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How Do They Remove Your Thyroid

Surgery For Thyroid Nodules & Cancers

Surgical Removal of the Thyroid Gland

Most noncancerous, or benign, thyroid nodules do not need treatment unless they are a cosmetic concern or cause symptoms including problems with swallowing, breathing, or speaking and neck discomfort. In these situations, NYU Langone doctors may recommend surgery or a minimally invasive procedure called radiofrequency ablation.

Doctors may also recommend surgery to manage a thyroid nodule if a biopsy shows its cancerous or if genetic testing shows its likely to be cancerous.;

People with toxic nodules or toxic multinodular goiters that are causing the thyroid to produce high levels of thyroxinea condition called hyperthyroidismmay also be recommended for surgery;

Your NYU Langone endocrinologist and endocrine surgeon determine the most effective and least invasive treatment or type of surgery based on diagnostic test results.;

Final Points To Remember About Thyroid Nodules

#1 if you have one or more thyroid nodules, remember that the vast majority are benign or non cancerous- so thats good news.

#2 When it comes to surgery- always, always, always Get a 2nd opinion- once you have your thyroid gland removed, There is no going back.! life as you know it, will never be the same.

You will now become permanently hypothyroid and that takes on its own unique treatment challenges.

After surgery, many people are told that its just a matter of taking thyroid replacement and you will feel fine. Unfortunately, very few people ever fee fine and have the outcome they were promised.

Weight gain, fatigue, brain fog, depression, hair loss, symptoms of either being overmedicated or under medicated will be the ongoing struggle for you.

With surgery, realize that, different doctors have different approaches- Some doctors like surgery and will want to remove the entire gland, while others feel that based on their surgical skill level, they can removed just the nodule and take a more conservative approach.

Another common concern that people have when it comes to complications of thyroid surgery, is damage to the Laryngeal nerve- these are the nerves that control vocal cords.

Discuss these concerns with your surgeon, and express your ultimate desire of trying to keep and preserve as much of your thyroid as you can.

That is going to wrap up todays video, I hope you enjoyed- until next time take care.

What Is A Thyroidectomy

A thyroidectomy is a surgical procedure to remove all;or part of the thyroid gland and used;to treat diseases of the thyroid gland including:

  • Thyroid cancer
  • Large goiters or thyroid nodules causing symptomatic obstruction such as swallowing or breathing difficulties.
  • Multi-nodular Goiter

A thyroidectomy is traditionally a minimally invasive surgery performed through a small horizontal incision in the front of the neck. The entire thyroid gland may be removed or just a single lobe, a portion of a lobe and the isthmus or other structures.;Depending on the extent of the operation,;patients may need to take the drug levothyroxine, an oral synthetic thyroid hormone.;

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What Will Happen During A Partial Thyroidectomy

  • General anesthesia is usually given before a partial thyroidectomy. This medicine will keep you asleep and free from pain during surgery. You may instead be given local anesthesia to numb the area. You may feel some pressure during surgery, but you should not feel any pain.
  • After one or more incisions are made, your surgeon will remove part of your thyroid gland. If you have cancer, your surgeon may also remove the tissue and lymph nodes around your thyroid gland. If you are awake during surgery, you may be asked to speak to your healthcare providers.
  • One or more drains may be placed into your incision to remove extra fluids from the surgery area. Your incision will be closed with stitches or surgical glue and covered with a bandage.

How Are Thyroid Nodules Treated

Surgeons

Treatment depends on the type of thyroid nodule. Treatment options include:

  • No treatment/”watchful waiting.” If the nodules are not cancerous, you and your doctor may decide that you dont need to be treated at this time. You will see your doctor on a regular basis so he or she can watch for any changes in the nodules.
  • Radioactive iodine. Your doctor may use radioactive iodine to treat hyperfunctioning thyroid nodules and goiters with several nodules. The radioactive iodine is absorbed into the thyroid gland, causing the nodules to shrink. Pregnant women and women trying to become pregnant should not have this treatment.
  • Surgery. Surgery to take out the nodules is the best treatment for nodules that are cancerous, cause “obstructive symptoms” , and are suspicious .

