Health, Fitness And Weight Loss Blog

Endocrine glands are the structures in the body which secrete hormones and the thyroid gland, anatomically placed in the front of the neck, is responsible for the production of thyroxine. Thyroxine is produced and passes into the blood and its function is to control the metabolism with some control over the functioning of all the cells in the body. More thyroxine can be stored and produced by the thyroid gland than can be used by the body so if a partial thyroid removal is the necessary operation then the patient may not need to take thyroid
replacement tablets.

If the whole thyroid gland is excised then the patient will need to take tablets for thyroxine replacement throughout their life. The size of four small rice grains, the minute parathyroid glands adhere to the thyroid gland and secrete a hormone called parathyroid hormone. Parathyroid hormone is closely involved in the blood regulation of calcium concentrations, which promotes good health and the maintenance of a healthy skeletal structure. During the thyroid removal operation the surgeons take care not to affect the parathyroid glands but the secretions of the glands can be altered.

Thyroidectomy is the removal of the thyroid gland, either a total thyroidectomy or partial removal, called a sub-total thyroidectomy, hemithyroidectomy or lobectomy. There are several reasons for removing all or part of the thyroid gland. Overactivity of the thyroid gland is the main reason, known as hyperthyroidism or Graves' disease or when goitre occurs with an enlarged thyroid. Goiters are removed either because they are causing pressure on the windpipe or gullet, are causing breathing or swallowing problems or they may look unsightly.

Thyroidectomy will be carried out under a general anaesthetic which means the patient is unconscious during the whole operation. An incision will be made in the neck, often made in the natural skin crease just above the top of the breastbone and always made symmetrically. This helps the incision to heal, leaving a scar which is usually inconspicuous and may become virtually invisible in time. The surgeon may leave a small drain tube in the neck to collect wound fluid and help speed up the healing process, removing it on the first or second day after operation. The stay in hospital will usually be two to four days.

Patients should refrain from eating for six hours before the operation and take clear fluids only up to two hours before the event. A venflon will be placed in the arm and through this the anaesthetic is given to last for the hour or two the operation will take. Some surgeons put stitches under the skin so removal is not necessary, others may use clips or stitches in the skin which are taken out after a few days. Two to four days is the typical hospital stay but this is dependent on how well people are, and on discharge they should be collected by a relative. The level of pain after thyroidectomy varies and typically patients have some around the neck.

It is uncommon to get a wound infection and patients should monitor the wound to check it does not become sore and red, in which case antibiotics will be used. Rarely the wound needs to be re-explored to release pus. There is a one in fifty chance of bleeding occurring into the wound and the hematoma has to be explored and removed in rare cases. It is common to have wound swelling and bruising which is caused by the bleeding under the wound and later by scarring.

Patients will have a vocal chord check before surgery and the surgeon will discuss the specific problems of operating so close to the voice box and its associated nerves. Bruising of the nerves during surgery may stop them working properly and as these nerves control the movements of the vocal chords if they are damaged this can cause hoarseness and weakness in the voice. The voice should recover over a period of a few weeks or months but occasionally a nerve will be permanently damaged but this is rare. Injury to both nerves is very uncommon and very serious as the voice is lost and a tracheotomy tube is placed in the windpipe to allow breathing to occur.

Jonathan Blood Smyth is a Superintendent of Physical Therapy at an NHS hospital in the South-West of the UK. He writes articles about back pain, neck pain, and injury management. If you are looking for physiotherapists in Manchester visit his website