How to convert PTH & Blood Calcium from U.S. Units to S.I units.

Karen has asked the question how do you convert PTH from picomoles per L (pmol/L) the standard NHS SI metric units into the NON SI (USA) units, so all us Brits can compare our UK blood results with our American cousins.

The following will allow you to roughly convert between the two units for Intact Parathyroid hormone (PTH) and serum calcium:

To Convert PTH units.

To convert from standard NHS SI units (pmol/L) to USA units (pg/ml).

Multiply the NHS units by 9.43

To convert from USA units (pg/ml) to NHS SI units (pmol/L).

Divide the USA units by 9.43

To convert Serum (Blood) Calcium results:

To convert from standard NHS SI units (mmol/L) to USA units (mg/dL).

Multiply the NHS units by 4

To convert from USA units (mg/dL) to NHS SI units (mmol/L).

Divide the USA units by 4

I hope all that is as clear as mud!

List of experienced UK NHS & Private Endocrine surgeons who offer Minimally Invasive Parathyroid Surgery.

I have compiled a new Document which lists some of the best UK based NHS & Private Endocrine surgeons who offer Minimally Invasive Parathyroid Surgery.

I have previously posted a basic list of UK based NHS & Private Endocrine surgeons who offer Minimally Invasive Parathyroid Surgery, but this was a little hard to read and was incomplete.

I’ve decided to put together a New Document which lists some of the best UK based NHS & Private Endocrine surgeons who offer Minimally Invasive Parathyroid Surgery in a Portable Document File (PDF) format so it can be easily distributed by e-mail and printed off in a fully formatted way.

Here’s a copy of the document – feel free to point out any errors, criticise, ask for additions of your favourite UK based parathyroid surgeon – private or NHS.

Here it is – hope it helps people find useful and I’m sure it’s going to run to more than one revision.

Click on the link below to download the PDF.

UK based NHS & Private Endocrine surgeons and NHS Hospitals in the UK who are experienced in Minimally Invasive Parathyroid Surgery

Please pass this document on, post it on the internet or a link to it if you know anyone who might find it useful.

I’ve got a date for surgery.

Had a phone call early this morning from High Wycombe offering me a date of Wednesday 4th January 2011.
As I’m a distance away they have been good enough to offer me an afternoon surgery, but I still have to be able to get there at 11:30 am which will mean an early morning train from Sheffield.
I haven’t really used the train for a long distance journey since I passed my test and was shocked to find a return price of £126 – no wonder the motorways are busy.
Anyway enough of the moaning as I’ll soon be joining the Post Parathyroidectomy Club and show off my very own scar. It’s going to be a weird New Year’s Eve with a surgery just days away, well It’ll be an excuse to have an extra drink or two – as if I need any excuse. I’m pretty sure I’m going to be nervous as the day looms but now’s not the time to be lilly livered, after all It’s taken long enough to get here.

Karen’s Post-Op scar.

Karen has sent me a pic of her scar to post.
Karen is worried that it’s not in the ‘natural crease of the neck’. To be honest, I’ve never been able to find my natural crease on my neck unless I push my chin down to my chest. I think it looks good to say it’s only days old. The main thing is that it parathyroid op wounds tend to be internally stitched with dissolving stitches and then glued together with essentially superglue.
The lack of external stitches gives a good scar free healing without the dots either side that you get with external stitches. I’m sure it will be virtually invisible within several months like Callum’s scar.
I’ve done a bit of reading around on whether to apply lotions and potions like oils, vitamin e cream or zinc based creams. The jury seems to be out on whether these help – not sure if Ann or Callum bothered applying anything to their scars. A diet rich in Vitamin C and Zinc helps with healing. Plenty of oranges and oysters then! :)

Good Luck with the surgery tomorrow Karen!!

Think this one deserves your very own post!
Hoping all goes well with your surgery.
Good luck for tomorrow Karen, we’ll all be thinking about you!
Fingers and everything else crossed!!
Looking forward to your reports of glowing health in the coming days and weeks.

Simon
xxx

Countdown to surgery…

Nothing happening at this end, wanted to know how your pre-op tests went this Friday Karen.

Less than a week to go for your surgery, hope you’re not feeling too anxious.

Let us know how you get on at the GP’s on Monday Callum.

Seeing the doc myself on Monday about the anaemia – might ask the GP for a prolactin test also – just to set my mind at rest.  As I didn’t trust my endocrinologist to diagnose Primary Hyperparathyroidism – which he didn’t!  I don’t feel I can trust him to rule out MEN1.  It has been 3 years since my prolactin test and as each gland doesn’t always present it’s problems in a nice neat order,  I think it’s best to be cautious.  Pretty sure my GP will chuck in a test, he’s good like that.  Have considered the gastrin test,  but I’m taking omeprazole and you have to come off them for 2 weeks before a gastrin test.  I could do without stomach troubles on top of things at the moment.  Anybody else get heartburn/reflux/acid stomach with their Primary Hyperparathyroidism?

