The Right Surgeon Matters As Much As Having The Right Thyroid Procedure
Rick Y of Boston, Georgia, has had two bouts of thyroid cancer, leading to two surgeries, the most recent this past December. His first surgery, which he had four years ago, was done by a general surgeon, and in retrospect he wishes he had found a thyroid surgeon, someone who specializes in the kind of surgery he needed. He made a point of doing this for the second surgery.
He was much more informative and descriptive about what his plans were before and after my surgery, and he coordinated very closely with my endocrinologist leading up to the surgery, Rick says of his second surgeon.
Choosing the right doctor for your surgery is something that Amy Chen, MD, MPH, director of surgery and the Willard and Lillian Hackerman Professor of Otolaryngology, Head and Neck Surgery at Emory University in Atlanta, suggests you ask your primary care doctor to help you with this is a hard decision to make on your own.
You should ask for assurance that both your endocrinology or primary care doc and the surgery will be communicating with each other so are well understood, and that post-surgery follow-up is smooth and easy for you. Its important that you know that surgeon and endocrinologist are on the same page with the same plan, says Dr. Chen.
What Happens Right After The Procedure
You will need to recover under a doctors supervision for about a day after the procedure. The review is necessary for ensuring you dont experience any long-term damage in the treated area. You will also need to recover from the anesthesia that was utilized during the procedure. There is a chance you might be able to go back home on the same day after the surgery, although that would depend on the intensity of the process.
You may notice some irritation in the neck and throat area for up to three days on average. This is from the area recovering after not having enough air during the procedure. Any hoarseness or other concerns here will be brief, as the nerves will need a few days to recover.
Tips For Thyroid Surgery Recovery
Aug 17, 2015 | Thyroid
Thyroid surgery is a common and safe procedure. It is normal for patients undergoing any medical procedure to have questions or concerns about recovery and life after surgery. You can expect to receive specific instructions from your physician following your procedure, but answers to common questions regarding recovery of thyroid surgery include:
Typically speaking, recovery from thyroid surgery is relatively rapid and pain is normally manageable. With the partial removal of the thyroid gland you can expect to be discharged the same day and with a total thyroidectomy you can plan to stay overnight in the hospital. Pain is generally described as minimal to moderate lasting four to five days post-procedure. The chief complaints from patients post-surgery are fatigue, sore throat and soreness, all of which generally subside within a week or two.
Following the surgery steri-strips are placed over the incision site. These small strips of white tape help to protect the incision and should remain in place for 7 to 10 days. If they have not fallen off on their own, you may remove them after a week.
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Can You Live A Normal Life After Thyroid Removal
Most people return to their normal lives and usual activities within a few weeks after thyroidectomy. If you have cancer, surgery may be the only treatment you need. If surgery isnt expected to cure the cancer, you may need to have other therapy, such as radiation.
Youll likely have regular blood tests, depending on how much thyroid tissue you have left. You may also need to take thyroid hormone replacement to prevent complications. But most people are able to continue their usual routines with the adjustment of periodic lab tests and daily medication.
Life After Thyroid Cancer Surgery
Congrats! You have finished the most important step in your thyroid cancer treatment: surgery to remove the disease. Take a few deep breaths and relax. I want to walk you through what your life after thyroid cancer surgery will look like.
Since the 1970s, the incidence of thyroid cancer has doubled. Until recently, thyroid cancer was the fastest growing cancer in the United States, mainly due to our ability to detect these cancers so well . Thyroid cancer is the 5th most common cancer in women. Overall, the 5-year survival rate for people with thyroid cancer is 98%. The 5-year survival rate is almost 100% for papillary, follicular, and medullary thyroid cancers that have not spread outside of the thyroid gland .
The 5-year survival rate for papillary thyroid cancer that has only spread to lymph nodes or tissue in the neck is 99%. For follicular thyroid cancer that only involves the neck, the survival rate is 97%. If there is distant spread to other parts of the body , it is called metastatic disease. The 5-year survival rate for metastatic papillary thyroid cancer is 76%. For metastatic follicular thyroid cancer, the rate is 64%. Medullary and anaplastic thyroid cancers are very rare, making up only 3% of the thyroid cancer cases. They are more aggressive and tend to spread around and outside of the neck more often.
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Your Diet During Recovery
You can eat whatever you like after surgery. Try to eat healthy foods. You may find it hard to swallow at first. If so, it may be easier to drink liquids and eat soft foods such as pudding, gelatin, mashed potatoes, apple sauce, or yogurt.
Pain medicines can cause constipation. Eating high-fiber foods and drinking plenty of fluids will help make your stools softer. If this does not help, try using a fiber product. You can buy this at a drug store.
