Hyperactive glands might lead to endocrine disorders with serious complications. Hyperthyroidism is one of such disorders caused due to overactivity of the thyroid gland. Hence, leading to enhanced body metabolism and other serious consequences.
To curb the secretions, thyroidectomy is performed which is often accompanied by post-surgery complications. Hence, the patients must be concerned about their diet and should be aware of the foods to avoid after total thyroidectomy.
So, if you’re done with thyroidectomy or you’re about to go for it, then rest assured because in this article I’ll tell you all about the surgical procedure, postoperative complications, recovery, diet, and the list of foods to avoid after total thyroidectomy!
Table of Content
- 1 Thyroidectomy Steps
- 2 Partial Thyroidectomy vs Total Thyroidectomy
- 3 Life After Total Thyroidectomy
- 4 Thyroid Surgery Recovery: 5 Things You Should Follow
- 5 What to Give Someone After Thyroid Surgery?
- 6 Foods to Avoid After Total Thyroidectomy
- 7 Final Words
- 8 FAQs
The surgery is initiated with positioning, eyes are protected and the neck is hyperextended. The position is known as the semi-fowler position in which the upper body is raised to an angle of fewer than 45 degrees.
After the patient is positioned, the step-by-step procedure is described below.
- Firstly, draping is done, and the face up to the chin area is covered. A double towel is usually used with one towel covering the head while the other is laid down on the table.
- After imprinting the incision, a skin incision is made followed by the platysma muscle incision. Now, the flaps of the platysma are lifted.
- The next step is the division of deep cervical fascia followed by the ligations of some vessels.
- After this, the strap muscle will be divided from the middle and retracted laterally. Now, the pretracheal fascia will be incised followed by the lateral dissection amid the fascia and true capsule.
- Now, the surgeon will mobilize the lateral lobe followed by the ligation of the middle thyroid vein. On medial retraction of the gland, the middle thyroid vein is exposed.
- After this, the superior pedicle will be divided. The surgeons try to divide the pedicle closest to the gland to prevent injury to the superior pharyngeal nerve. Such injuries might lead to a hoarse sound.
- Then, surgeons will expose and divide the inferior thyroid pedicle followed by the medial retraction of the gland.
- After this, the inferior thyroid artery will be ligated and divided individually.
- Now, the berry’s ligament will be divided which will ease the mobilization of the thyroid gland. Now, by using electrocautery thyroid can be dissected.
- The procedure is similar for both hemithyroidectomy and total thyroidectomy. However, in total thyroidectomy, the same procedure is performed on both lobes.
Partial Thyroidectomy vs Total Thyroidectomy
Thyroidectomy is a surgical procedure that involves the removal of the thyroid gland to treat cancer, tumors, hyperthyroidism, and other thyroid problems. However, there are two basic surgeries called total and partial thyroidectomy.
Most of the time, lymph nodes are the ones in which cancer develops initially. Cancer becomes the major reason for total thyroidectomy. The only treatment for it is the removal of the gland and if it is spread in all thyroid tissues, then a total thyroidectomy is the only solution.
However, doctors also recommend radioactive iodine treatment for eliminating cancer cells. After total thyroidectomy, the patient has prescribed a lifelong thyroid hormone intake. This is because the gland is removed and no more thyroid hormones can be produced.
If cancer is limited to a specific lobe of the thyroid gland, then doctors suggest a partial thyroidectomy. In this case, the entire gland isn’t removed and only a part of it is excised. The reason might be the overactivity of the gland, cancer, or any tumor. The effects and consequences of both the procedures are somewhat similar.
Depending on the thyroid condition, the doctor recommends any one type of surgery. However, both of the procedures are safe and have some risks. Hypocalcemia is the most common postoperative complication that is likely to occur permanently in less than 1% of patients.
Life After Total Thyroidectomy
Once you’re done with the surgery, you might recover within 24 hours of the procedure or it might take a week or two. However, it is a major surgery that affects hormonal balance in the body. An average of 150,000 thyroidectomies is done in the US annually. Patients with hyperthyroidism, cancer, tumors, and several other thyroid problems opt for thyroid surgery based on their complications.
When it comes to life after total thyroidectomy, patients might experience some short and long-term effects. Some people experience changes in their voices. This is because the nerves which control the vocal cords are so close to the gland that even a slight mistake might lead to severe consequences.
Some other effects include:
- A husky voice with a disturbed throat is most likely to be experienced by almost all the patients initially for a shorter time period.
- Soon after the surgery, you’ll be allowed to eat and drink. However, you must know the foods to avoid after total thyroidectomy and choose soft foods which could ease the swallowing.
- Scarring above the clavicle.
- Once you’re back home, try to rest and avoid any heavy lifting or arduous activities.
- After the thyroid surgery, your body cannot produce thyroid hormones. Due to the imbalance, your body might experience fatigue, cramps, sudden weight gain, memory issues, and dry hair and skin.
Post Thyroidectomy Complications
Back in the 18th century, postoperative complications often proved to be fatal due to infections. However, the risks are still constant but the fatality rate has dropped because of the advanced techniques.
