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WHAT YOU NEED TO 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.
WHILE YOU ARE HERE:
is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
Before your surgery:
- Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
- 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.
- Neck ultrasound: An ultrasound uses sound waves to show pictures on a monitor. An ultrasound may be done to show the inside of your neck.
- A thyroid scan may show how well your thyroid is working. You may be given contrast liquid to help the pictures show up better. Tell a healthcare provider if you have ever had an allergic reaction to contrast liquid.
- MRI: This scan uses powerful magnets and a computer to take pictures of your neck muscles, joints, bones, and blood vessels. You may be given dye to help the pictures show up better. Tell the caregiver if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the caregiver if you have any metal in or on your body.
- Fine needle aspiration: This test is also called a FNA or fine needle biopsy. It is used to collect fluid or take tissue samples from a cyst, lump, or mass.
- Laryngoscopy: You may have this test before and after your surgery. This test helps your caregiver know how well your larynx is working.
- Antithyroid medicine: This medicine decreases the amount of thyroid hormone made by your thyroid gland.
- Anesthesia: This is medicine to make you comfortable during the surgery. Caregivers work with you to decide which anesthesia is best for you.
- General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.
- Local or monitored anesthesia: Anesthesia is medicine that keeps you from feeling pain during surgery or a procedure. Local anesthesia is a shot of numbing medicine put into the skin where you will have surgery. You will be fully awake during the surgery or procedure. You may feel pressure or pushing, but you will not feel pain. Monitored anesthesia means you will also be given medicine through an IV. This medicine keeps you comfortable, relaxed, and drowsy during the surgery or procedure.
During your surgery:
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 your surgery:
You will be taken to a room to rest until you are fully awake. Caregivers will monitor you closely for any problems. A caregiver may remove your bandage soon after surgery to check for swelling, redness, and drainage. Tell your caregivers if you have difficulty breathing or swallowing. Tell them if your bandage feels like it gets tighter. Do not get out of bed until your caregiver says it is okay. When your caregiver sees that you are okay, you will be taken to your hospital room. You will have blood tests to check your calcium and thyroid hormone blood levels. You may be given calcium through an IV placed in your arm or as a pill.
- Deep breathing: This helps open air passages and prevent a lung infection. Slowly take a deep breath and hold the breath as long as you can. Then let out your breath. Take 10 deep breaths in a row every hour while awake. You may be asked to use an incentive spirometer to help you with this. Put the plastic piece into your mouth and slowly take a breath as deep and as long as you can. Hold it as long as you can. Then, let out your breath.
- You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.
- Drains: These are thin rubber tubes put into your skin to drain fluid from around your incision. The drains are taken out when the incision stops draining.
- Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.
- Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
- Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
- Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
- Thyroid hormone: You are given this medicine to bring your thyroid hormone level back to normal.
- Radioactive iodine: If your thyroid gland was removed because of cancer, you may need radioactive iodine treatments. This medicine may kill cancer cells that were not taken out during surgery.
- 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.
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.
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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.