It’s a toomah

When my doctor told me a routine blood test had showed excess calcium in my blood, I thought it was a minor problem, the kind of thing you might have to take vitamins for. But it turned out to be the first sign of something more complicated.

Calcium levels are controlled by your parathyroid glands, of which you have four, embedded into the back of your thyroid gland. When you have too much calcium in your blood, it can indicate a parathyroid tumor, a group of cells growing out of control and doing their job overtime without listening to the body’s normal feedback mechanisms. This depletes your bones of calcium, which causes osteoporosis, and sends it out through your urine, which causes kidney stones. Fatigue and excessive thirst are other symptoms, which I’ve had for some time now.

After the blood test I was sent for an ultrasound scan of my throat and that’s when I started getting some surprises. Of the four parathyroid glands, only two of them were visible on ultrasound because the other two were located behind the collar bone, but BOTH of the visible ones were greatly enlarged, indicating tumors. I was surprised there was more than one tumor and, since there are two more parathyroid glands we couldn’t see, maybe more than two tumors.

The next surprise was that there were also two tumors visible on the thyroid gland, one too small to worry about but one large enough that you can actually feel it through the skin if you know what you’re looking for. And there were also two enlarged lymph nodes, which could indicate that cancer from the thyroid has spread to the lymph nodes. Or maybe not. We won’t know until surgery.

This is going to be an operation where they have to make up a few things as they go along. We know the two enlarged parathyroid glands we can see have to be removed but the other two are a mystery right now. They’ll require exploratory surgery to see if anything’s wrong with them. If so, the surgeons will remove the worse one and leave all or part of the better one.

The thyroid tumor will also require some quick decisions during surgery. They’ll remove it, freeze it, and take a section of it to inspect while I’m still on the table. If it looks cancerous, the rest of the thyroid gland has to be removed and I’ll have to take synthetic thyroid pills every day for the rest of my life. I’ll also get treated wtih radioactive idione to kill off any cancerous cells which may have spread through my body. The good thing about thyroid cells is that they are the only tissue which absorbs iodine, so you can use radioactive iodine to track them down and kill them wherever they are.

I have the best surgeon in the world for this, I think, but the first opening in his schedule was a month away so I’m counting the days until then. Usually I like to prepare for the worst case so I can be pleasantly surprised, but in this situation the worst case is pretty bad and not very likely, so I’m trying to stick to a zen-like state of just not knowing for now.

One Response to “It’s a toomah”

  1. Jay
    December 1st, 2005 | 1:21 pm

    Dan, just wanted to thank you for posting about your experience. I’m a 2nd year medical student learning about thyroid/parathyroid problems and wanted to see a picture of the parathyroids. I searched and your blog came up on google images. I’m glad to hear the surgeons were spectacular and that everything turned out well. Reading your story will help me remember this info and make me a better doctor. Thanks again!