Questions to the surgeon about thyroidectomy

[Kari55]

Hello, I wonder if any of you have a list of questions that can be asked at the consultation about thyroidectomy?

[Hidden]

It is not advisable to have "keyhole"surgery, the op is already dangerous enough for you to be bothered about how big the scar is going to be. I am quite proud of my THREE scars.

Depending on whether this is partial or total, you may have the option some weeks later of taking radioactive iodine therapy (effectively swallowing one or more doses of juice with added radioactive iodine). Ask him what thoughts he has about that.

Ask him what he would do if he got so far and then felt insufficiently experienced to complete the op and what would then happen. This DID happen to me and the surgeon consulted with others during the op, discontinued and sent me home. Unfortunately it took them another 6 months in 2005 for another surgeon to volunteer to continue!

Ask about what medication, if any, you would need to take. If a total T then ask him why you are only likely to be offered levothyroxine when a study in 2011 suggested that after a total T, then levo on its own will be unlikely to give good health, which means that you would need to take NDT as even treatment with combined T3/T4 is unlikely to give good health.

ncbi.nlm.nih.gov/pmc/articl...

- which is also quoted in many other trials over the years.

[Kari55 in reply to Hidden]

Thank you, this is actually for my husband. I don’t think RAI is an option as I’m pregnant so I believe he wouldn’t be able to be around babies after the treatment. His thyroid levels have been in range and antibodies very low so I’m not sure why they push him so much into thyroidectomy.

[Greekchick in reply to Kari55]

Hi Kari,

I would ask the following questions:

Why is surgery being recommended? Is drug therapy an option?

What procedure will you use? Invasive or minimally invasive?

How many thyroid surgeries do you do a year (at least 5 per week is recommended)?

What is your audited error rate? Less than 1% is recommended

Do you use a vocal cord monitor? This is a must

How often have your patients experienced vocal cord damage or damage to the parathyroids?

Do you use a plastic surgery closing? This is not for cosmetic purposes - but because the scar heals better and has less of a chance to affix itself on the neck.

There are no absolutes in thyroid conditions - everyone is different and different treatments and replacement therapies after surgeries work for different people. Also, all things thyroid usually progress very slowly - so there is no rush to make a decision. Do not let any physician rush you unless there is an urgent situation.

Hope this helps you and wishing you and your husband all the best.

[Kari55 in reply to Greekchick]

Thank you very much, this is very helpful!

[LAHs in reply to Greekchick]

Yes, you mentioned the two questions I was going to suggest.

1. Be very careful not to clobber my vocal fold, especially pulling out the anesthetic tubes. Don't let the anesthetist use my larynx as a "washer".

2. Do not lose my parathyroids, I want the same 4 inside me when I come out of surgery as when I went in.

and a third:

Sew me back up carefully, I really don't need a big scar and I scar very easily. Please let someone do the sewing up who knows how to do it right.

[Greekchick in reply to LAHs]

Good questions!! All the best.