minimal access parathyroid surgery is available in the UK
It is crucial to identify the correct surgeon - who should work in a unit where a significant number of cases are performed each year.
Most surgeons in the UK submit data to the British Association of Endocrine and Thyroid Surgeons. This is a National Audit with results published every other year.
Minimal access parathyroid surgery is the ideal way to cure primary hyperparathyroidism.
Small incisions mean the operation can be done as a daycase procedure.
http://www.bucksendocrine.com/
http://www.thyroidsurgeon.org.uk/
Thursday 30 December 2010
Thursday 23 December 2010
High Calcium
It is important to remember that high calcium levels are never normal.
The first thing to check is that the patient is not taking any medication or additional calcium in the diet that might alter the results.
After this testing PTH levels is vital.
PTH - parathyroid hormone - levels should be essentially zero if the calcium is high. Normal (or better termed 'inappropriately high') PTH levels and high PTH levels both are indicators of parathyroid disease.
Patients should be seen by an endocrinologist or experienced parathyroid surgeon to sort out this condition.
Most but not all patients should be offered surgery as this is the only permanent cure.
www.bucksendocrine.com
www.thyroidsurgeon.org.uk
The first thing to check is that the patient is not taking any medication or additional calcium in the diet that might alter the results.
After this testing PTH levels is vital.
PTH - parathyroid hormone - levels should be essentially zero if the calcium is high. Normal (or better termed 'inappropriately high') PTH levels and high PTH levels both are indicators of parathyroid disease.
Patients should be seen by an endocrinologist or experienced parathyroid surgeon to sort out this condition.
Most but not all patients should be offered surgery as this is the only permanent cure.
www.bucksendocrine.com
www.thyroidsurgeon.org.uk
Tuesday 30 November 2010
Parathyroid Surgery
Succesful parathyroid surgery depends on a number of factors:
1. Quality imaging - Sestamibi and ultrasound are used for most cases. CT and MRI also may have a role.
2. Surgery - this should be offered as a minimal access procedure through a 2cm incision to those patients who are suitable. There are a number of centres where this is not available and patients should expect a different surgeon.
3. Anatomy - the parathyroid glands are extremely variable in their location in the neck. Indeed some can be in the chest. This can make it very difficult to identify the faulty gland(s).
http://www.bucksendocrine.com/
http://www.thyroidsurgeon.org.uk/
1. Quality imaging - Sestamibi and ultrasound are used for most cases. CT and MRI also may have a role.
2. Surgery - this should be offered as a minimal access procedure through a 2cm incision to those patients who are suitable. There are a number of centres where this is not available and patients should expect a different surgeon.
3. Anatomy - the parathyroid glands are extremely variable in their location in the neck. Indeed some can be in the chest. This can make it very difficult to identify the faulty gland(s).
http://www.bucksendocrine.com/
http://www.thyroidsurgeon.org.uk/
Sunday 24 October 2010
High calcium Levels
High blood calcium levels are never normal.
What is interesting is that many patients I see have had an elevated calcium level and the next response from their doctor is to recheck it. Often the second level will be normal as calcium varies day to day. The important thing is to recheck again.
Symptoms of a high calcium vary hugely. The standard advice is that calcium has to be high (nearly 3.0mmol/l) to cause symptoms.
This is wrong. Many patients with mild elevations of calcium have symptoms and indeed are at risk of osteoporosis. One of the reasons for this is that some patients will be passing out lots of calcium in the urine.
http://www.bucksendocrine.com/
http://www.thyroidsurgeon.org.uk/
What is interesting is that many patients I see have had an elevated calcium level and the next response from their doctor is to recheck it. Often the second level will be normal as calcium varies day to day. The important thing is to recheck again.
Symptoms of a high calcium vary hugely. The standard advice is that calcium has to be high (nearly 3.0mmol/l) to cause symptoms.
