Gen surgeon calls tomorrow

I'm at the end of my 70s and have had, since the start of 2023, still untreated hyperparathyroidism. Endocrinologists have told me that even though my calcium and PTH levels aren't alarming and are slightly above normal, I should undergo parathyroidectomy since I have hypercalcemia and osteoporosis (which was mainly based - it seems to me - on a hairline fracture in T7 of my spine: I have NO back pain). I kept putting off surgery since the scans that were done of my neck never showed to radiologists which of my 4 parathyroid glands was the haywire one (if there was only 1 that was haywire).

Last month I had another nuclear med scan of my parathyroid glands. [The first one was done in 2024.] A general surgeon's calling me tomorrow to talk about the findngs in this latest nuclear med scan and about parathyroidectomy. Tell me if you have questions I should ask the general surgeon maybe questions only or partly based on the following results of the latest nuclear med scan:

[Male, 79 years old]

Exam: NM PARATHYROID SCAN

Study Date: 25 Aug. 2026

Clinical History: Primary hyperparathyroidism

Comparison: None

Radiopharmaceutical: 25.1 mCi of technetium 99m labeled sestamibi was given intravenously to the patient. 276 uCi I-123 sodium iodide p.O. Was also administered to the patient.

Procedure: Static delayed images of the neck and chest with and without pinhole collimator are obtained in standard fashion post-radiopharmaceutical administration. No SPECT-CT imaging was performed. Dual isotope subtraction is also performed.

---> Findings:

Uniform distribution of radiotracer seen in the thyroid gland on I-123 images. No discrete hot or cold nodule. Uniform distribution of radiotracer is seen in the thyroid gland on Tc-99m labeled sestamibi images. No scintigraphic evidence of ectopic parathyroid lesion is seen in the thorax. Dual isotope subtraction images demonstrate a mild focus of retained radiotracer uptake adjacent to the inferior lower pole of the RIGHT thyroid lobe region on 10% subtraction images. Lack of SPECT-CT somewhat limits the accuracy and sensitivity of these
findings.

[End of nuclear med scan report.]

In June 2026, I was the subject of an US scan of my thyroid to find out if anything could be determined about the parathyroid glands. Here's that report:

Exam Date: 23 JUNE 2026@14:12
Req Phys: _______ ______ Pat Loc: MAD ENDOCRINE RESIDENT (Req'g
Img Loc: ULTRASOUND
Service: Unknown

(Case ___________ COMPLETE) US THYROID (US Detailed) CPT: ______
Reason for Study: hyperparathyroidism

Clinical History:
Please evaluate thyroid and examine for enlarged
parathryoid/parathyroid adenomas. Patient is being evaluated for
parathyroidectomy.

Report Status: Verified
Date Reported: 23 June 2026
Date Verified: 23 June 2026
Verifier E-Sig:

Report:
EXAMINATION: US THYROID

Clinical history: hyperparathyroidism

Comparison: 2024.

---> FINDINGS:

Limited visualization posterior to the thyroid gland to evaluate
the parathyroid glands.

MORPHOLOGY: Normal echotexture and diffuse increased vascularity.

SIZE:
Right hemithyroid: 4.2 cm x 2.1 cm x 2.5 cm . Volume: 10.33
ml .
Left hemithyroid: 3.8 cm x 1.6 cm x 1.9 cm . Volume: 5.68
ml .
Isthmus: 0.4 cm.

NODULE: 0.5 cm mostly solid in the right upper pole.

---> Impression:

1. Subcentimeter thyroid nodule gland nodule, recommend follow-up with ultrasound in 12 months. Limited evaluation of the parathyroid glands, recommend Sestamibi SPECT/CT scan or MRI.

Primary Diagnostic Code: FOLLOW-UP RECOMMENDED

Primary Interpreting Staff:
_________ ________, Radiologist

[End of US scan of my thyroid gland.]