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October 10th, 2016

Total Parathyroidectomy

By jprovisor

My doctor and I had been in the "watchful waiting" mode for 10 years, monitoring the levels of PTH and calcium in my blood. The levels were above normal for years, but hovered at the same place, a little high, but not an urgent situation requiring surgery. That is until this year when a bone density scan revealed Osteoporosis. That test result proved to be the tipping of the scale and it was determined I finally needed parathyroid surgery.

Prior to surgery a Sestamibi Scan was inconclusive and could not localize the diseased parathyroid glands. I planned to have the surgery done anyway, knowing Dr. Michael Yeh would find the diseased glands once inside, but a friend who is an endocrinologist said, "Don't go in until you see something specific."

Listening to my friend I went on to the UCLA website and read about the latest technology in parathyroid imaging--the 4D-CT Scan. The four-dimensional parathyroid CT scan is used to identify abnormal thyroid glands in the planning of parathyroid surgery. With knowledge of the new 4D-CT Scan and inconclusive Sestamibi Scan results I asked to have a 4D-CT Scan done to give the doctor a better image prior to surgery. At first I was told it was not available to those outside a particular study but I continued to ask after the latest technology written about on the UCLA website and after a bout a week of going back and forth I finally gained approval to have the 4D-CT Scan done. It was a battle to get, but the 4D-CT Scan showed and located the abnormalities in my parathyroid glands. Ideally this information helped Dr. Yeh plan the surgery.

As it turns out, my case was a challenging one. I consider myself a genetic anomaly- though not overweight, so much fat had grown over the glands that Dr.Yeh had to take everything out, look at it, examine it, clear away the fat and remove the diseased parathyroid glands. He ended up keeping the best part of half of one of my parathyroid glands, dividing it into eight parts and reinserting, or implanting, the eight parts. Despite the more radical parathyroidectomy I was never uncomfortable and was well attended to by Dr. Yeh and his staff.

I had my surgery in the Outpatient Surgery Center. There were two glitches - one, I needed a scopolamine patch to go behind my ear to prevent nausea during and after surgery. They didn't have the patch at the surgery center for some reason despite a pre-op meeting with the anesthesiologist two weeks prior. Consequently my wife had to take a prescription to the nearby pharmacy and bring it back to the surgery center before surgery. The second glitch was that after surgery the outpatient surgery enter didn't really seem set up for overnight patients. I ended up staying overnight and they didn't have any food for me; well they offered a ham sandwich but that was not a very good option post surgery. Thank goodness for my wife, she went out to get me something to eat --without her I wouldn't have had all the meds I needed or food post surgery.

Two weeks post surgery my parathyroid hormone is evident and rising. I will continue to follow up with my internist and endocrinologist continuing to check my PTH and calcium levels. I really don't know how people navigate the healthcare system without friends, family and committed physicians and their staff to offer support and guidance.

Tags: 4D-CT Scan, bone density scan, calcium blood level, Dr. Michael Yeh, endocrine, Endocrine, Endocrine Surgery, endocrine surgery, Endocrinology, four-dimensional parathyroid CT scan, osteoporosis, overweight, parathyroid glands, parathyroid imaging, parathyroid surgery, patient stories, PTH, sestamibi scan, watchful waiting

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