A thyroidectomy is most often performed by a general surgeon; however, there are times an otolaryngologist may be called in to perform the surgery. Done under general anesthesia, the surgeon makes a small cut in the front part of the neck. He takes extra care while making this incision: he must avoid damaging the laryngeal nerves as well as the parathyroid glands. Once the surgeon locates the thyroid glands he will clamp off the blood supply and remove all or just a part of the gland. How much is removed depends upon what thyroid disease each patient has. Normally if there is cancer present the whole thyroid gland is removed, otherwise just small portions may be removed for further examination. Before the doctor stitches you up, a soft plastic tube may be inserted in the incision to help drain any fluids that may collect in the wound area. Then the doctor will either stitch you up the old fashioned way, or use staples, metal clips, or medical glue. A large bandage then covers both the drain and the incision.
Recovery time depends upon what type of thyroid surgery one has. The less invasive the procedure, the less time is spent in the hospital and recuperation. People who undergo a partial thyroidectomy may only spend a day or so in the hospital, and another 2 weeks recovering at home. However, everyone heals differently, so saying that “you will be better in two weeks” may not be the correct answer for all patients. You know your body best, take time to recover, but do increase your activities as soon as you feel you can do so safely.
Most surgeries come with risks of developing complications, thyroidectomies are no different. Complications are very rare, but they do happen and can include laryngeal nerve damage, hypocalcemia, and hypoparathyroidism. The signs and symptoms of these conditions can include, bad headaches, muscles spasms and cramps, tingling and numbness in and around your hands, feet, and lips, hoarseness, trouble talking much above a whisper, anxiety, and depression.
After surgery you are moved to the recovery room, where the nurses can keep an eye on you until you can be moved to your room. You will have an IV line in your arm that constantly supplies you with needed medications. You will be on a liquid diet for a while. The nurses will monitor you closely for any drops in your calcium levels, as low calcium is a very common reaction after a thyroidectomy. Your voice may sound a bit hoarse and raspy, and you might have some pain and trouble swallowing for a few days post surgery – this is also normal. Your doctor may have closed your incision in a number of ways, and covered it well with clean dressings. You will be shown how to change these bandages in case you need to continue to do so once you return home. Over the next two to four days you will get up and walk, start eating normal meals again, and go to the bathroom alone. Once you have accomplished all three tasks, the doctor will release you from the hospital.
You will have neck pain and a weak or croaking voice. This does not mean that there has been permanent damage done to your vocal cords. During surgery an endotracheal tube (breathing tube) is inserted into the trachea, this will cause your throat to feel sore. Sometimes there can be a bit of nerve irritation from the surgery. Most of these are normal post-op symptoms for most patients who undergo a thyroidectomy.
If the thyroidectomy was not performed due to cancer, thyroid replacement hormones are given right after surgery. Patients with cancerous thyroids will be evaluated over the course of the next weeks to see exactly what dosage of medicine they are going to need.
Hormone replacement pills are tiny and easy to swallow. Your doctor will want regular blood tests done in order to keep a close eye on your hormone levels. Your thyroxine dosage may go up and down until your levels are in the normal ranges.
Will I Need To Take Vitamin D?
If you have low levels of calcium due to your thyroid condition then you will probably have to take calcium and/or vitamin D tablets, capsules or pills. Your doctor will always check your vitamin D levels when he checks your thyroxine levels. Fortunately, most calcium supplements now have vitamin D added to them; this not only allows for both to be better absorbed by the body, but you only have to take one pill.
Most doctors recommend that you rest and recuperate for at least a week to two weeks; this means no going back to work or resuming most of your normal activities. Before resuming your normal life you should be able to turn your head in a normal manner, without any trouble or pain hindering these movements. Do not begin any post-surgery activities until you clear it with your doctor. You might feel up to doing some things within a week, and not be scheduled for a post-op appointment for a couple weeks longer. Call your doctor and get his okay in order not to cause yourself further complications.