Know the Normal Blood Pressure for Adults and How to Maintain It

Thyroidectomy is a procedure to remove part or all of the thyroid gland. This operation is performed on patients who suffer from thyroid disorders, such as thyroid cancer, thyroid nodules, or goiters that make swallowing or breathing difficult.

The thyroid gland is shaped like a butterfly and is located in the middle of the front of the neck. This gland functions to produce thyroid hormones which regulate many body functions, from heart rate, breathing, body temperature, digestion, to mood.

Know the Normal Blood Pressure for Adults and How to Maintain It

Thyroidectomy is thyroid surgery to remove part (partial) or all of the problematic thyroid gland (total). If only part of the thyroid gland is removed, this gland can still function normally. However, if the entire thyroid gland is removed, the patient will need to take thyroid hormone replacement medication for the rest of his life.

Purpose and Indications for Thyroidectomy

Thyroidectomy is performed on patients diagnosed with thyroid disease. Some thyroid diseases that are generally treated with thyroidectomy are:

  • Thyroid cancer
  • A goiter disease that causes sufferers to have difficulty swallowing or breathing
  • Hyperthyroidism that cannot be treated with antithyroid drugs or the patient does not want radioactive iodine therapy
  • Thyroid nodules that can become cancerous when examined using a biopsy

Thyroidectomy Warnings and Don'ts

There are things you need to do if you are planning to undergo a thyroidectomy, including:

  • Tell your doctor if you suffer from certain medical conditions, such as heart disease or lung disease.
  • Tell your doctor if you are taking certain supplements, herbal products, or medications.
  • Tell your doctor if you are pregnant, may become pregnant, or are planning a pregnancy. Thyroidectomy may need to be postponed if you are pregnant. This is because the use of anesthesia during surgery can have a negative impact on the health of the fetus.
  • Tell your doctor if you take blood thinners; aspirin; or NSAIDs, such as ibuprofen or mefenamic acid. Consumption of these drugs may need to be stopped temporarily.

Before Thyroidectomy

Before thyroidectomy, the doctor will perform a thorough examination to ensure the procedure is safe and appropriate for the patient's condition. The examination can take the form of physical and supporting tests, such as:

  • Blood test
  • Thyroid gland ultrasound
  • Needle biopsy of thyroid nodule
  • CT scan of the neck
  • Vocal cord examination
  • X-rays
  • Electrocardiogram (ECG)

When the doctor has determined the thyroidectomy schedule, there are a number of preparations that the patient can make before the surgery schedule, including:

  • Do regular aerobic exercise several weeks before surgery, so that the patient's body can recover more quickly after thyroidectomy.
  • Stop smoking and consuming alcoholic drinks, at least 1 week before surgery, so that recovery can be better.
  • Taking thyroid hormone control medication, for patients who have hyperthyroidism, so that the condition is stable for surgery and the risk of bleeding is reduced
  • Stop taking certain medications according to doctor's recommendations

Before the day of thyroidectomy, patients are advised to ask friends or family to accompany them and accompany them during the operation. Patients should also leave jewelry or accessories at home before going to the hospital.

Before surgery, patients need to fast for several hours. Usually, fasting begins the evening before. Ask your doctor about the rules and duration of fasting before the thyroidectomy procedure. Patients should also not use any make up or nail polish before surgery.

Thyroidectomy Procedure

The thyroidectomy procedure can take 1–4 hours, depending on the part of the thyroid gland being treated. In general, the following are the stages of thyroidectomy that will be carried out by the doctor:

  • Administering anesthesia through a breathing mask and infusion
  • Install a breathing apparatus after the patient is under general anesthesia
  • Installing special equipment to monitor the possibility of vocal cord irritation during surgical procedures, for patients undergoing large thyroidectomy
  • Make an incision in the middle of the neck and widen it so that the doctor can directly access the thyroid gland
  • Binds blood vessels that supply blood to the thyroid gland
  • Cutting part or all of the thyroid gland, depending on the condition the patient is experiencing
  • Take samples of the lymph nodes around the thyroid gland, then examine them directly under a microscope
  • Remove the lymph nodes and surrounding tissue if a microscope examination shows the presence of cancer cells
  • Complete the thyroidectomy by untying the blood vessels, stitching the incision and covering it with a bandage

The steps above are conventional thyroidectomy or thyroid surgery by making a large incision. Apart from the method above, thyroidectomy can be carried out using the endoscopic method.

