What Should I Ask My Surgeon Before Thyroid Surgery?

What Should I Ask My Surgeon Before Thyroid Surgery?

The thyroid is a butterfly-shaped gland located at the base of the neck, just below the Adam's apple. It plays a crucial role in regulating various bodily functions by producing hormones that control metabolism, growth, and energy expenditure.

Thyroid hormones, primarily thyroxine (T4) and triiodothyronine (T3), influence almost every organ system in the body. They help regulate heart rate, body temperature, weight, energy levels, and mood. Thyroid hormones are also essential for the proper development and functioning of the brain, muscles, and other organs.

The production of thyroid hormones is controlled by the pituitary gland, a small gland located at the base of the brain. The pituitary gland releases thyroid-stimulating hormone (TSH), which stimulates the thyroid gland to produce and release T3 and T4. This feedback loop ensures that the body maintains a stable level of thyroid hormones in the bloodstream.

Issues with the thyroid gland can lead to various health problems. For example, an overactive thyroid (hyperthyroidism) can cause symptoms such as rapid heartbeat, weight loss, anxiety, and tremors, while an underactive thyroid (hypothyroidism) can result in fatigue, weight gain, depression, and cold intolerance. Thyroid nodules, thyroiditis, and thyroid cancer are other conditions that can affect the thyroid gland.


What is a thyroidectomy and can I live without my thyroid?

A thyroidectomy is a surgical procedure to remove all or part of the thyroid gland. It is typically performed to treat conditions such as thyroid cancer, large thyroid nodules, hyperthyroidism (overactive thyroid), or goiter (enlarged thyroid gland) that does not respond to other treatments.


There are several types of thyroidectomy, including:

1. Total thyroidectomy: In this procedure, the entire thyroid gland is removed. It is often recommended for thyroid cancer or Graves' disease (an autoimmune disorder that causes hyperthyroidism).

2. Subtotal thyroidectomy: Also known as a near-total thyroidectomy, this procedure involves removing most of the thyroid gland, leaving a small portion of tissue behind. It may be performed for large goiters or Graves' disease.

3. Partial thyroidectomy: In this surgery, only a part of the thyroid gland is removed. It is commonly used to treat thyroid nodules or benign thyroid conditions.


Thyroidectomy is typically performed under general anesthesia, meaning the patient is unconscious during the procedure. The surgeon makes an incision in the front of the neck, usually along a natural skin crease, to access the thyroid gland. The specific approach and extent of the surgery depend on the reason for the thyroidectomy and the individual patient's condition.

After the thyroid gland is removed, the surgeon may use stitches or surgical glue to close the incision. Some patients may require thyroid hormone replacement therapy after the surgery to maintain normal thyroid hormone levels in the body.

Thyroidectomy is generally considered a safe and effective treatment for thyroid conditions, but like any surgical procedure, it carries certain risks, including bleeding, infection, damage to nearby structures (such as the parathyroid glands or vocal cords), and changes in thyroid hormone levels. It's important for patients to discuss the potential risks and benefits of thyroidectomy with their healthcare provider before undergoing the procedure.


Before undergoing a thyroidectomy, it's crucial for patients to have a clear understanding of the procedure and its potential implications.


Here are some questions they may consider asking their surgeon about the surgery itself:


1. What type of thyroidectomy do you recommend for my condition (total, subtotal, or partial) and why?

2. What are the potential risks and complications associated with this surgery?

3. How long will the surgery take, and what type of anesthesia will be used?

4. How much experience do you have performing thyroidectomies, and what is your success rate?

5. Will I need to stay in the hospital overnight, and if so, for how long?

6. What is the expected recovery time, and when can I return to normal activities?

7. Will I need to take any medications or supplements before or after the surgery?

8. What are the potential side effects of thyroid hormone replacement therapy, if necessary?

9. Are there any dietary or lifestyle changes I should make before or after the surgery?

10. How will the surgery affect my voice and swallowing function, and are there any risks of damage to nearby structures?

11. Will I need any follow-up appointments or tests after the surgery, and what will be the long-term follow-up plan?

12. What alternatives to surgery are available, and what are the risks and benefits of each option?

13. Can you provide information about your team and the facilities where the surgery will take place?

14. Are there any specific preoperative preparations I need to undergo?

15. What should I do in case of emergency or if I experience complications after the surgery?

16. Will you assist me in finding a good Endocrinologist if I don’t already have one?

17. If I need RAI will I see someone different and if so, who will that be?


Here are some questions they may consider asking their surgeon about their expertise:

  1. Are you a thyroid or endocrine surgeon? IF not, what type if surgery is your specialty?
  2. How many thyroidectomies do you perform each year, day month?
  3. What is your success rate and rate of complications? You can also look this up online, it's important to know a surgeons quality of work and success. 
  4. Have you ever nicked the vocal nerve?

