What are the long term effects of a thyroidectomy?
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By Steven Reinberg HealthDay Reporter TUESDAY, Jan. 8, 2019 (HealthDay News) -- Surgery to remove all or part of the thyroid can trigger side effects that send some patients back to the hospital, a new study finds. These side effects include tingling in the fingers that can become tremors and spasms in all muscles of the
body -- including the heart and muscles surrounding the lungs. "The information we gleaned is directly applicable to patient care, and suggests more careful immediate follow-up for patients at high risk for side effects and complications of surgery," said study author Dr. Alliric Willis. He is co-director of the Jefferson Thyroid and Parathyroid Center of Thomas Jefferson University in Philadelphia. Removing the thyroid is usually a safe procedure. However, some of the side effects
of the operation can be so severe that patients need to be hospitalized, Willis explained in a university news release. For the study, the researchers used the 2014 Nationwide Readmissions Database to collect data on nearly 23,000 patients who had thyroid surgery. The procedures were done to cure cancer, treat goiter (an enlarged thyroid), or manage an overactive thyroid. In all, 4 percent were hospitalized again within 30 days. Most of these patients were
readmitted within a week after surgery. Of the patients that needed readmission, 25 percent returned within two days, the researchers found. "Although 4 percent is less than estimates from earlier, smaller studies, it still amounts to nearly 1,000 patients per year whose symptoms are severe enough to seek immediate medical attention and need admission to the hospital," said first author Dr. Arturo Rios-Diaz, a surgical resident at Thomas Jefferson University. The researchers found
that those at the highest risk of being hospitalized were those with Medicare and Medicaid. Also at risk were patients who had low calcium levels after surgery and those who remained in the hospital two days or more after surgery. Low calcium levels, or hypocalcemia, is the most common side effect and is usually caused by damage to or removal of the parathyroid glands. The condition can be treated with calcium pills. "Although the standard treatment for
hypocalcemia is simple, patients have to be able to get their medications after discharge from their surgery," Willis said. "Patients on Medicaid and Medicare could find it financially or logistically difficult to obtain the treatment before the symptoms begin and worsen," he suggested. Willis said patients should be checked on by phone in the first days after leaving the hospital, when they have the greatest risk for complications. The report was published Jan. 3 in the
journal Surgery. When I first noticed symptoms, I thought I was suffering from springtime allergies. My nose felt stuffy, and I was experiencing dull ear pain and pressure inside my ear canal—which I attributed to the fact that I was blowing my nose so much. I also had a raspy voice, which I assumed was the result of postnasal drip (secretion draining from my nose into my throat). At the time, I was a busy single mom of a 6-year-old boy and worked in publishing and as an author. So I resorted to my usual over-the-counter (OTC) allergy meds, armed myself with tissues, and waited for my symptoms to pass. But a month later, I was still using nasal spray 24/7. Thankfully my yearly checkup with my internist was rounding the corner. At my appointment, my doctor examined my neck with her cold hands and asked me how long my voice had sounded so scratchy. "I dunno, maybe a month?" I replied. "What about this lump?" she continued. "How long has this been there?" She pressed her hand into my neck, and I gulped; the area felt tender to her touch. She then guided my fingers to the right side of my neck. What I touched made my eyes widen and my brow crinkle up in confusion: It felt like a grape was in my neck. After that day, things happened at warp speed. My seasonal allergy symptoms and raspy voice turned out to be subtle signs that a mass was pressing against my trachea. A soft tissue neck ultrasound and fine-needle biopsy (removal of a tissue sample) soon revealed that I had a four-centimeter tumor covering the entire right lobe of my thyroid gland. It turned out to be a type of thyroid cancer called follicular variant of papillary carcinoma. I never gave much thought to my thyroid. But amid all the testing and my cancer diagnosis, I learned just how important it is. This butterfly-shaped gland produces thyroid hormones, which regulate just about every function in the body, such as metabolism, heartbeat, temperature, mood, and other important processes. It reaches out to nearly every cell in the body. "The most common type of thyroid cancer is papillary carcinoma," said thyroid cancer specialist Eric Whitman, MD, medical director of Atlantic Health Cancer Care in Morristown, New Jersey. "Follicular variant is a subtype. Papillary and follicular thyroid cancers account for more than 90% of all thyroid cancers. They tend to grow very slowly." While follicular thyroid cancers usually do not spread to the lymph nodes, like many other cancers do, they can move into other body areas, such as the lungs or bones. Though it was unclear how I, a young mom who prided herself on eating well and staying fit, developed thyroid cancer, I discovered that it disproportionately affects women in general—occurring three times more often in females than males, according to the American Cancer Society. Why there's a gender disparity isn't exactly understood, nor is it known why when men are diagnosed with thyroid cancer, it's usually at a more advanced stage. What did all this mean for me? My doctors told me I needed two surgeries to remove the tumor and right lobe, then another surgery to remove the left lobe a month later, leaving me without a thyroid. It felt like my life was completely out of control. My son, Jack, would be starting first grade in the fall, and I was dating a new guy, who had no idea about my diagnosis. Luckily my dad, mom, and two brothers jumped in like superheroes to help. After my second surgery at the Carol