Information for patients undergoing parathyroidectomy - The Royal ...

Patient information – Pre-operative Assessment Clinic
Information for patients undergoing parathyroidectomy
Introduction
This leaflet will explain what will happen when you
come to the hospital for your operation. It is
important that you understand what to expect and
feel able to take an active role in your treatment.
Your surgeon will have already discussed your
treatment with you and will give advice about what
to do when you get home. This leaflet will answer
some of the questions that you may have but if
there is anything that you and your family are not
sure about, then please read “Coming into hospital”
folder for further information about your stay in
hospital. You can also visit the Trust website to find
out more www.royalberkshire.nhs.uk/patients__visitors/your_stay_in_hospital
What is a parathyroidectomy?
Parathyroidectomy is the removal of one or all of your parathyroid glands. You may need to
have this done because one or all of the glands is overactive.
Your specialist will explain to you how many of your parathyroid glands need to be removed,
in order for you to give fully informed consent. If you do not understand any of the
information please ask, as it is very important for you to make the right decision.
The parthyroid glands
Most people have four little parathyroid glands in the neck, two on either side near the
thyroid gland. The parathryroid glands help control the level of calcium in the blood. An
overactive parathyroid gland increases the level of calcium in the blood, resulting eventually
in weakened bones. In addition, if left untreated, you may develop kidney stones, weakness
in the muscles, decreased alertness or stomach pains.
Are there alternatives to surgery?
Usually patients will have tried medication for their symptoms. The alternative to this surgery
is to decide not to have surgery.
Pre-operative Assessment Clinic – Information for patients undergoing parathyroidectomy 1

Information for patients undergoing parathyroidectomy
Are there likely to be any complications?
Scarring: Surgery of the parathyroid glands is undertaken through a cut, which usually follows a
natural crease in the neck. Usually it heals quite well, leaving only a thin line but in some people
the healing leaves a scar which is more coloured and thicker than the normal scar. This is not
normally predictable but if you have any other scars that have not healed well, please tell the
surgical team.
Voice change: There are small nerves to the voice box which pass close to the parathyroid
glands and may be damaged however carefully the operation is done. The effect of damage to
one of these nerves is a weak or husky voice. These changes normally improve with time and
the chance of you having a permanently abnormal voice is less than one in a hundred, (this
means that less than 1%).
Other complications: Like any other operation, complications such as infection, bleeding, etc can
occur.
Potential side effects and complications are exceedingly rare, but we believe it is best to inform
you of these rather than have you develop a complication without being forewarned. These risks
and complications will be explained to you when the surgeon asks you to sign the consent
form for the operation.
When do I come to hospital?
You will come into hospital the day before or on the morning of the operation. This will be
confirmed in a letter from the waiting list office, even if you have already been given a date
by the surgeon.
How quickly will I be up and about?
On the day of your operation you should resume normal activities gradually. Any heavy
lifting or activities that cause strain should be avoided and should be gradually built up to in
the next 2-4 weeks.
You will have your blood calcium checked the next day before you go home and will be
allowed home if your calcium is normal. Some patients may go home the same day.
We recommend that you start doing the recommended exercises (see the end of this leaflet)
as early as possible.
What happens after I am discharged?
The wound dressings will be left intact until you see the consultant at your follow up
outpatients clinic appointment, which is normally two weeks after the surgery. The stitches
are usually dissolvable so don’t need to be removed. Your GP will be sent a letter so that
he/she has details of your operation and can help you with any future problems.
When you are at home it is important to watch out for any tingling sensation in your body as
this is a sign that your calcium level is low. If you experience any tingling (this usually
Pre-operative Assessment Clinic – Information for patients undergoing parathyroidectomy 2

Information for patients undergoing parathyroidectomy
happens at night after the operation), we recommend that you drink a glass of milk straight
away. If the sensation doesn’t pass, ring the ward to arrange to have your blood calcium
level checked. These symptoms occur because the other glands have become lazy or
underactive. The other glands will recover their normal function quickly but you may need
calcium and Vitamin D tablets temporarily after the operation in order to boost your calcium
level.
Work - Most people need about 4-6 weeks off work, but this will depend on what you do. It is
important that you pay attention to your body, and only do as much as you feel able to do.
Driving - You will probably be fit to drive within a week, providing you feel alert and can carry
out an emergency stop with comfort. Please check with your motor insurance company
before you start driving again.
Exercises following a thyroidectomy / parathyroidectomy
These exercises are designed to keep your neck moving freely following your operation.
They are very gently and should not cause you any pain. You can start to do them on the
day after your operation. If you have any difficulty with any of the movements, please speak
to a doctor, nurse or physiotherapist.
1. Turn your head to the right as far as possible.
2. Turn your head to the left as far as possible.
3. Take your right ear down towards your right
shoulder.
4. Take your left ear down towards your left
shoulder.
5. Bend your head forwards onto your chest.
Hold for a count of 5.
6. Slowly tip your head back, looking upwards as
far as possible.
7. Keeping your head erect, tuck your chin in and
hold for a count of 5.
Do these exercises 3 times each, repeating them twice daily.
Pre-operative Assessment Clinic – Information for patients undergoing parathyroidectomy 3

Information for patients undergoing parathyroidectomy
Useful telephone numbers
Hunter Ward 0118 322 7535
Lister Ward 0118 322 7538
Adult Day Surgery Unit 0118 322 7622
More information
B ritish Thyroid Foundation www.btf-thyroid.org/
Pre-operative Assessment Clinic, April 2010
Review due April 2011
Pre-operative Assessment Clinic – Information for patients undergoing parathyroidectomy 4