What You Need To Know About Thyroid Removal Side Effects
Are you and your doctor discussing the possibility of thyroid surgery? If so, it is likely that you have many questions about what to expect once the procedure is completed. To help you plan for your recovery, we have gathered answers to some of the most commonly asked questions we receive from our thyroid patientsâso you can be well informed, feel confident in your care, and move forward into better health.
What Are The Risks Of Thyroid Surgery
All surgery brings risk for complications like bleeding and infection. Thyroid surgery can also involve risks for damage to vocal cord nerves, which could cause hoarseness, and damage to your parathyroid glands, which are located behind and very close to your thyroid and regulate your bodys calcium levels.
The Morning Of Your Surgery
Instructions for drinking before your surgery
; You can drink a total of 12 ounces of water between midnight and 2 hours before your scheduled arrival time. Do not drink anything else.Do not drink anything starting 2 hours before your scheduled arrival time. This includes water.
Take your medications as instructed
If your healthcare provider told you to take certain medications the morning of your surgery, take only those medications with a sip of water. Depending on what medications you take, this may be all, some, or none of your usual morning medications.
Things to remember
- Wear something comfortable and loose-fitting.
- Dont wear any lotion, cream, deodorant, makeup, powder, perfume, or cologne.
- Remove nail polish and nail wraps.
- If you wear contact lenses, wear your glasses instead. Wearing contact lenses during surgery can damage your eyes.
- Dont wear any metal objects. Remove all jewelry, including body piercings. The tools used during your surgery can cause burns if they touch metal.
- Leave valuable items at home.
- If youre menstruating , use a sanitary pad, not a tampon. Youll get disposable underwear, as well as a pad if needed.
What to bring
- Your Health Care Proxy form and other advance directives, if you completed them.
- Your cell phone and charger.
- A case for your personal items , dentures, prosthetic device, wig, and religious articles), if you have one.
- This guide. Your healthcare team will use it to teach you how to care for yourself after surgery.
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What Should I Expect After A Partial Thyroidectomy
Tell your healthcare providers if you have difficulty breathing or swallowing. Tell them if your bandage feels like it is getting tighter. You will have blood tests to check your calcium and thyroid hormone blood levels.
- Medicine may be given to bring your thyroid hormone level back to normal. A partial thyroidectomy means your thyroid gland can produce some thyroid hormone. You may need to take medicine daily to keep your thyroid hormone level steady. You may be given pain medicine after surgery. Radioactive iodine may be given if your thyroid gland was removed because of cancer. This medicine may kill cancer cells that were not taken out during surgery.
- Deep breathing helps open air passages and prevent a lung infection. Slowly take a deep breath and hold the breath as long as you can. Then let your breath out. Take 10 deep breaths in a row every hour while awake. You may be asked to use an incentive spirometer to help you with this. Put the plastic piece into your mouth and slowly take a breath as deep and as long as you can. Hold it as long as you can. Then let your breath out.
Day Before Your Surgery
Note the time of your surgery
A staff member from the Admitting Office will call you after 2:00 pm the day before your surgery. If your surgery is scheduled for a Monday, theyll call you on the Friday before. If you dont get a call by 7:00 pm, call .
The staff member will tell you what time to arrive at the hospital for your surgery. Theyll also remind you where to go.
This will be one of the following locations:
- Josie Robertson Surgery Center
Instructions for eating before your surgery
;Do not eat anything after midnight the night before your surgery. This includes hard candy and gum.;
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So What Do You Need To Know About Thyroid Nodules
In todays video, I want to share with you some of the symptoms that nodules may cause but, I want to share with you 5 reasons when you should be concerned about Thyroid nodules and I want to talk about 2 blood tests you should have done If your doctor identified that you do have nodules.
First off, Thyroid nodules are incredibly common and in fact most woman age 50 have at least one thyroid nodule. It is also known that as you get older, the incidence of thyroid nodules increase.
The other thing about nodules is that they can be solid or fluid-filled lumps sometimes felt in the neck.
If they are fluid filled, this is called a thyroid cyst and they are almost always benign.
Most of the time, thyroid nodules do not cause signs or symptoms unless these nodules begin to produce additional thyroxine, a hormone secreted by your thyroid gland.
Are There Other Means Of Treatment
Surgery is definitely indicated to remove nodules suspicious for thyroid cancer. In the absence of a possibility of thyroid cancer, there may be nonsurgical options for therapy depending on your diagnosis. You should discuss other options for treatment with your physician who has expertise in thyroid diseases.
Side Effects Of No Thyroid
Now your thyroid is gone, you may feel like youre on an emotional roller coaster. One minute youre laughing and having a great time, the next minute youre so pissed off you are seeing red â or, maybe today youre just sad. Yep, here come the tears again. It happens.
Its hot. Its cold. Youre in and out of the arctic tundra, all the way to the sweltering rain forest. Your bodys thermostat may seem broken. I experience hot flashes and, well, cold flashes, for lack of a better termâ¦ all day long.
