Understanding what to expect before and after parathyroid surgery is essential, as it can be a life-altering event for many people. The patient and the surgical team should get together before the procedure to go over the procedure’s specifics and any preoperative requirements.
Patients need to adhere to a structured recovery plan after surgery to guarantee a speedy and trouble-free recovery.
Before you see the surgeon, you may need to go through some tests to examine your parathyroid glands. Physical examination may include an ultrasound, a sestamibi scan, or a CT scan. These tests give valuable data to the surgeon about your parathyroid glands.
You will likewise have routine blood tests. Contingent upon your blood test results, a few people may need to take Vitamin D prior to surgery.
Before your Parathyroid Surgery:
Multiple routine screenings are performed before parathyroid surgery to make sure the patient is healthy enough to undergo the procedure.
Blood tests, a complete physical examination, and a review of the patient’s medical history are just some of the things that are often done at least a week or two before surgery.
Depending on your health background, you may additionally need a stress test, chest x-ray, or electrocardiogram (ECG). Your cardiovascular and respiratory health will be evaluated. No in-hospital observation is needed for these examinations.
These examinations may be ordered by your primary care physician, the surgeon, or a high-risk anesthesiologist, depending on your age and overall health.
Before surgery, you might also be advised to see an endocrine nurse practitioner who will instruct you about the surgery and ensure all your medical examination has been completed.
Medication Instructions
PLEASE CONSULT your doctor or surgeon PRIOR changing or halting any of your medications.
Medication Instruction before Surgery:
Many medications may require discontinuation prior to surgical procedures. Before discontinuing the use of any prescribed medication, you should check with your surgeon or primary care physician.
Medicines related to the heart (like blood pressure medications): AVOID taking them on the surgery day and consult your surgeon:
- Captopril (Capoten)
- Enalapril (Vasotec)
- Benazepril (Lotensin)
- Bumetanide (Bumex)
- Candesartan (Atacand)
- Eprosartan (Teveten)
- Fosinopril (Monopril)
- Furosemide (Lasix)
- Lisinopril (Prinivil, Zestril)
- Metolazone (Zaroxolyn)
- Olmesartan (Benicar)
- Perindopril (Aceon)
- Hydrochlorothiazide (HCTZ)
- Iosartan (Cozaar, Hyzaar)
- Irbesartan (Avapro)
- Quinapril (Accupril)
- Ramipril (Altace)
- Spironolactone (Aldactone)
- Telmisartan (Micardis)
- Valsartan (Diovan)
Blood thinning medicines: Please ensure you have discussed this with your PCP or surgeon before stopping any of these medications.
- Aspirin – Avoid taking 7 days prior to surgery
- Coumadin – Avoid taking 5 days prior to surgery
- Heparin – Must be held for 12 hours before surgery
- Antiplatelet agents (Plavix, clopidogrel, ticlopidine) – Please follow the instruction of your surgeon or cardiologist.
Diabetes medications:
Insulin – Patients using insulin pumps:
- Carry on with your basal rate ONLY
Patients not using insulin pumps:
During the morning of the surgery day:
- Hold short-acting insulin
- Pre-blended insulin (eg. 70/30): give 1/3 of regular dose
- Lantus: give a regular dose
Avoid taking any oral diabetes medications on the morning of surgery.
- Metformin
- Glyburide
- Glipizide
Other prescription drugs:
- MAO inhibitors – Avoid on the surgery day
- Premarin – Avoid on the surgery day
- Viagra or similar drugs – are not recommended to take 24 hours prior to surgery
Over-the-counter medications:
- Aspirin – avoid taking them 7 days prior to surgery
- NSAIDS (ibuprofen, Aleve, naproxen, Celebrex) – avoid taking them 7 days prior to surgery
- Iron – Avoid on the surgery day
- Herbal supplements and Vitamin E-containing multivitamins – avoid taking them 7 days before surgery
Surgery Day
The surgery day schedule will be sent to you by the surgical department the night before your surgery, or at the very latest, 24 hours before. You must check in at the hospital two hours before your scheduled surgery time. In most cases, patients are instructed to abstain from eating or drinking after 12 p.m. on the day before surgery. Regular medications can sometimes be taken with a small amount of water. At your pre-op appointment, you will receive a briefing on prescription guidelines.
Contingent upon your age, well-being, and surgical complications, you might need to remain in the hospital overnight. This is mainly discussed with your surgeon during your hospital visit. Kindly leave all valuables at home and wear comfortable clothes.
Prescribe Medications on Discharge
Regular medications you might be prescribed on discharge, please contact your doctor for medication or any health related issues.
- Medication for Pain.
- Calcium (TUMS): Post parathyroid surgery, all patients are discharged to go home with calcium supplementation. Parathyroid glands control calcium levels in the blood. Calcium is important because of expulsion of the overactive gland and remaining “sleepy” parathyroid glands. The remaining glands are generally underactive for a couple of days post-surgery. In the event that the remaining glands are underactive, you may have low calcium levels in your body. A low calcium level is mainly a short-term issue and can be treated with calcium supplements. Indications of low calcium levels may include numbness and tingling around the lips and in the fingers and toes. If you experience these symptoms, please contact your PCP or surgeon.
- Vitamin D (Ergocalciferol, calcitriol): If your Vitamin D levels are low prior to surgery, you will be prescribed a supplement to neutralize the deficiency. Post your surgery, you may require a different type of Vitamin D (calcitriol) since your parathyroid glands may create a low amount of parathyroid hormone, making your calcium levels low. This isn’t generally vital in all patients.
After Surgery
Around 1-2 weeks after surgery, you will schedule an appointment to visit the hospital with your surgeon. You will likewise have some blood tests. Depending on the results of the blood test, you may need to take extra calcium supplementation for some time.
Prognosis
In most cases, parathyroid surgery can effectively treat hyperparathyroidism, with a high success rate and a low risk of complications.
Patients get a comprehensive medical examination prior to surgery, which may include blood tests, imaging exams, and sometimes even a nuclear medicine scan to pinpoint the afflicted glands.
Patients might anticipate vast improvements in their symptoms, including fatigue, weakness, and bone pain, after the operation. However, for the greatest potential outcome, it is essential to keep in touch with the medical staff and to stick to a healthy routine.
Appointment
If you have any further queries regarding parathyroid surgery, kindly contact us @ 817-748-0200 or you can also make an online appointment with us.