This is wrong. Many patients with mild elevations of calcium have symptoms and indeed are at risk of osteoporosis. One of the reasons for this is that some patients will be passing out lots of calcium in the urine.
http://www.bucksendocrine.com/
http://www.thyroidsurgeon.org.uk/
Thursday 14 October 2010
Parathyroid disease and kidney stones
Parathyroid disease causes high blood calcium levels
In many patients the kidneys will attempt to clear the excess calcium and this can result in stones forming within the urinary tract system resulting in pain and occasionally damaging the kidneys.
Patients with kidney stones should have calicum levels checked and if they have had stones more than once should in addition have a 24 hours urine collection for calcium levels.
Patients with kidney stones due to parathyroid disease should almost always have parathyroid surgery
http://www.bucksendocrine.com/
http://www.thyroidsurgeon.org.uk/
In many patients the kidneys will attempt to clear the excess calcium and this can result in stones forming within the urinary tract system resulting in pain and occasionally damaging the kidneys.
Patients with kidney stones should have calicum levels checked and if they have had stones more than once should in addition have a 24 hours urine collection for calcium levels.
Patients with kidney stones due to parathyroid disease should almost always have parathyroid surgery
http://www.bucksendocrine.com/
http://www.thyroidsurgeon.org.uk/
Sunday 1 August 2010
Graves disease
This is a common cause of overactive thyroid disease characterised by bulging eyes or proptosis.
The condition is treated with drugs - carbimazole or propylthiouracil - which are anti-thyroid drugs and reduce the amount of excess thyroid hormone produced.
Once stabilised many patients continue with these medications for a year or so before coming off them. At this point approximately half of patients are cured but in the other half the disease recurs....
At this point the medications have to be restarted and definitive treatment considered to cure the condition once and for all.
There are only two options for definitive treatment:
1. Surgery - total thyroidectomy
2. Radioactive iodine
In general radioactive iodine is a good option and avoids the downsides of surgery (these are listed on my website - www.bucksendocrine.com )
Surgery is best of patients who fall into one of the following categories:
1. Large thyroid - which generally wont shrink with radioactive iodine
2. Thyroid eye disease - which can be made worse by radioactive iodine
3. Patients who wish to get pregnant within a few years of treatment
4. Some people cant cope with the concept of radiation treatment or the need to be away from children for up to 2 weeks afterwards.
More details on my website:
www.bucksendocrine.com
www.thyroidsurgeon.org.uk
The condition is treated with drugs - carbimazole or propylthiouracil - which are anti-thyroid drugs and reduce the amount of excess thyroid hormone produced.
Once stabilised many patients continue with these medications for a year or so before coming off them. At this point approximately half of patients are cured but in the other half the disease recurs....
At this point the medications have to be restarted and definitive treatment considered to cure the condition once and for all.
There are only two options for definitive treatment:
1. Surgery - total thyroidectomy
2. Radioactive iodine
In general radioactive iodine is a good option and avoids the downsides of surgery (these are listed on my website - www.bucksendocrine.com )
Surgery is best of patients who fall into one of the following categories:
1. Large thyroid - which generally wont shrink with radioactive iodine
2. Thyroid eye disease - which can be made worse by radioactive iodine
3. Patients who wish to get pregnant within a few years of treatment
4. Some people cant cope with the concept of radiation treatment or the need to be away from children for up to 2 weeks afterwards.
More details on my website:
www.bucksendocrine.com
www.thyroidsurgeon.org.uk
Friday 30 July 2010
Parathyroid Disease
Primary Hyperparathyroidism
This is a reasonably common problem but the diagnosis is often delayed.
Many patients I see have had parathyroid symptoms caused by high calcium levels for many months even years. Often looking back we can see in their blood tests results that calcium levels have been high for some time but the significance of this has not been recognised.
Surgery for primary parathyroid disease is a highly specialised area of surgical practice and should only be undertaken by surgeons who offer the full range of surgery - this nowdays includes minimal access parathyroid surgery.
The symptoms from parathyroid disease include:
http://www.bucksendocrine.com/
http://www.thyroidsurgeon.org.uk/
This is a reasonably common problem but the diagnosis is often delayed.
