Total Thyroidectomy

What you should know

A total thyroidectomy is surgery to remove your thyroid gland. Your thyroid gland makes hormones that regulate your metabolism, body temperature, heart rate, and the level of calcium in your blood. Your thyroid gland is shaped like a butterfly and found in the front lower part of your neck.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • You may bleed more than expected and need a blood transfusion. Your voice may be hoarse or weak after surgery, and this may become a long-term problem. Your neck may be bruised and swollen, and it may be hard for you to breathe or swallow. Your parathyroid glands may not work as well as they should after surgery. This can cause your calcium blood levels to drop too low. This may be a short-term problem after surgery, or it may be a long-term problem.

  • You may get a wound infection, which may become life-threatening. You may get a blood clot in your arm or leg. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke.

  • If you do not have surgery, your thyroid gland may keep growing, making it hard for you to breathe or swallow. If your thyroid has cancer, it could spread to other areas of your body. If a benign multinodular goiter is not treated, it could become cancer. Hyperthyroidism may make your heart beat too fast or it may not beat regularly, and this can lead to heart failure. It may also lead to low blood calcium levels and increased risk of bone fractures. You may have eye problems, such as double vision, eye tenderness, or bulging. If certain thyroid problems are not treated, they may become life-threatening.

Getting Ready

The week before your surgery:

  • Write down the correct date, time, and location of your surgery.

  • Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • Tell your caregiver if you know or think you might be pregnant.

  • Your caregiver may have you take antibiotic medicine before surgery. This may help prevent infections.

  • You may need to take antithyroid medicine to decrease the amount of hormone made by your thyroid gland.

  • You may need to donate blood before your surgery. Your blood is stored in case you need it during or after your surgery.

  • You may need a neck ultrasound, a thyroid scan, an MRI, a fine needle biopsy, or a laryngoscopy. These tests help caregivers learn more about your thyroid problem. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The night before your surgery:

Ask caregivers about directions for eating and drinking.

The day of your surgery:

  • Ask your caregiver before you take any medicine on the day of your surgery. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital. Caregivers will check that your medicines will not interact poorly with the medicine you need for surgery.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.

Treatment

What will happen:

Your surgeon will make an incision in your lower neck. He will remove your thyroid gland. If you have cancer, your surgeon may also remove the tissue and lymph nodes around your thyroid gland. If you are awake during surgery, you may be asked to speak to your caregivers. One or more drains may be placed into your incision to remove extra fluids from the surgery area. Your incision will be closed with stitches and covered with a bandage.

After surgery:

You will be taken to a room where you can rest until you are fully awake. Caregivers will monitor you closely. Do not try to get out of bed. When caregivers see that you are okay, you will be taken to your hospital room.

Contact a caregiver if

  • You cannot make it to your surgery.

  • You have a fever.

  • Your symptoms, such as weight loss, sweating, or muscle weakness, get worse.

  • You have questions or concerns about your surgery.

Seek Care Immediately if

  • You have shortness of breath or difficulty swallowing.

  • You have new or sudden chest pain.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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