Secondary Hyperparathyroidism

Question: Do fat people understand that Bariatric Surgery is not easy way out? The following is a list of possible side-effects and complications to consider before having weight-loss surgery. We will discuss these in more detail at your office consultation. 1. Anastomotic leak (leak from a connection made to the bowel, usually requires re-operation and long hospital stay) 2. Anastomotic stricture (narrowing or obstruction at an intestinal connection resulting in vomiting) 3. Bowel obstruction/strangulation/internal hernia/ischemic bowel possibly needing removal (associated with pain and vomiting, usually requires re-operation) 4. Injury to an abdominal or pelvic organ/structure (especially the liver, spleen, pancreas, bile duct, stomach, esophagus, colon, bowel, diaphragm, urinary bladder, nerve or blood vessel) 5. Conversion to an open operation (due to bleeding, poor exposure, large liver, tension on intestines, etc.) 6. Incisional hernia (more likely if procedure is done open) 7. Infection or abscess (due to a leak, spillage of intestinal contents, underlying infection, etc) 8. Bleeding and the potential need for blood transfusion. Blood transfusion carries the risk of infection with bacteria, parasites (malaria), and viruses (hepatitis, HIV/AIDS). 9. Need for additional surgery or procedures to treat any complication that may occur 10. Prolonged hospital stay or readmission may be needed to treat complications 11. Deep Vein Thrombosis (blood clot in a vein) 12. Pulmonary Embolus (blood clot going to lung, fatal 30% of the time) 13. Atelectasis (lung collapse causing fevers, possibly pneumonia) 14. Pneumonia, lung infection and fluid around the lungs (pleural effusion) 15. Heart attack (myocardial infarction) 16. Stroke 17. Pancreatitis 18. Rhabdomyalysis (breakdown of the muscle in the body) 19. Pressure ulcer or decubitus (skin breakdown, may require skin grafting) 20. Allergic reaction to anesthesia, medications or materials 21. Nerve or ligament injury from positioning or lying on the operating table 22. Kidney failure and/or the need for dialysis 23. Need for ICU care 24. Need for a ventilator (machine to help you breathe) 25. Multi-system organ failure (liver, kidneys, lungs, etc.) 26. Poor cosmetic results (ugly scar, keloid, unattractive incisions, contour defects) 27. Chronic pain, discomfort, numbness, burning or tingling in the incisions or anywhere else (abdomen, back, extremities) 28. Transient or chronic nausea/vomiting due to strictures, gastroparesis, food intolerance, etc. 29. Dysphagia (difficulty or painful swallowing) 30. Diarrhea, constipation, foul smelling gas and stools 31. Heartburn (acid reflux) symptoms 32. Ulcers or gastritis 33. Intestinal perforation due to ulcer, foreign body, obstructed food, etc. 34. Development of food intolerances/loss of taste 35. Dumping syndrome (abdominal pain, heart palpitations, sweating, nausea, diarrhea) 36. Hair loss or thinning 37. Development of malnutrition or vitamin deficiency 38. Anemia 39. Metabolic bone disease (loosing calcium from the bone because of inadequate intake and supplementation) with possible osteoporosis, secondary hyperparathyroidism and bone fractures 40. Failure to lose an adequate amount of weight 41. Loss of too much weight 42. Development of loose or redundant skin 43. Sterility or inability to become pregnant 44. Increased ability to become pregnant 45. Birth defects or fetal injury if you become pregnant. This is less likely once weight has stabilized and laboratory tests are normal. Usually, about 2 years after surgery. 46. Postoperative depression or other psychological reaction to surgery 47. Need to revise or reverse the procedure at some point in the future because of nutritional deficiencies, excessive weight loss, pain or other reasons 48. Extended disability, financial hardship as a result of complications related to weight loss surgery 49. Parts of your stomach and/or intestines will be inaccessible by endoscopy. 50. Death (1% nationwide) within 30 days

