Following thyroid surgery, you will need to take some time to recover. But, you should soon be able to return to your usual activities. Your healthcare team will give you exercises and tips to speed up your recovery.
RECOVERY FROM SURGERY
Your recovery will depend on the extent and type of surgery you have received. It takes longer to recover from traditional, open surgery than from a minimally invasive procedure.
Following surgery, you may experience:
- Voice changes, such as, a hoarse voice, difficulty in speaking loudly, voice fatigue, and a change in the tone of your voice. These changes are due to damage to the laryngeal nerves that supply your voice box (larynx) during surgery. This may last a few days or a few weeks but is rarely permanent. Using the NIM® Nerve Integrity Monitoring System from Medtronic helps surgeons reduce the risk of nerve injury during surgery.
- You may experience low blood calcium levels due to damage to the parathyroid glands during surgery. Again, this is usually only a temporary problem treated with calcium supplements over a few days. Signs that you may have low calcium are numbness and a tingling feeling in your lips, hands, and the bottom of your feet, a crawly feeling in your skin, muscle cramps and spasms, bad headaches, anxiety, and depression.
In the days right after surgery, you will need to take care of your incision area(s). Depending on the type of dressing (covering) you have on the wound, you may or may not be allowed to bathe, shower, or swim until healing is well underway. You might notice bruising or slight swelling around the scar. This is normal. But, if you notice any significant swelling, you should contact your surgeon right away as this could be a sign of infection. The scar may gradually turn pink and feel hard. The hardening is generally greatest at about three weeks after the operation and then reduces over the next two to three months. It can help to rub a small amount of non-scented moisturizing cream around the wound as this helps to soften the skin and prevent dryness as it heals.
You will need to take at least one or two weeks to recover before you return to work and other daily activities. You should not lift any heavy objects for about 2 weeks after your operation to avoid any strain on your neck.
Your neck is likely to be swollen and may feel hard and numb right after the surgery. This is normal and will gradually get better as the wound heals. As soon as you can turn your head without pain or difficulty (within about a week), you should be able to resume driving and other daily activities including non-contact sports. The hospital physical therapist will probably recommend some gentle neck and shoulder exercises to be performed after the operation. These will help prevent any permanent stiffness. Be sure to follow your physical therapist’s instructions. If you continue to have problems with pain or stiffness, contact your doctor.
While your neck is stiff and sore, you may need to eat foods that are soft and easy to swallow. Make sure you eat slowly and have plenty to drink during and after meals to soften your food and prevent blockages. It may help to use a blender to process solid foods.
You will need to visit your doctor or surgeon a few times after your surgery to check on hormone levels and healing. At these visits, you will receive advice on how soon you can return to your daily activities.
People who have a total thyroidectomy and most people who have a subtotal thyroidectomy will need to take thyroid replacement drugs (thyroxine) for the rest of their lives. Without this thyroid hormone replacement, people experience tiredness, depression, difficulty concentrating, memory problems, unexplained or excessive weight gain, dry skin, coarse and/or itchy skin, dry hair, hair loss, feeling cold (especially in the feet and hands), constipation, muscle cramps, joint pains, increased menstrual flow, low sex drive, and more frequent periods. The hormone replacement tablets are small and easy to take. Your doctor will check your hormone levels on a regular basis and adjust the dose of thyroxine until it is right for you.
Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.
Exercise and diet alone often fails to effectively treat people with extreme and excessive obesity. Bariatric surgery is an operation that is performed in order to help such individuals lose weight. Evidence suggests that bariatric surgery may lower death rates for patients with severe obesity, especially when coupled with healthy eating and lifestyle changes after surgery.
Principles of bariatric surgery
The basic principle of bariatric surgery is to restrict food intake and decrease the absorption of food in the stomach and intestines.
The digestion process begins in the mouth where food is chewed and mixed with saliva and other enzyme-containing secretions. The food then reaches the stomach where it is mixed with digestive juices and broken down so that nutrients and calories can be absorbed. Digestion then becomes faster as food moves into the duodenum (first part of the small intestine) where it is mixed with bile and pancreatic juice.
Bariatric surgery is designed to alter or interrupt this digestion process so that food is not broken down and absorbed in the usual way. A reduction in the amount of nutrients and calories absorbed enables patients to lose weight and decrease their risk for obesity-related health risks or disorders.
Body mass index (BMI)
Body mass index (BMI), a measure of height in relation to weight, is used to define levels of obesity and help determine whether bariatric intervention is required. Clinically severe obesity describes a BMI of over 40 kg/m2 or a BMI of over 35 kg/m2 in combination with severe health problems.
Health problems associated with obesity include type 2 diabetes, arthritis, heart disease, and severe obstructive sleep apnea. The Food and Drug Administration (FDA) approves the use of adjustable gastric banding for patients with a BMI of 30 kg/m2 or more who also have at least one of these conditions.
Types of Bariatric Surgery
There are various types of bariatric surgeries that can be performed. Surgery may be performed using an “open” approach, which involves cutting open the abdomen or by means of laparoscopy, during which surgical instruments are guided into the abdomen through small half-inch incisions. Today, most bariatric surgery is laparoscopic because compared with open surgery, it requires less extensive cuts, causes relatively minimal tissue damage, leads to fewer post-operative complications and allows for earlier hospital discharge.
There are four types of operations that are offered:
- Adjustable gastric banding (AGB)
- Roux-en-Y gastric bypass (RYGB)
- Biliopancreatic diversion with a duodenal switch (BPD-DS)
- Vertical sleeve gastrectomy (VSG)
Each of the surgery types has advantages and disadvantages and various patient factors affect which procedure is chosen including BMI, eating habits, health problems related to obesity, and number of previous stomach surgeries. The patient and provider should discuss the most suitable option by considering the benefits and risks of each type of surgery.
Surgical and post-operative risks
People who have had bariatric surgery need to adhere to a rigorous and lifelong diet and exercise plan to prevent complications and to avoid putting on weight after surgery. In addition, patients may develop excess loose and folded skin that requires further surgery to remove and tighten.
As with all types of surgery, bariatric surgery is associated with risks including internal bleeding, deep vein thrombosis, infections, and pulmonary embolism (blood clot in the lungs). It is estimated that the risk of dying shortly after bariatric surgery is around 1 in 200.
Bariatric surgery is an option for people who are severely obese and cannot lose weight by traditional means or who suffer from serious obesity-related health problems. The operation promotes weight loss and reduces the risk of type 2 diabetes by restricting food intake and, in some operations, interrupting the digestive process to prevent the absorption of some calories and nutrients.