Patient Guide to Thyroid Surgery

Surgery Overview
Thyroid surgery is performed under general anesthesia, usually requiring a one-night hospital stay. In some cases patients may go home the same day. The procedure takes from 30 minutes to two hours to complete. The smallest possible horizontal incision will be made under the Adam's apple in the neck, following the natural skin line for the best cosmetic result. Virginia Mason performs up to 200 thyroid surgeries every year, achieving the goals of effective treatment, avoiding postoperative problems and minimal scarring.

One Week Before Surgery

  1. Minimize taking aspirin-containing compounds, including these products: Excedrin, Alka-Seltzer, Advil (Ibuprofen) and most cold remedies.
     
  2. Visit the lab for preoperative tests and the Preanesthesia Assessment Clinic as scheduled by your surgeon.
     
  3. If you have received a prescription for pain medication, please have it filled and bring it with you on the day of surgery.

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One Day Before Surgery

  1. Call your surgeon's office at (206) 341-0040 between 1 and 5 p.m. to find out your check-in time for the following morning.
     
  2. Shower with an antibacterial soap (e.g., Dial, Lever 2000) the night before and the morning of your surgery.
     
  3. Do not eat solid foods after midnight the night before your surgery. After midnight, consume no more than 16 ounces (two cups) of clear liquid, up to two hours before check-in. Clear liquids include water, apple juice, black coffee, tea, carbonated beverages and plain Jell-O. No milk products, alcohol, fruit juices with pulp, chewing gum or tobacco are permitted.

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After Surgery

  • Daily activities — You may resume normal daily activities when you feel ready.
     
  • Returning to work — Most patients are able to return to work within a few days after the surgery.
     
  • Driving — You will be able to drive a few days after you leave the hospital. Do not drive if you are taking pain medication.
     
  • Diet — For the first few days, try soft, soluble foods to keep swallowing easy (any swallowing difficulty is usually mild and lasts just a few days). Emphasize fresh fruits, vegetables, bran and liquids to help prevent any constipation that can result from taking pain medication.
     
  • Wound care — Your incision may remain swollen for one to two months following surgery. Keep in mind your scar will be only faintly visible after one year. Your incision will be covered with sterile tape strips (Steri-Strips) that act like stitches. You may shower with the tape strips in place. Remove the strips when they start to curl and come off, usually 7 to 10 days after surgery. Any minor pain at the incision site should decrease over time. While you may apply lotion or cream to the incision after the tape strips are removed, try to avoid exposing the site to excessive sunlight for up to one year after surgery.
     
  • Follow-up visit — Attend your follow-up visit which will be scheduled for you prior to surgery.

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Surgery Risks
Complications during or following thyroid surgery are uncommon. Possible risks associated with the surgery are described below.

  • Infection — Infection at the surgery site is very rare, occurring in less than 1 percent of cases. Signs of infection should be immediately reported to your doctor and can include increasing pain, fever and discharge from the wound.
     
  • Postoperative bleeding — While uncommon, any signs of bleeding are carefully monitored in the recovery room and overnight to ensure swelling is controlled and there are no other complications.
     
  • Nerve dysfunction — Great care is taken during the procedure to protect the recurrent laryngeal nerve (the nerve to the vocal cord). About the thickness of a strand of hair, the laryngeal nerve is located behind the thyroid in a groove between the windpipe (trachea) and the esophagus. Although 1 to 2 percent of thyroid operations can result in injuries to the recurrent laryngeal nerve, most will resolve with time. In the rare case of a permanent injury, a secondary procedure can be done to improve the voice.
     
  • Hypoparathyroidism — The parathyroids are four tiny glands that are located behind the thyroid gland. They function to regulate calcium and bone metabolism. Although a person can function normally with only one parathyroid gland, the goal is to preserve all four during thyroid removal. Occasionally thyroid surgery can disrupt blood flow to a parathyroid. This is easy to detect, and is treatable during the surgery. By applying a technique called parathyroid autotransplantation, the affected gland is repositioned in neck muscle tissue to preserve its function.

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Contacting Your Doctor
If you have questions or problems, contact the surgeon's office at (206) 223-6629. The following symptoms are reasons to contact our office immediately:

  • Fever greater than 101º F (38.3º C)
  • Increased redness, swelling or drainage from your incision
  • Facial twitching or numbness and tingling of the fingertips or lips

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