A Diagnosis

I’m having surgery. It’s a line I’ve been sharing lately and it’s quite the attention grabber. I’m downright excited about it and it’s not even a facelift. My perhaps over-optimistic view is that I will feel younger, smarter, and more energetic after this. 

Last month, I told The Buzz Magazines that I needed to skip a month of this column. My brain is tired. Being forgetful is my natural state. But it’s getting worse. 

My neighbors texted me. “Did you know your trunk is open with groceries still in it?” All I remembered is I unloaded enough groceries to make lunch, then ate, felt sleepy, and passed out on the sofa. I can nap away the day, then have insomnia all night. My balance is also getting worse, making me afraid to walk Zoe-the-dog. This isn’t normal aging.

My family practice doctor, Imaad Siddiqi, M.D., took a comprehensive blood panel, and saw high calcium. After a few more tests he said, I think you have hyperparathyroidism. I want you to see an endocrinologist. Dr. Siddiqi recommended Dr. Cristina Boccalandro. Yes, you definitely have hyperparathyroidism, she said. Do you have kidney stones?

No, I don’t have kidney stones, though it is a common symptom. But I have other symptoms, like dry itchy skin, swollen lower legs, and foremost, brain fog and fatigue. Oh, I almost forgot to mention that in the process, I was tested for osteoporosis. I have that too, big time they say. Hyperparathyroidism can actually cause osteoporosis, removing calcium from your bones into your bloodstream, urine, and out of your body. 

See? I forget the most important things. I also forgot to say that this has nothing to do with my actual thyroid gland. Those four letters – para in parathyroid – mean next to. The parathyroid are four glands right behind the thyroid, each the size of a grain of rice. Their job is to regulate your calcium. One or more of those four little glands will show up looking enlarged in imaging, because of a tiny, benign growth on the gland. The good news is, there is a cure, said Dr. Boccalandro. 

A cure? That’s a strong claim for a doctor I didn’t meet through an infomercial. It requires day surgery in which the surgeon removes the offending gland or glands. Amazingly, only one of those four tiny glands needs to be working in order to regulate your calcium normally. How convenient. The body comes with spare parts. What a machine.

Dr. Boccalandro set me up with Helmi Khadra, M.D., Chief of Endocrine Surgery at Methodist Hospital for further inspection, and to schedule the day surgery. He saw two enlarged glands through imaging. Once removed, my blood calcium level should return to normal almost instantly.

The more I bring this up in conversation, the more common it seems. Oh, my sister-in-law’s sister-in-law had that. I’ve heard some version of that reaction in three out of four conversations. I called two of those people and quizzed them. One lived in Houston, the other in New Jersey. One considered herself a high-energy person to begin with and didn’t notice any symptoms. But weeks after her surgery, she reported a surprising burst of energy that she didn’t know was missing. Another reported a dramatic loss of energy that was actually crippling. She reported an equally dramatic life-changing turnaround that started the day of her surgery. The doctor said to take it easy the first couple of days, but I started reorganizing my house the same day, she said. 

I’m not reporting this because I think everyone has hyperparathyroidism. But some might. Turns out, according to the NIH, about 100,000 people develop primary hyperparathyroidism each year. Primary hyperparathyroidism is three to four times more common in women than in men. 

So many women I talk to in daily life report vague symptoms of fatigue, hair loss, insomnia, depression, etc. We often bear it silently, not wanting to invoke the eye roll of the skeptic who thinks we’re hypochondriacs – leaving us wondering if they’re right.

Here’s a big takeaway from my experience: I did not have an endocrinologist on my regular doctor list. I do now. My own 39-year-old daughter, Laura, has had fatigue and brain fog symptoms most of her adult life. She went to an endocrinologist after my experience, where a cyst was discovered on her pituitary gland. She has been on medication for it and reports more energy, less brain fog, and based on the scales, a better metabolism. 

Hyperparathyroidism surgery itself is highly specialized and only a handful of surgeons perform it. Dr. Khadra is one of the few in Houston. He makes a tiny incision in the front of the neck that he promises will basically disappear in a matter of weeks. 

By the way, do you have kidney stones? Dr. Khadra asked. There was that question again. No, I said, but you’re not the first to ask. Since he doesn’t leave scars, I couldn’t resist one last question. Could you throw in a neck lift while you’re at it? No, he said, but you’re not the first to ask.