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WHAT YOU NEED TO KNOW:
What do I need to know about a total thyroidectomy?
A total thyroidectomy is surgery to remove all of your thyroid gland. Your thyroid gland makes hormones that control your metabolism, body temperature, and heart rate. Your thyroid gland is shaped like a butterfly. It is found in the front lower part of your neck. You may need a thyroidectomy if you have thyroid cancer or a growth on your thyroid. A growth that is not cancer can still become large enough to cause breathing problems. You may also need this surgery if you have hyperthyroidism. This means your thyroid creates too much thyroid hormone.
How do I prepare for a total thyroidectomy?
- Your healthcare provider will tell you how to prepare for surgery. You may be told not to eat or drink anything after midnight on the day of surgery. Your provider will tell you which medicines to take or not take on the day of surgery. Blood tests are used to check the amounts of calcium and thyroid hormone in your blood. You may be given antithyroid medicine to lower the amount of thyroid hormone made by your thyroid gland.
- You and your surgeon will decide the kind of surgery that is right for you. A thyroidectomy can be done in several ways. Your surgeon may make an incision in your lower neck. This is called a conventional thyroidectomy. An endoscopic surgery means small incisions are made in your neck. Tools and a small camera are put into the incisions. The camera helps your surgeon find the right area for surgery. A robotic surgery means incisions are made in your chest and armpit, or higher in your neck. Endoscopic and robotic surgeries leave smaller scars that are less visible.
- An ultrasound may be used to check your thyroid and areas near the thyroid. This will help guide your surgeon during surgery.
- 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.
- An MRI may be used to take pictures of your neck muscles, joints, bones, and blood vessels. You may be given contrast liquid to help the pictures show up better. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
- Laryngoscopy may be needed before and after your surgery. This test helps your healthcare provider know how well your larynx is working.
What will happen during a total thyroidectomy?
- General anesthesia is usually given before a total thyroidectomy. This medicine will keep you asleep and free from pain during surgery. You may instead be given local anesthesia to numb the area. You may feel some pressure during surgery, but you should not feel any pain.
- After one or more incisions are made, your surgeon 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 healthcare providers.
- 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 or surgical glue and covered with a bandage.
What will happen after a total thyroidectomy?
Tell your healthcare providers if you have difficulty breathing or swallowing. Tell them if your bandage feels like it is getting tighter. You will have blood tests to check your calcium and thyroid hormone blood levels.
- Thyroid hormone medicine will be given. You will need to continue taking this medicine to replace the hormone your thyroid would have produced. You may also be given pain medicine. Radioactive iodine may be given if your thyroid gland was removed because of cancer. This medicine may kill cancer cells that were not taken out during surgery.
- Deep breathing 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 your breath out. 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 your breath out.
What are the risks of a total thyroidectomy?
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 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.
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