Dr. Kolachalam, Thyroid Surgery
Dr. Kolachalam’s endocrine surgery team diagnose and treat patients with a variety of thyroid conditions including tumors, and nodules. If you have been diagnosed with a thyroid condition, you can count on us to provide a personalized treatment plan, tailored to your unique condition and personal needs.
What is the Thyroid?
The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck. It is the only free floating organ in the body! For such a small organ, it certainly packs a punch when it comes to how your body is running.
What does the Thyroid do for my body?
The thyroid’s job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormone helps the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should.
Thyroid hormones control the way every tissue in your body uses energy. They are essential to help each cell in your body’s tissue and organs work right. For example, thyroid hormone controls the body’s temperature, heart rate, blood pressure, and the rate at which food is turned into energy (metabolism).
How do I know if I have a condition associated with my thyroid?
Thyroid disease is a common problem that can cause symptoms because of over- or under-function of the thyroid gland. It can also sometimes lead to enlargement of the thyroid gland in the neck, which can cause symptoms that are directly related to the increase in size of the organ (such as difficulty swallowing and discomfort in front of the neck).
Just as the types of thyroid conditions can vary, so can the symptoms of thyroid problems. Here, we have listed ten common symptoms of thyroid disease:
- Nervousness and tremor: These symptoms, along with agitation, can signal an overfunction of the thyroid gland (hyperthyroidism).
- Mental fogginess and poor concentration: Mental functioning can be affected in both hyperthyroidism (elevated levels of thyroid hormone) and hypothyroidism (too low levels of thyroid hormones). While sluggishness and depressed mood are often associated with hypothyroidism, hyperthyroidism can also lead to a reduced capacity for concentration.
- Menstrual changes: Hypothyroidism is sometimes associated with excessive or prolonged menstrual bleeding, while hyperthyroidism can be characterized by scanty or reduced menstrual flow.
- Feeling bloated: Fluid retention is often a sign of an underactive thyroid gland.
- Racing heartbeat: An increased heart rate (tachycardia) and palpitations can be symptoms of hyperthyroidism.
- Aches and pains: Muscle aches and pain can accompany different types of thyroid problems.
- Weight gain: A modest amount of weight gain often accompanies conditions in which thyroid gland activity is lower than normal.
- High cholesterol levels: An increase in blood cholesterol levels can occur in individuals with hypothyroidism.
- Heat intolerance: People with an overactive thyroid gland often complain of intolerance to higher temperatures.
- Feeling cold: Conversely, those with an underfunctioning thyroid may feel constantly cold.
It is important to remember that none of these symptoms is absolutely specific for thyroid disease. All of them may be caused by a number of different conditions and normal states. Your health care professional can order laboratory tests to evaluate the function of your thyroid gland if you have troubling symptoms.
What are the reasons a person may need surgery on their thyroid?
Thyroid surgery is performed for several reasons and can include:
- Symptomatic thyroid nodules
- Recurrent thyroid cysts
- Graves’ disease (Hyperthyroidism)
- Rule out or treat thyroid cancer
The purpose of thyroid surgery is to remove part or all of the thyroid gland. You will be in the hospital usually one night. Dr. Kolachalam will explain your specific surgery and why it is recommended in your case.
What are the risks with having surgery on my thyroid?
As with any surgical procedure, there are risks involved. There is a risk of:
- Bleeding, but this is very low. The average blood loss is less than an ounce. The risk of infection is so low that antibiotics are not routinely used.
- There is also a very low risk of injury to important nerves in the neck, called recurrent laryngeal nerves. These nerves control the vocal cords. Injury to these nerves could affect your voice.
- The parathyroid glands are located near the thyroid gland and may be injured during thyroid surgery. This can result in a drop in blood calcium levels.
- There is also a small risk associated with anesthesia.
However, the relative risk of complications is very low and is usually outweighed by the potential benefits of having the surgery. Dr. Kolachalam will go over this information with you and answer any questions you might have.
