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Integrative Approaches to Patients Undergoing Thyroid Surgery

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Management of Thyroid Nodules and Differentiated Thyroid Cancer

Abstract

This chapter focuses on patient-centered and holistic management of individuals undergoing thyroid surgery, from the preoperative to the postoperative phases of their treatment. Holistic care recognizes that illness involves the whole person and that mind and body issues need to be addressed, synchronously throughout the process, for the patient to feel served and whole at the end. Holistic care uses an integrative medicine approach that combines evidenced-based conventional medicine with complementary therapies, when needed, to achieve wellness after thyroidectomy and cancer diagnosis. Wellness is a state of health that encompasses vitality or vigor of body and mind, not just mere absence of disease. Data in the last decade has unmasked the physical and neurocognitive burden, after thyroidectomy, of hypothyroidism and the additive impact of a thyroid cancer diagnosis. Even though, in most, the original thyroid condition has been cured and thyroid replacement is adequate, many remain unwell with complaints of weight gain, fatigue, psychiatric and neurocognitive issues, worry, and impairment in quality of life. We lack evidence-based approaches to address these mind-body issues that result in lack of wellness post-thyroidectomy in these two groups of patients. Treatment of hypothyroidism is a complex and imperfect science, and levothyroxine therapy is never quite right for a significant (10–20 %) minority of patients. This chapter discusses the standard of care treatment of hypothyroidism after thyroidectomy and the rationale for use of complementary and alternative therapies to address hypothyroid complaints and other mind-body issues not adequately addressed by current treatment methods. The integration of complementary therapies to conventional medicine broadens the spectrum of options we can offer patients where standard therapies are limited.

Dedication: To my patients and my mentors

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Author information

Authors and Affiliations

  1. Endocrinology, Yale University School of Medicine, Middlebury, CT, USA

    Beatriz Olson MD, FACP

Authors
  1. Beatriz Olson MD, FACP
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Correspondence to Beatriz Olson MD, FACP .

Editor information

Editors and Affiliations

  1. Endocrine Surgery, Department of Surgery, Duke University Medical Center Duke Cancer Institute, Durham, North Carolina, USA

    Sanziana A. Roman

  2. Department of Surgery, Duke University Medical Center Duke Cancer Institute, Durham, North Carolina, USA

    Julie Ann Sosa

  3. Division of Surgical Oncology and Endocrine Surgery, Vanderbilt Endocrine Surgery Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA

    Carmen C. Solórzano

Supplement Section for Chapter 23

Supplement Section for Chapter 23

Chapter 23 section “Perioperative Period: Stress and Anxiety Around Surgery”

Relaxation and guided imagery: Integrative medicine centers recommend and use several commercially available “relaxation and guided imagery instructional materials” available online (http://www.amazon.com). Dr. Olson has experience with and tends to use for her thyroid patients Peggy Huddleston’s Relaxation/Healing CD plus instructional CD or Huddleston’s book and CD, Prepare for Surgery, Heal Faster with Relaxation and Quick Start CD: A Guide of Mind-Body Techniques.

Chapter 23 section “Understanding and Avoiding Weight Gain After Thyroidectomy”

Commercially available whole food diets include the Mediterranean diet [53] or Paleo diet programs that are reasonable guides for these patients [54, 55].

Mindfulness-based stress reduction (MBSR) is the process of training the mind to pay attention without judgment to oneself or what is happening in the moment. Mindfulness practice leads to greater awareness of one’s physical and mental state leading to better understanding of self, better self-regulation, and to making choices that support well-being and health. For mindfulness reading and available CDs recommended by Dr. Olson, search on the web Jon Kabat-Zinn, and mindfulness meditation CDs and reading lay press publications on the topic by Pickert K. 2014. For tertiary centers to initiate their own MBSR program, inquiry may be made through the University of Mass Center for Mindfulness.

Chapter 23 section “Dealing Well with Radioactive Iodine: Addressing Mind-Body Concerns and Complimentary Approaches to Patients Receiving Radioiodine Therapy”

Thyroid cancer survivor websites:

  1. 1.

    ThyCa website (http://www.thyca.org/download/document/231/Cookbook.pdf)

  2. 2.

    Light of Life Foundation, checkyourneck.com, see The Light of life Foundation Cook book, which also has recipes for low iodine diet.

Iodine-containing supplements examples: spirulina, seaweed, a high concentration iodine brands such as Iodoral (brand name for high iodine preparation), and kelp.

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Olson, B. (2017). Integrative Approaches to Patients Undergoing Thyroid Surgery. In: Roman, S., Sosa, J., Solórzano, C. (eds) Management of Thyroid Nodules and Differentiated Thyroid Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-43618-0_23

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