Good news & bad news from the surgeon!

The good news is that the mibi scan has shown a weak but definite hotspot in the neck.

Surgery should be in about 8 weeks time – I’ll be getting a date by letter in the next few weeks.

The bad news is that as the ultrasound was negative, it looks as though the tumour is behind the right thyroid lobe.

Trust me to be an awkward patient – I wont be having a minimally invasive surgery and so an overnight stay will be needed.  He’s going to be checking all 4 glands whilst he’s in there and so at least I can be almost guaranteed 100% success with no further symptoms or surgery required once it’s done.  The plus point is I’ve got a good experienced surgeon and so even though it wont be a mini op the results will be good.

The other bad news is that my anaemia is the worst it’s been for a good while, so much so that the anaesthetists is unlikely to want to put me under with this level of anaemia.  I was surprised to be told that it was 9.9 (normal for men 14-17).  The lowest it has been before my recent iron infusion was 10.6.  Four weeks ago it was at 11.2, so it’s dropped quite a bit in the space of a month.  My proctitis has been quite bad recently and blood loss has been a problem, but I didn’t realise that things had got so bad.  I’ve booked in to see my GP – though I can’t get in until 21st Nov.  I’m going to have to go back on my healthy gut diet – no red meat, no dairy and plenty of fish and chicken instead.  The last thing I want is for the anaemia prevent me getting the surgery.

Trip to High Wycombe Hospital Meeting the surgeon – Mr. Andrew McLaren

Just  quick note to say all went well yesterday.

Got to Wycombe Hospital early at about 10:20 and left at 14:15 with everything done.

Very busy day but worthwhile as now everything is out of the way and done except surgery with Mr. Andrew McLaren.

Bit of a mix-up with the appointment to see surgeon which was 11:00 am which was right in the middle of the mibi injection and the first mibi scan.  Got that sorted though and arranged to see Mr. Andrew McLaren in between the 2 hr wait between the  first and second mibi scan.

So the whole thing went something like this:

10:40 Parathyroid ultrasound (5mins). Came back negative.

10:50 Mibi injection after they finally found a vein on back of the hand – it has to be said my veins aren’t the easiest to find.

11:05 First mibi scan – far too hot in the rest of the hospital but nice and cool in the scan room – drifted off into a daydream for most of it.  They told me I could listen to my own CD but they lied!  At least they didn’t offer and I wasn’t going to make a point of putting then through my musical tastes. (45min).

11:50 See the surgeon Mr. Andrew McLaren.  We discussed my symptoms and he said they were typical of many patients and that others like my rheumatologist didn’t see enough patients to recognise the symptoms of Primary Hyperparathyroidism.  And that they didn’t understand that blood calcium level doesn’t correlate with symptoms.  He said he has a patients with blood calcium very high at 3.5 and me at 2.7 she has no symptoms and I’m in agony.  Typical surgeon – they are a different breed from medics – less touchy feely and more gung ho, let’s get you under and get it out.  When you have a parathyroid tumour the last person to help you is some wishy washy medic – you need a surgeon!  I’ll be speaking to Mr. Andrew McLaren on Thursday to discuss the results of the mibi and a date for surgery.  The ultrasound was negative but that doesn’t mean anything, in fact he’ll still go in with a negative scan as they do.

12:10 Had all the pre-op tests done except the voice box check which I’ll probably have on the table.

By the time I’d had the pre-op tests and filled out their questionnaire it was time to have some bloods taken then head back for the final mibi which took about 15 mins this time – quicker than I expected as I though both were 45 mins long.  Maybe that was a good sign or perhaps that’s normal?

Quick call to my better half who had been trolling around the retail wonderland which is High Wycombe (not) for several hours managing to spend £80 in the process.

The whole thing was a bit whirlwind and to be honest I was away with the fairies for most of it as my pain was so bad I was chucking back Tramadol like Smarties.

Well that’s the worst of it out of the way.

Hope everyone’s all keeping well!

I’ve got a date for the scans!

Apologies first of all for not posting for ages – not really had any news and I’ve been feeling a bit off it recently (low mood and bad aches and pains).

Finally got a letter with a date for the scans – Friday4th November at Wycombe General Hospital.

Going to be having an ultrasound and sestambi scan – ultrasound should be 10-15 mins and the sestamibi as most of you know will be injection then 15 min wait then scan for 45mins.  Then 2 hour wait and second scan for 45 mins.  Luckily my surgeon will be holding a clinic that day and so I can see him in between mibi scans.  He did mention pre-op tests, I’m hoping that they will be arranged on the same day.  I’m sure someone mentioned that I’ll need a larynx scan – think I might need to make sure this is going to be booked for me because no one has mentioned this so far.

Hoping the mibi scan will light up a single adenoma like a Roman Candle!

I don’t think I’ll be getting surgery until the early new year now – just hope it doesn’t get delayed due to snow, that would be just my luck!!  :)