I had PHPT and was cured in Tampa
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Hello
I just found this forum today and have read some of the posts.
I would like to share my story in the hope that it helps.
I am in the UK (I used to work for the NHS for 11 years until I got PHPT and was so ill I had to give up my job).
I had PHPT for at least 6 years before I found out what I had. It mainly affects postmenopausal women and I thought the start of my symptoms were menopausal as some were similar. Long story short, even though my Rheumatologist said I was "really too young", she diagnosed me with Polymyalgia Rheumatica and gave me steroids for a year (Prednisolone). My GP gave me Calcichew and Vit D, and Omeprazole to cover the Pred.
But I eventually found out I had high calcium and high PTH and that I had PHPT - I had been diagnosed, and was being treated for, the wrong disease! Being on the steroids was terrible - it masked the pain a bit but had horrible side-effects including the awful weight gain. When my GP said she didn't know why my calcium was high, I researched it on the web. I was aware of PHPT from working in the surgery (I was an administrator), but didn't realise at that time that's what I had.
Long story short I sent my results to the famous clinic in Tampa who confirmed that I had PHPT and 3 weeks later I went to have my adenoma removed.
The staff and the treatment and place were absolutely fantastic and absolutely first class. Everything that took place was just as it states on their website so there were no shocks or surprises, and the whole process went like clockwork.
My operation was carried out with a local anaesthetic in less than 20-30 mins. I have to say that I was one of the 20% of people for whom my tumour was NOT in the usual place behind the thyroid gland. It was buried deep in my thymus gland and had to be bisected. This tumour did NOT show up on their Sestamibi scan but their Sestamibi scans in not showing where the tumour is, can show where the tumour IS NOT i.e. it will show whether there is one in the chest near the heart and the thymus gland is at the top of the chest. They knew roughly where it would be and the gamma probe confirmed it.
The simple truth is that they are state-of-the-art, do only this operation and have perfected it over many years and are very experienced and I know with absolute certainty that the tumour in my thymus (the size of an olive) would not have been found in the UK and I refused an NHS scan and trusted Dr Norman at the Tampa Clinic to find where it was. It was the BEST thing I have ever done, I had been very sick for years and the sadly wrong diagnosis and treatment I got over here made my osteopenia even worse (when you have a parathyroid tumour, taking calcium and Vit D doesn't help - it just makes things much worse which it did in my case and could have caused a stroke or heart attack. In fact I did develop heart palpitations before going to Tampa.
Bottom line - sadly the NHS here and the private consultants (usually the same ones doing the NHS operations) - are not yet as advanced and far forward with parathyroid operations (no disrespect to them) as the clinic in Tampa. Over here they still work the way they were taught at medical school years ago and don't truly understand how this disease works. A lot of them think a low Vit D causes high calcium when in fact this is impossible - the body suppresses Vitamin D in the presence of a tumour by way of a protective measure and patients are often given big doses of Vit D which just makes you feel worse.
The Tampa clinic also have the benefit of the gamma probe which they invented which also helps to locate the tumours as it makes a loud buzzing noise when the probe is near a tumour.
Even doing the operation privately here is not the same as Tampa. I am aware that the surgeon in my area has tried to purchase a gamma probe but the NHS refused funding. The Tampa clinic has a virtual 100% success rate and the operation, not done with a General Anaesthetic and with only a 1" cut, is so much less traumatic for the patients. I left the clinic 1-2 hours later and was fine. I did have quite a bit of bruising and some swelling but it wasn't painful I didn't need any painkillers and they give you an ice bag and calcium to take with you which really helped. Had my tumour been in the usual place behind the thyroid, there would have been less bruising. I cannot recommend them highly enough. I could go on but my info is long - sorry, but I feel so sorry for all of you who are still suffering especially when there is a cure in Tampa and the wait for an op is just a few weeks once diagnosed. I really felt so ill by the time I got there, I had a headache and high BP on the day of my op, and now, 2.5 years later, I am soooo much better, not quite 100% but getting there (the steroids took even more calcium out of my bones and I had terrible bone pain that kept me awake at night, and all they really did was mask some of the pain, and since taking them I now have OA in my knees which I didn't have before I took them. If I could turn the clock back I would not have taken them.
PHPT is also often mistaken for fibromyalgia as well as PMR so be sure to get the right diagnosis, high calcium and high PTH (although there are a small number of cases where it can be high normal and still mean you have a tumour).
