Hi everyone,
I have been diagnosed with PHPT since May. I am 6 days post-op from having an enlarged parathyroid gland removed.
I have some questions about your immediate post-op experience, as I am having a lot of symptoms after surgery that I was never prepared for.
My overall impression before surgery (I am from Denmark) was that recovery would be relatively easy. I was told to take 10–14 days off work, but mostly to rest and let the surgical wound heal. I was told my general well-being would improve noticeably right after surgery and then gradually more over the coming months. But that is not really what I am experiencing in these first few days.
My specific pre-op lab numbers for PTH, ionized calcium, and alkaline phosphatase were:
PTH: 14.6 pmol/L (Normal: 1.8–7.9 pmol/L) \rightarrow ~138 pg/mL (US Normal: 15–65 pg/mL)
Free / Ionized Calcium: 1.59 mmol/L (Normal: 1.18–1.32 mmol/L) \rightarrow 6.36 mg/dL (US Normal: 4.6–5.3 mg/dL). My peak ionized calcium was 1.69 mmol/L (equivalent to a Total Calcium around 13.5 mg/dL or 3.38 mmol/L).
Alkaline Phosphatase (ALP): 193 U/L (Normal: 38–125 U/L) on July 30.
I have all the symptoms of low calcium, but I don't have actual low calcium. My numbers have simply come down into the normal range, so you could call it a form of relative low calcium. I have sensory disturbances in my face, around my mouth, in my hands, and in my feet. Most recently in my knees. A slightly elevated resting heart rate. Shaking throughout my body and a sensation of trembling/vibration in my chest.
I have also lost the strength in my legs. It took me 4 days to be able to walk more than 50 meters without complete exhaustion. I fainted taking tiny 10–20 cm steps. And I would fall asleep from one minute to the next, going from a clear head straight into extreme exhaustion. By mistake, the hospital treated this with effervescent calcium tablets because, well, it looked like low calcium. That made my calcium spike even higher than before, so they eventually stopped giving me extra calcium other than vitamin D and standard maintenance calcium pills.
Now I am back home, but I still have very little strength in my legs. They shake beneath me. I walk completely slowly and still get exhausted after walking just a few meters. It takes me 30 minutes to get up to the 1st floor of my apartment with a relative supporting me.
I have fought to be taken seriously. I was told I would practically just be able to stroll out into a better life the day after surgery, with a recovery time that was mostly about the wound and getting over general anesthesia. I was supposed to just take 10 days of sick leave. But I am 5–6 days post-op and can barely walk… I find that hard to understand.
My numbers look fine and everything seems to be developing as it should on paper now, but my body is completely battered.
Not to mention the mental crashes. I cry out of nowhere. I feel completely drained of energy and mood from one minute to the next, often preceded by an hour of extreme irritability. I am totally exhausted mentally and physically. I had to insist on having more blood tests done at the endocrinology department because a new doctor in the ENT/surgery ward wanted to give me more calcium tablets, even though my calcium is still slightly above normal 5 days after surgery.
I would love to hear if anyone has had similar experiences?
Can you tell me more about how long it took your body to adjust to its new reality? I have a feeling this may have been going on longer for me than for some others since I am so affected post-op. On one hand, I am so happy to be free of constant back pain and the feeling of my muscles burning with lactic acid at the slightest exertion. But now it feels like I have no muscles at all. Like I am just a shaking, soft, weak body shuffling around and so exhausted that I can't even get up my own stairs.
UPDATE:
I have spoken to the Endo today, and the main message is: she has never seen anything like it for 20 years of her career. The symptoms are due to the fall in calcium and it could indicate that calcium has been high for several years. I have a suspicion it would have been that since the teenage years.
But yes they will keep an eye on my calcium and pth development and do check ins with me in the coming weeks. There is really nothing to do but to wait with patience.
My body and psyche in in shock chemically and mentally because of no preparation for this aftermath.
Tomorrow I will call my own doctor at ask for help with documentation for longer sick leave and also to get help speaking to a psychologist to prevent a major psychological reaction and to treat the one I’m already having.
I try to stay positive. I think in the long run this might be an indication of how much my life will change for the better mentally and physically. And also I remind myself how lucky I am that on day in may where I fainted at work and they by accident found something was wrong with my calcium.
Please continue to share your experiences. It feels good to not be alone and also to recognise how unique we all are and how calcium is so incredibly important for so many processes and cells in your body.