My Hemithyroidectomy

Warning! Contains graphic images.

Day 0 (The Operation)

I had been dreading this for some time. I was anxious about so many things. The long-term effects of a hemithyroidectomy, how much pain would be involved post-surgery, would the general anaesthetic react badly with me…?

The waiting around was the worst part of the experience, since it gave me far too much time to dwell on my concerns. As it turns out, when I eventually got to the operating theatre (which by this point was the scariest looking room ever), things weren’t so bad. The anaesthetist inserted the cannula into my hand and gave me something to calm me. He then gave me a little anaesthetic to calm me further (all the time, keeping me talking with general chit-chat). He then told me that he was going to give me the full dose. The next thing I remembered was waking up (feeling very dizzy) in the recovery area!

Pain Levels

I expect this will be of most interest to people with an upcoming thyroidectomy. I was certainly very concerned, having read multiple reports on the internet and watching this video on YouTube. My advice? “Hope for the best, but plan for the worst”. My experience was very different to that of the woman in the linked video.

Now, I ought to declare that I have suffered from nasty headaches, which border on cluster headaches, for some years now. These headaches are the most painful things that I have ever felt, so any other pain I feel is relative to this. Following the operation, I was asked to rank the pain level out of 10 and I pegged it at 3. At this point, the nurse gave me a surprised look and asked “really?”, to which I replied “it only really hurts when I swallow” (it felt like having a very sore throat). She asked whether I would like some paracetamol and I accepted, since the feeling when swallowing was not too pleasant.

Food

At no point did I adapt my diet around the surgery. When in hospital, I did choose “soft options” like porridge for breakfast and pasta for lunch, but since the operation wasn’t on the throat itself, it didn’t make sense to me to avoid specific foods.

The initial problem was with swallowing feeling uncomfortable as the throat obviously had to expand to allow food to pass down to my stomach. It didn’t really matter what food I ate, I still had to swallow it! My method for mitigating the expansion of my throat was to take smaller mouthfuls and chew the food thoroughly. This approach seemed to serve me quite well.

It’s important to note that the feeling of swallowing was uncomfortable as opposed to painful. There was no pain (which I consider to be a sharp feeling), rather there was more of a “throb” when swallowing. It very much felt like having a sore throat when suffering with a cold, but amplified by about 25%. But only when swallowing. When there was no movement of the neck/throat, there was no discomfort.

Day 1

I managed to get a reasonable amount of sleep. It was mostly light sleep as the nurses would perform their “observations” regularly through the night, measuring my temperature, pulse, breathing and blood-pressure.

It wasn’t a comfortable night by any means. Ironically, the pain in my chest, caused by having to sleep partially upright (due to the drain in my neck), outweighed anything that I felt in my neck! By the early hours of the morning, I was suffering quite a bit with chest pain and the nurse gave me a little morphine to help me sleep, which worked well.

A doctor came to assess me at around 9am and was happy that I seemed to be recovering well, the wound on my neck was looking good, and that there was not much fluid collected from the drain in my neck. Given this, she said that somebody would return to remove the drain in my neck. Two nurses came to remove it later in the morning. The senior nurse told me that it would feel very unpleasant to have it removed, but would feel much, much better afterwards. She was right! As it was pulled out, it made me realise that it was the drain which was making swallowing feel unpleasant. Overall, everything still felt tender, which is no surprise given that it was only hours after surgery and there was undoubtedly a great deal of bruising and swelling within my neck.

The doctor returned just before lunch to assess me again and I was discharged just after lunchtime.

Photo of my neck shortly before being discharged from hospital (approximately 17 hours after surgery)

Day 2

Sleep was not much different to the first post-op night. I slept propped up with pillows. I’m not sure whether this was necessary or not, but the nurse had said that I needed to sleep like this for the first night due to the drain in my neck. When I was discharged, one of the things I was told to look out for was any swelling in my neck, and so I felt happier sleeping propped-up.

As part of my discharge, I was prescribed paracetamol, morphine and anti-sickness medication. I stuck with the paracetamol, though the temptation of taking some morphine was there when I was struggling to sleep in the early hours of the morning!

Throughout the day, my neck (where it was stitched) and my throat felt tight when swallowing. That’s not just when swallowing food and drink, but just general “swallowing” (i.e. swallowing saliva). Chewing and moving my tongue made my throat feel uncomfortable, so I undertook these tasks with care.

Day 3

Sleep was uncomfortable again. I did attempt to lie on my side at one point, but it felt very strange and unpleasant in my neck, so I gave up on that and returned to lying on my back. By this stage, I was getting pretty fed up of having to sleep in a single position — on my back. It was this, more than my throat, that was causing me the most discomfort.

