Parathyroid Surgery FAQ's

What is the function of parathyroid glands?

The purpose of parathyroid glands is to produce parathyroid hormone (PTH), which regulates and maintains calcium levels in the blood. When the blood calcium level falls too low, the parathyroid glands secrete just enough PTH to restore the calcium level to normal. The calcium reserves are stored in our bones and in response to PTH, calcium is released from the bones into the blood circulation. In addition, PTH promotes absorption of calcium in our intestines from dietary sources (dairy products etc.).

Why is calcium in my body so important?

Calcium is an essential element in the body. It plays a vital role in the development of bone and tooth and helps maintains their strength. Calcium also plays a very important role in muscle contraction and nerve transmission, as well as in many other vital biochemical interactions in our bodies.

What is hyperparathyroidism and why does it happen?

Overproduction of the parathyroid hormone by abnormally enlarged parathyroid glands, due to any cause, is called hyperparathyroidism. The cause is usually unknown but is thought to be genetically linked in approximately 5% of cases. It is two times more prevalent in women than in men. The incidence in both men and women increases with age. The signs and symptoms are often subtle and include kidney stones, premature osteoporosis detected by bone densitometry, generalized and unexplained weakness and fatigue. In addition, depression and impaired thinking and memory are attributed to hyperparathyroidism. Nausea, constipation, loss of appetite and increased thirst and urination could be the presenting symptoms. High blood pressure and peptic ulcer disease (stomach and duodenal ulcers) are also closely associated conditions.

How is hyperparathyroidism diagnosed?

A simple blood test can be done to see if the calcium and PTH levels in the blood circulation are too high. An ultrasound of the parathyroid glands and a radionuclide test (Sestamibi scan) will be needed for thorough evaluation and localization of the abnormal glands. Because high PTH levels can cause bones to weaken from excessive calcium loss, a measurement of bone density may help assess bone loss and risk of fractures. Ultrasound or X-ray of abdomen may reveal kidney stones, and a 24-hour urine test may show excessive excretion of calcium in the urine and as such, an elevated risk of future kidney stone formation.

Who is in charge of treating my hyperparathyroidism?

Close communication and coordination of care ought to take place between your primary care physician, your endocrinologist and Dr. Babajanian to manage your care appropriately. You may have such a mild case of hyperparathyroidism that you just need to be watched carefully and periodically, with no immediate need for surgery. If you are deemed to be an appropriate surgical candidate, you will be referred to Dr. Babajanian to undergo surgery for removal of the abnormal parathyroid gland, an operation called parathyroidectomy. Dr. Babajanian places an emphasis on active participation of all your designated physicians and yourself in the decision making process.

What is my expected level of activity and diet after parathyroid surgery?

Parathyroid surgery is by and large a safe and effective surgery. Recovery after parathyroid surgery is generally easy and simple. You will be discharged home either the day of surgery or the following day, based on your general condition and health. You will be able to talk, eat, walk and breathe comfortably, immediately after surgery. You should avoid strenuous activities and heavy exercise for one week after surgery. Your diet will be unrestricted. We encourage that you maintain adequate amount of calcium in your daily diet in order to replenish the loss of calcium that occurred while you had hyperparathyroidism before surgery. In some cases, we will place you on calcium supplements if needed, but otherwise no new medications are needed after surgery. You may return to all basic daily activities, including driving, within 1-2 days of surgery.

How long is the length of surgery?

Parathyroid surgery varies in length and extent. It may take anywhere from 30 minutes to several hours depending on the ease of localization of the tumor and the number of the abnormal glands to be removed. Minimally invasive parathyroidectomy may take 30 minutes to an hour to complete in those patients who have well localized tumors. Revision parathyroidectomies, on the other hand may need much longer time to finish. During the surgery we will immediately measure your post treatment parathyroid hormone level to ascertain that you are indeed cured.

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