In this article:
- What is a thyroidectomy?
- Reasons to have thyroid surgery
- Types of thyroid surgery
- Preparing for thyroid surgery
- How is a thyroidectomy performed?
- What to know after thyroid surgery
- Caring for yourself at home
What is a thyroidectomy?
A thyroidectomy is a surgery to remove part or all of the thyroid gland. The thyroid is the small gland, shaped like a butterfly, at the base of your neck. As part of the endocrine system, the thyroid gland produces hormones that help regulate the body's metabolism in the form of blood pressure, blood temperature, and heart rate.
Reasons to have thyroid surgery
Reasons to have the thyroid gland removed might be if it gets too big, does not function properly, or develops a growth. Most growths on the thyroid gland are benign, but some may be cancerous or precancerous. Benign growths can also cause problems if they grow too large and obstruct the throat or stimulate hyperthyroidism.
Types of thyroid surgery
There are a few different types of thyroid surgery.
Lobectomy
With a lobectomy, the doctor removes about half of the thyroid gland. What remains of the thyroid will still keep some or all of its functions.
Subtotal thyroidectomy
With a subtotal thyroidectomy, the doctor leaves a small amount of thyroid tissue to preserve thyroid function. Some people who undergo this procedure develop hypothyroidism and require lifelong thyroid hormone replacement therapy.
Total thyroidectomy
A total thyroidectomy removes the entirety of the thyroid and the thyroid tissue. It seems to be the preferred procedure when surgery is required for Grave's disease or multi-nodular goiter, as it has the advantages of an immediate and permanent cure.
Preparing for surgery
Work closely with a trustworthy doctor to determine if thyroid surgery is the right decision for you. You want to understand precisely which procedure is planned, the risks and benefits, and all other options for treatment.
If you decide to go ahead, tell your doctors all the medicines and supplements that you take. They will be able to tell you which medications to take or stop before your surgery.
On the day of surgery, follow your doctor's instructions about when to stop eating and drinking. Take a bath or shower before arriving for surgery, and take off all jewelry, piercings, and contact lenses.
How is a thyroidectomy performed?
While you are asleep under anesthesia, the surgeon makes an incision over the thyroid gland to carefully remove all or part of the thyroid. The procedure will likely take about two hours or more.
After thyroid surgery
You will likely have a tube inserted during surgery to let the fluid drain out of the cut. This tube will probably get removed before you go home, and if not, you will return a few days after surgery. You may also have stitches in your incision, and your doctor will tell you if you need to come back to have them taken out.
Be sure that you have someone to drive you home as anesthesia and pain medicine make it unsafe for you to drive. Follow your doctor's specific instructions about recovering from your surgery. Follow-up care is a critical piece of your treatment and safety.
Once home, you may have some difficulty chewing or swallowing, and your voice will probably be hoarse. Generally, these problems get better within a few months, but it can take as long as a year. Everyone recovers at a different pace.
Paloma tip: Bring a travel pillow for after surgery!
Caring for yourself at home
Follow these steps to recover from your surgery as quickly as possible:
Incision care
- Follow your doctor's specific instructions, if given.
- Otherwise, after the first 24 hours, the general advice is to wash around the wound with clean water two times per day. Don't use hydrogen peroxide or alcohol.
Paloma tip: As your scar begins to heal, use sunscreen! Vitamin E may also improve the way your scar heals.
Hygiene
- Take regular showers unless you still have a drain near your incision or have been instructed differently by your doctor.
- If you have a drain, follow your doctor's care instructions.
Paloma tip: Get soft, cozy clothes that don't rub against your neck
Movement
- Avoid strenuous physical activity for at least three weeks after surgery or until your doctor says it's okay.
- Walk each day and increase your distance or time by a little bit each day. Walking boosts blood flow and helps prevent symptoms.
Sleep and stress
- Make sure to get enough sleep, which is essential to your recovery. Rest when you feel tired, and put two or three pillows under your head to keep it raised.
Paloma tip: Use ice while resting to help with swelling and pain relief.
Diet
- If it is painful to swallow, start with liquids, and then move onto soft foods. Avoid eating hard, scratchy, or acidic foods that can irritate the throat.
- It is common to have irregular bowel movements after surgery. You may want to try a fiber supplement to regulate your system. And if you have not had a bowel movement after a couple of days, talk to your doctor.
Paloma tip: Try warm bone broth for easy swallowing and nutrition
Medicines
- Ask your doctor when you can restart your medications.
- Take pain medicines (if prescribed) exactly as directed. Ask for different pain medication if the one prescribed is making you sick.
- Take antibiotics (if prescribed) exactly as directed. Do not stop taking them if you feel better; you need to take the full course of antibiotics for them to work correctly.
- Ask your doctor when it is safe to take aspirin (or another blood thinner) again.
After surgery, you may develop hypothyroidism. In this case, your doctor will prescribe thyroid hormone replacement medication to balance your hormone levels. It may take several blood tests and adjustments to find the best medicine and dosage for you.
Paloma tip: Get a pill crusher if it feels difficult to swallow.
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Risks of thyroid surgery
The most glaring risk of thyroid surgery is an adverse reaction to the anesthetic.
Otherwise, the two most common risks, though they rarely occur, are damage to the parathyroid glands (responsible for calcium levels in the body) or damage to the laryngeal nerves (connected to your vocal cords).
A 2009 study looked at nearly one thousand patients who underwent thyroidectomy between 1985 and 2005 to evaluate complication rates and recurrence rates. It determined that total thyroidectomy is safe and is associated with a very low incidence of disabilities.
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