This video is about Surgery for Hyperthyroidism
Hi this is dr. mary kathleen figueroa coming to you from the thyroid channel thanks for tuning in if this is your first time please be aware this is for educational purposes if you have specific complaints or concerns please contact a local endocrinologist so today we’ll be discussing the ii treatment for hyperthyroidism last week we discussed radioactive iodine
And this week we’ll be discussing surgery for hyperthyroidism what might happen after you get diagnosed with hyperthyroidism is that you and endocrinologist will decide what would be the best treatment for you often that is radioactive iodine or methimazole which we’ll discuss next week but this week we’ll discuss surgery surgery is by far the most drastic reason
Drastic treatment for hyperthyroidism but why might you choose surgery well my patients who discussed surgery with me and decided on surgery often have a very large gland and it’s hard to breathe hard sleep and even though they’ve been on a tappa solar or methimazole or ptu they haven’t gotten their symptoms under control for some time period that’s too much for
Them that’s number one reason the second reason they might choose to have surgery is that they have nodules in the thyroid in addition to having hyperthyroidism so the entire gland is large and they have nodules inside the thyroid and a nodule might be producing more hormone than the rest of the thyroid well the best way to take care of that is to have surgery and
Remove the side where the nodule is or the entire thyroid if there are multiple nodules on both sides so the second reason the third reason you might choose to have surgery is that you have significant thyroid eye disease so much eye disease that you may have had surgery for the thyroid eye disease or be very gravely ill with it if that’s the case you might want
To undergo surgery because it’s a quick way of resolving the hyperthyroidism you do not have to worry about worsening of hyperthyroidism you might for radioactive iodine and it won’t take forever to get better as it might with tap azul or ptu and by forever i may mean two or three weeks it may be too much for you to to adjust to or you’ve been trying for several
Months to get treated with with tab azul or methimazole and it has not worked for you so those are the three main reasons people choose surgery and so what is involved in surgery well first of all whoever has diagnosed you and has chosen to send you to surgery would have to engage a surgeon who is very competent at taking out thyroids it may seem to you that it
Would be simple to take out a thyroid it’s so visibles right under your skin but there are a lot of important structures in the neck and if you have surgery from a person whom or a surgeon who is not as experienced especially when you have graves disease which makes the thyroid gland very bloody and difficult to manage during surgery then you may be more likely to
Undergo complications of surgery and what are those complications certainly you can have damage to the nerve the right record route laryngeal nerve that goes to your thyroid and excuse me goes to your vocal cord and determines whether you you sing beautifully or can talk wonderfully so that might be one complication another is that there are four glands called
The parathyroid glands two on each side of the thyroid and if the thyroid is specially enlarged and bloody and inflamed with hyperthyroidism that makes it more likely that you would have injury to these glands which control your calcium and can cause secondary hyperparathyroidism it’s complicated words meaning that you do not have enough affect of these four
Glands especially if all four are taken out by mistake so that’s the second most common complication and certainly if you have surgery you can have seroma inflections other things large pockets of fluids and and just a bad cosmetic outcome so those are major complications of surgery and you would have to discuss that with your surgeon you would want to know two
Important things of a surgeon what their complication rates are and how many of these surgeries they do per year since any confidence in a surgical procedure largely depends on how often the surgeon performs the procedure and the confidence of the surgeon can also be evaluated on whether he or she has a high or low complication rate so those are two things you’d
Want to discuss with anyone who was going to do surgery for you for hyperthyroidism so you have decided with your endocrinologist that you need surgery because of major three reasons we discussed you have decided that you are going with this surgeon you have met him or her and you’ve determined their complication rate and the number of procedures they do and it’s
Greater than 20 or some respectable number and they seem confident so that’s the second process the third is that’s scheduling the actual surgical date and so you want to make it so that you have enough time period to recover from surgery at least one to two weeks at most six weeks depending how sensitive you are to surgical procedures and you have determined that
You have you have multiple people to take care of you to help you recover from surgery and you’re ready for surgery okay what happens when you go to surgery there are two ways that surgery happens it can happen in outpatient setting or it can happen in an inpatient setting if it happens in the hospital then what you have is you stay overnight after a surgery and
Your monitor to make sure your calcium is right and that your hyper your parathyroid glands are not injured and your monitor to make sure that you have no excess bleeding because it’s a very bloody gland and then you’re sent home to recuperate and then and once you’ve recuperated you have to be well while you’re recuperating and the day after surgery you have to
Be started on thyroid medication because you’ve lost your gland and you need replacement so the steps for deciding on surgery for hyperthyroidism are first determined it is the right procedure for you to determine if the surgeon is competent and appropriate for the surgery to have the surgery and then to quickly get retreated to make sure that you did not become
Hypothyroid thanks for watching this video if you enjoyed it please give it a thumbs up if you’d like to subscribe please subscribe below and new videos every friday
Transcribed from video
Surgery for Hyperthyroidism By The Thyroid Doc