Key Components Of Differentiated* Thyroid Cancer Management
- Radioactive iodine ablation
- Dynamic Risk Stratification informed by ongoing surveillance with tumor markers and imaging
* Differentiated thyroid cancer includes Papillary, Follicular, and Hurthle cell thyroid cancer. Treatment for poorly differentiated, anaplastic, and medullary thyroid cancers are distinct and discussed separately.
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Temporary Or Permanent Hypoparathyroidism:
Surgery of the thyroid gland can cause injury of or accidental removal of a portion of the four parathyroid glands located at the back of the thyroid gland. The parathyroid glands produce parathyroid hormone that helps balance calcium and phosphorus in the kidneys and bones.
Injury to the parathyroid glands can lower the calcium levels in the body, causing hypocalcemia. Hypocalcemia can occur for a few weeks to months following the thyroid surgery and requires calcium supplements. In rare cases, it can be permanent.
Patients can have symptoms like:
- Muscle cramps and twitches
- Tingling and numbness in the hands, feet, or lips
- Headaches, anxiety, and depression
- Depression and difficulty in concentration
Pain Management At Home
Take NSAIDS like ibuprofen , naproxen or acetaminophen for the first 3-5 days as needed. Take medication as directed on the medication container. To prevent acetaminophen overdose, do not take acetaminophen when you are taking the pain reliever – Percocet – that was prescribed on your discharge from the hospital. They both contain acetaminophen. If you take the Percocet or any other narcotic – DO NOT drive a car or drink alcohol.
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Whats The Surgical Procedure Like For Thyroid Cancer
Before your surgery, your doctor will advise you to stop taking certain herbs, supplements, and medications that may cause bleeding, including aspirin. You will be asked to fast after midnight on the morning of your surgery.
Thyroid cancer surgery is done at a hospital. You will arrive early in the morning to check in, and a nurse will take your vitals. General anesthesia is also used to help put you to sleep.
During the procedure, a surgeon makes a small incision across the base of your neck, usually about 3 inches long .
In all, the surgery takes about 2 to 3 hours. You will then be placed in a recovery room where your vitals are monitored while you wake up from anesthesia.
In some cases, people who undergo thyroid surgery can go home the same day.
What Is The Thyroid
Your thyroid is a small, butterfly-shaped gland located at the front of your neck under your skin. Its a part of your endocrine system and controls many of your bodys important functions by producing and releasing certain hormones, which are often referred to as thyroid hormone.
Hormones are chemicals that coordinate different functions in your body by carrying messages through your blood to your organs, skin, muscles and other tissues. These signals tell your body what to do and when to do it.
Your thyroids main job is to control the speed of your metabolism , which is the process of how your body transforms the food you consume into energy. All of the cells in your body need energy to function.
There are two main parts of your thyroid: the two halves and the middle of the thyroid that connects the two lobes .
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How Long For Recovery After Thyroid Surgery
The thyroid is a gland present at the base of the neck, and appears like a butterfly, in shape. The thyroid gland produces hormones for regulation of metabolism. To treat the thyroid disorders such as cancer, a non-cancerous enlargement of thyroid or an overactive thyroid gland, thyroidectomy or thyroid surgery or removal of the gland is done. How much thyroid gland should be removed depends on the cause of thyroid surgery. In case the whole of the gland is removed during the surgery, the patient requires a daily treatment with thyroid hormone to replace its normal function. The recovery period after thyroid surgery in this case is different as it may take some more time to heal. The procedure is performed in a few hours.
After the surgery, the patient might experience sore throat and mild hoarseness which would go within a week or two. Painkiller medicine is given after the surgery to control the pain and discomfort. Taking care of the immediate symptoms help to fasten the recovery period after thyroid surgery.
What Not To Do When Recovering From Thyroid Surgery
- Lift heavy items for at least two weeks after the surgery. Physical stress can raise blood pressure, which in turn could force the cut open and cause bleeding. Try not to lift anything heavier than 10 pounds .
- Shower right after surgery. You should wait 48 hours after the thyroid surgery before taking a shower. Soaking or rubbing the incision site can keep it from healing properly.
- Smoke during the recovery period. Smoking affects your immune system, keeps your body from healing properly, and makes it more susceptible to infection.
- Drink alcohol while taking painkillers. Mixing alcohol with painkillers can be dangerous for your health. If you aren’t taking painkillers, avoid alcohol for at least 24 hours after the surgery.
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Why You Might Need Thyroid Surgery
The is an important gland located at the base of your neck. It looks a bit like a butterfly. Its main function is to control your metabolism, or the rate at which your body breaks down the calories you take in from food and drink in order to create energy to fuel your bodys wide range of daily functions.