My hands tingle often and my feet cramp every night, even when my calcium and potassium levels are âperfectâ.
All of these things may not be permanent, but for now its the ânew normalâ. Youll probably hear that phrase a lot while dealing with your post-thyroidectomy symptoms.
What Is Thyroid Hormone Replacement Therapy
Thyroid hormone therapy is the use of manmade thyroid hormones to raise abnormally low levels of natural thyroid hormones in the body. Thyroid hormone is usually given in pill form and is often used to treat an underactive thyroid that is secreting little or no thyroid hormones. The most commonly prescribed thyroid hormone replacement is pure synthetic thyroxine .
Who Performs A Thyroidectomy
The following specialists perform a thyroidectomy:
Otolaryngologists specialize in the treatment of diseases and conditions of the ears, nose and throat.
General surgeons specialize in the surgical treatment of a wide variety of diseases, disorders and conditions.
Pediatric otolaryngologists specialize in the treatment of diseases and conditions of the ears, nose and throat in infants, children and adolescents.
A Change In Thyroid Hormones
If your whole thyroid gland has been removed, you will need to take tablets to replace the hormones that your thyroid would normally make. The thyroid hormones are necessary to keep your body processes going at the right rate. This is called your metabolism. Without thyroid hormones, you feel extremely tired and lacking in energy.
A tablet called thyroxine replaces the hormones. You take this tablet every day for the rest of your life. You have regular blood tests to check the hormone levels in your blood. Your doctor may change the dose of your tablet if your hormone levels are too high or too low.
If you have had part of your thyroid gland removed, the remaining gland usually makes all the hormone you need. But some people might need to take thyroxine tablets. You have blood tests to check for this.
These hormone tablets may help to stop the cancer from coming back in follicular and papillary thyroid cancer. They stop your body from producing another hormone called thyroid stimulating hormone . TSH can help these types of thyroid cancer cells to grow.
Taking thyroxine every day won’t stop you from doing the daily activities you were doing before your surgery.
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How Will You Partner With The Rest Of My Medical Team
After surgery, youll likely need monitoring of your thyroid hormone levels and, in the case of thyroid cancer, follow-up treatment and testing. You want to know that the people taking care of different aspects of your thyroid disease or thyroid cancer are working together and communicating as a team, said Sosa. At Duke, weve created a clinic where you, your surgeon and your endocrinologist can meet at the same time, in the same place.
What Problems Can Occur With The Thyroid Gland
Hypothyroidism: An under-active thyroid is called hypothyroidism. The thyroid produces less thyroxine. This makes the pituitary gland send more TSH into the bloodstream to get the thyroid gland to make more hormone.
Common symptoms of hypothyroidism include:
- Weight gain
- Dry skin, hair, and nails
- Feeling tired
Hyperthyroidism: An over-active thyroid is called hyperthyroidism. The thyroid gland makes too much thyroid hormone. The pituitary gland decreases the amount of TSH in the blood.
Common symptoms of hyperthyroidism include:
- Heat intolerance
- Losing weight without dieting
- Muscle weakness, fatigue
Nodules: Thyroid nodules can be either solid or cystic . Most of the time, your thyroid works normally if you have nodules. Most nodules are not cancerous. However, your doctor might take a sample of the cells in the nodule. This is called a fine needle aspiration. This sample will be examined to make sure there are no cancer cells.
Goiter: This is an enlargement of the thyroid gland. You might feel swelling or enlargement in the neck. It can become larger because your thyroid is trying to make more thyroid hormone. Also, in hyperthyroidism the cells grow faster, which causes the thyroid to grow and make more thyroid hormone than the body needs.
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What Are The Risks Of A Partial Thyroidectomy
You may bleed more than expected and need a blood transfusion. Your voice may be hoarse or weak after surgery, and this may become a long-term problem. Your neck may be bruised and swollen, and it may be hard for you to breathe or swallow. Your parathyroid glands may not work as well as they should after surgery. This can cause your calcium levels to drop too low. Low calcium levels can cause many problems, including an irregular heartbeat, muscle spasms, and seizures. This may be a short-term problem after surgery, or it may be a long-term problem.
Drop In Calcium Level
There may also be a negative effect to the parathyroid glands after the thyroid removal surgery. These glands are located right next to the thyroid glands and they help in controlling the calcium level in your blood. There may be a severe fall of the calcium levels in the body in case the parathyroid glands are not working properly. There may be jerking muscles, twitching or muscle spasms in the body in case you have low calcium level. You may be prescribed with calcium tablets after the thyroid removal procedure. Though low calcium levels after the operation is temporary, in some people it may be a permanent side effect.
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What Can I Expect Once I Decide To Proceed With Surgery
Once you have met with the surgeon and decided to proceed with surgery, you will be scheduled for your pre-operative evaluation You should have nothing to eat or drink after midnight on the day before surgery and should leave valuables and jewelry at home.