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Causes Of Thyroid Nodules

Thyroid nodules, masses in the thyroid gland, can be the result of benign cell overgrowth or actual discrete tumors comprised of thyroid cells that can be benign or cancerous.;;Thyroid nodules can sometimes contain fluid, which usually collects due to bleeding from the fragile blood vessels in thyroid tumors, so called cystic degeneration.;;This event sometimes causes the sudden onset of pain and swelling in the front of the neck, which typically subsides over several days.;;

Fortunately, more than 90% of thyroid nodules are not cancers, but malignancy should be considered in every affected person.;;Often patients with small thyroid nodules, less than 1 cm in diameter, and no risk factors for thyroid cancer can simply be reexamined or imaged by sonography to be sure the nodule is not enlarging.;;For larger nodules, additional studies are usually indicated, as described below.

When To Notify Our Office

You should call our office at 410-328-6187 if you experience the following symptoms:

  • Fever with a temperature higher than 101.5.
  • Difficulty swallowing
  • Increase in pain at the incision that is not relieved by pain medication
  • Increased swelling, redness, or drainage from the incision
  • Numbness or tingling of fingers, toes, or around the mouth.
  • Muscle cramps

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What Happens During A Thyroid Fine Needle Aspiration Biopsy

Some people, like children, might need a medicine to help them relax before the procedure. Most people will not need this, though.

In some cases, your healthcare provider might inject a local anesthetic to the area before inserting the needle. Because the needle is so small, this is often not necessary.

Your healthcare provider may perform the biopsy with the help of an ultrasound machine. This machine uses high-frequency sound waves to provide an ongoing image of the nodule. This enables your healthcare provider to guide the needle to exactly the right spot. It also prevents damage to other structures. A gel-like substance will be applied to your neck, where the ultrasound detector will be used.

After cleaning the area, your provider will insert the thin, fine needle into your thyroid gland. This may hurt a little. He or she will slowly advance the needle into the nodule itself, moving it back and forth several times.

The needle attaches to a syringe that can apply suction and remove some cells from the nodule. After the removal of the needle, these cells will be placed on a slide. Your healthcare provider might repeat this procedure a few times to obtain different samples from different parts of the nodule. Sometimes the lump will be all or mainly fluid. The fluid can be removed during the biopsy.

After the procedure, the cells will be sent to a pathology lab and analyzed for signs of cancer. A small bandage will be placed over the needle insertion site.

Within 30 Days Of Your Surgery

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Presurgical Testing

Before your surgery, youll have an appointment for presurgical testing . The date, time, and location will be printed on the appointment reminder from your surgeons office. Its helpful to bring the following things to your PST appointment:

  • A list of all the medications youre taking, including prescription and over-the-counter medications, patches, and creams.
  • Results of any tests done outside of MSK, such as a cardiac stress test, echocardiogram, or carotid doppler study.
  • The name and telephone number of your healthcare provider.

You can eat and take your usual medications the day of your appointment.

During your PST appointment, youll meet with a nurse practitioner . They work closely with anesthesiology staff . Your NP will review your medical and surgical history with you. You may have tests, such as an electrocardiogram to check your heart rhythm, a chest x-ray, blood tests, and any other tests needed to plan your care. Your NP may also recommend that you see other healthcare providers.

Your NP will talk with you about which medications you should take the morning of your surgery.

Identify your caregiver

Your caregiver plays an important role in your care. Before your surgery, you and your caregiver will learn about your surgery from your healthcare providers. After your surgery, your caregiver will take you home when youre discharged from the hospital. Theyll also help you care for yourself at home.

For caregivers

Exercise

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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.

Things You Should Know If You Have A Thyroidectomy

I’ve treated hundreds of thyroid patients in my clinical practice and I’ve run into many patients without a thyroid.;

These patients are certainly more difficult to treat than run of the mill thyroid patients but I’ve learned much in my years of treating them.;

While they are more difficult, it’s still possible to help them lose weight and feel better.;

It just takes the right approach…;

With that in mind, here are 5 things that I think you should know if you’ve had your thyroid removed based on THIS experience.;

#1. You are now HYPOTHYROID.;

This is probably the single most important thing that you understand if your thyroid has been removed.;

Once your thyroid is removed you are now considered to be HYPOTHYROID.;

It doesn’t matter WHY your thyroid was removed, once it is removed you now have a sluggish thyroid.;

I don’t care if your thyroid was removed because you WERE hyperthyroid .;

Thyroid removal is considered to be a cure for hyperthyroidism but once your thyroid is out you’ve effectively traded hyperthyroidism for hypothyroidism.;

What does it mean to be hypothyroid?

