choking on liquids after thyroidectomy
The site is secure. It's definitely not convenient - I'm unable to go out to dinner with family and friends as I need to be close to the bathroom when I eat - my husbands wonderful and knows what I'm going through, so helps me to keep things "discreet"if we have to go to these family functions. I had a total thyroidectomy on Feb. 27th, and although the first few days after surgery were a little rough, I have made steady improvement since then. Scerrino et al. For this purpose, the literature review focused on all papers dealing with this topic during the last 15 years. The liquid formulation is supposed to overcome the food and beverages interference with absorption of LT4 tablets. 4-8 Swallowing complaints are common after surgery, but patients are generally counseled that symptoms should spontaneously resolve . Any input on my situation is appreciated. Sorry in admvance. (27) addressed this topic in a study of 19 hypothyroid patients with tablet LT4 malabsorption caused by calcium and/or iron supplements and who were switched to liquid LT4 at the same dose. Hence, several schemes are reported in the literature for the proper initial dose of LT4. It's been about 24 hours and while I have had a relatively easy recovery, I'm starting to get. The experimental group consisted of 300 patients (202 females and 98 males) who underwent thyroidectomy . I had a really productive cough. Do you have allergies? To promote the use of Poisson regression to estimate the proper LT4 dose, the authors developed an easy-to-use web application that allows the physicians to insert the patients parameters and automatically calculate the LT4 dose. over a year ago. This procedure could be a hemi (one lobe) or total (both lobes) of the thyroid. The coughing has just stopped. Bethesda, MD 20894, Web Policies Eventually, they thought that after my operation, they may have done something to the muscles in my throat which has weakened them and making it harder for me to swallow food. In the weeks after your thyroid surgery, you may have neck pain, soreness of your vocal chords or a weak . The ThyCa: Thyroid Cancer Survivors' Association Support Community connects patients, families, friends and caregivers for support and inspiration. Ferrara R, Ientile V, Arcoraci V, Ferrajolo C, Piccinni C, Fontana A, et al. Beyond the classic tablet form, new formulations of LT4, such as a soft gel capsule and an oral solution, recently became available. (31) performed a prospective randomized study in 2016 of 155 patients who had undergone total thyroidectomy and evaluated the patients mood state and their self-perception of mental well-being during a follow-up period of 2 months. May 4, 2015 7:40 PM. had total thryroid removed Feb 11, 2014 still grasping for air which they call spasms. Thanks. Approximately 75% of patients require dose adjustments, suggesting that body weight is not the only factor involved in the determination of the proper LT4 dose (3). I had a total thyroidectomy and also removed 18 lymph nodes and both parathyroids on the left side due to cancer. Depends on the possible causes of the difficulty swallowing (related to nerve damage or appearing after uncomplicated thyroidectomy), different types of diagnostic procedures could be used to study patient discomfort, as well as intraoperative nerve monitoring, fiber optic laryngoscopy, endoscopy, pH monitoring, esophageal . Italian consensus on diagnosis and treatment of differentiated thyroid cancer: joint statements of six Italian societies. Notably, a population-based study of 55,000 LT4 users reported a significant reduction in the number of TSH measurements after switching from the tablet to the liquid form, particularly in patients using drugs that potentially interfere with LT4 absorption (11). My doctor still thought I was crazy and exaggerating when I told him. Similarly, Cappelli et al. My oncologist seemed to know exactly what I was talking about when I told him and he prescribed: Hydrocodone-Chlorpheniram Suspension liquid. Coughing up thick yellow mucous - difficulat to bring up , don't seem to be able to get a strong cough. Inclusion in an NLM database does not imply endorsement of, or agreement with, Other notable aspects were evaluated by Pirola et al. The LT4 dose required for achieving normal TSH values did not differ between tablets and the soft gel capsule formulation. This might imply a long-term treatment with LT4 to the extent that in these patients it is even more important to individualize the therapy to balance accurately its supposed benefits against the potential risk of adverse effects during follow-up. There are also more instances of me choking on food, even if they are small. I count my lucky stars i proved the docs wrong but I'm also lucky in that my voice came back strong after a few days and the stiffness didn't get chance to get stiff i