My Surgery: Thyroid

Thyroid surgery that removes one or both of your thyroid lobes is called a thyroidectomy.

The surgeon makes an incision (cut) in the lower neck, usually, between 4 to 6 centimetres long but can be longer if you are having lymph nodes removed.

 

 

Pre-Admission Visit

What should I bring to my pre-admission appointment?

• Your health card (OHIP card). If you do not have an OHIP card, please bring another form of government-issued photo ID, such as a driver's license or passport.
• Any other insurance cards. You will need the policy number of your extended health insurance, if you have any.
• Your spouse/partner, a trusted friend or family member (to offer you support and be a second set of ears).
• All the medications you take in their original containers. This includes prescription medications, over-the-counter medicines, vitamins, supplements and herbal or natural products.
• A copy of your power of attorney for personal care and/or advanced directives.
• A list of any questions that you may have about the operation and recovery.
• The name or phone number of your pharmacy, as well as any medical specialists that you have seen in the past 3 years.
• If you have had a cardiac stress test, echocardiogram and/or a pulmonary function test in the past 3 years, it would be helpful to bring a copy of the final report with you to this appointment.

What happens during my pre-admission visit?

• You will have blood tests and routine skin swabs. The swabs are taken from your nose and other areas of your body to check for germs that can cause infections.
• You may also need an electrocardiogram (ECG) to check your heart and a chest x-ray to check your lungs.
• You will meet many health care providers during your pre-admission visit. Please feel free to ask them any questions that you may have.
• A pre-admission nurse will review your health history and give you information to prepare you for your operation, including directions for cleaning your skin, eating before your operation, taking your medications and pain management.
• A pharmacist will review your medications.

Depending on your needs, you may also meet:

• An anesthetist who will review your health history, discuss your anesthetic plan and pain relief after your operation.
• A member of the medicine team, if you have other complex health problems.

7 Days before your surgery

• You may need to stop taking Aspirin or medications that have Aspirin in them for 7 days before your surgery.
• Stop using herbal remedies or homeopathic medications which have not been approved by your surgeon for 7 days before your surgery. Some naturopathic medications may cause bleeding.
• Talk to your doctor if you are taking blood thinner medications.

The night before your surgery

• Do NOT eat anything after midnight the night before your surgery.
• Do NOT drink coffee, black coffee or tea, milk or milk products, or orange juice after midnight before your surgery.
• You may have a sip of water or clear fluids up to 5 hours before your surgery. Then do not drink anything within 5 hours of your surgery.
• Take all your usual medications unless your doctor told you otherwise.
• If you smoke, do not do so for 24 hours before your operation.
• Do not drink alcohol for 24 hours before your operation.
• Remove all nail polish and body piercings.
• You must have a shower with soap and water to clean your skin the night before and the morning of your operation to reduce the chance of infection after your operation.
• Follow all special instructions explained to you during your pre-admission visit.

 Stop smoking before your surgery: learn how smoking and tobacco can affect your recovery after surgery, and how quitting can improve your health.

What can I expect to have on my body?

• You may have Steri-Strips or surgical glue to close your wound
• Rarely, a drain tube called a Hemovac or JP is put inside the neck near your incision to remove any extra fluid under your skin. Do not pull on it or try to empty the attached plastic bulbs. The surgeon will let you know when it will be removed.
• An intravenous (IV) is a special needle put into a vein of your arm or hand. It is attached to tubing and a bag hanging from a pole. We use your IV to give you fluid and medication during and after your surgery. We usually take the IV out as soon as you can start eating and drinking well (usually right after surgery).

You may be connected to some tubes and machines:

• Heart monitor monitors your heart rate.
• Oximeter allows us to monitor oxygen level in your blood.
• Nasal prongs allow us to give you extra oxygen.
• Intravenous (IV) lines allow us to administer needed IV fluids and medications.
• Bladder catheter allows us to collect and measure your urine.

You will continue to recover when you return home.

Activity	How to manage at home
	You may eat, drink and speak normally after your surgery. Drink plenty of water for 24 to 48 hours after surgery.
	Your prescription pain medication may make you constipated. Eat more foods that are high in fibre (like fruits vegetables and bran cereal), and drink lots of water during the day.
	Do your daily activities again when you feel ready.
	Do NOT drive a car or use machinery/ power tools unless you have stopped your prescription pain medication and you can turn your head to see your car side view mirrors (usually about 3 days).
	You can shower or wash your hair the day after your surgery. Use a mild soap like Ivory or Glycerin and baby shampoo for about 1 week after the surgery. When you finish bathing or showering make sure to pat the incision dry. Do not rub. Do not take a bath over the incision or swim for 2 weeks.

Where and when

Wharton Head and Neck Centre
Wharton Head and Neck Centre Princess Margaret Cancer Centre – 2^nd floor

Otolaryngology, Head & Neck Surgery Clinic
Toronto General Hospital | Norman Urquhart Building – 7^th Floor

Three weeks after your surgery: if you don't have an appointment for a follow-up before you leave the hospital, call your surgeon's office the first week you are home.

Who do I call with general post-operative questions?

Call your surgeon's office:

Who do I call if I experience complications

If you have new symptoms and don't know what to do, do not wait. Get medical advice or help if you are concerned.

If you have numbness and tingling of your fingers or around your mouth:

• Take an extra dose of calcium 1000 mg pills (or 2 pills of Elemental Calcium 500 mg).
• Wait 15 minutes. If the tingling and numbness does not go away, take another dose of calcium 1000 mg pills (or 2 pills of Elemental Calcium 500 mg).
• If after the third dose the tingling and numbness are still there, call your surgeon to get a calcium blood test.

If you had your surgery at Toronto General Hospital, call your Clinical Nurse Coordinator at 416 340 4665.

If you are calling after hours, call the Nursing Unit where you stayed after your surgery:

Consolidated Surgical Short-Stay Unit at TGH: 416 340 3521
ENT/Head & Neck and Plastics Surgical Oncology Inpatient Unit: 416 340 3224

If you had your surgery at Princess Margaret Cancer Centre:
Short Term Care Unit – 18B: 416 946 4501 ext. 5510

Go to the hospital nearest emergency room if you have:

• Chills or a fever that goes higher than 38℃ and does not go away after you take Tylenol.
• Your incision bleeds or fluid or pus leaks from it.
• Redness, swelling or increased pain under your incision or on your neck that keeps getting worse.
  
• Pain, redness or swelling in your calf or your leg.
• Any stabbing pain in your chest or shooting pain in your back.
• Tingling, numbness of the fingers or toes or around the mouth that does not go away after taking calcium doses as directed.
• Difficulty breathing, shortness of breath and chest pain.
• Trouble swallowing or trouble coughing.