[green123]

#1060763

Hi all,

I wanted to ask your opinions. After reading potential consequences of thyroidsectomy, hypoparathyroidism seems very scary and it sounds like there is a 1% risk even with experienced surgeons. And reading people’s experiences with hypoparathyroidism (trips to ER, not being able to function like normal) seem to be worse than graves’ disease.

What is your opinion on this? Is thyroidsectomy a good choice for graves’ disease patience since it sounds like the thyroid of someone with graves’ disease is more enlarged and potentially even more difficult to operate. Please share your thoughts.

[Kimberly]

#1184624

Hello – Hopefully, others who have had surgery will chime in here, but it’s important to remember that ALL three treatment options have risks. Only you (with help from a doctor who understands your medical history) can decide which set of risks/benefits is the most acceptable to you.

Also, you definitely want an endocrine surgeon who does a lot of thyroidectomies each year AND who does surgeries specifically for Graves’ disease. As you mentioned, the surgery can be more difficult if the thyroid is enlarged.

Hypoparathyroidism is *usually* temporary and can be resolved by taking calcium. As with Graves’, some cases are more complicated than others – and those are the ones you are most likely to read about on the Internet. Here’s some more info from the American Association of Endocrine Surgeons on hypoparathyroidism and other complications:

(Note on links: if you click directly on the following link, you will need to use your browser’s “back” button to return to the boards after viewing, or you will have to log back in to the forum. As an alternative, you can right-click the link and open it in a new tab or new window).

http://endocrinediseases.org/thyroid/surgery_complications.shtml

[green123]

#1184625

Thank you!

[emmtee]

#1184626

green123 wrote:

“…the thyroid of someone with graves’ disease is more enlarged and potentially even more difficult to operate.

That’s exactly the excuse given to me by a surgeon I consulted with when I was first diagnosed. Back then, my thyroid was enlarged a little bit on the left and a lot on the right. You could see the goiter on the right side, but it wasn’t noticeable if you weren’t looking for it. I was so disappointed and annoyed that I actually walked out of the appointment. (I was having a bad day – suffering from a migraine, but I had dragged myself to the surgeon’s office, only to be told that he didn’t do TT’s on Graves’ patients – something his staff should have told me when I made the appointment).

Fast Forward 4 years to last fall. I had developed a large goiter on my left side. It was very noticeable and made me feel like I was choking when I tilted my head down. An ultrasound showed that I had a large nodule (thought to be over 6 cm) that was growing from the bottom of my thyroid and extended below my collar bone. It was also growing toward the center and pushing my trachea off center. My thyroid needed to be removed, even if the biopsy hadn’t found the nodule to be suspicious for cancer.

Fortunately, the hospital had recently hired a really good endocrine surgeon who specializes in thyroids and parathyroids. During my consultation with her, she mentioned that, even though we have 4 parathyroids, we can get by with only 1/2 of one parathyroid. When she wrote up my surgery orders, she included “possible parathyroidectomy” in the description just in case it was needed. (It wasn’t). I guess they don’t know what they’ll find until you’re in the operating room. The parathyroids are located behind the thyroid, but in some patients they can actually be embedded in the thyroid tissue. Even when they aren’t damaged in surgery, they can be “stunned” and stop working for a while. That’s why surgeons have their patients take calcium supplements until it’s clear that the parathyroids are functioning normally.

Another potential complication from the surgery is damage to the nerves that affect the vocal cords. They have a really neat tool to help prevent this, though. My anesthesiologist told me he was using a special breathing tube that has a sensor on it that alerts the surgeon when they are getting close to the nerves. All breathing tubes irritate the vocal cords and cause hoarseness for a couple of weeks, but this isn’t a big deal.

Even though my surgery was extra challenging (much more so than when I had first been diagnosed with Graves’), it went perfectly. I had no complications and really, not even a lot of pain. Even my pathology report was good: My nodule measured 7 cm long, but it was benign.

I still get a bit angry when I think of that first surgeon who wouldn’t operate on a Graves’ patient, but it’s probably for the best. You don’t want a surgeon who isn’t confident in his/her abilities to do the job. I’m glad I ended up having my thyroidectomy done by a really great surgeon. It just sucked that I had to go through all the worry of possible thyroid cancer. That’s a lot of stress that I could have avoided if I’d persisted in finding a good surgeon 4 years earlier.

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