believe largely due to all the choking i did the the first few days. Accessibility best dr to see is an ENT wishing you well, after my surgery i ended up in ICU. An official website of the United States government. Now I find it really hard to swallow food, sometimes even trying to drink is not that easy either! But I'd still love a perfect steak meal right now! Most of the debate in the past was focused on LT4 dosage and possibly on the timing of the administration. I suppose my message is if your having swallowing trouble post surgery, get yourselves out for a macdonalds milk shake and start there or melt some ice cream if you have some and over the coming days add milk until it gets thinner and thinner until you can drink just ice cold milk - if you haven't yet had your thyroid gland removed and are reading this- don't worry - this doesn't happen to many people but maybe stock up in some ice cream :), I had my thyroid removed Sept. 29 , this year. HHS Vulnerability Disclosure, Help over a year ago. Lots of phlegm (hope that didn't gross you out). For these reasons and because of the low risk of recurrence and death in DTC, ATA recommends a graded algorithm in which the potential benefits of this therapy are carefully weighed against its cardiovascular and skeletal risks (14, 15). Hi. American Thyroid Association (ATA) guidelines help in determining the class of risk in patients, mainly represented by the presence of distant metastases, and the response to the initial treatment. Since my surgery I choke on beverages often. This community is sponsored by ThyCa: Thyroid Cancer Survivors' Association, an Inspire trusted partner. MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. 8600 Rockville Pike I had my thyroid removed in July 2011. Al-Dhahri SF, Al-Angari SS, Alharbi J, AlEssa M. Optimal levothyroxine dose in post-total thyroidectomy patients: a prediction model for initial dose titration. Every doctor I mentioned it to thought I was crazy. i havent got my tesults from the surgery but anyone can tell me if could be benign and is nothing to worry about? Me tooI'm going to email endo I thinknot much fun anymore..starting to lose my mind here! A statistically significant decrease of approximately 28% in the mean TSH level was documented with the use of the soft gel capsule formulation, which may represent an important advantage considering the possible association between elevated FT4 levels, even in euthyroid patients, and cardiovascular disease. I had a second surgeryI had a second surgery mid-July and noticed a cough. We only considered articles that were published in the last 15 years and investigated LT4 treatment in adults (aged 18 years) after total, near-total, or completion thyroidectomy. If RAI alone, the thyroid would still be there but it would no longer function. After 2 days aspirating into my lungs everything i tried to drink i was landed with a feeding tube into my stomach through my nose. And if the parathyroid glands were removed along w/ the thyroid, that needs to be dealt w/ via therapeutic medication too. Copyright 2017 IJS Publishing Group Ltd. Long-term outcome of functional post-thyroidectomy voice and swallowing symptoms. It's not painful, but it's almost like something "clicks" into place when I swallow liquids. The diagnostic procedures described can help to identify the mechanisms involved in swallowing disorders, with the aim to choose the best therapeutic option. government site. It is not a substitute for professional medical advice. Thyroidectomy and weight gain - Good stories only PLEASE!! But for some reason every once in awhile I choke on liquids, and when I do this big air bubble blocks my air way and is nearly impossible to get out it seems. see the surgeon a lot for this issue. undefined will no longer be visible to you including posts, replies, and photos. It's possible there could be some swelling associated with the healing process. Beyond the classic tablet, new formulations of thyroxine can now be prescribed as a soft gel capsule and oral solution, which have been shown to overcome the food and beverages interference with absorption of LT4 tablets. I had only half my thyroid removed 9 years ago. Lombardi CP, Bocale R, Barini A, Barini A, DAmore A, Boscherini M, et al. I'm still sore and numb under my chin and neck area. The .gov means its official. If you want to confirm this, have a look at the scientific evidence in my paper in the following link. Finally, in 2019, Al Dhahiri et al. There's also little adjustments like eating more slowly. "One will . I had my thyroid removed about 10 days ago. Disclaimer. 