Many things can cause your thyroid to stop working optimally, including certain chronic conditions, an injury, or a deficiency of certain nutrients in your diet . If you end up with too much or too little thyroid hormone circulating throughout your body, a range of symptoms can result. Its critical to address these symptoms as soon as you notice them and to work with your health care provider to treat the underlying cause.
With certain thyroid conditions, the best course of action is sometimes to remove the thyroid, either entirely or partially, in a procedure called a . There are four main reasons a thyroidectomy might be performed:
, a condition in which the thyroid is overactive, that to or , or thats caused by a potentially cancerous . is the top cause of hyperthyroidism and is also a common reason for thyroidectomies.
A nodule or cyst in the thyroid gland. Nodules and cysts may be biopsied to determine your risk for cancer. Whether or not there’s a risk of cancer based upon the biopsy results will ultimately help dictate whether surgery is performed and what sort of surgery is performed, Dr. Sharbel says.
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, such as many sports, 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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Purpose Of Thyroid Surgery
The purpose of thyroid surgery is to eradicate cancer or reduce the symptoms and impact of a thyroid condition.
Specific indications for thyroid surgery vary from surgeon to surgeon. That said, common ones include:
- A thyroid nodule that is suspicious for cancer or found to be cancerous
- A goiter or benign thyroid nodule that is large, increasing in size, and/or causing symptoms like discomfort or problems breathing or swallowing
- Toxic nodule, toxic multinodular goiter, or Graves’ disease
When thyroid surgery is being considered, various tests will be performed including a blood thyroid-stimulating hormone test and a blood calcium level. Thyroid ultrasound images and/or fine-needle aspiration biopsy reports will also be evaluated.
With a diagnosis of thyroid cancer, imaging tests like a computed tomography scan of the chest are generally performed to determine if the cancer has spread.
Since thyroid surgery may result in injury or trauma to the recurrent laryngeal nerve , some surgeons also perform a routine laryngoscopy to evaluate for any baseline vocal cord problems.
Overall, these tests help the surgeon confirm the need for surgery and guide their surgical approach or technique.
When thyroid surgery is scheduled, various pre-operative tests for medical and anesthesia clearance will need to be run.
Such tests include:
What You Need To Know
- Thyroid cancer, thyroid nodules and other conditions may require thyroidectomy.
- Once the thyroid gland is removed, the person takes replacement thyroid hormone to keep the bodys functions in balance.
- Thyroidectomy can be performed through an incision at the front of the neck, or through the mouth .
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Understanding The Process For A Thyroidectomy
The length of time to recover from the thyroidectomy depends on how the thyroid gland is removed. The process will vary in intensity, but it often includes a small incision in the neck area. Patients will likely require a drain under the incision in the neck area. The drain helps clear out fluid that might build up from the procedure. The drain will be removed the morning after the surgery.
Hoarseness And Voice Problems
After surgery, your voice may be hoarse or whispery, and it may feel tiring to talk. This is very common and expected during the first week or two after surgery. While around 1% of people may have damage to the nerves supplying the vocal cords, around 5% to 10% of people will have temporary symptoms due to irritation of the nerves during surgery or inflammation around the nerves afterward.
Symptoms usually improve in the first few weeks but may persist up to six months after surgery. While there is no specific treatment for this hoarseness, it’s helpful for your loved ones to be aware of the problem so that you don’t feel the need to talk loudly or more often than is comfortable. If the nerve was injured, more severe symptoms may be noted after surgery.
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Thyroid Stimulating Hormone Suppression
Following surgery, patients may be treated with thyroid hormone to provide physiologic hormone replacement and to sufficiently suppress pituitary gland secretion of thyroid stimulating hormone , which is a growth-promoting factor for many types of thyroid cancer. All patients treated with total thyroidectomy require thyroid hormone therapy with levothyroxine approximately 25% of patients treated with lobectomy require thyroid hormone therapy. Thyroid hormone replacement is usually provided as a daily oral pill called levothyroxine. Your endocrinologist will monitor blood tests, including a TSH level, to determine the optimal dose for managing your thyroid hormone balance and the recurrence risk of your thyroid cancer . In general, patients with more aggressive disease and higher risk of recurrence are initially managed with levothyroxine to suppress the TSH level , while patients with lower risk of recurrence and/or other health factors that would increase their risk from side effects are managed with a TSH in the lower half of the normal reference range . Levothyroxine thyroid hormone therapy and TSH suppression in thyroid cancer patients are individualized and change over time based upon the risk of disease recurrence.
Whats A Thyroidectomy And When Is It Needed
Youll receive general anesthesia and a skilled surgeon will make an incision in the front of your neck. Your surgeon will identify the thyroid gland and remove what’s needed to give you the best outcome possible. The amount of thyroid gland they need to remove depends on the reason for the surgery.
Your provider may recommend thyroid surgery for a number of conditions. The most common reasons for thyroidectomy include:
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