Still, there are some post thyroidectomy complications very common in a majority of the patients. Some are enlisted below.
It is the most frequent complication that occurs in a majority of the patients. During the surgery, damage to any of the parathyroid glands or their devascularization might lead to decreased parathormone production known as hyperparathyroidism.
Parathormone functions to increase the serum calcium levels when they drop. Hence, a decrease in parathormone directly affects serum calcium levels.
Its incidence is 1% and might lead to compression of the trachea causing airway blockage within a day of surgery mostly. Immediate drainage of the hematoma is important to help a patient survive.
Dysphonia and dysphagia are the two common disorders observed by many patients after thyroid surgery. There can be a number of reasons for changes in voice. The thyroid gland is located in close proximity to the nerves which control the vocal cords. Hence, a slight mistake can adversely affect the speech.
Post-operative thyrotoxicosis is iatrogenic most of the time. Hence, precipitation of thyroid storms is a complication that can be prevented by using ATDs (antithyroid drugs).
Recurrent Laryngeal Nerve Injury
Incidence of this injury is usually less than 1% and it is the second most common complication after the surgery. Such iatrogenic injury can lead to the paralysis of the vocal cords and a permanent loss of speech called aphonia in rare cases.
Underactive thyroid gland or lack of certain thyroid hormones might lead to hypothyroidism. The root causes clearly explain why hypothyroidism is most likely to happen after total or partial thyroidectomy.
This is because the removal of the thyroid gland will definitely reduce the secretion of thyroid hormones. Hence, it’d lead to hypothyroidism.
Infections are common after the surgery. However, after thyroidectomy, they are rare. These are the surgical site infections and patients who are obese and those who consume alcohol are more likely to develop them. Make sure you keep looking for the signs of infection after thyroidectomy.
How to Reduce Swelling After Thyroidectomy
Neck swelling after thyroidectomy is very common. However, if you think it’s a hematoma, then let me tell you it’s not always that! Usually, bleeding is a postoperative complication that requires surgical management.
However, neck swelling is experienced by all patients after the surgery but its most common cause can be a hematoma which requires immediate drainage.
One can use cold packs to relieve pain at the site of the incision. Moreover, elevating the head of the bed might also help in reducing swelling. Make sure to avoid tilting your head as it might enhance the pain. There is also a rare post-surgery complication known as chyle leak.
How to Sleep Comfortably After Thyroidectomy
Many patients suffer from sleeplessness after thyroid surgery. Consumption of levothyroxine also leads to sleeplessness. However, you can tackle the sleep problems by simply following the enlisted methods:
- Using V-shaped pillows can help you sleep peacefully.
- You can also incline your bed at an angle of 30-45 degrees in the first week to minimize the swelling of the neck region.
- Try to create a peaceful environment with a clean room, lights off, and no noises.
- Consult your doctor if the issue doesn’t resolve even after the above-mentioned methods.
Thyroid Surgery Recovery: 5 Things You Should Follow
Recovery after the surgery isn’t a piece of cake. However, when it comes to thyroidectomy, the recovery rate varies from patient to patient. Physical recovery after the thyroidectomy might extend up to a few weeks. Once you’ll be discharged, the doctor will prescribe certain medications including pain killers.
Here I’ll share with you 5 tips that can help you recover faster after total and partial thyroidectomy.
Care of the Incision Site
You must take care of the incision after thyroid surgery. Soon after the procedure, the incision is dressed. Although it is mostly waterproof, it’s better to avoid soaking it completely in water. Moreover, keep massaging the scar within the first week of the surgery.
Surgeons usually use steri-strips after thyroidectomy which provide proper coverage to the site of the incision.
Avoid Arduous Activities
Make sure you should avoid any strenuous activity up to 15 days after the surgery. Moreover, over-extension of the neck is strictly prohibited as it might be swollen or stiffened after the procedure is done.
The neck is the only part of the body that is entirely involved in the surgical procedure. It often stiffens, so it’s better to avoid driving soon after the surgery to prevent the head from turning left and right sides.
It’s good to remain active and energetic after the surgery. Physiotherapy works well in helping the neck and shoulder relax. Your doctor might recommend a physiotherapist to perform daily or weekly exercises.
You’ll need to return to the surgeon for a scheduled follow-up within 15-20 days of the surgery. The doctors will analyze and determine whether your body needs certain nutrients or not. Hence, it is important to go for a check-up after the surgery.
When thyroidectomy is performed to treat cancer, there are further treatments as well. They include the evaluation of the tissue sample to know whether the cancer cells are completely removed or not. Moreover, some patients also go through radiation treatment.
What to Give Someone After Thyroid Surgery?
So, you must be wondering, what to eat after thyroid surgery? Well, don’t worry. Here, I’ll share with you what to eat and a list of foods to avoid after total thyroidectomy.
Initially swallowing is really difficult, some patients also complain of choking after the intake. However, you should consider your doctor’s recommendations and follow the diet plan given by them. Other than this, the following food items should be a part of your diet:
Cool, soft, and liquid foods suit every patient after thyroidectomy. Due to difficulty in swallowing food, make sure you add some healthy and soft foods to your diets such as soups, broth, jello, mashed potatoes, and soft vegetables.
