UpToDate gives Sandy the confidence to undergo a
parathyroidectomy
Since childhood, Sandy was never satisfied until she found
answers to her questions. That curiosity stays with her today as an
adult patient. "When it comes to my health, I want to know why a
decision is made and why I should follow it," said Sandy, a clinical
social worker and mother of four from Bellevue, Washington.
In July, 2004 at the age of 63 Sandy asked for an
osteoporosis
screening because she was two inches shorter than her greatest height.
She had used hormone replacement therapy and calcium supplementation
for years, and exercised moderately, but the results of the test
showed osteopenia. Osteopenia is defined as lower than normal bone
mineral density, but is not low enough to be classified as
osteoporosis. This, along with other symptoms, worried her.
Sandy explains, "I had been experiencing increasing cognitive
difficulties, apathy, and lethargy for several months. As a clinical
social worker, I deal with a lot of people's problems. I need to be at
the top of my capabilities to help them. I felt I really couldn't
afford to function at less than my best cognitive ability and
emotional energy." She consulted a naturopath for her symptoms and he
recommended blood tests for calcium and parathyroid hormone, to rule
out
hyperparathyroidism.
“I could not have undergone the
surgery without the support of what I learned from UpToDate.”
Sandy subscribes to UpToDate to learn more
Her primary care physician conducted the tests and they came
back outside the normal ranges indicating
hyperparathyroidism. After
receiving her test results Sandy subscribed to UpToDate to
learn more. "I looked at UpToDate's topic on
Parathyroid
hormone secretion and action and found a graph that showed how my test
results compared to the serum concentrations of parathyroid hormone
and calcium in normal and hyperparathyroid patients," said Sandy. She
also looked at UpToDate's professional-level materials on
pathogenesis and etiology, and on diagnosis and differential diagnosis
of hyperparathyroidism. According to Sandy, "the best review I found
was
Management of primary hyperparathyroidism."
Sandy's primary care doctor had been monitoring her PTH and
calcium levels for months when she asked to be referred to an
endocrinologist. The specialist recommended more monitoring. She
explains, "I wanted surgery, one of the options described in the UpToDate's
"Management" review. I have never had surgery before or since, but I
insisted on consulting with the Group Health surgeon who specializes
in the procedure." The surgeon could see from the graph that she was a
candidate for surgery, but continued to monitor her for another four
months, to be sure.
She undergoes surgery with the support of UpToDate
"Since I was so tired it was difficult to pursue surgical
treatment. I could not have undergone the surgery without the support
of what I learned from UpToDate," she said. On April 21,
2005, Sandy underwent a parathyroidectomy. During the surgical
procedure, the parathyroid glands on both sides of the neck are
examined. Abnormal tissue is removed, while normal parathyroid tissue
is left in place. "Dr. Harper had assured me that it was the only
effective treatment for hyperparathyroidism, and I had read in UpToDate
that it takes about two hours and has a low complication rate. I left
the hospital the next morning and my recovery was swift," said Sandy.
"Almost immediately, I felt much better. Strangely, my chronic
heartburn diminished, so that I was able to discontinue two strong
drugs I took for that, omeprazole and ranitidine. My energy and mental
capabilities were much improved, and I was eager to see if my bone
density would increase, one of the usual outcomes of surgery. This
past January, almost 21 months after surgery, and 30 months since my
last bone density scan, my hip bone density had increased by almost 2%
per year, and is now normal."
“One of the things that UpToDate
has done for me is made me feel much more confident and relaxed
because I understand what is happening and what the procedure
entails.”
Sandy is relaxed because she knows what the procedure entails
Sandy claims, "One of the things that UpToDate has
done for me is made me feel much more confident and relaxed because I
understand what is happening and what the procedure entails. I wasn't
worried about my surgery because I read about it and they said it was
fairly simple to perform."
Sandy believes the information she gets from UpToDate
enables her to intelligently request the best treatment options from
her physicians. In fact, after reading the information that Sandy
brought in to the office her primary care physician decided to
subscribe to UpToDate as well.
During this period of treatment, Sandy's primary source of
medical information became UpToDate. Sandy concludes, "I have
used UpToDate to learn about concerns from headaches to lung
cancer and always find the answers and reassurances I need. UpToDate
has made a tremendous impact on my health."
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