G. Simon Cancer Center in Morristown, my thyroid was gone, and I was put on a very high dose of Synthroid (levothyroxine sodium). The drug is "thyroid replacement hormone," said Dr. Whitman. It does two things: It recreates the function of a thyroid and suppresses thyroid-stimulating hormone (TSH), so cancer cells are less likely to develop. It's just a tiny blue pill, but this synthetic hormone was no picnic. My TSH levels drastically changed, and that meant all the body processes that the thyroid usually controls were out of whack. My body temperature was always shifting; I felt hot when it wasn't hot out and chilly when it wasn't cold. I had anxiety and felt very down, very blue. I was constantly drained. Even though my diet did not change, I started to gain weight, and my fatigue made it difficult to exercise. I toughed it out and prepped for the next phase of treatment: radioactive iodine treatment in pill form. That meant being quarantined in my apartment for four days so I couldn't contaminate Jack and my dog, Lucy. For the first 24 hours, my eyes, neck, and head hurt—and I dry-heaved. I couldn't eat for at least 48 hours, so I stuck to ice chips, water, and diet ginger ale. Going through treatment alone was not so bad. I am kind of a loner and a definite doer; I attribute this to the superpowers I acquired as Jack's single mom. I felt empowered by the process, and I got to watch a lot of Netflix in peace. When my son and pup came bounding through the door with flowers and balloons after the quarantine was over, I felt complete. After radiation was over, the final step in my treatment involved getting a full-body scan to see if the radiation worked. It did. Like a little Pac-Man, it ate up all the remaining cancer cells in my neck and a small spot on my chest. That small spot on my chest freaked me out, but at least it was gone. Being done with surgery and radiation was the strangest feeling, like when someone dies and you're so busy with the arrangements and guests and food...and then the next day, you're alone. That's how I felt. Sometimes, I also felt like I had a big secret. I did quickly realize that I was now part of the Big C club, and that meant I would require a lifetime of medication and tests. Every 3 to 6 months I had to see my doctors for blood work, and I needed an ultrasound twice a year. It was a dizzying experience juggling those responsibilities, especially because I was also back to taking care of Jack, running our home, and working as an editor. I tried to stay upbeat and positive. As vain as it sounds, gaining weight was the toughest side effect of my journey. I had always been small-boned and fit. I prided myself on eating clean and exercising. As a mother, I wanted to be in shape, racing Jack around the track and hiking up hills with him and Lucy. And yes, as a single woman, I wanted to look a certain way—not skinny, but the way I did before cancer. Instead, I found myself pathetically crying in my closet in a pile of size 2 jeans that no longer fit. Summer 2018 was the four-year anniversary of my diagnosis. In July, I found out that there were no tumor markers in my blood, and if all continued to go well, I would be considered officially cured. I did a happy dance when I got those test results. I also decided to make some changes so the physical and mental side effects of not having a thyroid would be easier to handle. Because my spirits were iffy, I joined a cancer survivor support group. It turned out to be the best thing I did since getting sick. I met people who had thyroid cancer and other types; I learned first-hand that we are all going through the same medication side effects, like bloating and mood swings. After the first meeting, I made some notes in my iPhone and stuck to them like they were the holy grail. I also committed to exercising at a challenging pace for an hour every single day. I joined a barre class and made new friends. Jack plays soccer, so I've started doing regular soccer drills with him. We also play tennis and always take the stairs in our apartment complex. Jack has been a terrific cheerleader, and Lucy is also an excellent motivator as my hiking and walking buddy. Meal planning has helped me eat healthier and feel better too. Every Sunday night, I cook a huge batch of grilled chicken and quinoa salad with peppers, kale, and a sprinkle of feta. I also stocked my fridge with natural, sugar-free yogurt, tuna packets, tons of green produce, and a pitcher of lemon water. My amazing Italian dad who loves to cook always stops over with healthy meals. Not having to think about what I was going to eat made it easier to stay on track. Over a period of months, I lost 16 pounds, gained back my confidence, and started feeling like a new version of myself. I'm pretty sure I'll never be a size 2 or wear a skimpy bikini—and I don't care, because I'm betting on my cancer not reoccurring. Something terrible happened to me out of the blue, but it will not define me. That scar on my neck? It's barely visible anymore, and I like it. It's a battle scar that reminds me of what I conquered. I've learned some things about cancer and its aftermath, however, and here's what I want Health readers to know:
Christine Coppa is the author of Rattled! (Crown 2009). What are the side effects of having no thyroid?These include:. Weight gain.. Cold intolerance.. Fatigue.. Sleep problems.. Trouble concentrating, or brain fog.. Depression.. Dry skin.. Muscle cramps.. What is the most common complication of thyroidectomy?The two most common early complications of thyroid surgery are hypocalcemia (20-30%) and recurrent laryngeal nerve injury (5-11%).
Can you live a long life without a thyroid?Thyroid disease is common, and in some cases may require removal of your thyroid (thyroidectomy). Fortunately, you can live without your thyroid. You will need long-term thyroid hormone replacement therapy to give you the hormone your thyroid normally produces.
Can you live a normal life after thyroidectomy?Most people do very well after treatment, but follow-up care is very important since most thyroid cancers grow slowly and can recur even 10 to 20 years after initial treatment.
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