The surgery usually takes 2-2½ hours, after which time you will slowly wake up in the recovery room. Surgery may be performed through a standard incision in the neck or may be done through a smaller incision with the aid of a video camera . Under special circumstances, thyroid surgery can be performed with the assistance of a robot through a distant incision in either the axilla or the back of the neck. There may be a surgical drain in the incision in your neck and your throat may be sore because of the breathing tube placed during the operation. Once you are fully awake, you will be allowed to have something light to eat and drink. Many patients having thyroid operations, especially after hemithyroidectomy, are able to go home the same day after a period of observation in the hospital. Some patients will be admitted to the hospital overnight and discharged the next morning.
Recuperation Time And Restrictions
Most people are advised to take roughly two weeks off from work to recuperate, depending on their occupation. You should not drive as long as you continue to need pain medications, and some surgeons recommend abstaining from driving for the first week after surgery altogether.
You should also avoid any heavy lifting or strenuous activities for a few weeks. The excess activity could increase your chance of developing a hematoma or keep your wound from healing properly. Light housekeeping and walking are usually fine once you arrive home.
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How Do I Select A Surgeon
In general, thyroid surgery is best performed by a surgeon who has received special training and who performs thyroid surgery on a regular basis. The complication rate of thyroid operations is lower when the operation is done by a surgeon who does a large number of thyroid operations each year. Patients should ask their referring physician where he or she would go to have a thyroid operation or where he or she would send a family member.
Why Is Thyroid Removal Surgery Performed
The main reasons a doctor may recommend thyroid removal surgery include:
- A nodule that could be thyroid cancer
- A diagnosis of thyroid cancer
- A nodule or goiter that is causing local symptoms
- Compression of the trachea
- Difficulty swallowing
- A visible or unsightly mass
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Complications Of Thyroid Gland Surgery
Surgery to remove some or all of the thyroid gland is usually safe, but as with all operations, there’s a risk of complications.
The risk of complications happening after thyroid gland surgery is estimated to be 1 to 2 in 100.
Before having the surgery, discuss the risks with your surgeon.
Infection, nerve damage and parathyroid gland damage are the main complications of thyroid gland surgery.
As with all surgery, there’s a risk of infection after thyroid surgery.
The thyroid gland is very close to the laryngeal nerves, which control your vocal cords.
If these are accidentally damaged during surgery, your voice and breathing could be affected.
Permanent damage to the laryngeal nerves affects 1 to 2 people in every 100 who have this type of surgery.
Temporary damage may affect up to;5 people in every 100.
Parathyroid gland damage
The parathyroid glands are tiny glands behind the thyroid. They help regulate the amount of;calcium in your body.
If the parathyroid glands are damaged during thyroid surgery, you’ll probably need to take calcium supplements for the rest of your life.
Page last reviewed: 15 April 2019 Next review due: 15 April 2022
How Much Of My Thyroid Will Be Removed
It depends on the reason for your surgery. If your thyroid is overactive , or the whole gland is enlarged and causing symptomssuch as a feeling of pressure or difficulty talking, breathing or swallowingthe whole thyroid should be removed in a procedure called total thyroidectomy, said former Duke endocrine surgeon Dr.;Julie Sosa, MD. If only half your thyroid is enlarged and causing symptoms, but the other half is normal, then half should be removed, said Sosa.
For the most common type of thyroid cancer, which is generally low-risk, your doctor may recommend removing all or half your thyroid, depending on your circumstances. If you have intermediate- or high-risk cancermeaning it has spread outside the thyroidwe recommend total thyroidectomy, said Sosa.
Sophisticated imaging called neck mapping can help your surgeon determine ahead of time how much of your thyroid and which lymph nodes, if any, need to be removed. While not in use everywhere, neck mapping is routine at Duke. The best chance for a cure for thyroid cancer is making sure we remove all of the disease, said former Duke endocrine surgeon Dr.;Sanziana Roman, MD. We dont want to overtreat, but we also dont want to undertreat. So knowing exactly how much surgery a patient needs is very important.
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Doctor Visits And Follow
Your health care team will explain what tests you need and how often they should be done. Your schedule of doctor visits, exams, and tests will depend on the original extent of your cancer, the specific type of thyroid cancer you had, how it was treated, and other factors.
Papillary or follicular cancer: If you have had papillary or follicular cancer, and your thyroid gland has been completely removed or ablated, your doctors may consider at least one radioactive iodine scan after treatment, especially if you are at higher risk for recurrence. This is usually done about 6 to 12 months later. If the result is negative, you will generally not need further scans unless you have symptoms or other abnormal test results.
Your blood will also be tested regularly for TSH and thyroglobulin levels. Thyroglobulin is made by thyroid tissue, so after total thyroid removal and ablation it should be at very low levels or not be found in your blood at all. If the thyroglobulin level begins to rise, it might be a sign the cancer is coming back, and further testing will be done. This usually includes a radioactive iodine scan, and may include PET scans and other imaging tests.
For those with a low-risk, small papillary cancer that was treated by removing only one lobe of the thyroid, routine physical exams by your doctor, thyroid ultrasounds and thyroid blood tests are typical.
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