Soon after the surgery, patients often suffer from disturbed bowel movements. Moreover, constipation is also caused due to the medications. However, staying hydrated can help your body in this case.
Vitamin C Intake
When it comes to healing wounds, vitamin C can help your body recover. So, try to increase your body’s vitamin C intake. Add some strawberries, and raspberries to your diet.
Zinc is crucial after surgery because it boosts the immune system. Hence, it can help in faster recovery. You can easily find zinc in chicken, nuts, pork, and grains.
Damage to the parathyroids might lead to a decrease in parathormone production. Hence, Calcium levels in the serum drop which leads to hypocalcemia. Many patients suffer from hypocalcemia after the surgery so if you are one of them, then you must take calcium supplements.
However, continuous calcium intake might lead to abdominal disorders so it’s better to take a laxative along with it to avoid constipation.
Usage of Levothyroxine
Removal of thyroid means the end of secretion of thyroid hormones. Initially, to combat the body’s needs, patients usually go through thyroid hormone replacement which is a long-lasting thyroid hormone therapy.
Doctors prescribe such patients with Synthroid (levothyroxine). This therapy works intending to suppress TSH secretion in the body. Hence, it prohibits any of the cancer cells from growing back and prevents the recurrence of cancer.
Foods to Avoid After Total Thyroidectomy
Although there isn’t any restriction after the thyroid surgery but for faster recovery, it is better to be aware of the foods to avoid after total thyroidectomy. The patients can resume eating and drinking soon after the procedure is done.
However, it’s better to start off with a soft diet. Although there are no limitations, here are some of the foods to avoid after total thyroidectomy.
A sore throat might not be able to accommodate hard food. A majority of the patients experience difficulty in swallowing. So, it is preferred to add soft foods to the diet initially and avoid hard foods such as raw fruits and vegetables.
To avoid irritating the throat it’s better to refrain from acidic foods such as tomato juice. This is because foods high in acidic content might worsen the irritation.
Well, alcohol won’t do any bad to your body after the surgery. However, it is important to consider the type of medications you are using for alcohol intake. So, ask your doctor if your medicines and alcohol can go hand in hand.
It’s better to avoid spicy and fried food after a thyroidectomy. This is because post-surgical consequences often include a sore throat and such foods might enhance the level of discomfort. Moreover, the high-calorie content of junk food might contribute to sudden weight gain.
Both total and partial thyroidectomy are safe procedures with few chances of severe complications. Although there are no diet limitations, it’s better to be aware of the foods to avoid after total thyroidectomy. This can boost the process of recovery.
It would be great if you add soft and liquid foods to your diet. Moreover, zinc and vitamin C can also help in speeding up the healing process as they improve the immune system. So, try to avoid spicy and fried food and make sure to follow the instructions of your doctor. Taking all the medications and supplements on time will contribute to faster recovery.
What foods to avoid after a total thyroidectomy?
Although there are no limitations when it comes to diet after total thyroidectomy. However, there are certain foods that you should avoid initially after the surgery. Such food items include hard food, spicy and junk food, and acidic foods. Simply follow the guidelines of your doctor for faster recovery.
What should I eat after thyroid surgery?
Initially, the patients are advised to eat soft foods because of the difficulty in swallowing. However, switching to a liquid diet might help a lot along with zinc and calcium intake. Make sure you keep yourself hydrated and also add some vitamin C to your diet as a booster of the immune system.
What foods to avoid if you have an underactive thyroid?
If you have an underactive thyroid, it means you are suffering from “Hypothyroidism.” In this condition, the secretion of thyroid hormones is relatively reduced leading to weight gain. The patients should avoid eating cauliflower, gluten, caffeine, foods having soy, foods rich in sugar, junk food, cabbage, and fatty meats.
Does your voice change after thyroid surgery?
Soon after the surgery, the patient experiences a visible change in his voice. It becomes husky and hoarse. However, such change is temporary but there can be permanent damage in case of the recurrent laryngeal nerve injury.
Do you gain weight after thyroid removal?
Yes, patients with hyperthyroidism experience a gain in weight after thyroidectomy are performed. This is because of the decrease in the number of thyroid hormones leading to hypothyroidism which contributes to weight gain.
What are the long-term effects of having your thyroid removed?
After the thyroid surgery, there are no thyroid hormones produced in the body. So, the patients have to consume levothyroxine (Synthroid). Other patients also suffer from iatrogenic recurrent laryngeal nerve palsy while some patients also develop hypocalcemia which can be permanent in 17.4% of the cases.
Does thyroid removal shorten life expectancy?
No, thyroidectomy doesn’t affect the life span. However, the patient must continue his thyroid hormone replacement therapy and there won’t be any danger. Such patients live a normal life, all they’ve to do is take medications and keep a check on calcium and thyroid hormones in the body.
Can a removed thyroid grow back?
Recurrence depends upon the type of surgery performed. Recurrence is rarely seen after the total thyroidectomy. However, in the case of partial thyroidectomy, there are good chances of growing back.