Surgery performed on the thyroid gland is known as a thyroidectomy. This usually involves removing all (a total thyroidectomy) or part (half – a Subtotal/Partial Thyroidectomy or quarter – Thyroid Lobectomy) of the thyroid. A thyroidectomy may be performed as treatment for thyroid cancer, when a goitre or nodule is causing problems or as a form of treatment for hyperthyroidism (it could be after trying radioactive iodine therapy and/or antithyroid drugs, with no success).
A total thyroidectomy is most common, and most commonly performed for thyroid cancer or hyperthyrodism.
Actual surgery to perform a thyroidectomy typically last a few hours at most and is pretty straight forward. You may need to stay a night or two in hospital, however. If you are having a thyroidectomy performed, check with your surgeon about any medications you are taking, and if you should stop taking any of these before the operation. You’ll also want to ask about eating and drinking prior to it, too. Thyroid surgery is most commonly performed with general anesthesia. To feel confident with your surgeon and minimise stress and anxiety, you may want to ask how many times they have done this operation and talk at great lengths about the operation and post-op care, too. Make sure you are fully happy to go ahead.
Mary Shomon explains that a total thyroidectomy has nearly a 100% chance of causing hypothyroidism, so, understandably, some surgeons prefer to perform a partial thyroidectomy whenever possible, as they believe that enough thyroid tissue can be left to prevent hypothyroidism and still produce enough thyroid hormones. However, the risk of developing hypothyroidism after a partial thyroidectomy is still quite high and many people find that having part of their thyroid left just isn’t enough to do the job.
Post surgery, you will be left with a 3-5 inch scar, and your surgeon will try to cut the skin so it is as least noticeable as possible.
Most surgeons use dissolvable stitches, but the non-absorbable stitches can cause less scarring, say some members of my Facebook group. If you have history of allergic skin reactions, you may also want to ask your doctor about using hypoallergenic material. Mary Shomon explains that before you are discharged, your incision is usually covered with a clear protective waterproof glue called colloidium, which allows you to bathe or shower after the surgery. This should come off within a week or so, on its own. You may notice some swelling or bruising around your incision, and this is expected, but excess swelling or bleeding must be reported to a doctor straight away. Any signs of infection must also be reported ASAP.
As expected, you may experience some short-term pain and neck stiffness after surgery; eating and drinking may be difficult or uncomfortable. As already explained, a lot of people become hypothyroid after a thyroidectomy, and require thyroid hormone medication for life, so you’ll need to have regular full thyroid panels to monitor this.
You’ll be expected to need one to two weeks to recuperate after the surgery, so expect to book some time off work. You’ll also need to return for a follow-up appointment to talk to your surgeon/doctor about how you’re doing, post-op. Make sure to raise any concerns here, especially about monitoring your thyroid levels going forward.
While complications are not common, there are a few:
- Hypoparathyroidism and hypocalcemia – A diminished concentration of parathyroid hormone in the blood, which causes deficiencies of calcium and phosphorus compounds in the blood and results in muscular spasms.
- Laryngeal nerve damage – Injury to the recurrent laryngeal nerves can result in a weakened voice (hoarseness) or loss of voice (aphonia) and cause problems in the respiratory tract.
Signs can include numbness and tingling around your lips, hands, and the bottom of your feet, muscle cramps and spasms, bad headaches, anxiety, depression, hoarseness, and difficulty speaking loudly. You can read more about it in Complications After Thyroid Surgery.
Adrenal fatigue seems to affect some people after this surgery, as explained by STTM, so you should also monitor yourself for signs and symptoms of this, and complete a 24 hour saliva test if you suspect you could have it.
You can click on the hyperlinks in the above post to learn more and see references to information given, but more reading and references can also be found at:
Rachel, The Invisible Hypothyroidism
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