Let's learn about parathyroidectomy in simple terms!

In our neck, specifically behind the thyroid gland, there are four tiny, bone-like glands. These are what we call the "parathyroid glands." Although they are small in size, they perform a very important function for our body. That is, they control the calcium level in our blood. Sometimes, one or more of these glands start working too much. Then, surgery has to be done to remove that particular gland or glands. That surgery is called a parathyroidectomy . So if you also want to know about this, let's talk about it in detail.

What is parathyroidectomy?

Simply put, parathyroidectomy is the surgical removal of one or more parathyroid glands.

Think about it, calcium is essential for our body to keep our bones strong, our nervous system to function properly, and our muscles to function properly. The main function of the parathyroid glands is to maintain the right level of calcium in the blood. These glands produce a chemical called Parathyroid Hormone (PTH) . This hormone controls the level of calcium in the blood.

If for some reason one or more of these glands become overactive, the PTH hormone is produced in excess . Then the calcium level in the blood increases unnecessarily. We medically call this condition hyperparathyroidism . This is when doctors recommend this surgery.

Why do you need this surgery?

There are several causes of hyperparathyroidism. Depending on these, it is decided whether surgery is necessary or not. Let's look at the main causes.

How do you prepare before surgery?

Okay, let's say your doctor has decided to perform surgery on you. Before that, you have a lot of questions in your mind, right? Don't worry, that's normal. The most important thing is to talk to your doctor about all the questions and doubts you have. The day before the surgery, you will be given a special set of instructions. But before that, you can ask the doctor these questions.

• Do I have to fast (not eat or drink) the morning of the surgery? Usually, you are asked to stop eating and drinking a few hours before surgery.
• Is it okay to take my usual daily medications and vitamins on the day of surgery? Some medications (e.g. blood thinners) may need to be stopped a few days before surgery. So be sure to ask about this.
• Do I need someone to drive me home after surgery? Because I'm under anesthesia, I may not be able to drive that day. So it's safer to have someone drive me home.

How is the surgery done?

Surgeons use several methods to perform this operation. Your surgeon will explain to you which method is most suitable for your situation.

• Traditional Surgery: In this method, a small incision is made along a crease in the skin of the neck and the glands are removed. Because the incision is made along a crease in the skin, the scar is not very visible after healing.
• Minimally Invasive Surgery: In this method, surgery is performed through a very small incision, sometimes with the help of a device such as a camera.
• Scarless Surgery: This is a very unique method. In this, no incision is made in the neck. Instead, an incision is made inside the mouth, on the lower lip. Then, no scar is visible from the outside.

On the day of surgery, these steps are usually followed:

1. Anesthesia: Initially, you will be given anesthesia to make you feel no pain and to keep you comfortable during the surgery. You will often be put to sleep (General Anesthesia).

2. Making the incision: The surgeon then makes a small incision (either in the neck or inside the mouth) depending on the chosen method to reach the parathyroid glands.

3. Gland removal: The problematic, overactive parathyroid gland or glands are carefully identified and removed.

4. Closing the incision: Finally, the incision is closed with either dissolvable sutures or regular stitches.

What happens after the surgery?

You will be able to go home the same day or the next day after the surgery. Take some care of these things after you go home.

• Eating and drinking: You can eat and drink normally. However, you may feel a little sore in your throat. If this happens, it is best to eat soft, easy-to-swallow foods such as porridge, yogurt, and soup for a day or two.
• Activities: Walking and doing light household chores are fine, but you should avoid heavy lifting, exercise, and running until your doctor gives you the okay.
• Calcium supplements: Sometimes, it takes a while for the remaining parathyroid glands to start working properly again. During this time, your blood calcium level may drop. To keep it at the right level, your doctor may tell you to take calcium supplements for a while.

What are the benefits of this surgery?

You may have had various problems due to hyperparathyroidism. After this surgery, once your blood calcium levels return to normal, your quality of life can improve significantly.

Are there any risks to the surgery?

Parathyroidectomy is generally a very safe surgery . However, as with any surgery, there is a risk of minor complications. However, these are often temporary and can be treated.

Short-term complications

• Sore throat: Your throat may be sore for a few days after surgery.
• Hoarseness of the voice: Because these glands are located near the vocal cords, the voice can sometimes become a little hoarse. This usually goes away in a few days or weeks.
• Infection: There is a small risk of infection at the incision site.
• Hematoma: Very rarely, blood may collect under the skin under the incision.

Long-term complications

• Hungry Bone Syndrome: This is a bit of a strange name. What happens in this is that the bones do not get the calcium they need because the blood calcium level is high before the surgery. After the surgery, when the blood calcium level returns to normal, the bones start to absorb calcium rapidly as if they are 'starving'. This can cause the blood calcium level to remain low. We call this condition chronic hypocalcemia . But don't worry, there is a treatment for this.
• Recurrent hyperparathyroidism: This condition can come back if another gland that was not removed later starts working too much. However, this is very rare.

How long does it take to fully recover?

It can take a week to three weeks to fully recover. But you should be able to resume normal activities (except heavy lifting) within a few days. The success rate of the surgery is excellent. It has a success rate of over 95% . In fact, it is the only permanent cure for hyperparathyroidism.

When do you need to talk to the doctor?

When you go home after surgery, be on the lookout for these symptoms. If you experience any of these, call your doctor right away.

• If you have a fever over 101 Fahrenheit (38.3 Celsius).
• If you have severe pain that does not subside even after taking painkillers.
• If you have difficulty swallowing food or drink.
• If the incision site is red, swollen, feels warm, or has pus-like fluid coming out (these are signs of infection).
• If you notice any symptoms of low calcium in your blood , for example:
• Numbness in the hands, feet, or around the lips.
• If you feel a muscle twitching or cramping.
• If you feel very tired.

Is this a major surgery?

No, a parathyroidectomy is not considered a major surgery. The traditional incision in the neck is usually small, about 2 inches (5 centimeters). So don't be unduly afraid of this.

In conclusion, when the parathyroid glands produce too much hormone, it can cause a variety of symptoms. Parathyroidectomy is a very effective and safe surgery to treat the condition. If you are experiencing these symptoms, it is best to see a doctor to find out the cause and get the right treatment.