Answer: It's just amazing how thousands and thousands of people have actually survived this surgery and are now healthy and happy. How long would your list be if you listed all the things that morbid obesity causes in a person. It would be much longer and certainly more serious than those you listed. You get this surgery to save your life. It has done that for my husband who is doing just great with it. He hasn't had a single problem yet other than getting adjusted to eating the right amount to not feel so full. He has lost 80 pounds and feels great. He is so much more active and actually takes long walks all the time. His energy level has skyrocketed. He started planting a garden yesterday and doesn't need anyone to help him get down on the ground to do it which he hasn't done in many years. He doesn't get out of breath like before. His blood pressure has dropped enough to lower his medication for it. Obesity caused him to have both his knees replaced and it still bothered him. Now he no longer has any pain in his knees, and he walks with ease. Next week, we are going to start riding our bikes. I always have had to do it without him, but no more. He is going along with others family and friends. This surgery has done much more for him than anyone can imagine. I don't know why you want to keep running it down, but it is a real lifesaver to many people. Yes, there are risks. But the real question is whether or not the risks of staying obese are greater than the surgery. Most doctors will agree that obesity is the bigger risk for anyone morbidly obese. My husband loves his new life without all that weight. He knew all the risks before he had it done. It was well worth taking those risks for his good health now.

Question: Do I have a broken Rib? I was leaning over my chicken coop, reach down to get some feed, and the leading pressure was on my left ribs, suddenly I felt my rib pop. That was Thursday. Thursday night I am having a lot of pain in my lower ribs. I hurts to take a breath, or even move a little. The pain is in lower ribs, now I am starting to get pain going around my ribs to my upper back. When I take a breath It feels like my ribs are being squeezed and my ribs in my back are going to brake. The pain is severe. I also have secondary hyperparathyroidism.

Answer: its probably a fracture

Question: Well, it is possible that my 10 OTTB may have "Big Head" syndrome- can anyone offer advice? My 10 OTTB gelding is showing symptoms of Big Head syndrome, also called Nutritional Secondary Hyperparathyroidism. I am finding mixed results online, however, concerning the diseases fatality rate. Has anyone out there dealt with this condition, managed it, known a horse who had it, and what happened? My boy is about to undergo the dietary supplements to attempt to reverse it. His symptoms: large (about the sz of 2 tennis balls side by side), was lame under saddle this past weekend, but not for turnout, and extra stubborn to get out of the pasture lately.

Answer: well it could be. have you had your vet look at him. your vet could help you find any problems he might have. it might be something else too. your vet should know if it is big head syndrome or not.

Question: What should I ask the Endocrinologist tomorrow? Okay... I've never been to an endocrinologist before, but recently got back tests with a high parathyroid level. I have a complicated medical history, but this parathyroid thing is new. I also have osteoporosis, I'm an organ transplant recipient, I have a slightly elevated creatinin. I'm sure he's going to order tests. Try to determine if it's primary hyperparathyroidism or secondary. I've already sent my paperwork, history & last round of bloods & testing to his office, to try and prepare the guy. But what questions should I ask this guy? Maybe I'm just being too nervous about this. I've never been to an endocrinologist before, and have no real concept... Any help would be appreciated!

Answer: Don't be too worried, hyperparathyroidism is very straightforward, and as an endocrinologist I'm sure he deals with it constantly.

Question: Because alcohol destroys your kidney cells is it possible the it disables your Body ability to make vitamin D? Vitamin d is synthesized in the liver the kidneys and intestines I used to be a heavy beer drinker are my enzymes destroys because i have symptoms of hyperparathyroidism and would like to know if its primary or secondary in its nature. Is it because of beer my cmp test alla re fine and kidney function liver etc... are ok but i still have thyroid symptoms as well as bone pain. Is it possible in a nut shell that heavy alchohol use cause damage to liver kidneys etc.. and disables it ability to convert vitamin d into its active form?

Answer: if you were a heavy drinker, then it's always a possibility that you did some kind of irreversible damage. However, it would take some SERIOUS drinking to completely wipe out your ability to synthesize the necessary enzymes to activate Vit.D. If you're really that worried, go see a doctor and have them take a sample of your blood to screen it for Vit D levels. if they are really low, then you're already at the doctor's office, and if they are fine then you're worrying about nothing.

Question: what are the effects of chronic secondary hyperparathyroidism? 50,000iu of vit d keeps it at 30 but PTH still at 185. This has ben going on for 18 months.

Answer: Secondary hyperparathyroidism is caused usually by renal failure but also by vitamin D deficiency. The blood picture is affected by the cause. Treatment is mainly with calcium and vitamin d (calcitriol) as you are having. It requires regular monitoring to get the balance right. There is a natural tendency to have high PTH values and low Vitamin D values. If the results are not improving with treatment you should have a chat with your doctor or an endocrinologist.