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Surgical site difficulties following thyroidectomy surgery

I had thyroidectomy - Graves/substernal goiter - 4 weeks ago.  The surgical scar is hard and swollen, as if something the size of a mini tootsie roll is laying under the skin along the suture line.  Sometimes it’s soft and relaxed - othertimes it swollen, hard and muscles around my neck are tight. Sitting seems to make it worse.  Activity seems to improve it.  It’s worst when I walk up.  I’m using scar creams and sun screen.  Also just started using silicone scar strips because it is starting to keloid a bit.  When it gets tight along there, it presses on my esophagus and feels much like it did when the goiter was there.  Even to the point it affects my voice chords making me sound a little hoarse at times.  I don’t know if it’s fluid swelling - or is the scar keloiding on the underside?  You don’t notice much from the outside....which was the same with the goiter.  I felt like I was going to choke but no one noticed it from the outside of the neck.  I even have thoughts that maybe there are some nuggets of thyroid left in there and it’s trying to goiter again!  Frustrated.  I thought I should feel normal by now.

Does anyone have any issue like this post surgery and if so, what is it - and how long will it last?
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649848 tn?1534633700
COMMUNITY LEADER
I haven't had a thyroidectomy, but from what I know from those who have, it does take a while for the incision to heal.  

You should be about ready to go back in for a post-surgery check up, but if you feel that there's anything abnormal about the incision, you should contact your doctor and ask to go in sooner.

Have you been put on replacement medication yet?  If not, that could have something to do with the feeling you're having as well, since you could be having some hypothyroidism, without a thyroid to produce the hormones you need.

Have you had any lab tests (TSH, Free T4, Free T3) done since your thyroidectomy?  If so, it might be helpful if you could post those results and their corresponding reference ranges so we can see what your levels are.
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Hi, yes started on Levothyroxine day of surgery - had my 4 week exam - all labs normal “right where I need to be” with the exception of the Vit D - which I’m supplementing now.   Calcium etc all normal now. I feel pretty good, a little lazier, but for this compression on my esophagus.  Annoying.  Even my scar is healing well...lightening up.  I think I may just make an appointment with him to look at it —-just to make sure my scare tissue isn’t so thick that it’s going to solidify like that into my esophagus forever. Lol. I had a very easy surgery - for a complicated problem.  All went well, little pain.  I can be patient as long as I know this is normal.  :). Appreciate your response.  Thank you so much.
If "right where you need to be" means within the reference ranges, that might not be right where YOU need to be... if your numbers are too low in the ranges, etc they might not be right for you.  Most of us find that we need Free T4 to be about mid range and Free T3 to be closer to the upper part of the range.  

Free T3 is the hormone that our body actually uses (Free T4 is a "storage" hormone and must be converted to Free T3 prior to use), so it's the one we  really need to pay attention to.  It should always be higher in its range than Free T4 in its.   The fact that you feel a little "lazy" could indicate that your Free T3 isn't quite as high as could/should be, but then Free T3 sometimes lags behind also.

Even slight hypothyroidism can make one feel as though we're choking and lower Free T3 is an indication of hypothyroidism; but it could also  have something to do with scar tissue, so yes, I'd recommend seeing your doctor just to be sure.  I just don't want you to think that because your numbers fall within the range that everything is great because that might not be the case.
Hi update... scar is pale and flat now. The pressurefeeling is only occasional. I think I’ll survive! Lol. I do have itchy skin and muscle tendon cramping,   Is that hypo or hyper?
Avatar universal
Hi Sparkle1950,

I had two thyroid surgeries last year, one in June 2018, one 2 months later in August 2018 (through the same incision site).  I'm pretty sure my first scar from June was pretty stiff for at least a month, like a hard seam.  Eventually, by the time of my second surgery, it had softened way up and was feeling a lot better.

I also had a lot of inflammation after my first surgery - I had a lobectomy and then the rest of my thyroid removed later, so I'm not sure if the inflammation was from the surgery or from my Hashimoto's inflammation (and lots of swollen lymph nodes), but it was definitely swollen around the scar in June for probably a month or so.

hope you feel better - if you are worried about the hardness, it should go away, mine did.  I feel like after my second surgery it took even longer, but now a year later, the scar is barely noticeable unless someone is looking for it, and it is very soft and flexible.  I still put sunscreen on it everyday - I have fair skin so I'll probably just do that just like sunscreen on my face everyday from now on.
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Thank you! It has softened flattened and lightened as of 8 weeks! I do have itchy skin and muscle cramping lately though. Any clue what causes that? Hypo or hyper?
Itchy skin and muscle cramping in general or just  near your surgical site?

Dry (itchy) skin is a symptom of hypothyroidism.  (When I am hypo, I notice it especially on the fronts of my legs (shins) and on my hands but I think it is everywhere, just worse there for me).

Muscle weakness, cramping, stiff muscles, and joint pain (especially in the shoulder and front of the legs, but anywhere I think can be affected) are symptoms of hypothyroidism.

Are you having any other hypo symptoms?  For me the fatigue is probably one of the worst symptoms I've experienced, but everyone is different and might experience different symptoms.

Have they been testing your thyroid hormone levels and adjusting your medication since your surgery?  Getting to the right level of thyroid hormone replacement can be pretty tricky.

I'm glad to hear the scar flattened out.  
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