Questions to ask about thyroidectomy?

kats3boys

I have my doctor's appt ( surgical specialist) tomorrow. I have done the family doctor, two endos, biopsies and been a general lab rat since Sept. I trust the surgeon under advice from my GP as he says he only knows 2 surgeons that he would trust and has sent me to the one with the most experience out of the two.

What questions should I ask?
What can I expect?
How about things like time in hospital/ time off work etc?

islandmonkey

My usual advice is to ask specifically how many thyroidectomies the surgeon does annually - the number of surgeries they have done directly correlates to a reduced risk of complications. Just because they're a good surgeon doesn't mean they're good at thyroidectomies - there is tissue near your carotid, and often around your vocal cords.

I found my surgeon a little unrealistic about time off work, recovery etc. My surgery was a Tuesday and I took 2 weeks off, then worked shorter weeks the 3rd. I probably could have done work sooner, but it's mostly on the computer and it was uncomfortable to sit for too long. One woman I talked to was back to running after 10 days, but I think that's a bit unusual. I found it uncomfortable to drive for the first 3 weeks after because I couldn't properly turn my head all the way. If you have any calcium and/or parathyroid issues you could be in hospital longer.

The first night after surgery was really uncomfortable. I was in pain, on morphine, and getting bouts of nausea (all normal). By the next evening I was at home and took 1-2 tylenol 3s, and after that I only took a regular tylenol now and then. The incision itself wasn't too bad after the first few days, but the portion above (where the essentially burn out the thyroid tissue) was VERY tender for 1-2 weeks.

My throat was sore, and my voice was really, really quiet for at least a week after. Don't panic, that's just from the intubation.

I'm almost 5 months post-surgery and still feel a tiny bit of tugging when I swallow, and some people have described a sensation like a lump in their throat, but that all fades away.

I would ask WHERE they are doing the incision - mine is along a natural crease in my neck so not that noticable, but I've seen others where it's straight across the neck.


What's the reason for your thyroidectomy? Cancer, nodules/growth, hyperthyroid...?


More importantly: who will be managing your thyroid meds after the surgery? Have you talked about the meds plan? Will you be starting meds before the surgery to get some in your system? What meds? T4 only meds, or a combo T3/T4 med? Personally, I don't think anyone without a thyroid should be on a T4-only med. Some people are fine on it, but by and large thyroidectomy patients need T3 in pill form (because your thyroid produces 20% of your current T3 so you're starting from behind).

What labs will they run - free T3 and free T4? How often? What labs will they base your meds dose on? What is their take on "normal" vs. "optimal", and will they listen to how you FEEL even if the numbers are "normal"? Do they understand that your TSH may be suppressed because your only source of thyroid hormone is now the meds?

If it's for thyroid cancer - what is the plan for RAI and when? What kind of followups will be done after initial treatment? Annual scan? Do they understand that your TSH *must* be suppressed after and WHY that is the case?


That's just off the top of my head, will add more later if I think of it...

kats3boys

This surgeon is a thyroid specialist ( this is why there is only 2) . I am not worried about follow up as most of my follow up has been with my GP and he is on the same page as me. just uses the Endo to run labs as an Endo can order a lot more at the same time than a GP.

They are worried about me going hyper again.
I have 2 nodules that are both inconclusive and after 2 biopsies and due to the location they refuse to do anymore biopsies.
Endo # 2 has ruled out sub acute, acute or almost any other type of acute inflammation that is causing and increase in goiter size and/or causing pain.

fall216

I had a tt last September, FNA discovered nodules containing Hurthle cells and I have Hashi's. Post surgery my neck and shoulder area was really sore (they have you in a uncomfortable position during the surgery) and my throat was irritated from the breathing tube but other than that I was fine. I only stayed one night in the hospital due to monitoring my calcium levels which were fine. My voice was never affected. I really didn't need any pain meds after a day or so and was back to working out normally about 4-5 days later. Only took a week off work and was fine when I returned, although I do work a sedentary desk job. I have a 4 yr old daughter so work may have been more relaxing for me! After the surgeorn ok'd it I started using Bio oil (purchased at Target) daily for about 3 months and my incision is hardly noticable. I also had a thyroid surgeon specialist who came highly recommend, ranked in the top 5 in my region of the US. The hard part has been getting levels correct. Fatigue and joint pain have been my biggest issues. I have to FORCE myself to workout on bad days and if I stray from eating clean I can feel it in my bones! I am 33 and in good health despite my crazy thyroid! Message me any questions, would love to help!

kats3boys

The surgeon wrote me off, so it looks like I don't need surgery. He says the issue is thyroiditis with hypo graves but because I can not take the meds ( ASA etc) I have to let it run its course which could be another 6 months. He says the problem is most new doctors are not use to seeing it run its course and panic.

If he does surgery now he runs a high risk of damage because under inflammation the thyroid is soft jelly like so I need to wait til it runs its course before he can do surgery, and after it runs its course I should not need surgery.