Swelling after thyroid lobectomy

[Sarahjogs]

I had a thyroid lobectomy yesterday.  I've noticed the area around the incision site is more swollen today than yesterday, and the area is a bit more tender and painful.  (I also went shopping this morning for about an hour and walking around more - not sure if the swelling is because I "did too much" or if it's just part of the healing process).  Should I put ice on it?  Lie down more?  (It is quite uncomfortable to lie on my back so I've been sitting upright pretty much non-stop except when I went to bed last night).  Is it too soon to start putting ice on it?

I don't think it is infected or more swollen than what is expected with this kind of surgery - when I left the hospital there was virtually no swelling or bruising 2 hours after the surgery, last night my neck got a bit splotchy above the incision site and a little swollen, now, a day later, it looks less splotchy, skin is pretty much normal color, but looks more swollen, especially when I look at my neck in profile.  I probably have a skinny neck to begin with, so the swelling is noticeable to me, but again I don't think this is something unexpected or more than normal recovery, just not sure if I should ice it or if anyone has any other tips.  I'm not supposed to take ibuprofen right now - which would help reduce swelling but I think increases risk of bleeding problems at this point.

If it gets more swollen I will of course call my doctor, but the amount of swelling I have seems like part of the normal recovery process at this point.

I'm taking medication for the pain and my pain level is probably at a 2-3 for me with the medication (except if I push on the swelling area), and up to about a 5-6 when the medicine wears off.  Pain hasn't really been above a 6 since I woke up in recovery, so that's good.  Only other problem is my uvula (dangling thing in back of throat) seems quite stretched out from the intubation tube, and this will probably get better on its own with time.

If anyone has advice it would be appreciated - again I don't think this is anything unexpected/unusual for the thyroid surgery I had, I just want to know if there is something else I could be doing to help!  Besides sore throat/uvula and incision site on neck, I feel pretty good now.

I am going to try to lie down for a bit and see if that helps decrease the swelling.

[Barb135]

Hi sarahjogs... I guess I missed that your surgery had already passed; I've kind of been out myself a little bit due to an eye injury.  At any rate, I'm glad the surgery seems to have gone well.  

I'm not sure I'd actually use ice on the area; instead, I might try a soft cloth soaked in ice water or cooled in the freezer for a while, as ice, itself, might feel hard and painful against the incision.  Of course, that's just the way I am when I need to put cold against anything... lol

As for sitting/lying down, I'd say that's up to you depending on whichever is most comfortable.  I can see where lying down could be uncomfortable.  If you have a recliner, perhaps you could try reclining to get an in-between position or if you don't have a recliner, try piling pillows behind you to get the most comfortable position.  

My last bit of advice would be: do not push on or palpate the incision area... palpating the thyroid area always causes more irritation, plus you could cause stitches to come loose or get dirt into the incision and cause an infection, etc.

Has your doctor prescribed thyroid medication for after your healing or has s/he taken a "wait and see" approach to determine if your remaining lobe can handle the demand?

[Sarahjogs]

Hi Barb,

Thanks for your advice!  I think I always say "ice" when I mean any freezer/cooling pad - last night I tried a freezer pad we have that can be heated or cooled (I used it cold) and is supposed to mold to your body, but I think it was way too heavy and didn't feel like it did anything.  I'm going to try your method of a towel cooled in the freezer today to see if it helps.  

I'm not sure if the swelling has gone down, but it feels much better today than yesterday.  I slept much better than the first night too (I'm almost at 48 hr post op now, so still early days in the healing process).  My uvula is elongated and uncomfortable when I'm lying on my back because it just sits on my tongue and annoys me, but I slept on my side most of the night and that seemed to help both my uvula and the swelling/incision site area.  The rest of my throat seems fine, just damaged uvula which is annoying more than painful - I can still eat/drink ok, but if it's still a problem on Monday I will call my doctor to see if she recommends anything.  I think they will sometimes prescribe steroids, but it's not really impeding my breathing or anything, so I think I just have to give it time to heal.  I've been "gargling" with salt water which is supposed to help with the uvula damage (gargling is too painful with tilting my neck back and I think you need your uvula to do it, so right now I just swish with salt water after eating).

My doctor did not prescribe thyroid medication yet.  She thinks my remaining thyroid may produce enough hormone despite the fact that I have Hashimoto's and already have many hypo symptoms (she is a very good surgeon, so I didn't want to fight her on this before the surgery).  I've only had my thyroid hormones checked once, and I know with Hashimoto's levels can fluctuate quite a bit, so I will push for getting tested to make sure I'm in the right range.  I have a feeling I will need to take hormones (and if my surgeon/ENT isn't willing to give me anything before I go out of range, I think my primary care provider is willing to do a trial dosage to see if it helps with my hypo symptoms, I just wanted to get the surgery out of the way  before focusing on treating the Hashi's).  I have a follow up appointment next Friday, and then another one about a month after the surgery, so I will push to get tested.  

It sounds like my surgeon did not see any swollen/suspicious lymph nodes during the surgery, and she had the right lobe sent to pathology for a quick look during the surgery - if it looked cancerous they would have taken the whole thyroid out, which they didn't, so hopefully that is a good sign, but I'm still waiting on full pathology.  (My mom said my doctor told her that even if it was cancer there is no further treatment because the nodule was small and it's out now - I'm not sure my mom has all the details right, but I'm hoping I don't need to get the other half out anytime soon).

Feeling pretty good now - I think I'm going to go for a short walk and then relax for a bit.