The procedure for endoscopic thyroidectomy is more or less the same as conventional techniques. The difference is, the incision made in the skin is smaller, limited to inserting a camera and special surgical tools that can be controlled from the outside.

After Thyroidectomy

After thyroidectomy, the patient will be moved to the recovery room to monitor his condition. The doctor will check the patient's vital signs, such as heart rate, pulse and blood pressure periodically.

In addition, the doctor will check the calcium levels in the patient's blood periodically to ensure that the parathyroid glands are not damaged.

The parathyroid glands have an important role in maintaining blood calcium balance. This gland is at risk of being damaged during thyroidectomy because it is attached to the thyroid gland.

In some patients, the doctor can place a catheter in the surgical incision to help remove blood and fluid that may have accumulated in the surgical area. The catheter will be removed 1–2 days after surgery.

During hospitalization, patients are allowed to eat and drink as usual. If the condition is stable, the patient can return home. However, patients need regular control according to the schedule determined by the doctor.

Patients may experience fatigue, sore throat, stiff neck, or hoarseness after surgery. This complaint is normal and will generally heal completely in 4-6 weeks. However, patients can only return to activities or work 1-2 weeks after surgery.

To help the recovery process, there are several ways that patients can do, namely:

  • Keep the suture wound clean and dry
  • Do not swim or bathe for at least 1 week after surgery
  • Wear a turtleneck or scarf and sunscreen to protect the neck area from direct sunlight, for at least 6 months after surgery
  • Massaging the incision area using vitamin E or cocoa butter, which can be started about 2 weeks after thyroidectomy
  • Do not eat foods that are rough, fatty or spicy for several days after surgery
  • Do not lift or carry heavy objects, at least 2 weeks after surgery
  • Perform neck stretching exercises slowly to reduce complaints of neck stiffness
  • Do not drive or operate machinery while still experiencing neck stiffness or pain after surgery
  • Take medications prescribed by your doctor, such as pain relievers and calcium or vitamin D supplements

Patients who have had their entire thyroid gland removed need to consume artificial thyroid hormone throughout their life to keep thyroid hormone levels in the body balanced. An example of a thyroid hormone replacement drug is levothyroxine.

It should be noted that patients who undergo thyroidectomy for thyroid cancer may still need further treatment, such as radiotherapy. The aim of this therapy is to destroy the remaining thyroid tissue that was not removed during surgery.

Radioactive iodine therapy can also be done to treat cancer that has spread to the lymph nodes or other parts of the body.

Side Effects and Complications of Thyroidectomy

Thyroidectomy is a safe procedure. However, as with other operations, thyroidectomy also carries the risk of causing the following side effects and complications:

  • Neck tension and pain
  • Hoarseness that persists for a long time (more than 6 months)
  • Difficulty swallowing
  • Throat irritation
  • Bruising or purplish red spots (hematoma) appear on the neck
  • Hypoparathyroidism, due to damage to the parathyroid glands, which is characterized by numbness, tingling, or cramps
  • Injury to the esophagus or trachea

Go to the doctor immediately if you experience the following symptoms after undergoing thyroidectomy:

  • Fever or chills
  • The incision scar is reddish, swollen and feels warm
  • Fluid or pus comes out from the incision site
  • Numbness and tingling in the lips, fingers or toes

Immediately go to the nearest hospital emergency room if you experience the following complaints:

  • The incision is bleeding
  • Difficulty breathing
  • The sound sounds squeaky
  • Swelling in the neck is getting worse
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