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ThyroidsSurgery.com
Expertise in surgery for Thyroid Swelling

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What is the Thyroid?
As described in greater detail above, thyroid is an endocrine gland in the neck that produces thyroxin and calcitonin hormones. Thyroxin is essential for release of energy and for body activity.

What are the common Thyroid problems?
Common problems of the Thyroid are over activity (Hyperthyroidism), under activity (Hypothyroidism), increased size (Goiter), formation of nodule(s) (Solitary Nodule or Multi Nodular Goiter) in the thyroid. Thyroid cancers and Thyroiditis (Inflammation of Thyroid with pain, fever) are the other common problems.

What are the symptoms of hyperthyroidism?
Excess thyroid causes loss of weight in spite of excessive appetite, intolerance to heat, frequent passage of stools, decreased and infrequent menstrual flow, weakness, palpitations, anxiety, tremors in the hands, protruding eyes, etc.

What are the symptoms of hypothyroidism?
Symptoms of hypothyroidism include fatigue, exhaustion, feeling run down and sluggish, depression, difficulty in concentrating, brain fog, unexplained or excessive weight gain, dry skin, coarse and/or itchy skin, dry hair, coarse and/or thinning hair, feeling cold, especially in the extremities, constipation, muscle cramps, joint pain, increased menstrual flow, more frequent periods.

What are the causes of Goiter?
Thyroid swelling can be due to tumors, iodine deficiency, autoimmune (self destructing) conditions, infection, etc.

What are the ill effects of Goiter?
Thyroid swellings can compress the vital structures under it like the gullet, breathing tube, speech nerves, etc. causing difficulty in swallowing, breathing, speech, etc. There may be excessive or decreased production of thyroid hormone. If there is cancer it can spread and produce problems in other parts of the body.

What tests do you do for a goiter?
Ultrasound scan, FNAC (Fine Needle Aspiration Cytology), Thyroid function tests, Anti thyroid antibodies assay etc. are done. When required, Radio isotope scan, CTscan of neck and chest, MRI scan, blood tests for cancer markers may be done.

How is a goiter treated?
Depending on the cause it is treated with appropriate medicines, radioactive iodine and surgery to remove the whole thyroid (Total Thyroidectomy) or half of it (Hemi Thyroidectomy) or part of it (partial/subtotal/lobectomy/Isthumusectomy).

How are Hypo- and Hyper-thyroidism treated?
Hypothyroidism is treated with thyroid hormone (Thyroxin) tablets.
Hyperthyroidism is treated with thyroid blocking drugs, radioactive iodine or surgery.

What are the types of anesthesia and surgery for thyroid?
Thyroid surgery can be done under local, regional or general anesthesia, with a 7 to 10cm cut across the neck by open surgery or when feasible through a small less than 3 cm skin cut by endoscopic (minimally invasive) surgery.

What are the risks of thyroid surgery?
Possible risks include: 1) bleeding that can cause acute breathing difficulty, 2) hoarseness due to injury to the speech (recurrent laryngeal) nerve, and 3) damage to the parathyroid glands that control calcium levels in the body, causing hypoparathyroidism. The overall risk of complications should be <2% with an experienced surgeon.

What can I do before thyroid surgery to be optimally prepared?
It is important that you do not eat or drink anything after midnight the night before surgery. Continue to take all important medications such as heart, asthma, or blood pressure medicines as advised by your anesthesiologist with a small sip of water on the morning of surgery. Diabetic medicines are not taken by mouth on the day of surgery. Do not take blood thinning drugs or aspirin for 7-10 days prior to your surgery date. Quit smoking.

Will I have pain? Will I have stitches? What can I expect after surgery?
You will be asleep during your surgery and will feel no pain. Pain after surgery is easily suppressed by prescribed medicines. Stitches placed under the skin are not visible and dissolve after a period of time and do not need to be removed. You might have a sore throat, difficulty swallowing, or a slightly hoarse voice after the operation. These conditions will resolve with time. There may be a tube (surgical drain) in the incision in your neck (which will be removed the morning after the surgery). Once you are fully awake, you will be moved to a bed in a hospital room where you will be able to eat and drink as you wish. Most patients having thyroid operations are hospitalized for about 24 to 48 hours. Near normal activity can begin on the first day after surgery. You will have some difficulty with full range of movement of your neck for one week after surgery. You can return to work in 1-2 weeks time. Vigorous sports should be delayed for at least 1 month. You may experience low blood calcium (hypocalcaemia). You may need to take Thyroid hormone (Thyroxin) tablets, calcium and vitamin D after surgery, sometimes lifelong. During your follow-up visit, your TSH (thyroid stimulating hormone) levels will be checked and Thyroxin dose adjusted accordingly.

What are the signs of low blood calcium and how will I know if I need to take extra calcium?
Low blood calcium occurs if the parathyroid glands (behind the thyroid gland) do not function properly. Symptoms of low blood calcium include numbness and tingling in the fingers and around the mouth, weakness, headaches, muscle cramps, intestinal cramps, heart arrhythmia (rhythm disturbance). Low blood calcium can be prevented or treated with extra calcium intake. Left untreated, very low calcium levels can cause chocking.

Will I have a scar?
All surgeries cause some scarring. When performed by skilled endocrine surgeons, the thyroid operation will be performed using the smallest, cosmetically placed incision possible. Plastic surgery type closures are used to minimize scarring. Ultimately the type of scar formed depends mostly on the type of your body response to any injury. The majority of people having thyroid surgery have minimal scar present by 6 months after surgery

Who are more likely to get thyroid cancer?
Thyroid cancer is more common in people who have a history of exposure of the thyroid gland to radiation, have a family history of thyroid cancer, and are older than 40 years of age.

What are the types of thyroid cancer?
Papillary thyroid cancer is the most common type of thyroid cancer (70% to 80% of thyroid cancers) and can occur at any age. Follicular thyroid cancer (10% to 15% of thyroid cancers) tends to occur in somewhat older patients than papillary cancer. Medullary thyroid cancer (5% to 10% of thyroid cancers) is more likely to run in families and may be diagnosed by genetic testing. Anaplastic thyroid cancer (less than 5% of thyroid cancers) is the least likely to respond to treatment.

How do you check if thyroid cancer has spread?
It is treated by surgery to remove the entire thyroid (Total Thyroidectomy) and certain adjoining tissues (depending on the type of cancer and extent of spread). This is followed by radioactive ablation (RAI) i.e. destruction of any residual thyroid or cancer with radioactive isotope of iodine as Iodine is preferentially taken up by thyroid tissue from the blood stream. Thyroid hormone (Thyroxin) tablets have to be taken daily, life-long. Regular check up (may include scans, blood tests for TSH, Thyroglobulin, calcitonin, etc.) is essential to detect any recurrence early.

How is thyroid cancer treated?
It is treated by surgery to remove the entire thyroid (Total Thyroidectomy) and certain adjoining tissues (depending on the type of cancer and extent of spread). This is followed by radioactive ablation (RAI) i.e. destruction of any residual thyroid or cancer with radioactive isotope of iodine as Iodine is preferentially taken up by thyroid tissue from the blood stream. Thyroid hormone (Thyroxin) tablets have to be taken daily, life-long. Regular check up (may include scans, blood tests for TSH, Thyroglobulin, calcitonin, etc.) is essential to detect any recurrence early.

What is the outlook or prospects (prognosis) for patients with thyroid cancer?
The outlook for patients with thyroid cancer is excellent in that safe and effective therapy is available in most cases. Even those patients whose thyroid cancer cannot be cured, can usually live a long time and feel well despite their cancer.

 
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