2 Tracheal perforation related to thyroidectomy is usually detected during surgery, and recovery without major complications is possible with . I am 5 weeks out from TT today. I mentioned it to my surgeon at a follow up appointment since he also deals in sinuses and allergies, he looked at me like I was crazy. The authors concluded that liquid LT4 could be considered as a valid alternative formulation in patients after thyroidectomy for DTC and that the initial dislike by the patients was overcome by a significant decrease in subjective symptoms. These complaints are usually related to superior and inferior laryngeal nerves dysfunction, but these can appear even after uncomplicated surgical procedure. First, Ojomo et al. who developed a Poisson regression formula that takes into account seven factors: four of them were found in previous proposed schemes (actual body weight, BMI, age, sex), whereas the remaining three additional factors were preoperative TSH, vitamin-mineral supplementation, and iron supplementation (21). You may have had some damage to a laryngeal nerve. The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. due to medications). After a thyroidectomy, some people experience symptoms of low calcium such as burning, tingling, or numbness in their hands, feet, or around the mouth. Treatment pattern and frequency of serum TSH measurement in users of different levothyroxine formulations: a population-based study during the years 2009-2015. How long till the sore throat goes away? I had the same results. Other signs of dysphagia include: coughing or choking when eating or drinking; bringing food back up, sometimes through the nose; a sensation that food is stuck in your throat or chest; persistent drooling of saliva and Elfenbein et al. In a study of 148 consecutive patients who underwent total thyroidectomy for DTC, Ito et al. 2009 Dec;146(6):1174-81. doi: 10.1016/j.surg.2009.09.010. My doctor told me after the surgery that I have a "hole" in my throat now and to give it a good year before it completely heals. But I am also having feeling of my throat closing when I walk and it makes me panick. For those of you who follow my blog, you may recall that last Thursday, January 7, was the date for my thyroidectomy. over a year ago. Received 2020 Nov 5; Accepted 2020 Dec 14. Afterward, Di Donna et al. It feels like there is always a lump of mucous in my throat. Some people need a more permanent solution. Sahli Z, Canner JK, Najjar O, Schneider EB, Prescott JD, Russell JO, Tufano RP, Zeiger MA, Mathur A. Laryngoscope. (33) in 2018 of patients who underwent total thyroidectomy with severe hypothyroidism reported that euthyroidism was progressively restored after sublingual administration of liquid LT4, making this formulation a valid alternative method for acute treatment of severe hypothyroidism. It is reasonable to conclude that because most of the schemes show a considerable complexity but do not offer significant advantages in the percentage of patients reaching the expected results, the search for a fully predictive model seems to be an exercise of futility. However, that information will still be included in details such as numbers of replies. For some reason I do not remember anything from when I was 14!!! If your incision was closed with stitches, ask your surgeon when you can shower. "Following a thyroidectomy in 2004, I was choking all the time," she recalls. over a year ago, Psi208197 Virili C, Stramazzo I, Santaguida MG, Bruno G, Brusca N, Capriello S, et al. It is how we ensure our lungs are clear after surgery. The coughing has just stopped. The management of symptomatic patients varied case by case, from voice . When I would choke the only option was to bring it up and when it did I noticed most of it was mucus. Anyone undergone completion thyroidectomy?? I've been on antibiotics 3 times since surgery can't get over congestion in my lungs. Depends on the possible causes of the difficulty swallowing (related to nerve damage or appearing after uncomplicated thyroidectomy), different types of diagnostic procedures could be used to study patient discomfort, as well as intraoperative nerve monitoring, fiber optic laryngoscopy, endoscopy, pH monitoring, esophageal manometry and videofluorography. Epub 2018 Sep 7. Data were collected and scrutinized from the PubMed database using combinations of the following search terms: levothyroxine, dosing,thyroidectomy, differentiated thyroid cancer, and liquid levothyroxine. The .gov means its official. (22) performed a study to identify factors that would predict the LT4 dose after thyroidectomy. Pain not bad. Junior Member. Epub 2013 Mar 22. laying down is also difficult. Thyroidectomy is the surgical removal of all or part of your thyroid gland. It's bad enough at times I throw and feel like I'm choking to death before I cough it up. Giandalia A, Russo GT, Romeo EL, Alibrandi A, Villari P, Mirto AA, et al. I have the same problem. 