Having the answer to these questions can help patients feel more informed and confident about their decision to undergo thyroidectomy and ensure they have a thorough understanding of the procedure and its potential outcomes.



The importance of finding an Endocrine Surgeon as opposed to a General Surgeon. 

Having specialized surgeons for different parts of the body is important for several reasons:

1. Expertise: Specialized surgeons have focused training and experience in a particular area of the body, allowing them to develop expertise in specific surgical techniques, procedures, and treatments. This expertise often leads to better outcomes for patients.

2. Precision: Surgery requires precision, especially when operating on delicate structures or in complex anatomical areas. Specialized surgeons are familiar with the nuances of the anatomy and can perform procedures with greater accuracy and precision.

3. Comprehensive care: Specialized surgeons can provide comprehensive care tailored to the needs of patients with specific conditions or diseases affecting particular body parts. They are often better equipped to diagnose, treat, and manage complex or rare cases within their area of expertise.

4. Innovation: Specialized surgeons are at the forefront of advancements in their field, including new surgical techniques, technologies, and treatments. They are more likely to incorporate the latest innovations into their practice, leading to improved outcomes and patient satisfaction.

5. Collaboration: Specialized surgeons often work closely with other specialists, healthcare professionals, and multidisciplinary teams to provide coordinated care for patients. Collaboration among specialists allows for a more holistic approach to treatment, addressing all aspects of a patient's health and well-being.

6. Reduced complications: Specialized surgeons are less likely to encounter complications during surgery because of their familiarity with the specific anatomy and potential risks associated with procedures in their area of expertise. This can lead to lower rates of surgical complications and improved patient safety.


Overall, having specialized surgeons for different parts of the body ensures that patients receive high-quality, specialized care that is tailored to their individual needs, resulting in better outcomes and improved quality of life.


Talking with your doctor or surgeon about surgery is crucial for several reasons:

1. Informed decision-making: By discussing surgery with your doctor or surgeon, you can gain a better understanding of the procedure, its potential benefits and risks, alternative treatment options, and what to expect during and after the surgery. This information allows you to make an informed decision about whether surgery is the right choice for you.

2. Clarification of concerns: Talking with your doctor or surgeon gives you the opportunity to ask questions, express any concerns or fears you may have about the surgery, and receive clarification on any aspects of the procedure that are unclear to you. This can help alleviate anxiety and ensure that you feel confident and prepared for the surgery.

3. Establishing trust and rapport: Open communication between you and your healthcare provider fosters a trusting and collaborative relationship, which is essential for effective medical care. By discussing surgery with your doctor or surgeon, you can build rapport and establish trust, leading to better cooperation and adherence to the treatment plan.


Remember, your doctor works for you. If you're not happy with the answers or information provided by your doctor or surgeon, there are several steps you can take:


1. Ask for clarification: If there are aspects of the surgery or treatment plan that you don't understand or that concern you, don't hesitate to ask for further explanation or clarification from your doctor or surgeon. They should be willing to address your questions and provide additional information to ensure that you feel comfortable and informed.

2. Seek a second opinion: If you have doubts or reservations about the proposed surgery, consider seeking a second opinion from another qualified healthcare provider. A second opinion can offer you a different perspective on your condition and treatment options, helping you make a more informed decision about your care.

3. Express your concerns: Be honest and open with your doctor or surgeon about your concerns and preferences regarding the surgery. Communication is key to ensuring that your healthcare needs and preferences are taken into account, and your doctor or surgeon should be receptive to addressing your concerns and accommodating your preferences to the extent possible.

4. Explore alternative options: In some cases, surgery may not be the only or best treatment option for your condition. Talk with your doctor or surgeon about alternative treatments, therapies, or approaches that may be available and appropriate for your specific situation. Together, you can weigh the pros and cons of each option and determine the most suitable course of action for you

5. Consider changing providers: If you consistently feel dissatisfied with the communication, care, or treatment provided by your doctor or surgeon, you may consider seeking care from a different healthcare provider who better meets your needs and preferences. It's important to feel comfortable and confident in your healthcare team, so don't hesitate to make a change if necessary.


By addressing these questions, patients can make informed decisions and cultivate confidence in their treatment journey. Additionally, seeking a specialized endocrine surgeon enhances the likelihood of optimal outcomes and surgical scarring, given their focused expertise and experience. Advocating for oneself and fostering open communication with healthcare providers remain paramount throughout the process, ensuring personalized and effective care.

Ultimately, advocating for yourself and actively participating in discussions about your healthcare decisions can help ensure that you receive the best possible care and achieve the most favorable outcomes.



Johns Hopkins Medicine: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/questions-to-ask-before-surgery#:~:text=Ask%20what%20to%20expect%20in,placed%20on%20you%20after%20surgery.



References: Johns Hopkins Medicine

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