Getting Ready For Your Surgery
You and your care team will work together to get ready for your surgery.
Help us keep you safe during your surgery by telling us if any of the following statements apply to you, even if you arent sure.
- I take a blood thinner, such as:
About drinking alcohol
The amount of alcohol you drink can affect you during and after your surgery. Its important to talk with your healthcare providers about how much alcohol you drink. This will help us plan your care.
- If you stop drinking alcohol suddenly, it can cause seizures, delirium, and death. If we know youre at risk for these complications, we can prescribe medications to help keep them from happening.
- If you drink alcohol regularly, you may be at risk for other complications during and after your surgery. These include bleeding, infections, heart problems, and a longer hospital stay.
Here are things you can do before your surgery to keep from having problems:
If you smoke, you can have breathing problems when you have surgery. Stopping even for a few days before surgery can help. Your healthcare provider will refer you to our Tobacco Treatment Program if you smoke. You can also reach the program by calling .
About sleep apnea
Please tell us if you have sleep apnea or if you think you might have it. If you use a breathing device for sleep apnea, bring it with you the day of your surgery.
Why Might I Need A Thyroidectomy
Hyperthyroidism can be the result of an autoimmune problem, too much iodine in the diet, a benign tumor in the pituitary gland, too much thyroid medication, a swelling in the thyroid gland or an inflammatory process.
Highlights Of Our Center
More Care, Fewer Visits
Coming back and forth to the doctor’s office for multiple appointments is a burden, which is why we work with you to coordinate efficient and effective visits. See multiple specialists, get blood work completed and even have a procedure all in a single appointment. For added convenience, we have both a Manhattan and a Westchester location, and we offer video visits which can be done from the comfort of your own home. Need to be seen soon? We also do same-day consultations. Just call to be seen by the next available doctor on our team.
Dedicated Patient Navigator
Our on-site patient navigator is here to help make sure your experience with us goes as smoothly as possible. Theyll help you prepare for your appointment, coordinate appointments with other specialists, clarify any insurance and billing concerns, and will always be available to make sure your questions are answered.
More Surgical Experience and Better Results
Comprehensive Thyroid Cancer Care
Our surgeons and endocrinologists work closely with oncologists, radiologists and other specialists to create personalized treatment plans for all forms of thyroid cancer, at any stage. We are proud to be part of Columbias Herbert Irving Comprehensive Cancer Center, one of only a few programs in the country to earn the National Cancer Institutes official comprehensive cancer center designation.
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What Are The Different Types Of Medical Degrees
There are two different types of medical degrees: a Doctor of Medicine and Doctor of Osteopathic Medicine .
A Doctor of Medicine focuses on the diagnosis and treatment of disease. An MD must attend med schools accredited by the Liaison Committee on Medical Education .
A Doctor of Osteopathic Medicine takes a more holistic approach to treating and preventing disease. This includes factors like natural healing and the patients entire ecosystem, such as environment, nutrition, etc. DO programs must be accredited by the The American Osteopathic Association Commission on Osteopathic College Accreditation .
Both kinds of degrees can specialize in a certain area.
Key Issues In Goiter & Thyroid Nodule
Whenever a person has a goiter or thyroid nodule, three questions must be answered.
Table 2. Key Issues to Evaluate in a Person with a Goiter or Thyroid Nodule
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Potential Complications & Side Effects Of Thyroid Surgery
As far as surgeries go, thyroid surgery is generally a very well tolerated operation which has a low incidence of complications.
The thyroid gland sits very close to the surface of the skin so it is relatively easy to get to without large or deep incisions.
Having said that, it’s worth exploring some of the potential consequences of thyroid surgery .
All in all, the risk of serious complications relating to thyroid surgery are typically less than 2%.
Is Tsh Over 25 Indicative Of Disease
1 in 10 of people with TSH values above 3.0 mIU/L has Hashimotos .
TSH itself, as a marker of disease is not enough. If you have any symptoms connected to thyroid, talk to your health provider and get the full thyroid blood work done. This is the best first step towards understanding the health of your thyroid.
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How Well It Works
Success of a thyroidectomy to remove thyroid cancer depends on the type of cancer and whether it has spread to other parts of the body. You may need follow-up treatment to help prevent the cancer from returning or to treat cancer that has spread.
If a large noncancerous nodule causes symptoms, such as pain or problems breathing or swallowing, surgery may help relieve symptoms. All or part of the thyroid gland may be removed. Surgery may also help relieve symptoms if other treatments, such as draining a cyst , have not worked. Surgery may also be an effective treatment if you have a thyroid nodule that makes too much thyroid hormone.
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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Why Do People Need Thyroid Surgery
The main reason why you would undergo thyroid surgery is that there is something wrong with your gland that can’t be fixed through other means.
In most cases, surgery, of any organ or tissue, is considered the last possible resort.
The best option is to try and fix whatever issue is happening in your body with other less invasive measures before you resort to simply “taking it out”.
But, even with the best intentions, it’s not always possible and you may ultimately require thyroid surgery.
But what conditions absolutely require that your thyroid be removed?
The most common condition that results in the removal of your thyroid gland is thyroid cancer or a high suspicion for cancerous cells in your thyroid gland .
Thyroid surgery is usually considered to be the single best therapy required to treat thyroid cancer.
Lastly, conditions that result in excessive thyroid hormone production may also necessitate the removal of your gland.
Conditions that fit into this category include hyperthyroidism, toxic nodules and Graves’ disease.
In most cases, your Doctor will not recommend thyroid surgery unless it is absolutely necessary!