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I couldn't even swallow my saliva. ***this post is edited by moderator *** *** private e-mails not allowed*** Please read our Terms of Use. A minimum of two years of undertreated primary hypothyroidism, as a T result of drug-induced malabsorption of L-thyroxine, may have metabolic and cardiovascular consequences. I've been drinking lots of fluid but it hurts to cough with my throat being so sore. They'll also check the lymph nodes next to your thyroid gland and remove any that have or might have cancer cells. Do not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. This formula was applied retrospectively and compared with the other existing schemes, both by Di Donna et al. no resolutions yet. Finally, patients included in the ATA low-risk category, with undetectable thyroglobulin, should maintain a TSH level between 0.5 and 2 mU/L, whereas the level decreases to 0.10.5 mU/L if the thyroglobulin is low. Epub 2022 Apr 19. 7 years on I'm mostly tube free but when i get a throat infection i need 24 - 36 hours of NG tube fluids to keep me out of hospital and the same if i get a bug - the vomiting sends my swallowing out of sync. What Is Thyroidectomy And Why Is It Performed? A total or near-total thyroidectomy is the surgical removal of all or most of your thyroid tissue. 6. Nevertheless, when retrospectively applied by other authors, the rate of patients being reported to be euthyroid at the first postsurgery follow-up was amendable, ranging between 23 and 53.2% (19, 21). It's better to avoid spicy and fried food after a thyroidectomy. Your surgeon will tell you when it is time to remove the drain. . After a thyroid lobectomy, you'll need to have your thyroid hormone levels checked and will be prescribed a thyroid hormone replacement, if needed. On the other hand, when the formula proposed by Elfenbein et al. Using body mass index to predict optimal thyroid dosing after thyroidectomy, Thyroid Hormone Replacement in Patients Following Thyroidectomy for Thyroid Cancer. As a library, NLM provides access to scientific literature. official website and that any information you provide is encrypted The authors concluded that the liquid form of LT4 can be administered directly through the nasogastric tube without the need for an empty stomach and is more easily managed by a nurse. All authors contributed to the article and approved the submitted version. Anyone else experience similar?? Spicy Food. before surgery i had this weird cough like if i was smoking, after surgery i still have the same cough! I finally found an ENT doctor who listened to me & suggested seeing a swallowing specialist. As far as my understanding goes, this is due to the lowered levels of thyroxine, resulting in a lowered basal metabolic rate and therefore lowered response to stimuli; it also results in the skin being dry and, if thyroxine levels are excessively low, mental deficits can result. However, that information will still be included in details such as numbers of replies. investigated the relationship between symptoms and serum TSH and FT3 levels (26). Oral L-thyroxine liquid versus tablet in patients submitted to total thyroidectomy for thyroid cancer (without malabsorption): A prospective study. I think it might be something going on with hormone adjustments.might be a little high or lower and you get that feeling then you normalize and it goes away. weight gain of 47 pounds and still gaining. Immediately after i woke up from the op it was clear there was something very wrong. Lastly, in patients with mildly suppressed TSH levels and FT3 levels superimposable to the preoperative values, all symptoms remained equivalent to their preoperative levels. Immediately after waking up in recovery room had feeling of shortness of breath and like I couldn't get a satisfying breath. Prospective Intervention of a Novel Levothyroxine Dosing Protocol Based on Body Mass Index after Thyroidectomy. I also had issues with choking on liquids & foods after my TT in 2013. Do you have any tips on this? He suggested Nasacort to make the mucus less thick. This additional amount of T4 may be the substrate for the peripheral deiodinase network to compensate the absence of T3 production from the gland (17). Thyroid function related symptoms during levothyroxine monotherapy in athyreotic patients, Undertreated hypothyroidism due to calcium or iron supplementation corrected by oral liquid levothyroxine. I had half mine removed over a year ago. In particular, the rate of patients in the hypothyroid range was significantly higher in the solid form LT4 group (13.5%) compared with the liquid LT4 group (1.8%). Nevertheless, due to the complexity of calculating the dose, finding a practical and clinically relevant prediction model is yet of limited efficiency. Most of the methods for monitoring and adjusting thyroid hormone replacement after thyroidectomy for benign disease use LT4 at an empirical dose of approximately 1.6 g/kg, with subsequent changes according to thyroid function test results and assessments of the patients symptoms. (17) in a longitudinal study including 