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.;
Will This Be Outpatient Surgery Or Will I Be Hospitalized
Depending on the extent of the surgery and your health status, you may have thyroid surgery as an outpatient, or you may be hospitalized for one or more days after surgery. The issue of whether outpatient thyroidectomy is as safe as hospitalization is controversial, and is worth discussion with your surgeon. In particular, if you are discharged soon after surgery, have a plan in place to deal with any post-operative complications such as bleeding, infection, or hypoparathyroidism.
When To Seek Medical Attention
- Fever or chills
- Warmth, or increased redness/swelling/discomfort around your incision site
- Discharge from your incision site
- Numbness and tingling around your lips, fingers, or toes
If you experience signs of bleeding in your neck, such as trouble breathing, a high-pitched voice, or increasing swelling in your neck, seek emergency medical attention.
Are There Any Alternatives To Thyroid Surgery For My Thyroid Cancer
If you have a low-risk, small , slow-growing papillary thyroid cancer, experts now recommend active surveillance also known as watchful waiting instead of surgery. John C. Morris, III, M.D., is a Rochester, Minnesota-based endocrinologist at the Mayo Clinics division of Endocrinology, Diabetes, Metabolism, and Nutrition. He has said that If the thyroid cancer is not dangerous and wont cause a problem, we can argue that any treatment is more than is actually needed.
Everything You Need To Know About Thyroid Surgery
You may not think much about your thyroid, but if youre having problems, youll know. The thyroid is responsible for hormones that regulate a variety of conditions and actions in the body, and thyroid issues may be more common than you think.
In some cases, surgery is required to help heal issues with the thyroid, and that can be a scary thought. Surgery isnt without risk, but with the right knowledge, youll be able to proceed with more confidence.
If your medical professional has recommended surgery, theres no need to worry. We have everything you need to know right here, so youll be informed and ready.
Lets take a look at the process from start to finish.
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Removing Your Thyroid Gland
Thyroid surgery is done through an incision in the lower part of the front of your neck. It takes about 2 to 3 hours.
During your surgery, your surgeon will examine your whole thyroid gland and remove the parts that have cancer. Theyll also check the lymph nodes next to your thyroid gland and remove any that have or might have cancer cells.
- If half of your thyroid is removed, its called a lobectomy or hemi-thyroidectomy.
- If your whole thyroid is removed, its called a total thyroidectomy.
Your surgeon will talk with you before your surgery so you know what to expect.
There are 2 nerves very close to your thyroid gland that help your larynx work. These nerves are called the recurrent laryngeal nerve and the superior laryngeal nerve. They may be affected during your thyroid surgery.
- Your recurrent laryngeal nerve goes behind your thyroid to your voice box. If your tumor is close to this nerve or this nerve is injured during your surgery, your vocal cords could be damaged. This can make your voice hoarse. Voice hoarseness is common after thyroid surgery and usually goes away with time.
- Your superior laryngeal nerve helps you raise the volume and pitch of your voice. If this nerve gets weak or injured, the pitch and tone of your voice can be affected. This may make it hard for you to raise your voice or sing.
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.
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What Is A Thyroidectomy
There are different kinds of thyroid surgery, and the type chosen depends on the reason you are having it done:
- Total or near-total thyroidectomy: This involves the removal of all or most of the thyroid gland. This surgery is often indicated for large thyroid cancers, large goiters, and Graves’ disease.
- Hemithyroidectomy or thyroid lobectomy: This involves the removal of one of the two lobes of the thyroid gland. This option may be indicated if a thyroid nodule is small and localized to one side of the thyroid gland.
- Isthmusectomy: This involves the removal of the isthmus, the bridge of tissue that crosses over the middle of your trachea and sits between the two thyroid lobes. This surgery is reserved for the removal of small tumors located in the isthmus itself.
Regardless of the type, thyroid surgery is typically a scheduled inpatient procedure performed in a hospital. Less commonly, it may be performed on an outpatient basis in a surgical center.
