Parathyroid surgery is a very common procedure used to restore the body's natural calcium levels to normal. Despite the fear associated with surgery, knowing what happens prior to and after surgery puts one at ease. The following is a step-by-step procedure of the entire process from preparation to recovery.
Pre-Surgery – Preparing for the Procedure
The procedure begins with a diagnosis. If one or more of the parathyroid glands are discovered to be overactive (primary hyperparathyroidism) by a doctor, surgery is typically the way to go. But first (before going to the operating room) there are some things to take care of.
Medical Tests and Imaging
As a precursor to surgery, doctors will:
Perform blood tests in an attempt to measure calcium and parathyroid hormone (PTH) levels.
Use imaging tests, such as ultrasound, sestamibi scan, or CT scan, to locate the gland(s) involved.
Assess kidney and bone function since excess calcium can affect them.
Pre-Surgery Instructions
The patient is provided with special pre-surgical instructions to make surgery safe and stress-free. These may be:
Medication Changes: Blood thinners and some supplements need to be stopped.
Fasting: Nothing by mouth (including water) after midnight before surgery.
Hydration & Nutrition: Proper hydration and eating nutritious meals prior to the surgery help with the recovery process.
The Day of Surgery – What to Expect
Patients come to the hospital or surgery center early in the morning on the day of the operation. A nurse checks for vital signs, and the surgeon goes over the procedure one last time. General anesthesia is administered by an anesthesiologist, making it painless. Once the anesthesia has been administered, the procedure begins.
During Operation – What happens in the Operating Theater?
The surgery usually lasts 30 minutes to an hour. The surgeon makes a small incision in the neck to access the parathyroid glands. The one gland is removed if it is hyperactive, and the others are left alone. Additional ones may be removed if there are multiple glands that are affected.
The surgery is done differently, based on the type:
Minimally invasive: Shorter incision, shorter recovery, less scarring.
Bilateral examination: Slightly longer incision if more than one gland needs to be evaluated.
As the surgery is performed, constant levels of calcium are closely monitored by the surgical team. When removing the overactive gland, the incision is closed with sutures or surgical glue, and there is little, discreet scarring.
Waking Up – The First Few Hours After Surgery
After the surgery is complete, the patient is taken to a recovery area, slightly drowsy. The following are most likely to occur first:
Throat soreness from the tube used during surgery for anesthesia, it’s mild.
Neck stiffness or pain, which typically settles in a couple of days.
Calcium test to prevent sudden loss, resulting in numbness or tingling.
The patient is usually discharged on the same day, but some stay overnight for calcium stability observation.
The First 24 Hours – Taking It Easy
Home rest is the biggest priority. The swelling in the neck is quite mild and it is uncomfortable to swallow. Here are some really good plans to have for the first day:
Raising the head to reduce the swelling.
Eating softer foods in order to avoid discomfort.
Use pain medication according to instructions.
Be aware of tingling sensation, indicating low calcium.
Some patients receive calcium supplements to prevent transient hypocalcemia (low calcium). These need to be taken as directed.
The First Week – Recovery Has Begun
Recovery is quick, and the patient soon starts feeling improved within a few days. Some side effects might be experienced for a while, such as:
A slight voice change (hoarseness), which will clear in a few weeks.
Mild fatigue, as the body stabilizes at normal levels of calcium.
Tingling of the lips or fingers, sign of low calcium that is relieved with supplements.
Incision Care
The incision is small and closes well. To have it fade:
Keep it dry and clean to prevent infection.
Don't do heavy lifting or strain on the neck.
Apply sunscreen while recovering to avoid scarring.
By the end of the first week, most patients resume light activity, but heavy exercise is still not advised for two weeks.
Long-Term Recovery – Life After Surgery
Two weeks post-surgery, follow-up visits ensure recovery is going well. Complete tests confirm the normality of PTH and calcium levels.
What Changes After Surgery?
Calcium and PTH levels decrease after surgery in most patients, and the following are some of the short-term benefits of surgery:
Energy level – No longer enigmatic fatigue.
Stronger bones – Lower likelihood of broken bones in the future.
Improved concentration and mood – Less brain fogs and irritabilities.
The Scar – What Happens
Small neck incision resolves significantly within a period of a few months to one year. Sunscreen and moisturizing decrease it.
Potential Long-Term Side Effects
Occasionally, some individuals experience:
Permanently low calcium levels with the need for intermittent supplements.
Change in their voice if the nerve to the vocal cord is injured (extremely rare).
Healing from parathyroid surgery is easy within a short time frame for the majority, with long-term health advantages.
Final Thoughts
Parathyroid surgery is a very straightforward and extremely effective treatment for elevated calcium. Endocrinologist Brisbane can guide patients through the entire process. Although it seems intimidating at first, knowing what to expect both before and after surgery makes the process so much less intimidating.
