About Michael Yeh

Per 100 surgeries performed

 The 10 Potential Consequences of Thyroid Surgery by Dr. Michael Yeh

  1. Vocal cord paralysis: it occurs when the Recurrent Laryngeal Nerve is Injured (RLNI). If the nerve is damaged during surgery, it can be immediately repaired if the surgeon is skilled and prepared. If a damaged RLN is not repaired, it results in lifelong problems for the patient related to swallowing, breathing, and speaking. Patients must screen their surgeon and ask if he/she uses nerve monitor equipment during surgery and if he/she has the right tools and training to repair a damaged RLN. Also, patients should ask the surgeon how many times he/she has damaged the RLN or caused vocal cord paralysis during surgery.
  2. Parathyroid impairment: This happens when a surgeon injures the parathyroid glands; known as hypoparathyroidism. The result, lifelong symptoms that include tingling in the lips, fingers, and toes; dry hair, brittle nails, and dry, coarse skin; muscle cramps and pain in the face, hands, legs, and feet; cataracts; dental problems; memory loss, headaches, and muscle spasms. And, lifelong dependency on calcium carbonate and vitamin D supplements.
  3. Bleeding: called neck hematoma, it represents a major concern for surgeons because it can result in severe and life-threatening complications. In fact, postoperative hemorrhage may result in airway compression and respiratory distress. Bleeding during thyroidectomy puts the RLN and the parathyroid glands at significant risk of injury.
  4. Residual cancer: with advancements in technology and ultrasound, this should never occur. But, a less skilled surgeon will sometimes leave malignant lymph nodes behind. This will leave the door open for more surgery. A patient may choose to forego a follow up surgery and opt for active surveillance instead.
  5. Shoulder impairment: very little research and data exists regarding shoulder pain due to thyroidectomy, however, it occurs often and is very painful. On average, 10.2 years after surgery, DTC (differentiated thyroid carcinoma) patients reported a 58.7% prevalence of shoulder pain, which was significantly more than the 13.8% reported by healthy controls. The condition has a dramatic impact on quality of life (QoL).
  6. Problems swallowing and breathing: under-reported in medical journals, but a prevalent problem related to thryoidectomy is acid reflux and aspiration, or problems swallowing. Breathing problems will most often occur when there is damage to the recurrent laryngeal nerve (RLN) which results in paralysis of the vocal cord. The RLN is important for vocalization, breathing and swallowing. Damage to the RLN will result in shortness of breath. Breathing problems may also occur if a clot forms, blocking the air passage, which can sometimes result in death.
  7. Quality of life (QoL) downgrade: University of Chicago Medicine researchers Briseis Aschebrook-Kilfoy, PhD and Raymon Grogan, MD, say “Often times, family members don’t take thyroid cancer treatment seriously. Society, healthcare professionals, and the media have minimized thyroid cancer, and in return it has made patients feel minimized and alienated.” During their research, findings show a significant downgrade in QoL for patients.
  8. Brain fog: mental health is impacted by thyroidectomy. Research is lacking, however, almost all thyroidectomy patients complain of mental impairment including panic attacks, brain fog, forgetfulness, anxiety, lack of motivation, and difficulty concentrating. Meanwhile, these complaints are discounted by many physicians, alienating and minimizing the patient.
  9. Weight gain: studies recognize weight gain in thyroidectomy patients, however, the number of patients complaining of this condition is not accurately represented in research. Meaning, the complaint is often discounted by physicians, including endocrinologists. Many doctors blame the weight gain on diet or menopause. Patients should be told in advance, if a thyroidectomy is performed, it will result in weight gain more often than not. And, in many cases, such weight gain is not due to menopause, diet, or other factors. Instead, it is caused by thyroidectomy and research has yet to determine exactly why.
  10. Osteoporosis: research confirms a direct correlation between TSH suppression and osteoporosis. Patients receiving thyroid surgery will experience bone loss much more so than those who have a thyroid. I was first alerted to this issue when going for an MRI; my technician said she observed severe osteoporosis in thyroidectomy patients taking Levothyroxine, compared to her ‘control group’ patients, or those not taking synthetic thyroid replacement. Her hypothesis is based on two decades of observations as an MRI technician.
Patients should note, unavoidable consequences include scarring, lifelong reliance on Levothyroxine, and RAI in some cases. RAI has been shown to lead to blood cancer for some patients. When interviewing dozens of thyroid surgery patients, we found only 12% were told of the possible consequences of surgery. Most said if warned of the dangers, it would have influenced their decision to move forward with surgery or choose active surveillance instead.