Are these the key things to ask about parathyroidectomy?

Posted by musicbart @musicbart, May 16 6:27pm

Tell me if I'm not including or maybe overlooking something important below and tell me if you agree that what I've written below are the key things to ask a parathyroid surgeon about:

- Do you always try to do minimally invasive parathyroidectomy surgery on the neck? When are you forced to do non-minimally invasive surgery and does the patient know of your new plan or is it too sudden and you can't really inform a surgery-drugged patient about a notable change in the plan?

- Do you always do complete and thorough inspection to find all 4 healthy and unhealthy parathyroid glands? Do you rely only on visual inspection or is there some other maybe some technical equipment way during surgery to find one or more of the glands?

- In the case when you can't find and correctly identify all 4 parathyroid glands, what do you do during surgery? Do you then remove just 1 gland, or maybe stop at 2 glands, or what?? If you can't find all 4 glands in the usual locations, do you suspect the patient has one or more ectopic glands somewhere? How do you locate ectopic glands?

- If you've removed more than the correct number of ailing parathyroid glands, what happens to the patient? Does the patient then have to take a calcium supplement forever after your surgery? [I suppose this can only be known some time after the excisions. Yes?]

- I suppose it may not be possible to know *during surgery* that you've *permanently* damaged/severed the nerve(s) on one side serving the vocal cord on that one side (and this applies too when you do surgery on both sides). How soon after completion of the surgery does the patient usually report either a lousy voice or NO voice at all? Is this poorly uttered report or written report by the patient usually hours after surgery or days after the surgery?

- ASKED LAST IN A MEETING: If *you* had this same hyperparathyroidism medical problem and were told by one or more endocrinologists that you, beyond doubt, need surgery to remove one or more of the 4 glands, where would you go and, if you have some top parathyroidectomy surgeon in mind, who is that by name?

[End of my thoughts on questions.]

What have I not considered that's quite to really important in questioning a possible surgeon for parathyroidectomy? How are my above questions?

Interested in more discussions like this? Go to the Diabetes & Endocrine System Support Group.

@musicbart sounds like you found the Norman group in Florida…

Dr Norman performed a parathyroidectomy on me in 2008. I felt better almost immediately.


How many of these surgeries have you done? You need an expert surgeon to find those glands that are hidden. Wife went to Norman in 2020 for the best surgery of her life. I told her you’re going to Norman if I have to drag you onto the airplane. Afterwards she agreed we made the right choice.


Very thorough insightful questions!!
If you go to the Norman website ( it is loaded with info AND it has a great calculator where you can input your own data and see what your data says, like a virtual, non committal 2nd opinion. Then check out More great info, a smaller simpler calculator. I found it useful to keep re-entering my info, by age..this helped me get a sense of when my body changed from secondary to primary HPTH. This was another mini 2nd opinion. Dr. Boone's practice is in AZ, she worked at the Norman center in FL for 6+- years and was the medical director for 3+- yrs. My drs were all Kaiser Permanente HMO. Dr. Boone offers a free simple review of some of your tests and a full comprehensive 2nd opinion and virtual appt for a little less than $600. It was worth every penny. Since my numbers, symptoms and history are all whacko!! I was diagnosed with secondary HPTH 17 years ago by accident, that led to my diagnosis of severe (congenital) celiac disease. Now I have switched to primary HPTH. My scans at Kaiser are negative, my endocrinologist told me to "wait and see ", a phrase that should NEVER be used with HPTH, per Dr. Norman and Dr. Boone's websites. Good luck. If you feel like it, I would be interested to know how you got on the HPTH merry go round. Shelley


What got you started on your journey? I learned yesterday that my pth is 69.1. I have an endo appointment next Friday.

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