After your consultation with Mr Lee, you may have further questions. These FAQs are here to help answer some of your questions, or remind you of your discussion with Mr Lee. Please do not hesitate to contact us if you still have unanswered queries.
How long will my operation take?
Thyroid and parathyroid operations generally take between 1 to 3 hours.
Will I need a general anaesthetic?
This type of surgery always requires a general anaesthetic in order to stop muscle movement during the delicate dissection. The general anaesthetic is supplemented by local anaesthetic or a nerve block, which may result in you having a numb face, neck and / or ear for 24 hours afterwards.
How long will my incision be and where will it be placed?
For open thyroid or parathyroid surgery the scar is a curved line in the "collar" position, about 2 cm above the collar bone. The length varies depending on the size of the gland to be removed. For minimally invasive surgery, the scar is only 2 to 3 cm long and is placed on one side of the neck.
How will my scar heal?
Your wound will be closed with dissolving stitches under the skin (these will not need to be removed). The incision will have a small waterproof dressing on so you can shower normally (dab dry after), and this should be left intact for around 2 weeks until you see Mr Lee. In your post-operative visit, the dressing will be removed.
You may notice that your neck is slightly numb and the wound may be thickened and slightly swollen for around 3 months. Mr Lee will advise you on the best way to manage your wound. It may involve gently massaging moisturiser cream into the neck or supporting the wound with Micropore® tape which you can replace yourself. By 3 months, the scar can still be red and visible. Thereafter, it will gradually fade, but may take 12 months before the scar is fully healed to a fine white line in the neck.
How long will I be in hospital?
Thyroid and parathyroid surgery usually only requires a one-night stay in hospital. However, for total thyroidectomy patients, cancer patients, or if more than one parathyroid gland is removed, a couple more nights in hospital may be required.
Can I eat and talk after surgery?
You can generally talk straight after surgery, and depending on your reaction to the anaesthetic, you should be able to have a light meal the same evening. However, many patients are aware of some difficulty swallowing over a period of months after surgery. This always gets better with time. Minor voice changes after neck surgery are common and usually settle within days, but may persist for some weeks. Permanent and major change to the voice (hoarseness) may occur due to damage to the nerves to the voice box, but this complication is very rare (<1%).
What can I eat after surgery?
On the night after surgery, you are advised to have something light and soft (eg sandwich, cake, yogurt, congee, mash). After that, you can gradually get back to your normal diet over the next 24 to 48 hours. There are no specific restrictions on what you can or cannot eat, but a healthy, well-balanced diet is always desired.
Will I put on weight after thyroid surgery?
Most people maintain their weight after thyroid surgery. A small percentage put on weight, while others lose weight. Which group you will be in cannot be predicted. The more important thing is that the thyroid hormone levels in your blood are within normal limits.
How long will I need off work?
On average most people require around 2 weeks before returning to normal activities or work. However, each individual is different. Exactly when you get back to work will depend on how you are feeling at the time.
Will I get a stiff neck after surgery?
Some neck stiffness is common as a result of the prolonged extension (backward tilting) of the head under anaesthetic. Doing some gentle neck stretching before and after surgery will reduce it, but it may last for some weeks and require physiotherapy in some patients.
Will my parathyroid glands be taken out with the thyroid?
If you are having thyroid surgery (thyroidectomy), then every attempt is made to preserve all your parathyroid glands. They are left in place with their blood supply intact most of the time. But if that is not technically possible, they may need to be removed and transplanted into the adjacent muscle. Sometimes very small parathyroid glands are buried under the thyroid capsule and cannot be identified at operation, so they can get taken out with the thyroid specimen. Transplanted parathyroid glands take between 6 weeks to a few months to recover. The body can generally get by with just part of one parathyroid gland if necessary.
Will I need to take thyroid hormone tablets after my surgery?
If you are having a total thyroidectomy (removal of the whole thyroid gland) you will need to take thyroid hormone (thyroxine) everyday for the rest of your life. Whereas, if you are having a hemithyroidectomy (removal of half the thyroid) there is only a 10% chance that you will require thyroid hormone supplements. For those that need to be on thyroid hormone, this will be a lifelong requirement. Thyroid hormone tablets are taken once daily 30 minutes before food in the morning. Once at a stable level, the blood hormone levels can be simply monitored with a yearly blood test. They have no side effects as they are replacing the natural thyroid hormone of the thyroid gland would otherwise be producing.
Would it be better to leave a small part of the thyroid gland to avoid having to take thyroid hormone tablets?
No. The risk of recurrent disease, whether It is multinodular goitre, tumour or over-activity, is high and you may well require repeat surgery which carries a much higher risk.
What does the thyroid gland do?
The thyroid gland is an essential endocrine gland in the body, it secrets thyroid hormone, which has a key role in controlling the body's overall metabolism. It plays a role in controlling almost all bodily functions, including the heart and cardiovascular system, the brain and neurological system, the gastrointestinal system, bones, growth and body weight, the female menstrual cycle, the body's temperature. Over- or under-activity are both detrimental to the health of these organ systems. Therefore it is vital that the blood thyroid hormone levels are maintained within the normal ranges.
What do the parathyroid glands do?
There are 4 parathyroid glands located closely behind the thyroid gland. They tightly control the calcium levels in the blood. For the cells in your body to function normally, including heart muscles cells, they require the blood calcium levels to be maintained within a narrow range. In thyroid surgery, every attempt is made to leave the parathyroid glands intact. In parathyroid surgery, the aim is to remove the abnormal gland/s and leave the normal ones intact.
Will I require calcium tablets after my surgery?
It is routine to require some calcium tablets (Caltrate®) after total thyroidectomy, occasionally you may require vitamin D tablets (Calcitriol®) as well. In most cases, these supplements will be weaned off over a period of a few weeks by your GP. It is rare (1 – 2 %) to require long-term calcium supplements after thyroid surgery.
Occasionally you may require Caltrate® tablets after parathyroid surgery. As your calcium levels return to normal, you may develop some pins & needles, numbness or tingling in your fingers or lips. If this occurs, taking 2 Caltrate® tablets or a glass of milk will alleviate your symptoms. This is generally a temporary situation. Your endocrinologist may place you on calcium or vitamin D supplements after your surgery if they are concerned about your bone density.
If you have any other questions you should contact us on 9246 6466 or email firstname.lastname@example.org