PARATHYROID ASSESSMENT

Dr Jones provides a detailed assessment of patients with parathyroid issues and parathyroid adenomas. The adenoma produces high parathyroid hormone levels resulting in high calcium levels in the blood.

Dr Jones works very closely with experienced parathyroid radiologists who will review existing scans and perform further scans as required, to help locate the parathyroid adenoma. Dr Jones also works closely with hand-picked endocrinologists (hormone specialists) who often help with the hormone workup of parathyroid patients.

All patient concerns are considered and addressed during treatment. Dr Jones remains in close communication with the patient’s GP and the endocrinologist. She sends the GP a detailed management plan, that includes a patient copy. Dr Jones regularly attends Australian and international parathyroid meetings to remain up to date with the latest advances in parathyroid surgery.

PARATHYROID SURGERY

The majority of parathyroid operations are to remove a benign (non-cancerous) parathyroid adenoma. This adenoma is an overgrowth of one of the four, small pea-sized, parathyroid glands, in the lower part of the front of the neck. The glands are usually stuck to the sides of the thyroid gland. (There are right and left sided superior and inferior parathyroid glands). High blood calcium levels can produce subtle changes in mental function, kidney stones, bone pain with osteoporosis, stomach pains due to an inflamed pancreas, constipation and aching heals and muscles.

Dr Jones operates at St John of God Hospital in Subiaco with experienced anaesthetic and nursing staff. In theatre state of the art equipment is used including the intraoperative nerve monitor (IONM). This nerve monitor helps to locate and preserve the function of the recurrent laryngeal nerve RLN (voice box nerve), that runs very close to the side of the thyroid gland and the trachea (windpipe). Dr Jones performs parathyroid operations with excellent cosmetic results.

When the parathyroid adenoma is removed the tissue is sent straight away to the pathology laboratory and a frozen section performed. This confirms the parathyroid tumour has been removed during the operation. Post op regular calcium and parathyroid blood tests are performed. Calcium and vitamin D tablets may be required for a time.

TEAM MANAGEMENT OF VERY COMPLICATED PARATHYROID TUMOURS

Occasionally the parathyroid adenoma is very large with unusual features and causes very high calcium and parathyroid hormone levels in the blood. This causes a lot of severe symptoms. Such complex parathyroid adenomas will be discussed at the Sir Charles Gairdner Hospital (SCGH) Endocrine Pathology Multidisciplinary Team Meeting (MDM). Young patients less than 40 years with parathyroid adenomas of any size, will also be discussed at this MDM. During the MDM, parathyroid scans and pathology are reviewed by a team of medical specialists including other parathyroid surgeons, endocrinologists, nuclear medicine physicians, pathologist and parathyroid radiologists. Relevant cases will be referred to the state Genetics Service of Western Australia (HSWA) at King Edward Memorial Hospital in Subiaco. Complex treatment plans are created.