But that doesn’t mean that you shouldn’t read more to learn and understand what is happening in your body.
You can read more about alternatives below.
What Questions Should I Ask My Doctor
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Thyroidectomy: Recovery And Next Steps
In some cases, patients return home the same day as the surgery, but somepeople spend the night in the hospital. There, the team can observe thepatient and monitor calcium levels in the blood.
When the thyroid gland is surgically removed, the body still requiresthyroid hormone to keep vital functions in balance.Thyroid hormone replacement therapyinvolves taking synthetic or naturally derived thyroid hormones in pillform.
For Best Thyroid Surgery Results Pick Doctor With 25
With commentary by senior author Julie Ann Sosa, MD, chief of endocrine surgery and leader of the Endocrine Neoplasia Diseases Group, Duke University.
Patients who need to have their thyroid gland removed, due to cancer or other conditions, should seek out a surgeon who performs more than 25 such operations each year, according to new research.
That will greatly reduce their risk of complications, according to the study findings. Patients whose surgeons did fewer than 25 thyroid removal surgeries a year were 1.5 times more likely to have complications, the researchers found.
The fewer surgeries, the higher the risks of complications. “If your doctor does, on average, just one total thyroidectomy a year, you have an 87% increase in the odds of sustaining a thyroid complication from your surgery compared to a patient who undergoes a thyroidectomy from a high-volume surgeon who performs 26 or more per year,” says Julie Ann Sosa, MD, senior author of the study, chief of endocrine surgery and leader of the neoplasia diseases group at Duke University, Durham, N.C. Complications can include bleeding and damage to the laryngeal nerve that can make it difficult to speak, breathe and swallow.
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What Will Be My Physical Restrictions Following Surgery
Most surgeons prefer that patients limit extreme physical activities following surgery for a few days or weeks. This is primarily to reduce the risk of a postoperative neck hematoma and breaking of stitches in the wound closure. These limitations are brief, usually followed by a quick transition back to unrestricted activity. Normal activity can begin on the first postoperative day. Vigorous sports, such as swimming, and activities that include heavy lifting should be delayed for at least ten days to 2 weeks.
What Type Of Thyroid Surgery Am I A Candidate For
Conventional thyroid surgery is done through an incision in the front of the neck. The size of the incision depends on factors such as how large your thyroid is and whether the surgeon needs to remove lymph nodes.
If your thyroid isnt very large, and no lymph nodes are involved, you may be a candidate for minimal-access surgery. Said Roman, We use a small incision, which minimizes the scar. The incision is directly over the thyroid, making it easy for the surgeon to access the gland.
Another approach is robot-assisted surgery. The surgeon controls a robotic system that directs the movements of small instruments inserted into an incision under your arm. Using the systems high-definition 3-D vision technology, the surgeon guides the instruments under your skin to your thyroid, avoiding a neck scar. Duke endocrine surgeon Dr. Michael Stang, MD, has extensive experience with this technique. Some patients are candidates for this procedure, as long as the thyroid isnt too big, said Stang. However, if its thyroid cancer and its too advanced or has spread beyond the thyroid, then a conventional surgical approach is best.
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What Is Involved With A Thyroidectomy
The patient is fully asleep during this procedure.An incision is made across the lower part of the central neck and layers of skin and muscle are lifted up to expose the thyroid gland underneath.
The thyroid tissue to be removed is then exposed, separated from its blood supply, and removed.
Drains are sometimes placed under the skin after the surgery to help drain any blood or fluid that might accumulate after the procedure. The muscle and skin layers are replaced and the surgical incision is then closed with sutures .
A hospital stay of about two to three days is required. During this time, thyroid hormone levels will be checked to make sure they are in the normal range.
Depending on the reason for the surgery and the amount of thyroid tissue removed, thyroid hormone medications may also be started at this time. Once the wound starts to heal and the stitches and drainage tubes can be removed, the patient may leave the hospital.
How Does A Doctor Check Your Thyroid
Doctors check your thyroid with blood tests and imaging. Blood tests look at levels of:
- Autoantibodies, which indicate Hashimoto’s or Graves’ disease
Imaging tests, especially for hyperthyroidism, may include an ultrasound, thyroid scan, or a radioactive iodine uptake test to identify thyroid nodules and see how active the gland is.
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.
Reasons For Thyroid Surgery
The most common reason for thyroid surgery is the presence of nodules or tumors on the thyroid gland. Most nodules are benign, but some can be cancerous or precancerous.
Even benign nodules can cause problems if they grow large enough to obstruct the throat, or if they stimulate the thyroid to overproduce hormones .
Graves disease causes the body to misidentify the thyroid gland as a foreign body and send antibodies to attack it. These antibodies inflame the thyroid, causing hormone overproduction.
Another reason for thyroid surgery is the swelling or enlargement of the thyroid gland. This is referred to as a goiter. Like large nodules, goiters can block the throat and interfere with eating, speaking, and breathing.
There are several different types of thyroid surgery. The most common are lobectomy, subtotal thyroidectomy, and total thyroidectomy.
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Hashimotos Disease And Hypothyroidism
The most common cause of hypothyroidism is Hashimotoâs disease. Itâs an autoimmune disorder, meaning that the bodyâs own immune system attacks the thyroid and causes inflammation. This prevents the thyroid from making enough hormones, causing hypothyroidism.
Hashimotoâs disease often runs in families, and it affects women more than men. People with other autoimmune diseases are also more likely to get Hashimotoâs disease.
What Type Of Doctor Does A Thyroidectomy
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