Dr. Kolachalam’s endocrine surgery team diagnose and treat patients with a variety of parathyroid conditions including tumors, nodules and hyperparathyroidism. If you have been diagnosed with a parathyroid condition, you can count on us to provide a personalized treatment plan, tailored to your unique condition and personal needs.
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What and Where is the Parathyroid?
Most people have four pea-sized glands, called parathyroid glands, on the thyroid gland in the neck. Though their names are similar, the thyroid and parathyroid glands are completely different.
They are located near or attached to the back side of the thyroid gland. They produce parathyroid hormone. This hormone controls calcium, phosphorus, and vitamin D levels in the blood and bone.
What does it do for me?
The parathyroid glands make parathyroid hormone (PTH), which helps your body keep the right balance of calcium and phosphorous. If your parathyroid glands make too much or too little hormone, it disrupts this balance. If they secrete extra PTH, you have hyperparathyroidism, and your blood calcium rises. In many cases, a benign tumor on a parathyroid gland makes it overactive. Or, the extra hormones can come from enlarged parathyroid glands. Very rarely, the cause is cancer.
If you do not have enough PTH, you have hypoparathyroidism. Your blood will have too little calcium and too much phosphorous. Causes include injury to the glands, endocrine disorders, or genetic conditions. Treatment is aimed at restoring the balance of calcium and phosphorous
How can Dr. Kolachalam be sure that I have a parathyroid condition?
- Blood tests will be done to check for extreme changes in the levels of parathyroid hormone (PTH), calcium, and alkaline phosphatase, and extreme changes in the levels of phosphorous.
- A 24-hour urine collection test can help determine how much calcium is being removed from the body.
- Bone X-Rays and bone mineral density (DXA) tests can help detect bone loss, fractures, or bone softening.
- An ECG may show abnormal heart rhythms.
- X-Rays ultrasound, or CT scans of the kidneys or urinary tract may show calcium deposits or a blockage.
What are the reasons I would need to have my parathyroid glands removed?
Parathyroidectomy is surgery to remove parathyroid glands or parathyroid tumors.
- Dr. Kolachalam may recommend parathyroidectomy if one or more of your parathyroid glands is producing too much parathyroid hormone. This condition is called hyperparathyroidism. It is often caused by a small non-cancerous (benign) tumor called an adenoma.
- Parathyroid cancer is an extremely rare type of cancer. Men and women are equally affected. It usually occurs in people older than 30. The cause of parathyroid cancer is unknown.
Dr. Kolachalam will consider many factors when deciding whether to do surgery and what type of surgery would be best for you. Some of these factors are your age, calcium levels in your urine and blood, and whether you have symptoms.
What to expect before the procedure
- Parathyroid glands are very small. You may need to have tests that show exactly where your glands are. This will help Dr. Kolachalam find your parathyroid glands during surgery. Two of the tests you may have are a CT scan and an ultrasound.
- Before surgery, an anesthesiologist will review your medical history with you and decide what type of anesthesia to use. The anesthesiologist is the doctor who will give you the medicine that makes you asleep and pain-free during surgery and who monitors you during surgery.
- Fill any prescriptions for pain medicine and calcium you will need after surgery.
- Several days to a week before surgery, you may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), warfarin (Coumadin), naproxen (Aleve, Naprosyn), and other drugs like these.
- You will probably be asked to stop eating or drinking at least 6 hours before surgery.
- Ask Dr. Kolachalam which medicines you should still take the day of surgery.
- If you smoke, try to stop. Your recovery time will be shorter if you do not smoke. Ask Dr. Kolachalam or your nurse for help.
- Dr. Kolachalam or nurse will tell you when to arrive at the hospital.
What to expect after the procedure
- Often, people can go home the same day they have surgery. You can start your everyday activities in a few days. It will take about 1 to 3 weeks for you to fully heal.
- The surgery area must be kept clean and dry. You may need to drink liquids and eat soft foods for a day.
- Numbness or tingling around your mouth in the 24 to 48 hours after surgery is caused by low calcium. You can take calcium supplements every 4 hours until the symptoms go away.
- After this procedure, you should have routine blood tests to check your calcium level.