Research suggests that in the right circumstancesfor example, the patient has support at home during recovery and lives within a reasonable distance from a hospitaloutpatient thyroid surgery may be just as safe as inpatient thyroid surgery.
Why Is A Thyroidectomy Performed
Your doctor may recommend a thyroidectomy to treat a variety of diseases, disorders and conditions of the thyroid. Your doctor may only consider a thyroidectomy for you if other treatment options with less risk of complications have been ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion before having a thyroidectomy.;
Your doctor may recommend a thyroidectomy for:
Benign thyroid tumors, nodules or cysts
or an enlarged thyroid gland. Surgery may be recommended for a goiter that interferes with breathing and swallowing.
when radioactive iodine and medications are not options
Thyrotoxicosis, also called thyroid crisis or thyroid storm, is a sudden worsening of hyperthyroidism that can be life threatening.
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What Is Thyroid Surgery
Understanding what is really happening when you undergo thyroid surgery is important. In our practice during this surgery, the patient is placed under general anesthesia usually at an outpatient surgical center during. Depending on the diagnosis that the particular patient is facing, they may have a hemithyroidectomy or total thyroidectomy. Our surgeons only perform these thyroid procedures via minimally invasive options in usually 1-2 hours and patients leave for home 4-6 hours after the procedure is complete without drains to recover in the comfort of their own homes.
Things You Need To Know Before Your Thyroid Surgery Procedure
Monday, August 10th, 2015 | Written by Premier Surgical Staff
The thyroid is an important gland in your body producing a hormone responsible for regulating many body functions. The gland has a left and right side as well as a middle section known as the isthmus. Just as with any other part of the body, things can go awry in this gland requiring a surgical procedure of the partial or full removal of the gland. If a thyroid surgical procedure is in your future, here are some common questions and things you need to know:
Why would a patient require thyroid surgery?
There are a number of reasons someone may require thyroid surgery. The most common of which includes the presence of thyroid nodules. Thyroid nodules of 3 cm or greater or those with rapid charted growth normally require surgery. In addition, those with suspicious cell types as identified through needle biopsy or nodules identified as malignant, are cause for thyroid surgery. Hyperthyroidism that does not respond to medicine may also be grounds for thyroid surgery. During the procedure, a surgeon will remove part or all of the thyroid gland.
What makes an ideal candidate for thyroid surgery?
Generally speaking, most people are acceptable candidates for thyroid surgery. Characteristics that would present concerns in qualifying for the procedure include individuals of advanced age, numerous other medical conditions, previous neck surgery, or previous neck radiation.
How do I prepare for thyroid surgery?
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How Long Does Hoarseness Last After Thyroid Surgery
If you do have the hoarseness side effect after your thyroid surgery, it could last anywhere from two weeks after the surgery to three to six months after surgery. As time goes on and the nerves in your throat start to heal, the hoarseness will get better. You may wake up sounding normal but return to hoarseness by the end of the day. Hoarseness will come and go through the recovery process over the course of several weeks to months. This is about the nerves being weak and irritated. As the day goes on, your body continues the healing process; some days may be more irritated than others. ;;If hoarseness lasts more than 6 months, then your physician may make various recommendations to improve it.
Recovery After Thyroid Removal Surgery
Thevast majority can resume their regular activities the day after thyroid removalsurgery with few precautions such as avoid physical exercises or sports for acouple of days or weeks, or until surgeon recommend to begin.
An individualwill probably have a sore or sensitive throat for a couple of days.Over-the-counter pain relievers, for example, acetaminophen or ibuprofen, mayreduce the pain. In the event that the pain is unbearable and sever, you needto contact your surgeon immediately.
Post-surgery,the surgeon may screen your thyroid hormone and calcium levels to examine forhypothyroidism or hypoparathyroidism.
An individual shouldconsult with their surgeon if experiences dryness in their voice or trouble breathing.
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Endometrial Bladder Urethral Venous Ablation
Endometrial, bladder, urethral, and venous ablations are similar to cardiac ablation in that where you have the procedure done and how long you stay will depend largely on the extent of the procedure and the type of anesthesia used. If you require general anesthesia or have complications during your surgery, you may have to stay in the hospital for an extra day or two.
