If you need parathyroid surgery, it will be important to be well prepared, this will allow you to participate in your care. Feel free to contact your surgeon if you have any questions before or after your operation. Every surgeon will do things slightly differently so be prepared for some variations, however, here are some general answers to frequently asked questions:
What are the benefits of parathyroid surgery?
You will no longer have an elevated calcium level in your blood. The abnormal parathyroid gland(s) have been removed. By returning your blood calcium levels to normal you will not suffer the short and long term consequences of elevated calcium levels.
What are the risks of parathyroid surgery?
The risks are minimal but include a small chance of bleeding or infection. Some patients may experience temporary hoarseness, an occasional patient (less than 1%) may have permanent hoarseness. Rarely, a patient may have a recurrence of hyperparathyroidism if the disease develops in a previously unaffected gland.
How long will I be hospitalized?
You will be admitted to the hospital the morning of your surgery. A bed is automatically reserved for you. Some patients may be able to go home after an 8 hour observation period in the recovery room.
What type of anesthesia will I have? What do I do the night before my surgery?
You will most likely have your parathyroid surgery under general anesthesia. You will be completely asleep and will feel no pain during your surgery. Selected patients may be able to have their surgery with intravenous sedation and local anesthetics infiltrated into the neck. In either case you will meet the anesthesiologist in person before the surgery. Because you will be getting anesthetics, it is important that you not eat or drink anything after midnight the night before surgery. Take all of your important medications such as heart, asthma, or blood pressure medicines with a small sip of water the morning of surgery. Do not take aspirin 7-10 days prior to your surgery date. If you are a diabetic please consult with your physician or the anesthesiologist to discuss if you should take your diabetes medication.
Will I have pain after the operation?
All patients will have some pain. This pain is easily treated with pain medicines prescribed by your surgeon. You might have a sore throat, difficulty swallowing or a hoarse voice after the operation, these conditions will resolve with time.
What medicines will I have to take at home after the surgery?
Most patients only need pain medicines (prescribed by surgeons) for a few days after surgery. Because any remaining parathyroid glands that control blood calcium levels may be somewhat dysfunctional after surgery, you may need to take calcium and vitamin D supplements, depending on your surgeon's recommendations. Some patients require calcium supplementation on a temporary basis. If the parathyroid glands continue not to function properly, you may need to take calcium and vitamin D permanently (very rarely).
Will I have a scar?
All surgeries cause some scarring. Parathyroid operations done by trained endocrine surgeons are done through the smallest, cosmetically placed incisions possible. Plastic type closures are used to minimize scarring. Ultimately the type of scar formed depends mostly on your own body. The majority of people having parathyroid surgery are very pleased with the minimal scar present at 6 months after surgery.
Will I have stitches?
Your incision will be closed with stitches placed under your skin that are not visible. These stitches dissolve after a period of time and do not need to be removed. Strips (steristrips or butterfly strips) may be placed on your incision to help healing and for protection. It is best if you do not peel these off. Once these strips fall off or are removed by your surgeon, you can apply a small amount of lotion over the incision.
What do you do with the removed parathyroid tissue?
The removed parathyroid tissue will be given to a pathologist. The pathologist will process and analyze the tissue under the microscope. This usually takes up to 5 working days. Your surgeon will discuss the results of your pathology with you in detail at your follow up appointment.
Will I have any restrictions after my surgery?
You will be somewhat sore and have some difficulty with full range of motion in your neck for one week post-surgery. Gradually you will feel better everyday. Some patients may have muscle spasms in their upper back or neck. It is important to keep your neck muscles relaxed an a normal posture during your recuperation period. Most patients can return to work within 7-14 days after their surgery (depending on the physical requirements of their job). Most patients are able to start driving one week after the surgery (as long as they are no longer taking pain medication and can turn their head comfortably. After two weeks you can return to non-strenuous exercise. You can return to all your normal activities within 3-4 weeks after surgery.
Will I lose my voice after parathyroid surgery?
Your voice may undergo some temporary changes after the operation. This is more rare for parathyroid surgery patients than patients undergoing thyroid procedures. Some patients are hoarse or have voice fatigue (their voice is "tired" at the end of the day). In most cases, these voice changes subside within 6-8 weeks. Less than one percent of patients will have permanent changes or hoarseness. If this occurs there is non-surgical treatment available to improve voice quality.
What are the signs of low blood calcium and how will I know if I need to take extra calcium?
Some patients experience low blood calcium (hypocalcemia) after parathyroid surgery. Low blood calcium occurs if the remaining parathyroid glands do not function properly or if brittle bones depleted of calcium try to rapidly readjust their calcium content. Symptoms of low blood calcium include numbness and tingling in the fingers and around the mouth. Some patients experience muscle cramps. Low blood calcium can be prevented or treated with extra calcium intake. Most surgeons will ask you to take extra calcium (usually 1000mg every 6 hours). You can take Tums, Caltrate, or Oscal for 5-14 days after surgery. If symptoms persist then contact your surgeon.
Why is the area around my scar swollen?
During the healing process it is natural to get some swelling around your incision. A healing "ridge" will form above and below your incision as your muscles heal. A small amount of bruising is normal. If you have any sudden swelling or have difficulty breathing, contact your surgeon immediately or go to the nearest emergency room as this can be a sign of bleeding
We hope this section has been helpful, please contact your surgeon with any further questions.