It means that you are reliant upon thyroid medication.;

And because doctors do a terrible job at replacing lost thyroid hormone once the thyroid has been removed, you will probably always feel a little bit hypothyroid .;

This is so important because many people will read my blog posts and if they’ve had their thyroid removed they will ask if it applies to them.;

#2. T4 isn’t enough by itself for you.;

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Complementary And Alternative Medicine

Some people try other therapies to cleanse the body, restore immune function, and balance the production and release of hormones. You should talk to your doctor if you’re interested in these other methods to make sure they won’t harm you or interfere with your treatment.

A naturopath may use homeopathic mixtures, herbs, preparations based on traditional Chinese medicine , and acupuncture to remove blocks to your ”life force energy.” Naturopaths are authorized to treat thyroid disease in some states, but in others, it’s illegal. While they may help with the stress associated with thyroid disease, there are no good studies showing that these therapies are effective for treating thyroid disorders.

Chiropractors use spinal manipulation to treat symptoms of thyroid disorders by easing muscle tension and improving blood circulation.

Radioactive Iodine For Hyperthyroidism

Whats behind low thyroid function?

Radioiodine, or RAI, is given as a pill, to treat hyperthyroidism by gradually shrinking your thyroidultimately destroying the gland. Yes, RAI is the same as radioactive iodine threapy, which was the formal medical term. It has been changed to lessen the scariness of sound of this therapy.

This thyroid treatment is much safer than it sounds; in fact, it is the most commonly used hyperthyroid treatment in the US. Unlike antithyroid medications, radioactive iodine is a permanent and more reliable cure for hyperthyroidism.

Radioiodine Ablation Radioactive iodine therapy can destroy all or part of the thyroid gland, depending on need. While there may be instances when you won’t need to have the entire thyroid gland rendered nonfunctional to alleviate your hyperthyroid symptoms, total destruction of the thyroid is most often necessary.

Your doctor may refer to it as radioactive iodine ablation .; This article will focus on what you might expect when you are faced with the total elimination of your thyroid gland and its key functions.

Graves disease, the most common form of hyperthyroidism, occurs most often in women, is treated with radioactive iodine, given as a pill. Photo: 123rf

In determining the best dose, the size of the thyroid gland and results of the uptake test are the two most important factors. The larger the gland, the larger the radioactive iodine dose. The higher the iodine uptake, the smaller the dose.

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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.

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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How Should I Be Evaluated Prior To The Operation

As for other operations, all patients considering thyroid surgery should be evaluated preoperatively with a thorough and detailed medical history and physical exam including cardiopulmonary evaluation. An electrocardiogram and a chest x-ray prior to surgery are often recommended for patients who are over 45 years of age or who are symptomatic from heart disease. Blood tests may be performed to determine if a bleeding disorder is present.

Importantly, any patient who has had a change in voice or who has had a previous neck operation and/or who has had a suspected invasive thyroid cancer should have their vocal cord function evaluated routinely before surgery. This is necessary to determine whether the recurrent laryngeal nerves that control the vocal cord muscles are functioning normally.

Finally, in rare cases, if medullary thyroid cancer is suspected, patients should be evaluated for endocrine tumors that occur as part of familial syndromes including adrenal tumors and enlarged parathyroid glands that produce excess parathyroid hormone .

What To Expect During Pediatric Thyroid Surgery

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In pediatric thyroid surgery, a sideways incision is made in the base of the neck at the natural skin crease. The muscles in front of the thyroid gland are pushed aside to expose the thyroid gland.

Care is made to avoid damage to the delicate recurrent laryngeal nerves which run in the groove between the trachea and the esophagus. These nerves look like a strand of angel hair pasta. They control the vocal cords and help protect the airway so food, liquid or other items do not enter the lungs. At Children’s Hospital of Philadelphia , we use a special nerve monitoring device in the operating room to identify, confirm, and monitor motor nerve function to help reduce the risk of injury to the nerve during the procedure.

An important part of surgery is the successful location of the parathyroid glands, four tiny pea-shaped glands, each the size of a grain of rice, that are located in the neck behind the thyroid gland two on top, two on the bottom. These glands share blood supply with the thyroid gland and produce a hormone that controls the amount of calcium in the blood. If they are damaged during surgery, the parathyroid gland can be temporarily or permanently shut down, resulting in lowered calcium levels.;

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