In some cases, these procedures can be done with minimal or local anesthetic, and may even take place in your doctors office. This is particularly true for superficial or surface ablation procedures that are meant to fix minor imperfections or even out skin coloring.
Thyroid Lobectomy Surgical Removal Of Half Of The Thyroid Gland
Removal of one half of the thyroid gland is called a thyroid lobectomy. Importantly, all of the critical structures other than the thyroid are left behind and undamaged, including both parathyroid glands and the nerves that provide movement and sensation and tightening to the voice box. The lymph nodes along the side and beneath the thyroid gland are also examined during a thyroid lobectomy to make sure that they are not cancerous as well . Editors note: A thyroid lobectomy is generally not recommended when there are nodules present in both sides of the thyroid gland .
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How Long Does Thyroid Surgery Take
To remove the entire Thyroid, your surgeon may need three to four hours to complete the surgery.
Partial Thyroidectomies take less time, but it will all vary depending on your particular set of circumstances and any complications that arise. Its not a quick surgery, but certainly faster than many other major types of surgery.
You Can Never Ask Too Many Questions But You Can Ask Too Few
Actually, people often have their vocal strength back quickly, but doctors often do not think to talk about changes in pitch that can occur. Someone who has been singing in the church choir as a soprano may end up as an alto after a thyroidectomy, says Dr. Chen. And, this is likely not to change back.
Like Rick, Dr. Oltmann has had to face two surgeries, and now with medical training, she wishes that she had asked more questions before agreeing to have both of the procedures. Its important to ask questions if something youre been told doesnt make sense, she says, and, you should feel ok asking if there are other optionsboth surgical and non-surgical treatmentsthat might work just as well for you, or even if the need for surgery can be avoided for months or even years.
If there is something causing you to hesitate or worry, its a really good idea to seek out a second opinion. And while your first reaction might be, take it out, now, know that the word cancer doesnt always mean you need to rush to surgery, particularly with most types of thyroid tumors. In fact, with this type of cancer, you are likely to have plenty of time to plan for a second opinion, to get support systems into place, and to find a high-volume surgeon with plenty of time to spare before deciding to have your thyroid gland removed, she says.
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Can You Talk After Thyroid Surgery
Some people experience issues with their vocal cords directly after surgery. With anesthesia that puts you under, a breathing tube is inserted into your throat to help regulate your breathing and ensure as few complications. The breathing tube can irritate your throat, causing hoarseness for a few days.
Some people may also experience weakness in their vocal cords, but this isnt permanent. Incisions, breathing tubes, and anesthesia may cause temporary effects with your vocal cords themselves, but with rest and time, your voice will come back.
A very small number of people may experience complications during surgery because of damage to the nerves that attach to the vocal cords. If this is the case, your medical professional will work with you to find a solution to whats happened and restore normalcy if possible. This is a highly rare occurrence, however.
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.
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What Type Of Surgery Will Be Performed
Ask your surgeon how the surgery will be performed. Traditional thyroid surgery involves an incision in the neck taking care to place the incision in a neck fold to minimize the scars visibility. If your surgery is not for thyroid cancer, however, you may be a candidate for robotic axillary surgery. According to Duke Health endocrine surgeon Michael Stang, M.D.: Some patients are candidates for this procedure, as long as the thyroid isnt too big.
What Will Happen In Surgery
You will be given general anesthesia to put you to sleep.;You are positioned with special pillows under your neck to tilt your head back.;An incision is made at the base of your neck and is about three to four inches long.;Using magnifying lenses, the surgeon locates the thyroid gland and associated structures and all or part of the thyroid is removed.;In some cases additional surgery will involve removal of lymph nodes and other structures. The incision is stitched closed and is then covered with steri-strip tapes and a dry gauze dressing.;The operation generally lasts from two to three hours.;After surgery, you will stay in the recovery room for several hours.;You will be monitored closely as you recover from the anesthesia.
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.