Is it Too Late to Back Out on Surgeon (IntraOp PTH Tester)?

Hi all,

Lovelydark here (25/f/TX(USA). Thank you all again for your very warm welcome earlier this week! I'm a little under 3 weeks out from my scheduled surgery and finally started looking through some of the resources here on the forum to help me prepare. I was really caught off-guard when I read the article about Intra-operative PTH Testing (http://blog.parathyroid.com/intra-operative-pth-assay-problems/), which is what my surgeon has explained that she will do during my surgery. Now, I'm worried that I might have more than one gland that is affected... is this a big deal? Is it too late to back out on my surgeon and try to find another? I mean, what are my chances that 1.) I have more than one gland affected or 2.) My surgeon misses a gland and I end up with pHPT again later down the road? Any guidance, advice, etc that you can lend would be tremendously helpful! 

Sending positive vibes of healing and well-being to you all!
-Lovelydark

Lovelydark. Lots of surgeon use iopth I feel that is a very good way to test during surgery if you pth drops by half the surgeon will close if not they keep looking. I would be worried if they didn't do it. That is my opinion.  Some like to look at all

the glands. Did your adenoma show up on a scan?  No worries.  


To me if the doc can do a focused surgery and NOT disturb the normal glands or the thyroid to me that is the way I would want. Everyone is different.
       Kathi

Well, I too would prefer a doctor use IOPTH. I do think that is necessary to help ensure a successful surgery.

Also, my tumors never showed on a scan. I only had 1 scan. It was performed the morning of surgery. It was negative. A few minutes later I had 2 parathyroid tumors and a thyroid nodule removed.

I think you'll be just fine, lovelydark! I think maybe you just have some pre-surgery jitters.

Audrey

Thanks so much for the responses Kathi and Audrey! I think you are both right that I'm getting a case of the jitters. I have had 2 ultrasounds and a SPEC/CT scan done that confirmed a growth (adenoma) on my lower right parathyroid gland. I should take some solice in the fact that my surgeon has a pretty good idea of where the growth is and it showed up on the different scans. I think I'm just getting nervous in the days leading up to surgery... T-minus 18 days!

You will be fine, lovelydark - take comfort in the fact that you actually have a diagnosis and they have seen an enlarged adenoma!

In your shoes, my only thought would be: will they take the opportunity to investigate all 4 adenoma when removing the enlarged one they have actually seen?

This was my case. They had seen on US a large lower left adenoma, but neither this one, nor any others showed up on the nuclear scan. It was about an hour before the surgery that I saw the surgeons's registrar and asked this question. He told me that they would remove the one seen on US, then measure I-Op PTH, and if it had reduced by 50% of more then I "was cured".

I had been "aware" for some months however of a tight "fat" feeling on the opposite side of my neck to where the original adenoma was seen, so I told the registrar that I would be grateful if they would check out the other side at the same time as removing the adenoma they already knew about. I had to make the point that I only wanted go through this procedure once and wanted them to check all 4 glands whilst they were there. I also had to say that I didn't care how large the incision was as long as all 4 glands were checked.

As it turned out, the two glands on the other side of the neck were also enlarged (hyperplastic in fact, just like the one seen on US) and had to be removed, so I'm glad I insisted on a 4-gland exploration.

I'm not saying you should do the same thing, but it might be a good idea to consider asking if your surgeon plans to look at all 3 glands whilst they have the chance.

Apart from that, just sit back and tick off the days - not long now!

Love from Tigerlily xxxx