One final thing otherwise this will be too long - although it does cost (about £6,000 ish) for the operation in Tampa, over here if you have it done privately it is about the same cost and it is NOT the same operation. In Tampa there is no large cut, no exploration of your neck and no long hours spent on an operating table and there is a faster recovery after a short anaesthetic with no damage to the vocal cords (I know of someone whose vocal cord was damaged and they have to have ongoing treatment for it).
I hope that the skills and expertise in the Clinic in Tampa will one day be practised over here but unfortunately by the time that happens a lot of people will be very, very sick. I can only tell you my experience and that I am now cured. The damage to the body is caused not by how high the calcium actually is but how long you have had the disease.
Also it's not advisable to get venous sampling - the surgeons in Tampa say this is dangerous and it is of no help with the diagnosis. Also the intraoperative testing of the PTH is of no value - this used to be done at one stage but it is now known that this is not helpful (and it takes about 45 mins while you are on the operating table).
The gamma probe used in the Tampa Clinic is linked to a computer which measures in real time EXACTLY how much PTH is being produced by all the parathyroid glands so the tumour is removed and the levels of the normal ones left behind can be verified.
All this info is very important to the health of the people suffering out there so I hope it won't be moderated to the point where it isn't shown. The bottom line is you CANNOT live with a parathyroid tumour, it slowly destroys your whole body and makes you very sick. At the end of the day you need an acurate diagnosis and first class and prompt treatment so you can start to heal. I know it is quite expensive, but it will ultimately give you back your quality of life and save your life.
Regarding symptoms, I had daily headaches, nausea, it felt like my brain was frying like an egg, I used to fall asleep by midday (a classic symptom), at night I had 'brain zaps' - just as I was falling asleep it was like having a crisp bag popped right in my ear which woke me up) and I developed heart palpitations and tachycardia (fast heartrate) and ended up in A&E because my potassium level dropped to a crisis level). Since my op, my headaches have gone, my bones have improved a lot and my blood levels are much better (one of the symptoms is high liver results and mine were high). High blood pressure is another symptom and I also had a pain in my left nipple which has also gone since the surgery.
Again sorry this is so long but I hope it helps - 3 weeks after my diagnosis from Tampa I had my op and started feeling better (and took the opportunity to have a 2-week holiday in Florida before coming home).
Oh just remembered - the other thing about the gamma probe and computer - by knowing exactly how much PTH the tumour was producing, they can work out how much calcium to give you after the op and for how long and also there are different types of calcium and the one they prescribe is calcium citrate which the body can easily absorb.
I just wish the best for all of you out there suffering, I know how terrible it is, I just hope this info helps.
tampapatient
0 likes, 47 replies
liz44044 rosemary25383
Posted
Hi Rosemary Hope all is well....I had a right thyroid lobectomy 40 years ago, due to a growth that was the size of a cherry tomato is all i remember the surgeon telling me at 21 yrs old. It of course was benign the left thyroid compensated for the right i am told today....therefore i never needed thryroid replacement medication. It wasn't until now that the calcium level was at 11 that brought concern and that was because i was having palpatations and went to my primary. I was recovering from HHernia repair and Nissen Fundoplication surgery in March. From what i read the high calcium level could produce the high stomach acid for which my surgeon never saw 60 % acid in anyones stomach before. Now i have recently gone to endocrinologist she and my primary feel no surgery as yet....she did ultra sound and in the thryroid is a small growth that is benign. They will repeat blood work in August., I guess i will wait til then. I am still not happy with their decision regarding this...It seems as tho they are waiting for changes....i dont feel comfortale waiting for what heart problems, past history is kidney stones i have had removed that was lodged 10yrs ago. I feel very anxious these days perhaps from the recovery of the 2 operations which was difficult. I am relying on their decision but it can be frieghtening because i am now 65 years old and dont want more problems as i am getting older. The PTH i believe was 51, not positive awaiting for them to send me copy of blood work. I am still trying to decide as to my going to Tampa and what they would think about all this.....I too wonder can a person live with out their thyroid if something happens to this only one left? Thx for your advise. Liz
rosemary25383 liz44044
Posted
Hi Liz - thanks for your message, sorry to be a bit late replying.
