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Parathyroidectomy

What you should know

A parathyroidectomy is surgery to remove part or all of your parathyroid glands. The parathyroid is made of 4 small glands that usually sit near the thyroid gland. The parathyroid glands make a hormone that controls the amount of calcium in your blood.


Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • During or after surgery, you may bleed more than expected, or get an infection. Your thyroid gland, blood vessels, or other tissues may be damaged during surgery. You may have nerve or vocal cord damage. You may have a hoarse or weak voice that lasts for a few days or longer. You may get a blood clot in your leg or arm. This can cause pain and swelling, and can become life-threatening. Your blood calcium level may be lower than normal after surgery. Your condition could return and you may need to have surgery again.

  • If you do not have surgery, an overactive parathyroid gland could cause elevated blood calcium levels. This could cause fatigue, and bone, joint, or muscle pain. You may also have headaches, muscle spasms, weak bones, a broken bone, hallucinations, and confusion. Cancer of your parathyroid gland that is left untreated may prevent your kidneys from working correctly. You may also develop kidney stones or congestive heart failure. These conditions can become life-threatening.

Getting Ready

The week before your surgery:

  • Write down the correct date, time, and location of your surgery.

  • Arrange a ride home. Ask a family member or friend to drive you home after your surgery or procedure. Do not drive yourself home.

  • Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • Tell your caregiver if you think or know that you may be having a kidney transplant.

  • You may need blood tests, an electrocardiogram (EKG), chest x-ray, or other tests before your surgery. Talk to your caregiver about these and other tests you may need. Write down the date, time, and location of each test.

The night before your surgery:

  • You may be given medicine to help you sleep.

  • Ask caregivers about directions for eating and drinking.

The day of your surgery:

  • Ask your caregiver before you take any medicine on the day of your surgery. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital. Caregivers will check that your medicines will not interact poorly with the medicine you need for surgery.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.

  • Your caregiver may give you an IV injection of a radioactive dye 1 to 2 hours before your surgery. This will help him clearly see your parathyroid glands during surgery.

Treatment

What will happen:

  • An incision will be made in your neck, and the muscles of your neck will be pulled to each side. Your surgeon will gently move your thyroid gland aside to see the 4 parathyroid glands. A handheld probe (wand) and camera may be used during the surgery to find your parathyroid glands. Your surgeon will remove part or all of your parathyroid glands. If all 4 glands need to be removed, your surgeon may leave a small part of 1 gland in place. He may also put a small piece of gland into a muscle in your arm.

  • You may need blood tests during surgery. A drain may be placed in your wound to remove blood or extra fluid from the surgery area. The wound will be closed with stitches and covered with bandages.

After your surgery:

You will be taken to a room to rest until you are fully awake. Caregivers will monitor you closely for any problems. Do not get out of bed until your caregiver says it is okay. A caregiver will check your incision soon after your surgery to make sure everything is okay. If you have a drain, your caregiver will check it when he checks your incision. He will remove it when your incision stops draining fluid. Try to avoid jerking movements and coughing. When your caregiver sees that you are okay, you will be taken to your hospital room.

Contact a caregiver if

  • You cannot make it to your surgery.

  • You have a fever.

  • You get a cold or the flu.

  • You have a skin or wound infection near the area where surgery will be done.

  • You have questions or concerns about your surgery.

Seek Care Immediately if

  • You have new symptoms since the last time you saw your caregiver, or your symptoms are getting worse.

  • You feel too depressed or sad, or think that you cannot cope with life or your problems.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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