Absence for surgery next week.

[-Jim-]

Congrats on what sounds like a successful surgery. Now you can focus on enjoying your system like never before!

 

[Eppie]

Glad to hear that all went well.

 

[j_garcia]

Glad you are back.

 

[Swerd]

Glad to hear about the good outcome. Any surgery that's easier than a bad day at the dentist is always good news.

 

[DigitalDawn]

Good luck with the surgery!

 

[Dan]

So glad to hear. Only 10-20% of parathyroid adenoma are in the chest which makes the surgery much harder than the neck. At least it was in the anterior portion accessible via a scope and not the posterior portion which means a much more extensive surgery.
I am not too familiar with the C 11 labeled choline as we don’t have our own cyclotron to make it and I don’t read nuclear medicine studies myself. I have done many ultrasounds for this disease but they aren’t that helpful. We use a sestamibi scan labeled with Technicium 99m combined with a four phase CT scan which provides excellent anatomical localization.

well that’s two parathyroids down and probably two left. Hope they don’t act up. I wish you a speedy recovery.

 

[TLS Guy]

So glad to hear. Only 10-20% of parathyroid adenoma are in the chest which makes the surgery much harder than the neck. At least it was in the anterior portion accessible via a scope and not the posterior portion which means a much more extensive surgery.
I am not too familiar with the C 11 labeled choline as we don’t have our own cyclotron to make it and I don’t read nuclear medicine studies myself. I have done many ultrasounds for this disease but they aren’t that helpful. We use a sestamibi scan labeled with Technicium 99m combined with a four phase CT scan which provides excellent anatomical localization.

well that’s two parathyroids down and probably two left. Hope they don’t act up. I wish you a speedy recovery.

Good to hear from you Dan.

I had the Sestamibi Technetium 99m scan, and it failed to identify the parathyroid. Mayo say that this scan fails to show a lot parathyroid tumors in the chest, since they have had their C11 choline scan available. That C11 choline scan made the parathyroid tumor glow a bright green on the screen. It was literally as bright as small LED Christmas tree light. The detail in that scan was incredible, and you could see all the relationships clearly to the right innominate vein, subclavian artery and aorta.

Prior to that I had every test in the book, so that the C11 choline scan, which is incredibly expensive was paid for. They left it to me to get approval from Medicare. Blue Cross/Blue Shield of Minnesota were very helpful, and we had a three way call with me, them and the Medicare reviewer and we got the approval.

My calcium dropped from almost 11 to just below the lower limit of the normal range, and then recovered to just above. They were planning to transplant a portion of the removed tumor into an accessible location in my left neck if the calcium really crashed, but this was not necessary. I am taking 5 mcg of Calcitriol to support it a little at the moment.

I did develop pseudo gout in my left knee today I think this morning. Like most geriatrics I'm sure I have plenty of calcium pyrophosphate crystals in my joints. So I suspect the drop in my serum calcium exposed the crystals and set off the reaction. Anyhow it is responding very smartly to the Naproxen I took this morning. All in all the surgery has been an outstanding success.

I really feel very good now. All the post op. discomfort is gone.

 

[Dan]

Wow amazing story about how all else failed and then you actually got hide bound Medicare to approve it. Unfortunately few places have a handy cyclotron which explains the expense. I think NIH near me does. The radiology group there does a ton of good imaging research. I see tons of pseudo gout on the rare days I read bone x rays. Yes it is very common after a certain age. Much more than gout. So glad the calcium is stabilizing. Sounds like it couldn’t have gone better.

I went to Mayo once. It truly is an amazing place. I know several radiologists at Mayo Scottsdale. Super bright folks. They all live and breathe medicine and all seem to have no hobbies as far as I can tell.

 

[TLS Guy]

Wow amazing story about how all else failed and then you actually got hide bound Medicare to approve it. Unfortunately few places have a handy cyclotron which explains the expense. I think NIH near me does. The radiology group there does a ton of good imaging research. I see tons of pseudo gout on the rare days I read bone x rays. Yes it is very common after a certain age. Much more than gout. So glad the calcium is stabilizing. Sounds like it couldn’t have gone better.

I went to Mayo once. It truly is an amazing place. I know several radiologists at Mayo Scottsdale. Super bright folks. They all live and breathe medicine and all seem to have no hobbies as far as I can tell.

Mayo are putting in their second cyclotron now. For the members, this is the cyclotron that is the part of the atom smasher, that accelerates protons to 75% the speed of light, so they get very heavy. I'm sure members here are familiar with Einstein's laws of relativity, but if not, the protons can not be accelerated to the speed of light, or they would be infinitely heavy. But they are heavy enough to do a lot of damage, so atoms of different structure can be created. This is the basis of the creation of their specialist isotopes.

The tech that injected me with the C11 choline happened to be one of the technicians involved in making the isotopes. She said they make isotopes with the cyclotron in slots they have reserved for this purpose twice daily. I just can't help being inquisitive.

Their first proton beam radiation unit is in so much demand that it runs 24/7 including Sundays. The unit took care of my prostate cancer with minimal disturbance to me in five treatments. My PSA last fall was undetectable. So it seems it may have done a total prostatectomy remotely without a surgical incision. I am due for another PSA in April.

Mayo continue to be well endowed, and their current unit was paid for by one guy. They charge the same for proton beam treatment as standard radiation therapy, and as far as I know they are the only institution to do that.

 

[cpp]

Good to hear from you Dan.

I had the Sestamibi Technetium 99m scan, and it failed to identify the parathyroid. Mayo say that this scan fails to show a lot parathyroid tumors in the chest, since they have had their C11 choline scan available. That C11 choline scan made the parathyroid tumor glow a bright green on the screen. It was literally as bright as small LED Christmas tree light. The detail in that scan was incredible, and you could see all the relationships clearly to the right innominate vein, subclavian artery and aorta.

Prior to that I had every test in the book, so that the C11 choline scan, which is incredibly expensive was paid for. They left it to me to get approval from Medicare. Blue Cross/Blue Shield of Minnesota were very helpful, and we had a three way call with me, them and the Medicare reviewer and we got the approval.

My calcium dropped from almost 11 to just below the lower limit of the normal range, and then recovered to just above. They were planning to transplant a portion of the removed tumor into an accessible location in my left neck if the calcium really crashed, but this was not necessary. I am taking 5 mcg of Calcitriol to support it a little at the moment.

I did develop pseudo gout in my left knee today I think this morning. Like most geriatrics I'm sure I have plenty of calcium pyrophosphate crystals in my joints. So I suspect the drop in my serum calcium exposed the crystals and set off the reaction. Anyhow it is responding very smartly to the Naproxen I took this morning. All in all the surgery has been an outstanding success.

I really feel very good now. All the post op. discomfort is gone.

Glad everything worked out in your favor. I was just at Mayo Jacksonville Tuesday for my bi-annual followup, love the place and my medical team..

 

[3db]

Im happy to hear that the surgery went well as well as your recovery. Congrats Mark.

 

[TLS Guy]

Im happy to hear that the surgery went well as well as your recovery. Congrats Mark.

I think it is my surgeon and the scientists developing these novel imaging techniques that need the congratulations. I had to just lie down and go to sleep. I doubt that is deserving of congratulations.

 

[3db]

I think it is my surgeon and the scientists developing these novel imaging techniques that need the congratulations. I had to just lie down and go to sleep. I doubt that is deserving of congratulations.

Dont forget that the reaction to meds and sugeries by the human body is as individual as the person. Thats the angle I was coming from with the congradulations.