Before & After Parathyroid Surgery- Dr. Valeria Simone

1. Before & After Parathyroid Surgery- Dr. Valeria Simone B Y B Y D R . D R . V A L E R I A V A L E R I A S I M O N E S I M O N E M D , M D , S O U T H L A K E G E N E R A L S O U T H L A K E G E N E R A L S U R G E R Y , T E X A S , U S A S U R G E R Y , T E X A S , U S A

2. Overview Understanding what to expect before and after parathyroid surgery is essential, as it can be a life- altering event for many people. The patient and the surgical team should get together before the procedure to go over the procedure’s specifics and any preoperative requirements. Patients need to adhere to a structured recovery plan after surgery to guarantee a speedy and trouble- free recovery. Before you see the surgeon, you may need to go through some tests to examine your parathyroid glands. Physical examination may include an ultrasound, a sestamibi scan, or a CT scan. These tests give valuable data to the surgeon about your parathyroid glands. You will likewise have routine blood tests. Contingent upon your blood test results, a few people may need to take Vitamin D prior to surgery.

3. 5 / 2 7 / 2 0 2 3 5 / 2 7 / 2 0 2 3 S A M P L E F O O T E R T E X T S A M P L E F O O T E R T E X T 3 3

4. Before your Parathyroid Surgery: Multiple routine screenings are performed before parathyroid surgery to make sure the patient is healthy enough to undergo the procedure. Blood tests, a complete physical examination, and a review of the patient’s medical history are just some of the things that are often done at least a week or two before surgery. Depending on your health background, you may additionally need a stress test, chest x-ray, or electrocardiogram (ECG). Your cardiovascular and respiratory health will be evaluated. No in-hospital observation is needed for these examinations. These examinations may be ordered by your primary care physician, the surgeon, or a high-risk anesthesiologist, depending on your age and overall health. Before surgery, you might also be advised to see an endocrine nurse practitioner who will instruct you about the surgery and ensure all your medical examination has been completed.

5. Medication Instructions PLEASE CONSULT your doctor or surgeon PRIOR to changing or halting any of your medications. • Medication Instruction before Surgery: Many medications may require discontinuation prior to surgical procedures. Before discontinuing the use of any prescribed medication, you should check with your surgeon or primary care physician. Medicines related to the heart (like blood pressure medications):AVOID taking them on the surgery day and consult your surgeon:

6. • Captopril (Capoten) • Olmesartan (Benicar) • Enalapril (Vasotec) • Perindopril (Aceon) • Benazepril (Lotensin) • Hydrochlorothiazide (HCTZ) • Bumetanide (Bumex) • Iosartan (Cozaar, Hyzaar) • Candesartan (Atacand) • Irbesartan (Avapro) • Eprosartan (Teveten) • Quinapril (Accupril) • Fosinopril (Monopril) • Ramipril (Altace) • Furosemide (Lasix) • Spironolactone (Aldactone) • Lisinopril (Prinivil, Zestril) • Telmisartan (Micardis) • Metolazone (Zaroxolyn) • Valsartan (Diovan)

7. Blood thinning medicines: Please ensure you have discussed this with your PCP or surgeon before stopping any of these medications. • Aspirin – Avoid taking 7 days prior to surgery • Coumadin – Avoid taking 5 days prior to surgery • Heparin – Must be held for 12 hours before surgery • Antiplatelet agents (Plavix, clopidogrel, ticlopidine) – Please follow the instruction of your surgeon or cardiologist.

8. Diabetes medications: Insulin – Patients using insulin pumps: • Carry on with your basal rate ONLY Patients not using insulin pumps: During the morning of the surgery day: • Hold short-acting insulin • Pre-blended insulin (eg. 70/30): give 1/3 of regular dose • Lantus: give a regular dose

9. Avoid taking any oral diabetes medications on the morning of surgery. • Metformin • Glyburide • Glipizide Other prescription drugs: • MAO inhibitors – Avoid on the surgery day • Premarin – Avoid on the surgery day • Viagra or similar drugs – are not recommended to take 24 hours prior to surgery Over-the-counter medications: • Aspirin – avoid taking them 7 days prior to surgery • NSAIDS (ibuprofen, Aleve, naproxen, Celebrex) – avoid taking them 7 days prior to surgery • Iron – Avoid on the surgery day • Herbal supplements and Vitamin E-containing multivitamins – avoid taking them 7 days before surgery

10. Surgery Day The surgery day schedule will be sent to you by the surgical department the night before your surgery, or at the very latest, 24 hours before. You must check in at the hospital two hours before your scheduled surgery time. In most cases, patients are instructed to abstain from eating or drinking after 12 p.m. on the day before surgery. Regular medications can sometimes be taken with a small amount of water. At your pre-op appointment, you will receive a briefing on prescription guidelines. Contingent upon your age, well-being, and surgical complications, you might need to remain in the hospital overnight. This is mainly discussed with your surgeon during your hospital visit. Kindly leave all valuables at home and wear comfortable clothes.

11. Prescribe Medications on Discharge Regular medications you might be prescribed on discharge, please contact your doctor for medication or any health-related issues. • Let’s explore more: Before & After Parathyroid Surgery- Dr. Valeria Simone - Southlake General Surgery

12. Appointment • If you have any further queries regarding parathyroid surgery, kindly contact us @ 817-748- 0200 or You can also make an online appointmentwith us. • Follow us on Facebook and YouTube. • Source: Before & After Parathyroid Surgery- Dr. Valeria Simone - Southlake General Surgery

13. THANK YOU! SOUTHLAKE GENERAL SURGERY 1545 E. Southlake Blvd, Suite 270 Southlake, TX 76092 EMAIL: info@southlakegeneralsurgery.com VISIT US AT: www.southlakegeneralsurgery.com