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can you live without a thyroid



Life after thyroid surgery


After any operation you need time for your body to recover and your wound to heal. You should not lift any heavy objects for about 2 weeks after your operation to avoid any strain on your neck wound. If you are working, you will need to take time off after your surgery. Most people are able to return to work two weeks after their operation. But this will depend on how strenuous your work is.


If the muscles in your neck are sore and stiff it will be difficult to look side to side safely while you are driving. So you should not drive until you can turn your head without any discomfort. This will be at least one week following surgery or longer. Do not drive while taking any pain medication that may make you drowsy. It will say on the pharmacist's label if you shouldn't drive.


After a few weeks, any stiffness in your neck and shoulder will be much better. The hospital physiotherapist will probably have given you advice on how to do some gentle neck and shoulder exercises following the operation. This is to help prevent any permanent stiffness. Be sure to do these every day or as often as you have been told by the physiotherapist. If you continue to have problems then contact your doctor.


Be patient with yourself and do not expect to recover overnight. You have been through a lot and you need time to heal and adjust after your operation. If you are worried about anything, let your doctor know. It is better to ask about things than sit at home worrying.


Generally, if you have had surgery for thyroid cancer, you will be able to return to most of the things you were doing before your operation. The recovery period varies and may take longer for some people. Some people are back playing sports within 2 weeks of their surgery - obviously you shouldn't play if you are scrum half in the local rugby team! But non-contact sports such as golf or tennis should be fine as soon as you feel well enough.


Possible problems


There are a number of possible problems you might have after your operation. You may


* Have a hoarse voice
* Need calcium replacement because a gland called the parathyroid has been removed
* Need thyroid hormone replacement because your thyroid has been completely removed
* Have swelling, numbness and soreness after you operation and need a soft diet
* Get an infection in your wound

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Hoarse voice


This can happen because a nerve supplying your voice box has been damaged during your operation. The thyroid gland lies close to your voice box (larynx) and the nerves that supply the voice box may be affected during surgery. After your surgery, you may find that your voice sounds a bit different. This happens in about 1 out of every 250 people who have this operation. Your voice may be hoarse and you may have difficulty making high pitched sounds. Other people may not notice this as much as you do yourself. Your singing voice may also be different. Usually, the hoarse voice gets better within a few weeks and your singing voice will recover. In a very, very small number of people the voice changes may be permanent.


Calcium levels


Sometimes the parathyroid glands can be affected by thyroid surgery. These are small delicate glands that are right next to the thyroid gland. They help to control the level of calcium in your blood. If they are not working properly, your blood calcium levels can fall below normal. If this is the case then you will need to take calcium tablets and possibly extra vitamin D. If you have a low calcium level in your blood, you may have twitching or jerking muscles (muscle spasms). Low calcium happens in about 3 out of 10 people who have a thyroidectomy. It is usually only temporary - the parathyroids normally start working again a short while after the thyroid is removed. But it can sometimes be permanent. Removing the parathyroid glands is not usually necessary, so it is rarely done.


Thyroid hormones


If you have had your whole thyroid removed, you will have to take thyroxine tablets to replace the hormones that would normally be made by the thyroid gland. The thyroid hormones are necessary to keep your body processes going at the right rate. This is called your 'metabolism'. Without thyroid hormones, you feel extremely tired and lacking in energy. You will need to take these tablets every day for the rest of your life. The tablets are small - about the same size as an artificial sweetener. Your specialist or GP will keep a close eye on you and you will need to have regular blood tests to keep a check on the hormone levels in your blood. Your doctor may alter the dose of your tablet if your hormone levels are too high or too low. Generally, this is not a problem and shouldn't stop you from doing all the daily activities that you were doing before your surgery.


You may also be given thyroxine tablets if you only had part of your thyroid removed. If you have had follicular or papillary thyroid cancer, the hormones may help to stop the cancer from coming back. They stop your body from producing another hormone called thyroid stimulating hormone (TSH), which can encourage these types of thyroid cancer cells to grow.




Straight after your operation, your neck is likely to be swollen and feel hard and numb. This is to be expected and will gradually get better as your wound heals. It may take a couple of weeks or more. Until this happens you may find that you need to eat foods that are soft and easy to swallow. You may be given pain killers to take at home to help you swallow more comfortably. Make sure you eat slowly and have plenty to drink during and after meals to soften your food and prevent blockages. It may be helpful to use a blender to process solid foods. You will find that you can eat most of your favourite foods - with maybe a few changes here and there. Here are some suggestions for a soft diet


* Use more sauces and gravies - moist food is easier to swallow than dry
* Long, slow cooking softens meat and vegetables
* Finely chop meat and vegetables in a food processor before or after cooking
* Blend or process meat or vegetable casseroles or curries to make tasty soups


It is also important that you eat a nutritious diet to help with healing. If you are having trouble with this, a dietician may help. With everyday difficulties such as dietary problems, it often helps to get advice from people who are in the same situation as you. Try contacting a support group or asking your doctor for a referral to the hospital dietician. Look in help and support for organisations that can help.


There is more about soft diet and boosting calories in the managing diet problems section of CancerHelp UK.


Wound infection


Wound infection is a possible complication after any surgery. While you are still in hospital, the nurses will check your wound regularly and keep it clean. To help prevent any infection once you are at home it is important to


* Keep your neck wound clean and dry until it is completely healed
* Expose your neck wound to the air when possible but avoid direct sunlight to the area
* Avoid going to crowded places (shopping centres, crowded tubes and buses)
* Do not go swimming until your wound is completely healed
* Avoid knocking or putting pressure on your wound


You can have a bath or shower but take care to pat dry your neck area with a clean towel for the first few weeks after surgery. While your wound is healing, you may want to avoid places where you may pick up infections such as colds.


It can help to rub in a small amount of non-scented moisturising cream to your scar once the wound is healed and your stitches or clips have been removed. You can use E45, aloe vera or petroleum jelly. This will help to soften the skin around the wound and prevent dryness as it heals.


If your neck starts to become red, swollen or more painful, or if you have a fever, or oozing from the wound, you should tell your doctor straight away. You may have an infection and need a course of antibiotics to stop it getting worse.



For more information, visit the cancer research website


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