges were closed precisely with the edges of the skin rolled outward. Deeper stitches hold the skin together and provide support. A the deeper stitches dissolve the skin edges will become flat and smooth. This is the best way to create a perfect scar. Steri-strip tape will be present over the skin. Leave it in place until Dr. Denys checks your incision. A sterile bandage is present which covers the steri-strip tape. This should remain in place for three days. The bandage is designed to permit a person to shower even the day of surgery as it is mostly water proof. Try to keep it dry. One the steri-strips are removed, the skin should be treated with antibiotic ointment for one week Apply triple antibiotic ointment to the skin twice per day. After one week the incision no further treatment is required but it is advised to protect the incision from sunlight for the next six months, as sun will often cause pigmentation of the scar. SPF greater than 30 is suggested.
Day of surgery: relax. Recline in chair or bed with head and neck higher than level of chest. This will reduce swelling and pain. Walk periodically during day to improve blood circulation which reduces risk of blood clots. Drink fluids as desired and advance diet. You may shower but be careful with incision and dry the area by pressing on area not rubbing it. Take pain medication as required. Take prescribed medications are directed. Take home medications as directed.
The first week after surgery most people have less pain and feel better the day after surgery although swelling of the neck may be worse three days after surgery. Increase activities as tolerated but no heavy lifting or exercise for one week. Do not participate in actives which place strain on you neck and upper body. Return to work as tolerated.
Some complications may occur after surgery. Low calcium levels are noticed by symptoms of tingling, numbness, and "pins and needle" sensation around the lips and nose. If you have these symptoms you will need to take calcium. Please call the doctor for treatment advise.
Bleeding is possible after surgery and the most serious cases may cause trouble breathing. Symptoms include rapid swelling in the neck, trouble breathing, red and purple discoloration of the skin over the incision. Please call doctor immediately or if trouble breathing is present, got to emergency or call 911.
FOLLOW -UP CARE
An appointment is required and should be scheduled for one week after surgery. At this visit we will check your incision, review needs for thyroid hormone therapy or change of dose, discuss surgical details, review final pathology report, and discuss in detail future care required.