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Parathyroidectomy

A parathyroidectomy is an operation to remove part of the parathyroid gland which is located in your neck.

Why do I need a parathyroidectomy?

The parathyroid gland produces a hormone which helps control calcium balance in the body. In kidney disease, the gland may become over active, causing calcium deposits in the heart and blood vessels, brittle bones, and leg ulceration. If the gland is not removed it may lead to severe bone pain.

Before your operation

A full medical history will be taken, and a medical examination performed in either the preadmission clinic or once you have been admitted.

  • The doctors will explain the operation along with the benefits and any associated risks so that you can provide informed consent. You will then be asked to sign a consent form.
  • Blood tests, chest X-Ray, and an ECG (heart tracing) will be taken.
  • An anaesthetic doctor will review your history and talk with you about the anaesthetic and what will happen
  • The vocal cords in your throat will be checked to see that they are normal.

On the day of your operation

  • Your usual medication will be given with a sip of water
  • Staff will ask you to shower with antiseptic soap, and dress in theatre clothing.
  • If you are on peritoneal dialysis, you must “drain out” before going to theatre.
  • A pre-medication may be given to help you to relax.

You may be taken to the operating theatre one hour before surgery for the insertion of a special intravenous drip (Central venous access device or CVAD) into the side of your neck. This allows high dose calcium replacement to be given, as it is too concentrated to give into smaller veins in your arm. The doctors and nurses will advise you if this is to happen.

After the operation

  • You will be positioned sitting upright.
  • Nursing staff may take regular observations (including temperature, pulse and blood pressure) and undertake two tests that can indicate if your calcium levels are low.
    These tests are:
    • staff lightly tapping on the side of your face, next to the eye
    • placing a blood pressure cuff on your arm and inflating for two minutes during which time the thumb is observed for any twitching.
  • You must tell the staff if you feel any tingling (pins and needles), numbness and/or muscle twitching around your mouth and/or fingertips. These can be signs of low calcium levels in the blood.
  • Your calcium levels will be checked by frequent blood tests. The amount of calcium in the drip or number of tablets you will need to take will be adjusted according to the result.
  • There will be one or two small drain tubes in the wound to prevent any collection of blood.
  • You may drink fluids and eat soft food four hours after the operation.
  • Medication for pain will be given if required. Please let the staff know if you are uncomfortable.
  • You may mobilise, but will need staff to assist with drip poles and drain tubes.

Wound care

The surgical doctors will see you and give instructions on removal of drains and any stitches or clips.

  • Drains are usually removed in 24–48 hours, depending on the amount of drainage.
  • Neck clips/stitches will be removed between three and five days after your surgery.

Medication management

  • Your usual medications are likely to be changed a number of times, even before the operation.
  • Please check with your nephrologist (kidney doctor) one week prior to the operation, if you have not already received advice on increasing your calcium treatment.
  • The medical, nursing and pharmacy staff will explain changes to your medication as they occur. The changes are aimed at maintaining a normal calcium level in your blood, using tablets where possible, or through a drip (only if needed). 

Discharge

  • It is very important that your calcium levels are monitored after discharge. Staff will discuss how best to manage your calcium levels and who will check the results to make any necessary changes to your tablets. It is expected that the calcium supplements you will be taking will gradually be reduced over a period of weeks, but you will need to keep in close contact with your renal team until your calcium levels have stabilised.
  • Appointments will be made for you to see the Surgeon and your Nephrologist in an outpatient clinic.
  • The pharmacist will give you your discharge medication, with written instructions and explanations. Please let the staff know if you have any problems taking the medication or understanding the information, and ask questions if you are unsure or want more information.

Please ask the staff in the ward if you have any further queries or concerns regarding your treatment/care.

Mater Hospital Brisbane - Nephrology Department

Phone: 3163 3000 – please ask to speak with the renal nursing staff.

Mater acknowledges consumer consultation in the development of this patient information.
© 2018 Mater Misericordiae Ltd. ACN 096 708 922.

Document ID number: PI-CLN-420122
Release date: 13 May 2019
Version 1

Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: PI-CLN-420122
Last modified 13/5/2019.
Consumers were consulted in the development of this patient information.
Last consumer engagement date: 09/5/2019
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