Wednesday, July 14, 2010

Questions+Answers=More Questions... You do the math...

I got the call from my doc today, you know, the one they give you when your labs come back... All was normal except two: one of the liver function tests (blamed on that darned fatty liver...) and the Parathyroid Hormone. Hmmmm... That's a new one. We had done thyroid tests before, all normal, but what physician does parathyroid tests? Well, come to find out the answer is usually only the ones looking for reasons for high calcium levels.

The parathyroid glands are 4 very tiny grain of rice sized glands on the back side of the thyroid gland. They have a similar name, but serve a much more different function than the thyroid gland. Blame the name on the location I guess.
This gland controls the amounts of calcium and phosphorus in your body. If you happen to neglect that glass of milk, the PTH kicks in and asks your kidneys to be stingy and keep some in your blood.

One thing I have learned: high calcium, even by small amounts is NEVER ok, and is a sign that you could have a problem with your parathyroid gland. My calcium levels have always been "normal" but they have always been on the high end of normal and it amaze me how one labs interpretation of normal can be so many points different than another labs, so whenever labs are mildly abnormal I have an instinct to never trust them. It has always been my nursing judgement that any lab that is very close to being abnormal should be considered that way until proven otherwise, forget this innocent until proven guilty stuff...

So what symptoms come with high PTH? Well, according to all the reading I've done there are muscle, joint and bone pain, heart palpitations, stroke (as a very late, almost to late sign...), osteomalacia and osteoporosis (loss of bone mass), muscle weakness, including in the swallowing department, headache, nausea, vomiting, thirst, increased urination, constipation, kidney stones, confusion, impaired thinking and memory, irritability, and a few more...

In most people with hyperparathyroidism the PTH and Calcium levels are high, but it appears with mine, (as nothing can be done the easy way with me...), the PTH is high and the calcium is on the high end of normal.

Most of the time the high PTH is caused by a benign tumor on one of the 4 glands, very rarely by cancer and even more rarely by genetic disposition. Fixing the problem would be: drum roll please..... Taking out the gland with the tumor... =) Duh.
Surprisingly, it can be done laparoscopically with a 1 inch incision that generally only requires a steristrip over it afterward. This particular procedure can be done in 30 minutes and often doesn't even require a hospital stay.

So what's next for me? Well, since my labs are never cut and dry, I will probably be doing a repeat of the labs just to make sure, and a 24 hour urine for calcium content and also imaging of my parathyroids to look for the tumor. Everything I have read says imaging is pointless and a waste of time, but that's what the good doc wants since the labs were off, so we'll see.

So if there is a tumor the next step after that would be surgery to remove it, and she seemed confident we could get it done before my medicaid runs out July 31st... You see, in August the disability kicks in, that means my "income" will be to high for medicaid, but I will not qualify for medicare for 2 years, nor will I have insurance... So, if this is the answer I have been praying so earnestly about and nothing can be done about it because I don't have any insurance I am going to be highly upset... Or at least moderately irritated.

So the final thought from Dr. O? EDS+Hyperparathyroidism=A very bad year for me... =)

Interesting the medicine I have learned about in such great detail this year. I could work in neurology, endocrinology, metabolics... I love putting the pieces of the puzzle together to fit! If I had an MD behind my name I think Diagnostician would be my game. =) Oh well, we'll leave that to the bigger egos.


  1. Best of luck! And I'm glad that you seem to be pointed in a hopeful direction!

  2. Thanks! I just hope it's not to late to be fixed with my insurance being gone in a couple of weeks... That's so frustrating!