Do you have to have a thyroid operation? (Thyroidectomy) - Let's learn about this without fear

Has the doctor told you that you need to have an operation to remove your thyroid gland ? It is very normal to feel a little scared and anxious when you hear that. But in fact, this is a surgery that is performed by many people in Sri Lanka and all over the world, and it usually ends very successfully. So there is no reason to be afraid. Let us talk about this thyroid surgery , or `(Thyroidectomy)`, in a simple way that you can understand.

What is thyroidectomy?

Simply put, a thyroidectomy is the surgical removal of all or part of the thyroid gland, a butterfly-shaped gland in your neck. This gland produces many important hormones that control your body's metabolism .

There are two main types of this surgery:

• Total Thyroidectomy: This is where your entire thyroid gland is removed.
• Partial Thyroidectomy/Hemithyroidectomy: This involves removing only the right or left lobe of the gland.

The type of surgery you need will depend on your condition. Your doctor and surgeon will work together to decide what is best for you.

Why do you need thyroid surgery?

There are several reasons why a doctor might suggest you have this surgery. Let's look at the main reasons.

What should you do before surgery? (Preparation)

Before the operation, your doctor will clearly explain what you need to do. This is usually what happens:

• Tests: An ultrasound scan of your neck can help pinpoint the exact location of the lump. If there is a lump, a fine needle aspiration may be done to determine if it is cancerous.
• Voice testing: Your doctor may check how your vocal cords are functioning.
• Medication Management: If your thyroid hormone levels are very high, you may be given medication to control them before surgery. If you are taking any other medications, such as blood thinners, you should definitely tell your doctor about them. He or she will tell you whether or not you need to stop taking those medications before surgery.
• Fasting: You will be asked to abstain from eating or drinking for a few hours before surgery. You will be given specific instructions regarding these times.

What happens on the day of the operation?

An anesthesiologist will first come and give you general anesthesia , which puts you completely asleep. So you won't feel any pain. A breathing tube will be placed down your throat to help you breathe during the surgery.

The surgeon has several ways to remove the thyroid gland:

• Traditional method: Surgery is performed through a small incision in the front of the neck.
• Mini-incision technique (MIVAT): The surgery is performed through a very small incision with the help of a camera.
• Methods that leave no scars: The surgery is performed by making an incision in an inconspicuous place, such as inside the mouth or in the armpit.

If you are having surgery for cancer, your doctor will examine the lymph nodes around your thyroid and may remove them if cancer cells have spread. After the surgery, the incision is closed with a dissolvable suture and a special glue is applied to the skin. It usually takes 1-3 hours to remove the entire gland.

Are there any risks to this surgery?

Thyroidectomy is a very safe surgery . However, like any major surgery, there are some very rare risks.

• Bleeding: Excessive bleeding can cause difficulty breathing.
• Voice changes: If there is any damage to the vocal cords, the voice may become hoarse.
• Damage to the parathyroid glands: Attached to the back of the thyroid gland are four very small glands called the parathyroid glands. These are responsible for controlling the calcium levels in our body. If these are damaged during surgery, the calcium levels in the blood can drop.

What happens after the operation? (Recovery)

After the anesthesia, when you regain consciousness, you can have a light meal and drink. You will usually stay in the hospital for about one night.

• Sore throat: Your throat may be a little sore for a day or two because the breathing tube was in place.
• Hormone pills: If your entire thyroid gland is removed, you will need to take a hormone pill (Levothyroxine) every day for the rest of your life to replace the hormone it produced. This is very simple. Your doctor will explain this to you in advance.
• Calcium tablets: Sometimes calcium tablets are prescribed for a few weeks to prevent low blood calcium levels.
• Recovery and Scarring: It takes about 2-3 weeks to fully recover. It is best to avoid strenuous exercise or heavy lifting for a week or two. A small scar will remain on the neck. This will gradually fade over time.

When do you need to talk to the doctor?

If you experience any of the following symptoms after returning home from surgery, call your doctor immediately.

It's normal to feel nervous about any surgery. But thyroid surgery is a safe and successful procedure for most people. If you have any questions or concerns, don't be afraid to ask your doctor.