How to Prepare for Thyroid Surgery?

Before Surgery

To ensure you're ready for thyroid surgery, several examinations will be performed a few days beforehand. These include a chest X-ray, blood tests, an electrocardiogram, and an anesthetic examination. These tests are necessary for you to give informed consent for the surgery. It's crucial to refrain from eating or drinking for at least 8 hours before the operation. You'll have the opportunity to ask questions and clarify any uncertainties. You will need to give your consent to the operation, confirming your understanding of the benefits and risks. On the day of surgery, you'll be admitted to the hospital in the morning, having fasted for at least 8 hours. Stop taking any anticoagulant or antiplatelet medications at least ten days prior. With the nurse's assistance, you'll be prepared for the procedure, removing jewelry, glasses, contact lenses, and dentures. You'll be taken to the operating room approximately 30 minutes before the operation. Surgery is generally performed under general anesthesia, explained by the anesthesiologist during a pre-operative interview. The thyroidectomy takes about an hour and a half. A transverse incision, approximately 4 to 6 cm long, is made in the anterior and middle part of the neck, about 3 to 4 cm above the jugular vein. Intradermal sutures are used to close the wound, without drainage tubes. Blood transfusions are not usually necessary.

After Surgery

Thyroid Issues: If your thyroid gland has been totally removed due to cancer, a nodule, or other thyroid regulation problems, you'll need to take a prescribed daily dose of thyroid hormones. Take the thyroxine tablet on an empty stomach, 30 minutes before breakfast. Hormone dosage is regularly assessed using FT3, FT4, and TSH tests (except on the morning of the test). Your thyroid endocrinologist will determine the correct dose. Missing a few days of thyroxine won't cause significant issues; don't adjust your daily dose. The surgical scar takes about three months to fully heal, even cosmetically. In the weeks following surgery, you may experience swallowing discomfort, like a foreign body sensation, skin adhesion to the neck, or a pulling sensation in the chest. These discomforts are temporary and gradually decrease due to deep wound scarring that immobilizes neck muscle layers.

Your voice might be altered in timbre, though remaining clear, or weakened (fatigue, difficulty speaking loudly). Most voice issues resolve within a few months. Changes in timbre are often due to the loss of compression of the larynx by thyroid gland hypertrophy (goiter) and postoperative scar tissue and adhesions affecting laryngeal dynamics. You can move your neck freely after surgery. A short convalescence period is generally needed. Covering the dry scar isn't necessary, and you can resume all activities without limitations, even after a total thyroidectomy. Women of childbearing age can have pregnancies and breastfeed, with the only recommendation being regular hormone replacement therapy. Post-operative hypocalcemia may occur, addressed by doctors upon discharge. We administer oral calcium and vitamin D post-operatively, gradually reducing dosage after weekly calcium checks. Calcium levels usually normalize within weeks.

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Conclusion

The thyroid gland, located in the neck, produces hormones controlling metabolism. Thyroid surgery addresses tumor or nodule growth (often non-cancerous), or goiter (enlarged thyroid causing swallowing or breathing problems). Your surgeon will explain precautions and medications, emphasizing your safety. Avoid anticoagulants in the days before surgery. The surgeon will answer your questions. Hospital stay is about two days, with minimal risks (laryngeal nerve damage, accidental parathyroid gland removal leading to voice changes or hypocalcemia). Plan for a few days of rest post-op; some discomfort and sore throat are normal. If the gland is fully removed, hypothyroidism is a common side effect, managed with hormone replacement therapy. You can expect a return to normal life and stable health.

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