For most people with hyperthyroidism, surgery is usually a last resort. People usually turn to surgery if they don't want to take antithyroid drugs or undergo RAI treatment or have had limited success with the other two options.
Surgery may involve removing part of the thyroid gland, called a partial thyroidectomy. If only one lobe is removed, it is called a lobectomy. Surgery might also mean removal of the entire gland, which is called a total thyroidectomy. Partial thyroidectomy retains part of the thyroid, so you may not need thyroid hormone replacement for life. A total thyroidectomy ensures that you will not develop hyperthyroidism, but it does mean you will become hypothyroid.
Your ability to return to routine activities after surgery will depend largely on your level of discomfort. The one prohibition is swimming, which you cannot do until the incision is fully healed. You will be able to resume driving as soon as you can comfortably turn your head. Most patients can return to work within two weeks, and go back to leisure activities within a week.
Surgery is sometimes considered for women who are pregnant or planning to become pregnant. It may also be done in people with Graves' disease who have a large goiter that is obstructing breathing and swallowing. It may also be an option for people who have tried antithyroid medications without success and who cannot have RAI.
After surgery, you may notice some pain in your neck and some pain when swallowing. You may also experience some tension and stiffness in your neck. In addition, your voice may be hoarse. Most of these side effects are temporary and will disappear after about a week of normal activity.
Risks of Surgery
Like any surgical procedure, thyroid surgery comes with its share of risks. There is potential damage to the vocal cords and to the parathyroid glands, which are both located near the thyroid gland. Damage to the vocal cords can affect your voice, while damage to the parathyroid gland can lower blood levels of calcium, causing numbness, muscle pain, and depression.
The best way to prevent these risks is to choose an experienced surgeon, one who has done several surgeries on the thyroid. Do not hesitate to travel to locate a skilled surgeon. The expertise and abilities of a skilled surgeon will more than make up for the time and expenses involved.