Swallowing felt much better by day 3. I removed the dressing for the small wound where the drain was inserted in the morning. This had left a small wound that had already scabbed over.

I continued taking paracetamol throughout the day, but otherwise was starting to feel much more “normal”.

I did sneeze in the afternoon, which, as you can imagine, was not too nice! It made my throat throb for a few minutes afterwards.

Day 4

I felt a little dizzy when getting up in the morning, which concerned me a little as it was not obvious whether this was due to losing half my thyroid, or just a general “lack of strength” due to recovering from surgery. I felt fine after eating some breakfast.

I started to notice some prickly feelings in my neck on day 4, which I put down to the dissolving stitches that were used on the wound. The bruising really started to come out on day 4, with my neck looking very yellow. I felt much more able to move my neck around, though there was still a tugging sensation if I tried to move things too far.

Swallowing felt much better; almost normal! However, my throat still felt dry for most of the day (as it had done since the operation) and when trying to sleep, I would get a tickle in my throat that would cause me to cough and wake up.

Washing had still only occurred from the shoulders down. I was determined not to get the wound wet, and was hesitant to lean too far forward (too much extra blood pressure in the neck area), or back (too much tugging on the wound) — so hair-washing would have to wait a little longer!

Bruising was probably at its peak on day four

Day 5

I managed to get around five and a half hours of straight sleep during the first part of the night, and it was glorious! The chest pains due to lack of movement began to reappear after that. I tried lying on my side, but it still made my neck feel a bit uncomfortable and “throbby”, so I thought it best to not stay like that.

I felt a little dizzy again when getting up in the morning. I still couldn’t decide whether this was due to losing half my thyroid or whether it was part of the recovery process.

The wound was healing up nicely by this point. The bruising had begun to subside and it was looking less prominent. Swallowing was pretty much normal by this point and it was easy to forget that anything had been done to my neck. I could also move my neck more easily without feeling any “tightness”. Of course, I still had to restrict movement to maintain comfort, but I felt way less restricted than the previous day.

Unfortunately, there was a side effect to feeling more “normal” in that it led me to believe that I could do more than I really ought to have. I managed to wash my hair on day 5 (I won’t lie, it was starting to smell and it had to be addressed somehow!) This alone knocked the stuffing out of me! I felt quite exhausted afterwards and my neck was throbbing a little. This, again, led me to start wondering whether I felt that way due to recovering from an operation, or whether it was due to the lack of thyroid tissue.

I still took paracetamol on day 5, but the doses were more spaced out, at 5+ hours. It was less about “pain” at this point, and more about comfort. The wound itself was beginning to feel a little prickly, with the occasional feeling of a needle-prick, and the paracetamol took that sensation away.

Day 6

During the night, I woke up with a strange sensation that I would liken to when you feel hot and “pumped” after doing exercise, only my heart wasn’t racing or anything like that. It’s likely that this was not related to the hemithyroidectomy as this is something that I had experienced in the past, prior to my operation.

This was the first day where swallowing felt “normal” for me, well, not quite normal, but I could swallow without thinking about it. Up until day 6, I could feel a slight restriction in my neck (not my throat, my neck; as in, the wound on my neck) each time I swallowed.

At this point, I could also move my head more freely, especially back (which obviously pulled on the wound a little, so I still had to be careful).

I was generally feeling more normal by this point though.

Day 7/Week 1

I actually slept quite normally at this point. I even managed to get a few hours on each side, which was a huge relief on my chest, which really seems to object to me sleeping only on my back!

Swallowing felt even better. I hadn’t realised how much the nodule on my thyroid was actually restricting my swallowing. The (presumed) swelling and “tight" wound had meant that I was not really able to discern any difference prior to day 7.

On day 7, I felt pretty much back to normal, which was kind of a blessing and a curse! On the one hand, it was good to feel one-hundred percent, but on the other, it meant that I would occasionally forget that I still couldn’t twist my neck too far, or move my jaw too much. Speaking of which, I never realised before, how much the neck is involved in opening your mouth wide! Ouch!

I still seemed to get physically exhausted quite easily, which I hoped was still down to recovering from surgery and not a lack of thyroid hormone. I hadn’t (yet) experienced “brain fog” or anything else untoward, so I remained positive.

Actually, that’s not entirely true, I had noticed an increase in my hunger levels since the operation, but this didn’t concern me because for a good couple of years or more I had been sitting right at the bottom of the BMI scale, being 6ft tall, but weighing just 67kg.

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