23 goitrous patients treated with LT4, the therapeutic dose of T4 after total thyroidectomy must be increased by one-third compared with the presurgical one. Post-thyroidectomy voice and swallowing disorders and association with laryngopharyngeal reflux: A scoping review. Dysphagia occurred depending on the operative therapy between 6.1% for parathyroid resection and 33% for total thyroidectomy with lymph node dissection. It gets better. I still have the chocking sensation but it is because I've just had my fourth neck dissection and the scar tissue build up is quite bad. A smaller less vascular mass with a maximum diameter of 1.2 cm it is posterior to the dominant mass in the left lobe. Most things (energy level, swallowing) are improving but in the last week, it often feels like something is choking me. Among all these procedures, videofluorography is considered the gold standard to evaluate the entire swallowing process, since that allows a real-time study of all the three phases of swallowing: oral phase, pharyngeal phase and esophageal phase. Di Donna V, Santoro MG, de Waure C, Pia Ricciato M, Paragliola RM, Pontecorvi A, et al. eCollection 2022. Help. FOIA This might not work for everybody but hope it helps somebody out. I would really appreciate it. It usually gets worse when I lay down or if I am driving. The discomfort also could be due to an infection or inflammation, not cancer nevertheless, a doctor should always examine ear pain, especially in an adult. 2023 Jan 11;8(1):140-149. doi: 10.1002/lio2.1009. Concomitant ingestion of calcium supplements, ferrous sulfate, proton-pump inhibitors, bile acid sequestrants, and sucralfate can also influence LT4 absorption and/or metabolism (6, 7). I got my thyroid gland removed about a month ago (through RAI), and I've been noticing that it is difficult swallowing. Association Between Age and Patient-Reported Changes in Voice and Swallowing After Thyroidectomy. eCollection 2023 Feb. Melfa G, Siragusa G, Cocorullo G, Guzzino M, Raspanti C, Albanese L, Mazzola S, Richiusa P, Orlando G, Scerrino G. J Clin Med. Pirola I, Daffini L, Gandossi E, Lombardi D, Formenti A, Castellano M, et al. The Annual International Thyroid Cancer Survivors' Conference and Regional Workshops, Papillary and follicular thyroid cancer (differentiated), Multiple endocrine neoplasia type 2 (MEN2), Mental challenges of living with thyroid cancer, ThyCa fundraising and thyroid cancer research grants. (13) performed a prospective randomized study of 102 patients who underwent total thyroidectomy and radioactive iodine therapy for DTC and were classified as low risk according to the 2009 ATA guidelines. It is the main treatment for most people with thyroid tumors. ENTER wants me to have injection in my vocal cord to poof it up to close a place where it's seeping in to the windpipe by pushing it over . A literature review was performed focusing on all papers dealing with this topic within the last 15 years. I'm not noticing it now. The heterogeneity of these schemes implies the contribution of several parameters to the LT4 dose calculation and raises the need for an accurate, simple, and widely shared formula. Worse than the voice part is the fact that I cannot swallow liquids very well and am often choking. I was told that coughing is healthy. Laryngoscope Investig Otolaryngol. It lasted two or three weeks. At least it did for me. Rehabilitation of Post-Stroke Swallowing Dysfunction with Repeated Transcranial Magnetic Stimulation RTMS Based on Tomographic Images. My nose didn't feel plugged up and no amount of blowing produced anything so I didn't think that could be an issue. POST THYROIDECTOMYJust had total thyroidectomy on 9/18/09. Bethesda, MD 20894, Web Policies Department of Surgical, Medical, Molecular and Critical Pathology, University of Pisa, Pisa, Italy, Edited by: Bernadette Biondi, University of Naples Federico II, Italy, Reviewed by: Salvatore Benvenga, University of Messina, Italy; Marco Centanni, Sapienza University of Rome, Italy, This article was submitted to Thyroid Endocrinology, a section of the journal Frontiers in Endocrinology. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. An inadequate level of thyroid hormone levels in these patients can be due to several factors. National Library of Medicine Chirurg. and transmitted securely. Although both formulations can be taken during breakfast, the liquid one should be preferred for patients in whom even small changes of thyroid hormones levels must be avoided (30). I'm so sorry to hear of all the post-op problems everyone has had after their thyroid surgery. Administration of the optimal dose of levothyroxine (LT4) is crucial to restore euthyroidism after total thyroidectomy. (My thyroid was one of the largest one's that the surgeon had ever seen). More studies are needed for understanding the causes of the dysphagia appearing after thyroidectomy.