Parathyroid Surgery FAQ

Most patients have questions prior to surgery. Below are some of the most frequently asked questions doctors at the parathyroid surgery center receive from patients about their upcoming parathyroid surgery.

Parathyroid glands are four tiny glands located in the neck, behind the thyroid gland. These glands secrete parathyroid hormone (PTH). This hormone regulates phosphorous and calcium in the blood. Calcium is essential for keeping bones strong and for maintaining normal muscle and nerve functioning.
Parathyroid surgery is performed when one or more of the parathyroid glands become enlarged and are generating excessive amounts of PTH. Excess PTH can result in hypercalcemia (escalated blood calcium levels). Removing the enlarged gland(s) is the only known effective treatment for the majority of forms of enlarged parathyroid glands.
Many patients can go home on the same day that they have parathyroid surgery, after staying in the recovery room for approximately 4 to 6 hours. Some patients stay in the hospital overnight. You will have a bed that has already been reserved for you, in case your doctor determines that it is best for you to stay overnight.
Parathyroid surgery is requires skill and accuracy. Have the procedure performed only by a surgeon who is well experienced in parathyroid surgery. The surgeon makes a horizontal neck incision, and examines the area to identify and remove up to three abnormal parathyroid glands. If all of the parathyroid glands appear abnormal, the surgeon will probably remove only three of the glands entirely, leaving about half of the fourth gland in place in the body. The remaining partial gland can typically be expected to produce a sufficient amount of PTH to meet all of the body’s needs for the hormone.
General anesthesia is used for most patients having parathyroid surgery. During the operation, you are entirely asleep, and when you awaken, you feel very alert and awake. In certain cases, parathyroid surgery can be performed using only a local anesthetic. Your parathyroid surgery options might include MIRP mini surgery, which may be performed with local anesthesia. With the local anesthetic, the patient feels awake, but sleepy due to sedatives delivered through an intravenous (IV) line.
During your recovery, you may experience some pain. Oral pain medicine is very effective in controlling the discomfort. You may have a sore throat, difficulty swallowing, and some difficulty moving your neck. Some patients have minor muscle spasms in the neck and upper back. You can expect to feel better every day. The majority of patients are able to return to work within 1 to 2 weeks after parathyroid surgery, and can resume their exercising and all regular activities within 1-3 weeks.
Usually, patients can simply resume taking the same daily medications as before the surgery, if any. As mentioned, pain medication will be added for a few days. Additionally, in some cases, calcium and vitamin supplements may be prescribed for a brief period.
The voice box nerve is runs under your parathyroid glands. Some patients find that they are a bit hoarse. Others experience a sense of tiredness in the voice (voice fatigue), later in the day. For most patients, these are temporary effects that disappear within 6 to 8 weeks. The possibility of any significant voice change is very small.
As mentioned, blood calcium levels can drop after parathyroid surgery. Your surgeon may instruct you to monitor for symptoms of low calcium, such as numbness and a tingling sensation in fingers or the mouth area, or muscles cramping. Your doctor will instruct you on what you should do if you experience low calcium. Common temporary side-effects of any type of surgery include one or more of the following: constipation, appetite loss, feeling tired, sleep difficulties, poor concentration. If you experience one or more of these effects for a prolonged period, tell your surgeon.
As with any surgery, you will have a scar. How the surgical scar heals varies between individuals. However, today's parathyroid surgeons utilize special techniques that help minimize scarring. The surgical incision can be expected to appear more blended with the surrounding skin after the redness disappears. Typically, after six months or so, patients no longer have a noticeable scar.
Healthier patients are usually scheduled for a phone interview prior to the surgery, to talk with a nurse from the anesthesia staff. Blood tests, an EKG, or X-rays are necessary, in some cases. During the phone interview, the nurse will explain how to prepare for your surgery. The nurse's instructions will cover eating and drinking before surgery, taking routine medications, and taking aspirin or other blood-thinning medications within the week to ten days prior to your surgery.
Preparing the final report requires thorough analysis, sometimes involving special methods of processing. The final pathology report is usually complete within 7 business days from the date of the operation.

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