The success rate of the surgery is 98% with the minimally invasive operation or the standard parathyroidectomy. Almost all patients will have symptomatic improvement and a better quality of life with a successful operation.
The neuromuscular symptoms (fatigue, low energy level, emotional problems, sleeping disorder) will usually improve within the first month after surgery. Other symptoms may take several months to improve. Gastrointestinal problems usually improve with a month or two but this may take up to 6 months.
In patients with kidney stones, the chance of a recurrent stone significantly decreases.
In patients with osteopenia or osteoporosis, bone density will improve over the course of one to two years.
The small number of failures are usually due to one of two factors:
Long term recurrence rates after a successful operation are very low, approximately 3%.
Most patients will have a little bit of swelling and soreness in the lower neck. Some will have a little difficulty swallowing, but this resolves quickly. Surgery and anesthesia may cause some fatigue for a few days. Most patients will get back to normal
activity within 3-7 days.
Hyperparathyroidism is excessive activity of the hyperthyroid glands. There are three common forms of this condition:
Of these three types, by far the most common is the first one, sporadic primary hyperparathyroidism (SHPT).
Signs and symptoms of SHPT may be nonspecific, mild or severe.
The range of signs and symptoms include:
The diagnosis of primary hyperparathyroidism is made by blood tests. Calcium and parathyroid hormone (PTH) are measured.
The most common cause of SHPT is the development of a benign tumor (adenoma) involving one of the parathyroid glands. This overactive parathyroid gland is not cancerous; however, it induces high levels of calcium in the blood due to an overproduction of PTH that can cause a variety of health problems.
Cancer of the parathyroid glands is very rare (less than 1% of cases).
No imaging studies are necessary to make the diagnosis of HPT. However, these tests help the surgeon to preoperatively localize the offending gland or glands and allows him/her to perform a targeted, minimally invasive parathyroidectomy. A combination of two imaging tests to locate the parathyroid gland or glands before parathyroidectomy can be performed:
Surgical removal of the abnormal parathyroid gland(s) or parathyroidectomy is the treatment for PHPT. A surgeon will remove one or more of the glands that are abnormal. If all four glands are abnormal, three glands and a portion of the fourth gland are removed, leaving some functioning parathyroid tissue in the neck (subtotal parathyroidectomy).
You will be contacted by the pre-operative call center prior to your surgery to confirm the time and date of your surgery. If you do not hear from them by the business day before your surgery, please call them at 720-848-6070 between 2 and 4
Do not eat or drink anything for 6 hours before the operation.
Shower or bathe as usual on the morning of the operation.
If you have questions before your surgery, please call 303-724-2724.
You will wake up in a recovery room.
Pain will be controlled with oral pain medication.
If you feel numbness of the face and/or tingling in your hands and feet, it’s a sign that your calcium level is too low. This is usually temporary and can be addressed by taking calcium pills.
The most common way to take calcium is as calcium citrate:
You may take an extra dose per day if you are still experiencing numbness and/or tingling.
An alternative is calcium carbonate, but some patients experience gastrointestinal side effects such as constipation with high doses.
You may take an extra dose per day if you are still experiencing numbness and/or tingling.
After hours and on weekends you may contact the answering service at 303-724-2728.
Scarring is a part of every surgery and is very important to many patients for a variety of reasons: Scars may be painful, itchy or unsightly. Below is a list of common topical agents that are available over-the-counter for scarring.
Most incisions will heal to a thin, cosmetically acceptable scar without using any of the agents described below. However, if you would like to use a topical agent to improve healing and the cosmetic appearance of your scar, we recommend a silicone-based product. See below for additional details.
If you're short on time, you can skip to the summary.
Silicones are synthetic polymers that can be a liquid, gel, or rubber.
Several studies illustrate that treatment of hypertrophic and keloid scars with silicone gel improves the appearance and bulk of the scars, especially in patients with burns. The superiority of one form of silicone gel dressing over another is not clear. Although both silicone gel sheeting and silicone gels improved scars, studies indicate no significant difference between the two forms.
Silicone dressings are believed to decrease scars via wound hydration, increased static charge, and modulation of growth factors.
