Absence for surgery next week.

[TLS Guy]

Just an FYI for members. You will have a slow response to posts and PMs from me next week.

I am having surgery at St. Mary's Hospital Rochester on Monday, February 13.

I am having an ectopic parathyroid which is excreting excess parathormone from my chest removed. Hopefully this can be removed from an incision, just above the sternum, but my right chest may have to be opened.

I have been having an issue with hyperparathyroidism for four years now at least. Parathormone controls the ionized calcium fraction in the blood, literally on a minute to minute basis. I had a tumorous parathyroid removed from my neck four years ago at Mayo.

The problem has recurred. After exhaustive studies including an exotic study using choline prepared from choline made with the C11 isotope of carbon, an overactive "hot" gland was identified in my right chest just above the right innominate vein. It is probably in the thymus. This isotope is made at Mayo using their cyclotron proton beam machine to make the isotope. This test is only available at Mayo and costs a fortune. All the usual tests failed to locate the problem ectopic gland.

I am going to Mayo tomorrow for extensive base line lab tests. Surgery will be Monday morning, and is expected to take at least three hours. The chief of endocrinology will be monitoring calcium levels closely, and intervening as required.

If all goes well and my ionized Calcium is stable I should be discharged on Tuesday, licking my wounds I'm sure.
So if I fail to respond in the coming days that is why.

 

[Swerd]

Good luck and best wishes for the surgery as well as your recovery afterwards.

I didn't know anything about Carbon-11 labeled choline as an imaging method. If you want to understand just a bit more, see this.

Carbon-11-choline - Wikipedia

en.wikipedia.org

 

[GO-NAD!]

Good luck, Doc! Hope all turns out well.

 

[TLS Guy]

Good luck and best wishes for the surgery as well as your recovery afterwards.

I didn't know anything about Carbon-11 labeled choline as an imaging method. If you want to understand just a bit more, see this.

Carbon-11-choline - Wikipedia

en.wikipedia.org

The unit that did the study, was a combined CT scanner and nuclear imaging camera. The unit must cost a fortune. The study took 30 minutes and you had to stay absolutely still, but with normal spontaneous breathing throughout. My surgeon showed me the images, and they are stunning in their detail.

 

[NINaudio]

Hope everything goes smoothly Doc!

 

[Swerd]

The unit that did the study, was a combined CT scanner and nuclear imaging camera. The unit must cost a fortune. The study took 30 minutes and you had to stay absolutely still, but with normal spontaneous breathing throughout. My surgeon showed me the images, and they are stunning in their detail.

I'm no radiologist, but I am aware of how F18 labeled fluoro-deoxyglucose (FDG) has been used in positron emission tomography (PET) scans. F18, a non-radioactive fluorine isotope that emits positrons, has been widely used to light up PET scan images of tumor tissue that takes up glucose faster than other surrounding tissue. These FDG-PET scans have been routinely done with simultaneous CT scans. The two scans are overlaid by computer, to reveal the hot spots, with spectacular results that sometimes have been revolutionary to cancer diagnosis & treatment. (You clearly already know this, but I want other readers to understand this too.)

The only problem is that FDG doesn't always result with bright enough hot spots to allow useful images. So the search has been on to find other sources of positron emitters, such as F18 labeled DNA precursors. (Rapidly dividing cells take up more labeled DNA precursors.) I didn't know that this general method has been extended to Carbon-11-choline. (Rapidly dividing cells take up more choline, a precursor to cell membrane phospholipids.) But I'm glad to learn about it. And I'm glad to know its available for you.

 

[TLS Guy]

I'm aware of how F18 labled fluoro-deoxyglucose (FDG) has been used in positron emission tomagraphy (PET) scans. F18, a non-radioactive fluorine isotope that emits positrons, has been widely used to light up PET scan images of tumor tissue that takes up glucose faster than other surrounding tissue. These FDG-PET scans have been routinely done with simultaneous CT scans. The two scans are overlaid by computer, to reveal the hot spots, with spectacular results that sometimes have been revolutionary to cancer diagnosis & treatment. (You clearly already know this, but I want other readers to understand this too.)

The only problem is that FDG doesn't always result with bright enough hot spots to allow useful images. So the search has been on to find other sources of positron emitters, such as F18 labeled DNA precursors. (Rapidly dividing cells take up more labeled DNA precursors.) I didn't know that this general method has been extended to Carbon-11-choline. (Rapidly dividing cells make more choline, a precursor to cell membrane phospholipids.) But I'm glad to learn about it. And I'm glad to know its available for you.

Mayo developed the technique for finding bony metastases, which are notoriously hard to find, unless large. It works very well for this application at Mayo. They happened to have a patient who also had a parathyroid adenoma, and that glowed like blazes. So they found another indication.

 

[Alex2507]

This is not a good time for me. Please reschedule the surgery for after I get another couple of alignments out of you.

TIA

 

[Kleinst]

Take care! Sure all will go well

 

[Eppie]

Best wishes Mark, I hope it all goes well.

 

[cpp]

You got this and good luck.

 

[William Lemmerhirt]

Good luck doc! I’ll try and share some candor in your absence.

 

[Bruce53]

Good luck.

 

[afterlife2]

Sending You Good Vibrations, Doc!

 

[Alex2507]

... and the next time you need surgery you tell people it's for a penis reduction.

 

[lovinthehd]

Best wishes for successful surgery and a speedy recovery!

 

[TLS Guy]

Good luck.

I need skill not luck!

 

[Mikado463]

I need skill not luck!

fair enough, best of luck to you and may the surgeons have the best skills possible !

 

[Mark E. Long]

My thoughts and prayers are with you Sir !

 

[TLS Guy]

I was discharged today after thoracoscopic surgery yesterday.

I am glad to report that all went well. The parathyroid tumor was indeed in the thymus which was removed using a thoracoscopic approach behind the sternum (breast bone). Pre op showed that my calcium and parathormone levels had increased significantly in the recent past and both elevated. After removal both levels are at the lower limit of normal. I am now taking calcitriol to support levels.

I have had little discomfort actually, just slight soreness on swallowing and in the lower muscles of the neck. I am currently not using any pain killers.

Interestingly the bone and joint pain that had been worsening has already resolved, which is a great relief, but also fascinating at how fast these symptoms resolved.

So all in all a very successful procedure. I am very grateful for the extraordinary skill and competence of the physicians and staff at the Mayo Clinic. They have brought off an extremely skilled, complex procedure, that carried significant risk of horrendous complications with minimal disturbance to me. I regard the whole process from diagnosis to definitive treatment as an incredible achievement. This is almost certainly something that at this time could have only been achieved at the Mayo Clinic. Another good reason to live in this part of the Midwest.