For patients who suffer from chronic thyroid issues, large thyroid nodules, goiters or thyroid cancer, thyroid surgery may be something that they have to consider. Many of these patients have been given the option of thyroid surgery as a treatment for their condition. Below is your guide to thyroid surgery, giving you an insight into what the surgery is, how to prepare for it, and what you can expect after the surgery.
What Is Thyroid Surgery?
Understanding what is really happening when you undergo thyroid surgery is important. In our practice during this surgery, the patient is placed under general anesthesia usually at an outpatient surgical center during. Depending on the diagnosis that the particular patient is facing, they may have a hemithyroidectomy (half gland removal or lobectomy) or total thyroidectomy. Our surgeons only perform these thyroid procedures via minimally invasive options in usually 1-2 hours and patients leave for home 4-6 hours after the procedure is complete without drains to recover in the comfort of their own homes.
How Common Is Thyroid Surgery?
For the most experienced surgeons at C/V ENT Surgical Group, having a minimum of 25 or more thyroid surgeries annually means they are experienced in the field. For many surgeons, this is one of the more common surgeries on their operating tables throughout the year than others. Usually, general surgeons and head and neck surgeons/ENTs commonly perform these surgeries.
How Long Does Thyroid Surgery Take?
When you are undergoing thyroid surgery with an expert, it can take anywhere from one to two hours, depending on how much of the thyroid is being removed and how large or stuck down it is. If you have only one lobe removed, then the surgery is much shorter than those where both lobes are removed. Patients who have thyroid cancer and need to have both of the lobes and the lymph nodes removed will be in surgery for 1.5 to 3.0 hours usually with our expert surgeons at C/V.
How To Prepare For Thyroid Surgery?
Once you are scheduled for thyroid surgery, you should do a few things to make sure that you are properly prepared. In the days leading up to your surgery, you want to maintain a healthy diet and make sure to get lots of rest.
- Schedule a ride home after surgery as you will not be in any shape to drive.
- Check with your doctor before you take your prescribed medications and any OTC supplements you may be taking; stop all blood thinners prior to surgery according to your surgeon’s instructions.
- Do not eat or drink anything after midnight on the day of the surgery.
- Arrive at least two hours before your scheduled surgery so that you can be prepared in enough time before surgery begins.
It is important to go over all of these different components and any questions you may have from your doctor before you show up at the facility for surgery.
Morning of Surgery
Before you leave for the hospital, you can take a shower or bath. Make sure to use standard soap and warm water for your shower. You do not need to apply any perfume or lotion onto your body before surgery. Also, do not attempt to shave the area where the surgery will be. Allow the medical team to take care of this during the preparation stage.
How To Recover From Thyroid Surgery?
Most patients are amazed at the ease of recovery with minimally invasive thyroid surgery with one of our expert surgeons. Patients usually go home 4-6 hours after surgery and are able to talk, walk and eat the same day. They will experience a sore neck, sore throat and some voice changes for the first few weeks after surgery. Most patients are fully recovered in 1-2 weeks after surgery and return to work or school. Shorter recovery periods depend on how well you are maintaining your body once you are at home. Patients can shower the next day at home but are encouraged not to get the incision wet for 48 hours.
Once you start home from the surgical center, you are responsible for your recovery moving forward. You will need to monitor and maintain the following based upon your doctor’s recommendations:
- Incision Dressing
- Gradual Exercise
- Reduce Unhealthy Practices (i.e., smoking, drinking alcohol)
Your scar from the incision will start to heal and is often covered with steri-strips over the incision. It is there to prevent bacteria and infection and will start to fall off as the incision heals. Keep the area clean until you see your surgeon one week later and he removes the steri-strips. You can then begin to add topical scar treatment to the area to help with healing as instructed by your surgeon.
Your diet should be healthy and well-rounded so that you get all the nutrients and vitamins your body needs during this time of recovery. You want to avoid lots of sugars and processed food that redirect your body’s energy and could extend your recovery time.
When your body is trying to heal and work on a speedy recovery, rest is essential. It would be best if you got a full night’s sleep every night following the surgery. It is also essential to make sure that you are moving around and walking. While you will not feel like running a marathon after surgery, it is important to be mobile and build up your physical activity over your recovery period. No heavy lifting or bending or sweating for one week after surgery.
What To Expect After Thyroid Surgery?
While you are on your road to recovery after thyroid surgery, there are a few side effects you may experience early on after the surgery but will start to fade out as your body heals.
- Swallowing Difficulties
- Neck Pain
You may find that swallowing is not as easy right away, limiting your diet to soft foods until the swelling goes down and you can swallow comfortably. You may also notice that you are hoarse when you are trying to speak. This is not uncommon for those who have undergone thyroid surgery to experience. It’s best to avoid straining and yelling for two weeks after surgery. Also whispering should be avoided. The voice will gradually improve over months.