So sorry to hear you had to have a thyroid lobectomy in the past and that you are now having further problems. As you say, the half of the thyroid that was left compensates for the half that was taken out, producing all the necessary hormone. I have a friend who just a few years ago had a large goitre and had to have her entire thyroid removed as the mass was a lot bigger than they thought and caused swallowing and breathing problems. Ever since then she has had to take a synthetic thyroid hormone replacement because once the entire thyroid has been removed, the body cannot make any further thyroid hormone and therefore needs some synthetic thyroid replacement. She finds it a bit tricky sometimes finding exactly the right level of hormone that she feels comfortable with but I know from other people that they often find that to be the case and tend to have discussions with their doctors about what doses to try that suits them. My friend was also unfortunate in that the surgeon accidentally damaged her recurrent laryngeal nerve (one of the complications of surgery) which affected her voice and she has to have teflon coating treatment on her vocal cord about once a year and also had to have some speech therapy after the operation (she was in her early 60s at the time).
I think you are saying that you now have high calcium? I think you must be in the States somewhere as your blood level ranges are different to those in the UK where I live. I know that if the parathyroid glands are damaged or removed when you have thyroid surgery (there are 4 of them right behind the thyroid (usually)), then the calcium can be low but normally when a person has high calcium together with a high PTH as well (parathryoid hormone level), that means you have an adenoma (benign tumour) on one or more of your parathyroid glands.
My friend lost at least one or two of her parathyroid glands when she had her surgery as they were apparently tangled up in the thyroid goitre but she told me that the surgeon told her she has one parathyroid gland that still functions well.
It's not clear whether you have a thyroid growth or whether you could have a parathyroid adenoma but it sounds like a parathyroid adenoma because of the fact that you have a high calcium. Having high calcium and hyperparathyroidism (an adenoma on a parathyroid gland) can cause kidney stones in some people too. Do you have any other symptoms such as fatigue, bone/muscle aches and pains, osteopenia/osteoporosis, poor memory, poor concentation, high blood pressure? Those are some of the symptoms of parathyroid disease including heart palpitations which you describe, which I also had.
Regarding surgery in Tampa:
Dr Norman's parathyroid centre in Tampa (on the 6th floor of Tampa General Hospital) performs only parathyroidectomies when you have Primary Hyperparathyroidism (with classic blood results of high calcium and a high parathyroid hormone level). That said, if you do have Primary Hyperparathyroidism (PHPT), and when they do the operation they discover that you have any nodules on your thyroid, then they also remove the thyroid nodules too (if they think it necessary) at the same time which I think is very good, saves people a second operation but they don't perform thyroid surgery per se, the thyroid fixes are on the back of a parathyroid operation.
If your blood results show you have a high calcium and high PTH (although in a small number of cases they can be high normal rather than outside the range), then you could contact the NPC in Tampa. They request a series of blood results and other tests such as ECG, bone scans if you have had those done, they will tell you what they want. You don't actually go there for a consultation, you have to send them all your results and they work out whether you need the operation by looking at your test results and creating a personal chart for you. It is fairly expensive for a consultation but it is well worth it for them to give you a diagnosis and to tell you if you would be a candidate for an operation there. I have heard that if they do the consult and you are not eligible for an op there after they view your results, then the fee is less, but that could have changed (I had my op there in Dec 2013). They are a centre of excellence and if you do have PHPT rather than a thyroid growth per se, if I were you I would go there to get cured because they are the most experienced and the operation is so minimally invasive and done with a local anaesthetic in less than 20 minutes. I lost only 3 ml of blood which is about half a teaspoon !
If you do have PHPT it would be very wise to get the adenoma removed as soon as possible because the symptoms will just get worse. Did they say they thought it may be Primary Hyperparathyroidism? As Dr Norman in Tampa says, lots of doctors just watch the calcium and do nothing and doing nothing is not the right thing to do, you need surgery.
If you do have PHPT then Tampa would be the best place to go since you have already had half your thyroid removed because operations cause internal scar tissue which can be obstructive in further operations and going to Tampa would ensure you got it fixed correctly the first time. They do have certain criteria regarding neck surgery in patients who have already had surgery but you would have to give them all your details and results and they can then consider your eligibility for surgery. Most people can have the surgery but there can be exceptions.
I am sorry this is such a long message but I hope at least some of the information is helpful to you. I am by no means medically trained (I have worked in a doctor's surgery on the admin side for 11 years), and can only tell you what I do know and tell you of my experience.
I wish you all the very best. Do let us know how you get on. Take care.
Kind regards.
Rosemary