Frequently Asked Questions

No.  There is uniform agreement in the medical profession that persons with diagnosed primary hyperparathyroidism require surgery for removal of the abnormal parathyroid adenoma.  You may not be experiencing any of the common signs or symptoms such as bone pain, kidney stones, or abdominal discomfort; nevertheless, the constantly elevated parathyroid hormone level is causing thinning of your bones and abnormally elevated calcium.  Ultimately this leads to osteoporosis which may result in bone fractures in later years of life.  The "wait" strategy is no longer considered a reasonable option for most people.

Surgical pain is minimal so all that is required is either Tylenol or Tylenol with Codeine for several days postoperatively.

It is very important that you take calcium with vitamin D supplements after surgery.  The parathyroid adenoma (tumor) has been depleting the calcium storage in your bones which leads to thinning and weakness of your bones.  Calcium and vitamin D together has been shown to increase the thickness and strenghth of your bones.  It is very important that you take BOTH calcium and vitamin D.  There are many calium with vitamin D combination pills that you can purchase at a drug store with the "elemental calcium" dosage of 500mg or 600mg per pill.  We recommend that you take two pills twice a day postoperatively for 2 weeks and then reduce this to 2 pills once a day on a continuing basis.

More Information on Calcium and Vitamin D

After your surgery you will have an adhesive bandage covering your wound called "steri-strips."   Try to keep the steri-strips and wound dry during the first week.  Simply dry them after you shower.  One week after surgery you should wet the steri-strips in the shower and gently peel them off.  You have a single skin suture which will dissolve so you do not need to return for suture removal.  After the strips are removed, we recommend using antibiotic ointment (Bacitracin) for one week and then  Mederma gel on the wound 3 times a day for 8 weeks.

We accept and work with most major United States insurance plans including Medicare to cover your surgery.

Consultation and Chart Preparation Fee: $650 USD prior to consultation.  This is not covered by insurance.  This involves collection of all chart material, communication with your local physician, and phone consultation with the patient.

Surgery Fee: $9,750 USD.  This is covered by most insurance companies.  This fee coveres surgeon, operating room, anesthesia, anesthesiologist, radiology, laboratory and hospital fees. There are no other fees related to your care.

Travel and Hotel fees are the responsibility of the patient.  We assign a concierge to you after initial consultation who will help arrange transportation from the airport, local accomodations as well as local sight-seeing and restaurants. 

Currency exchange

If you are from out of the area you typically can expect to stay 2 nights: the night before surgery and the night after surgery.  The following is a standard itinerary:

• Day 1: Arrive the night before surgery and stay at local hotel or bed and breakfast.
• Day 2: Surgery is performed at the hospital.  You the remain in the hospital or return to local lodging.  You can safely return home at this point if your surgery is performed early in the day, but most people prefer to stay an additional night.
• Day 3: The New York Center for Advanced Parathyriod Surgery staff check in with you before you leave.

If your preoperative localization procedures have not yet been performed, they will be arranged either the day before surgery (Day 1) or the morning of surgery (Day 2).  Your itinerary will be confirmed before you arrive at the New York Center for Advanced Parathyroid Surgery.

If you have not had a localization procedure already performed we recommend that you wait and have the localization performed at the New York Center for Advanced Parathyroid Surgery. This will decrease the chance of false negative scans.  Moreover, we are able to perform both the parathyroid sestamibi scan and ultrasound together within about 3 hours the first morning you come to visit us.  At your option, you can then proceed to surgery if you have not had anything to eat that morning.  Alternatively, your surgery can be performed the following day.  Because all imaging, laboratory and surgery is performed at the same center, this convenience enables us to work in an efficient and well coordinated manner.

Yes.  In most cases of minimally invasive parathyroid surgery, the patient is able to leave the hospital on the same day.  Typically most patients stay for several hours after the procedure and, after being observed, return home or go to local lodging.  All patients have the option of staying overnight and safety is our highest priority.  We advise overnight stay in the hospital if there are signficant contributing  medical conditions such as heart or lung disease. 

Yes, more than 85% of patients with primary hyperparathyroidism are eligible for minimally invasive parathyroid surgery.  Many hospitals that do not perform sestamibi scan on a regular basis have false-negative scans.  When the repeat scan is performed at our center the result is frequently positive.  Combining a properly performed sestamibi scan with high sensitivity surgeon performed ultrasound enables us to localize the parathyroid adenoma in over 85% of cases.  In the small percentage of cases where these imaging modalities fail to localize the parathyroid adenoma, we turn to high resolution CT or T2 weighted MRI scan to localize the adenoma.  The localization of the parathyroid adenoma preoperatively is what enables us to perform minimally invasive parathyroid surgery on an ambulatory basis.

Yes. All that is required is that the incision be long engough to accomodate the short-axis of the parathyroid adenoma.  Even very large parathyroid tumors can be removed through a mini-incision.