My calcium and PTH levels were in the grey area, Calcium in the 10s, but low normal PTH (range 27 to 43) ...over a period of months.  I had never had a Sestamibi scan or Ultrasound until I got to Tampa.  I had one adenoma removed and a 2nd parathyroid  gland removed that was normal size,  but putting out too much PTH.  The other 2 parathyroids were normal and dormant.  I am SO glad that the surgeons examined all 4 parathyroids, and removed 2!  Otherwise I would have had to go back for a 2nd surgery in a few years.

Our newest blog blog.parathyroid.com/broken-parathyroid-adenoma has some good photos and discussion about how sestamibi scans underestimate the number and size of parathyroid tumors. About 30% of people with primary hyperparathyroidism will have more than one bad parathyroid gland. And, like most things in life, this is pretty easy to understand: The bad ones need to come out, and the good ones need to stay in.

I am the inventor of the "Operate on one side of the neck only" parathyroid operation back in the early 1990's. However, because we do so many of these operations (now over 50 per week), we realized that we were seeing people for a SECOND operation some time later because they either were not completely cured, or they were cured for only a year or two. We stopped doing one-sided parathyroid operations over a decade ago. It doesn't work!

These people presented back to us in one of two ways: First, about 10% weren't completely cured at the time of their first operation. They were better (their calcium and PTH were lower) because we took a parathyroid adenoma out of them, but they didn't feel better and their labs were not perfect. When we operated on these people a few months later on the OTHER side of the neck, we found a second tumor. Obviously these people were not cured at the time of the first operation because they had two tumors and we took out only one.  If your calcium is not perfect (in the 9's) after your parathyroid operation, then almost always it is because there is another parathyroid adenoma in your neck and your surgeon did not see it.  Adults over 35 are not allowed calcium levels in the 10's!
The SECOND way these folks show up is 5-10 years later. This is what Joyce is describing above. She had one adenoma (removed), two normal glands (we can tell they are normal because they are small and dormant--they are not making any hormone--they are asleep). Her fourth gland was a little bit enlarged, but more importantly than it's size is the fact that it was not asleep. It was still making hormone and not paying attention to the fact that her calcium was elevated.  These non-dormant parathyroid glands are not paying attention and these are the glands that become tumors in the future. These will show up 5-10-15 years later as another tumor. The only way we figured this out is by taking care of thousands of these patients every year for almost 25 years now. Thus, by taking out Joyce's parathyroid tumor we cured her for the next 5 years. By taking out the non-dormant gland and leaving only the two perfect glands we cured her for life.

Remember my rule: Nobody gets primary hyperparathyroidism twice-- not if the operation is performed the correct way and all four parathyroid glands are examined and their activity measured.  The internet is full of surgeons who have a web page claiming to be a parathyroid surgery expert.  EVERY ONE of them will get a scan and operate on you if your scan is positive--and remove the one parathyroid tumor shown on the scan--and quit.  This is cheating and 25-30% of these people will never feel better. Their bones will not get better. Their fatigue will not resolve, and they will continue to go back to the doctor saying how bad they feel.  We perform 10-12 parathyroid operations every day, 2-4 of which are re-operations on people who were never cured after being operated on by some other surgeon.  Be careful folks. Be smart. You just can't tell which patient has one parathyroid tumor and who has more than one. Demand that your surgeon look at all four glands!

I am so glad I went to Tampa. I had one bad gland with a very old tumor and 3 health glands that were dormant. After living with this disease and not knowing it for almost a decade, I am so proud to say that now I am cured for life! Thanks for all you and your staff do to provide the skill and have the knowledge for curing this disease. I knew I was extremely sick. I just didn't know why. Thanks to your time and effort for checking all 4 glands, Joyce and I are well on our way to living the good life again!There is a huge difference between truly living and merely existing. I am forever grateful for the chance to live again.