While your incision is healing, you will experience neck pain. In the beginning, it will be painful to move your neck around. With moderate stretches to your neck each day, you can keep your neck from getting stiff and speed up the recovery process. After the first two weeks, this pain will start to dull out, and you will not feel it by the time the standard six-week period after surgery is up. When you visit your doctor for a follow-up, the neck pain should be almost gone, if not already.
What To Eat After Thyroid Surgery
When you first come out of your thyroid surgery, swelling and attempting to swallow may be difficult. Your diet should be restricted simply due to texture and the ease of being able to eat. For the first day to two, you will want to eat soft foods that are easy to swallow. Softly cooked vegetables and nutrient-rich soups are great options because you can still maintain the nutrients and vitamins you need to stay healthy.
Most patients find chilled smoothies to be a great option for the days immediately after the surgery. The cooling temperature soothes the irritated area and vocal nerves. Also, adding lots of fruits and vegetables to these smoothies keeps your body healthy and getting the nutrients that it needs.
As the swelling goes down and swallowing becomes easier, you can start to transition your diet to more regular food options. You want to make sure that your diet is balanced and regularly maintains a healthy intake of fruits and vegetables.
How Much Does Thyroid Surgery Cost?
For most patients and facilities around, the cost of thyroid surgery ranges based on exactly what was removed and what treatments were associated with the surgery. Each practice and facility will have its own costs associated with the surgery. Depending on your health insurance and your deductible for your plan, the cost could be more or less than other patients. Usually costs out of pocket are less when these procedures are performed at surgical centers than hospitals.
Ensure that you reach out to your doctor’s office regarding the cost of this surgery and any payment options available for you, if necessary. They can give you a quote on your surgery and give you a real estimate of what you will owe after the surgery is complete.
Is Thyroid Surgery Outpatient?
With our surgeons it almost always is as we perform minimally invasive thyroid surgery with minimal recovery. However, if a patient has significant medical issues or needs extensive surgery, your surgeon may elect to have the procedure done at a hospital setting and may ask the patient to stay overnight.
Does Your Voice Change After Thyroid Surgery?
One of the first side effects that almost all patients experience immediately after thyroid surgery is their voice changes because the nerves get swollen and irritated during the surgery. While they are healing, your voice could reflect a different sound until you recover. Your voice will sound hoarse in most cases, just like it does when the nerves are irritated with laryngitis.
The voice changing is almost always temporary, but it could last beyond the standard 6-8 weeks for recovery. You will find these nerves take a longer time to heal and can last up to three to six months before your original voice starts to resurface when you speak. Any long-term voice changes are rare in these surgeries and are not a large difference in the voice.
How Long Does Hoarseness Last After Thyroid Surgery?
If you do have the hoarseness side effect after your thyroid surgery, it could last anywhere from two weeks after the surgery to three to six months after surgery. As time goes on and the nerves in your throat start to heal, the hoarseness will get better. You may wake up sounding normal but return to hoarseness by the end of the day. Hoarseness will come and go through the recovery process over the course of several weeks to months. This is about the nerves being weak and irritated. As the day goes on, your body continues the healing process; some days may be more irritated than others. If hoarseness lasts more than 6 months, then your physician may make various recommendations to improve it.
Do You Gain Weight After Thyroid Surgery?
Depending on how much of your thyroid was removed during the surgery will determine if medication will need to be taken for the duration of your life. With a half glad removal about 60-70% of patients will not need medication supplementation as the other side takes over. With total thyroidectomy 100% of patients will need medication after surgery. Once you get the right medication dosage and balance your hormones, the involuntary weight gain will start to subside. You will have your medication dosing coordinated by your endocrinologist or internist in most cases.
In most cases, this weight gain can be monitored and is much easier to avoid with a balanced diet. Maintain lean proteins and high amounts of vegetables in your diet to provide the nutrients your body needs. Make sure to take all medications prescribed by your doctor, especially if you had a total gland removal surgery. You will need this medication to function in place of your thyroid to maintain a healthy weight.
Does Thyroid Surgery Leave A Scar?
Like all surgeries that require an external incision, there is an initial scar from the incision made to remove some or all of your thyroid. Over time this scar will heal over 8 to 12 weeks and become barely noticeable if taken care of properly. For many patients, the scar will get so light over time that it is unrecognizable, especially if the scar treatment regimen and creams are followed.
When going out in the sun, however, you need to make sure that you place sunscreen and a cover over the scar for the first 6 months to avoid redness in the area. Any ultraviolet light that comes in contact with these incision scars will darken and can be noticeable. Most patients will either wear a scarf or a bandaid when going outside to cover the incision for the first 6 months.