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

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:

• muscle aches and pains
• joint aches
• tiredness
• headaches
• bone pains
• thirst
• passing urine more frequently including at night

There are also the more classic symptoms / conditions associated with it:

• kidney stones
• abdominal pains
• mental disturbance
• osteoporosis

Surgery is the only recognised treatment - for more information look at my main sites:

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

• 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

These elements combine together to result in over 90% of my patients going home the same day painfree and consequently able to return to work more quickly.

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/

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