Discharge Instructions After Surgery for Cancer of the Thyroid

You've been diagnosed with thyroid cancer, the out-of-control growth of cells in the thyroid gland. Your thyroid gland makes hormones that control your metabolism. 

The most common treatment for thyroid cancer is surgery to take out some or all the thyroid gland (thyroidectomy). If your thyroid gland is gone, you'll need to take thyroid medicine for the rest of your life. Even if your surgeon left some of your thyroid in place, you may need to take thyroid hormone to make sure you have enough in your body. Thyroid hormones can also help decrease the risk that the cancer comes back.

This sheet can help you know how to take care of yourself after surgery.

Home care

At home: 

  • Don’t get your incision site wet for a few days after your surgery. When you wash, use soap and water to clean the incision. Don't scrub.

  • Don't do any strenuous activities for  3 to 5  weeks after surgery. Listen to your body. If an activity causes pain, stop.

  • Limit your activity to short walks. Slowly increase your pace and distance as you feel able.

  • Rest when you are tired. Don’t worry if you are very tired (fatigued). Fatigue and weakness are normal for a few weeks. It will get better over time.

  • Ask your healthcare provider when you can expect to return to work and your usual activities.

  • Go back to your regular diet as you feel able. Try to eat a healthy, well-balanced diet.

  • Keep a card in your wallet that lists the following:

    • Your name and contact information

    • Your healthcare provider’s name and contact information

    • The name of your disease

    • The brand name and dose of your thyroid medicine

Medicine

Take your thyroid hormone medicine exactly as directed. Follow these tips:

  • Keep your pills in a container that's labeled with the days of the week. This will help you remember if you’ve taken your medicine each day.

  • Take your medicine with a liquid like water. Don't take it with soy milk or grapefruit juice. These change the way your body absorbs thyroid hormone. To work, the pill must make it to your stomach and not dissolve in your throat.

  • Try to take your thyroid medicine at about the same time every day and on an empty stomach, at least 30 to 60 minutes before other foods or medicines. This will help you absorb the medicine and keep a steady amount of thyroid hormone in your system.

  • Don't stop your thyroid medicine on your own.

  • After taking your thyroid medicine:

    • Wait  4 hours before eating or drinking anything that contains soy.

    • Wait  4 hours before taking iron supplements, antacids that contain either calcium or aluminum hydroxide, or calcium supplements.

    • Wait  4 hours before taking medicines that lower your cholesterol.

Tips for healthcare provider visits

  • During your routine visits, tell your healthcare provider about any signs of too much thyroid hormone (hyperthyroidism). These include:

    • Restlessness, nervousness

    • Rapid weight loss

    • Sweating

    • Heart palpitations, more rapid heartbeat, or chest pain

    • Trouble sleeping

    • Shortness of breath

    • More frequent bowel movements

    • Stopping of menstrual period

    • Hair loss

  • During your routine visits, tell your healthcare provider about any signs of too little thyroid hormone (hypothyroidism). These include:

    • Fatigue or sluggishness

    • Puffy hands, face, or feet

    • Hoarseness

    • Muscle pain

    • Slow pulse (less than  60 beats per minute)

    • Weakness

    • Weight gain

    • Feeling cold often

    • Constipation

Follow-up

It is important to go to follow-up appointments after surgery:

  • Make a follow-up appointment as directed.

  • Make and keep appointments to see your healthcare provider and get blood tests. Your thyroid hormone levels will need to be monitored for the rest of your life.

  • Let your healthcare provider know if you've been prescribed any new medicine. This is because some medicines can change how well your thyroid hormone dose works.

  • Know what problems you should watch for after thyroid surgery. Know how to get help any time, including after office hours, on weekends, and on holidays.

When to call your healthcare provider

Talk with your healthcare provider about the symptoms you should watch for. Call right away if you have any of these:

  • Fever of  100.4° F ( 38°C) or higher, or as advised by your healthcare provider

  • Chills

  • Swelling or bleeding at the incision

  • Incision that opens or its edges pull apart

  • Choking, coughing, or trouble breathing

  • Trouble eating or swallowing

  • Pain that's getting worse 

  • Sore throat that lasts longer than  3 weeks

  • Tingling or cramps in your hands, feet, or lips

  • Lump in your neck

  • Pain, redness, swelling, or warmth in an arm or leg

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