Materials other than silicones (i.e., polyurethane) have shown to be equally effective in the treatment of hypertrophic scars. Both silicone and non-silicone gel dressings have been effective in reducing scar size, induration, and symptoms, but no significant differences have been noted between treatment with silicone and treatment with non-silicone gel dressings.
Bottom Line: There is good evidence showing the efficacy and safety of topical silicone for the treatment of hypertrophic and keloid scars. Silicone gel may improve the thickness, color, and texture of scars, especially thick ones. Although early treatment is ideal, silicone gel sheeting may still be beneficial for older scars.
Patients who wish to use silicone gel for scar management should apply it to the scar for 8 to 24 hours per day. It may take several months to see improvement.
Vitamin E preparations are probably the most popular for use in improving the cosmetic appearance of scars.
Early studies showed that vitamin E, applied topically, penetrates deep into the dermis and subcutaneous tissue, which is likely what led to the idea that vitamin E may improve wound healing when applied topically. When the skin is injured, free oxygen radicals are released in the inflammatory phase and may affect healing. In theory, Vitamin E could reduce free radicals by its antioxidant activity, thus enhancing wound healing.
Research on the effects of vitamin E on skin healing is sparse. Studies have shown that topically applied vitamin E provides no more effect than other emollient-type ointments, and hydration appears to be its only beneficial effect. Interestingly, topical vitamin E may actually cause more harm than good, possibly worsening a scar's appearance and causing contact dermatitis, contact urticaria, and erythema multiform-like reactions in some patients. A recent report from Widegrow has highlighted the skin irritation and reduced tensile strength caused by vitamin E. Use of vitamin E later on in the scar's maturity (4 to 6 weeks and later) may flatten the scar because of its hydrative capabilities, but it may result in a stretched and weakened scar because of its decreased strength effect on the scar; and if used too early, wound separation can occur.
Bottom Line: Although many patients believe vitamin E speeds wound healing and improves the look of a scar, current research evidence does not support this idea. In fact, studies report adverse effects with use of vitamin E.
We discourage patients from using topical vitamin E on healing wounds and scars.
Another popular and heavily marketed over-the-counter scar treatment consists of onion extract in a topical gel, which has been marketed as a product to improve scar appearance and texture (Mederma, Merz Pharmaceuticals).
The mechanism of onion extract seems to reside in its antihistamine properties. The theory behind this is that a compound that blocks histamine release may decrease collagen production by fibro-blasts, resulting in reduced scar volume and normalization of the scar maturation process. The cosmetic result is a decrease in scar redness and hypertrophy.
Wounds treated with Mederma did show significantly better improvement of collagen organization. However, a prospective, double-blind study of Caucasian males demonstrated that the effects of topical onion extract on cosmetic appearance, erythema, and hypertrophy of scars in new surgical scars were equivalent to those of petroleum emollient.
Bottom Line: Products containing onion extract (i.e., Mederma) do not improve scar symptoms and have not shown any benefit over petroleum emollients. Applying this product to scars will probably not cause any harm, but will also probably not improve them.
Honey has been used as a dressing for wounds and burns for centuries.
Honey' effects on wound healing are theorized to be from its antibacterial activity in addition to its hydrating properties.
A review of 22 clinical trials involving more than 2,000 patients concluded that honey rapidly clears existing wound infections and protects against further infection, reduces swelling, minimizes scarring, removes infected and dead tissue, and speeds
healing by stimulating new tissue growth.
Bottom Line: More well-designed, double-blind controlled trials in humans are needed, but preliminary studies are promising regarding honey and its wound-healing and scar-improvement properties.
Applying honey to a healing wound or existing scar has not been shown to be harmful and may speed healing and improve scar appearance.
To summarize, silicone gel has the most data behind it as an efficacious topical, over-the-counter treatment option for scars, and is an option for patients who want something they can buy themselves. Also, there is probably not any harm, and possibly some benefit, to rubbing honey onto healing wounds and scars.
Further controlled studies involving human subjects are needed for topical, natural preparations for scars, so in the meantime, we recommend that patients not waste time or money on other “natural” products that claim to improve the look of scars.
We do not endorse any particular silicone gel over another; the products below are simply examples of brands that are available over the counter at the time of this posting.
This information is provided by the Department of Surgery at the University of Colorado School of Medicine. It is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.