What to expect before surgery:
Dr. Kolachalam will need some tests first to properly diagnose and treat your thyroid condition. These tests include:
- Laboratory work
- Chest X-ray
Once your surgery has been scheduled, you will need to consider what medication your are taking regularly. If you take aspirin or nonsteroidal anti-inflammatory agents, you should stop taking these one week before surgery. The night before surgery, do not have anything to eat or drink after midnight. Get a good night’s sleep.
What to expect the day of surgery:
Keep on hand all the information our office gives you. You will need to know where your surgery will be and what time you need to arrive at the hospital on the day of surgery. It is very important to arrive at least 2 hours before surgery.
During the surgery, your family can wait in the family waiting area. They will be kept updated by the patient representative and operating room staff. Dr. Kolachalam will speak with them after surgery has been completed.
What will happen in surgery?
- You will be given general anesthesia to put you to sleep.
- You are positioned with special pillows under your neck to tilt your head back.
- An incision is made at the base of your neck and is about three to four inches long.
- Using magnifying lenses, Dr. Kolachalam locates the thyroid gland and associated structures and all or part of the thyroid is removed. In some cases additional surgery will involve removal of lymph nodes and other structures.
- The incision is stitched closed
- It is then covered with steri-strip tapes and a dry gauze dressing.
- The operation generally lasts from two to three hours.
- After surgery, you will stay in the recovery room for several hours. You will be monitored closely as you recover from the anesthesia.
What to expect after surgery?
The evening after surgery you will have:
- A liquid diet for dinner. You may have a sore throat. The nurse will provide lozenges and/or throat spray to help relieve this.
- If you need something for pain, the nurse will give you a liquid pain medicine.
- You will have a dressing on your neck which will be removed in the morning.
- The head of your bed will be raised to decrease swelling.
- You will have an intravenous line to give you fluids until the next day.
- You will have routine blood tests.
- You will be offered regular food the next morning. Most people are ready to go home after breakfast.
What will my incision look like?
After the dressing is removed, you will notice that the incision is covered with tapes (steri-strips). These will stay on for about a week. Leave the steri-strips in place.
You may shower the day after surgery. Try to keep the neck area as dry as possible and pat dry after showering.
The stitches will be removed in the office about a week and a half after surgery.
Infection is extremely rare. If you notice any redness or drainage from the incision contact Dr. Kolachalam.
After the stitches are removed, the most important thing you can do to improve the appearance of your scar is to protect it with sunscreen that has a sun protection factor (SPF) of 30 for an entire year. During the year your scar may become raised or red, but will almost always fade into a thin line which will be less noticeable.
How will I feel after surgery?
Everyone is different. You will most likely be tired and a bit sore for a few days. You may have pain not only from your incision, but also from muscle soreness in your upper back and shoulders. This is from the positioning in the operating room during the surgery. You will have liquid pain medicine in the hospital and a prescription for pain pills at home. Click here for pain management PDF: Managing-Your-Pain-After-Surgery
You may have a sore throat. This is a result of the placement of anesthesia tubes during surgery. Throat lozenges and spray usually help. Your neck may be slightly swollen as well. You may feel like you have a lump in your throat when you swallow. This will improve after a few days but may continue for a week or so.
If you notice sudden swelling in your neck contact your surgeon’s office. Your calcium level may drop after surgery. This is related to disturbance of the parathyroid gland, which regulate calcium balance. This will be monitored through blood tests. You may notice numbness and tingling of your fingers or around your mouth. You will have instructions about taking calcium replacement if needed.
Recovering at Home
Most people take 1 to 2 weeks off to recover. You should not drive for at least a week. There are no other restrictions. Depending on the amount of thyroid tissue that was removed and the reason for your surgery, you may be placed on thyroid hormone (Synthroid or Cytomel). Dr. Kolachalam will discuss your situation with you.