Many patients I see have had parathyroid symptoms caused by high calcium levels for many months even years. Often looking back we can see in their blood tests results that calcium levels have been high for some time but the significance of this has not been recognised.
Surgery for primary parathyroid disease is a highly specialised area of surgical practice and should only be undertaken by surgeons who offer the full range of surgery - this nowdays includes minimal access parathyroid surgery.
The symptoms from parathyroid disease include:
- muscle aches and pains
- joint aches
- tiredness
- headaches
- bone pains
- thirst
- passing urine more frequently including at night
- kidney stones
- abdominal pains
- mental disturbance
- osteoporosis
http://www.bucksendocrine.com/
http://www.thyroidsurgeon.org.uk/
Daycase thyroid surgery
Thyroid surgery is offered as a daycase procedure as a routine in my practice.
We have acheived this routine excellent result by a number of changes in the way that the surgery and anaesthetic is undertaken.
Key elements include
http://www.bucksendocrine.com/
http://www.thyroidsurgeon.org.uk/
We have acheived this routine excellent result by a number of changes in the way that the surgery and anaesthetic is undertaken.
Key elements include
- small incisions
- preservation of the muscles in the neck (strap muscles - still cut by some surgeons)
- local anaesthetic nerve blocks to reduce pain to a minimum during and after the surgery
- very light anaesthetics to minimise sickness etc after surgery
http://www.bucksendocrine.com/
http://www.thyroidsurgeon.org.uk/
Minimal access thyroid surgery
Thyroid surgery can be done as a daycase procedure through a small neck incision (4-5cm) and with the majority of patients taking no painkillers after surgery.
Does this sound different - well it is as the average patient in the UK does not get offered this kind of package.
I offer minimal access thyroid surgery and have been doing so for the last 6 years as a consultant surgeon in both my NHS and private practice.
More details are available on my websites:
http://www.bucksendocrine.com/
http://www.thyroidsurgeron.org.uk/
Does this sound different - well it is as the average patient in the UK does not get offered this kind of package.
I offer minimal access thyroid surgery and have been doing so for the last 6 years as a consultant surgeon in both my NHS and private practice.
More details are available on my websites:
http://www.bucksendocrine.com/
http://www.thyroidsurgeron.org.uk/
Parathyroid Surgery
Parathyroid surgery has been transformed in recent years.
No longer do patients have to have large neck incisions to cure their disease and symptoms.
I offer minimal access parathyroid surgery to suitable patients in the NHS and in my private practice.
Two scans are required:
1. A radioactive Sestamibi scan - this attempts to identify the usually single offending gland by its level of activity. Usefully if more than one gland is faulty this test is usually negative.
2. A neck ultrasound - this maps the thyroid and parathyroid glands next to it and can often give me as the surgeon a very good 3D picture of the faulty gland.
Minimal access parathyroid surgery is done through a 2cm incision and as a daycase. It can be done under local anaesthetic but most patients prefer a short and very light general anaesthetic.
More info is available on either of my sites:
http://www.bucksendocrine.com/
http://www.thyroidsurgeon.org.uk/
Andrew McLaren
No longer do patients have to have large neck incisions to cure their disease and symptoms.
I offer minimal access parathyroid surgery to suitable patients in the NHS and in my private practice.
Two scans are required:
1. A radioactive Sestamibi scan - this attempts to identify the usually single offending gland by its level of activity. Usefully if more than one gland is faulty this test is usually negative.
2. A neck ultrasound - this maps the thyroid and parathyroid glands next to it and can often give me as the surgeon a very good 3D picture of the faulty gland.
Minimal access parathyroid surgery is done through a 2cm incision and as a daycase. It can be done under local anaesthetic but most patients prefer a short and very light general anaesthetic.
More info is available on either of my sites:
http://www.bucksendocrine.com/
http://www.thyroidsurgeon.org.uk/
Andrew McLaren
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