Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Provider photo for Ninad Dabadghav

Ninad Dabadghav, MD

Surgery: General

Welcome to My Doctor Online, a web site that my colleagues and I developed to make it easier for you to take care of your healthcare needs. On this site you will find answers to many of your questions about my clinical practice. Also included are several online features that will allow you to e-mail me, check your laboratory results and refill prescriptions. I hope you find its content informative and useful.

My Offices

Santa Clara Homestead
Appt/Advice: 1-408-851-2000

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Parathyroid surgery removes one or more of your parathyroid glands. There are 4 tiny parathyroid glands in the lower neck. They’re next to your thyroid gland and windpipe (trachea). 

The parathyroid glands make parathyroid hormone (PTH). PTH: 

  • Regulates the amount of calcium and phosphorus in your bones and blood. 
  • Helps absorb calcium from your diet. 
  • Moves calcium between your bones and bloodstream. 

If these glands produce too much hormone (hyperparathyroidism), the amount of: 

  • Calcium in the blood increases. 
  • Calcium stored in the bones gradually decreases. 

If left untreated, the condition may lead to: 

  • Kidney stones 
  • Stomach ulcers
  • Osteoporosis, or thinning of your bones
  • Pancreatitis
  • Psychiatric disturbances

During parathyroid surgery (parathyroidectomy), we remove 1 or more parathyroid glands.

Additional References:

Causes and Types

We don’t know much about the cause of primary hyperparathyroidism. 

  • Women are twice as likely to develop it.
  • The risk increases with age for both men and women. 

Primary hyperparathyroidism is caused when one or more parathyroid glands grow large. Causes may include: 

  • A noncancerous (benign) growth on a gland. 
  • Enlarged parathyroid glands. 
  • Family history of hyperparathyroidism. 
  • A rare, cancerous (malignant) tumor.

Secondary hyperparathyroidism occurs when the body produces too much PTH due to low calcium levels. This may happen when you:

  • Have low vitamin D levels. 
  • Cannot absorb enough calcium from your diet. 
  • Have kidney problems.
  • Are on kidney dialysis.


At first, you may not notice any symptoms. Common symptoms of high calcium may include:

  • Pain in your side and back, below your ribs (kidney function problems).
  • Frequent urination.
  • Loss of appetite, nausea, or vomiting.
  • Constipation.
  • Bone, joint, or muscle aches.
  • Fatigue.
  • Depression, confusion, and memory loss.

Schedule an appointment right away if you have any of these symptoms. Early diagnosis and treatment may prevent serious symptoms, such as thinning bones (osteoporosis).

If left untreated, you may develop very high levels of blood calcium (called hypercalcemic crisis). You may need a hospital stay while we lower your calcium level.


To diagnose overactive thyroid gland(s), or hyperparathyroidism, we: 

  • Review your medical history. 
  • Talk about your symptoms. 

We order more tests: 

  • A blood test to measure calcium and PTH levels. 
  • A urine test to determine the amount of calcium removed by your kidneys. 

Some medications can increase calcium levels in the blood, such as: 

  • A mood stabilizer (lithium). 
  • Water pills (diuretics) used to treat high blood pressure (such as hydrochlorothiazide and chlorthalidone).

Together, we’ll talk about the need to use different drugs. 

If your condition is mild, we recommend regular medical checkups to monitor your calcium levels. In serious cases, we recommend surgery (parathyroidectomy). 

Before Surgery

We use a “localization study” to help us see the exact location of the abnormal parathyroid gland(s). 

Parathyroid scan. We first inject you with a radioactive tracer. We take several pictures of your neck over a 3-hour period. Each set of pictures takes about 30 minutes.

Be sure to tell us if you:

  • Are pregnant or breastfeeding.
  • Have difficulty lying flat. 
  • Have great fear of small spaces (claustrophobia). 

Ultrasound. This study uses sound waves to scan your lower neck. We use it to identify the position of the abnormal parathyroid gland(s). 

When a test can’t detect the abnormal parathyroid gland(s), it may be too small to see. We may recommend exploratory surgery.

Methods of Surgery

Depending on the gland affected, we may recommend: 

  • Open parathyroidectomy. We make a small incision in the neck and view all 4 glands. We remove the affected gland(s). 
  • Minimally invasive parathyroidectomy (MIP). We remove a single affected gland. 

During surgery, we:

  • Give you medicine to make you fall asleep (general anesthesia). 
  • Remove the gland(s) through a cut in the front of your neck. 
  • Confirm that your blood hormone level has dropped. 

After surgery, you may:

  • Go home the same day or 1 to 2 days later.
  • Have blood tests over the next few weeks to monitor your calcium level. 
  • Have a small tube placed in your neck for 1 to 4 days to drain fluid.
  • Return to normal activities after about 2 weeks.


General surgery risks include: 

  • Bleeding. Tell us before surgery if you take aspirin, ibuprofen, or other blood-thinning drugs. 
  • Infection. Call us right away if your incision becomes red and painful. 
  • Neck scar. Expect your scar to be somewhat red and swollen during the first few weeks. It should improve with time. Avoid using scar treatments on the wound for the first 3 weeks after surgery. 
  • Recurrent disease.

Be sure to let us know if you have any questions or concerns.

Possible Complications

It’s possible to have temporary low calcium levels after surgery because: 

  • The remaining glands may not function right after surgery.
  • Your bones may quickly reabsorb calcium for a short time (called bone hunger). 

Low calcium levels usually last only a few days or weeks and then return to normal. 

To prevent low calcium after surgery, take calcium supplements. Even with calcium supplements, your calcium level may be temporarily low. It can take time for your glands to return to normal functioning. 

Call us right away if you have: 

  • Muscle cramping in your arms, hands, legs, or feet. 
  • Tingling in your hands and feet. 
  • Tingling around your mouth. 
  • Heart palpitations. 

These symptoms are easily treated and usually respond to additional calcium and vitamin D. In rare cases, you may need a hospital stay. 

Rare Complications

Although rare, the following complications may require additional treatment.

Persistent hyperparathyroidism. Your condition may not improve if: 

  • We can’t identify the abnormal gland during exploratory surgery. 
  • You have more than one overactive parathyroid gland (hyperplasia). 

Permanent hypoparathyroidism. It’s possible to develop the opposite condition (called hypoparathyroidism) when:

  • The remaining parathyroid glands don't produce enough PTH. 
  • Your calcium level gets too low, instead of too high. 

In this case, you must take calcium and vitamin D supplements for the rest of your life. 

Vocal cord paralysis. The vocal cord nerves are close to the parathyroid glands. In very rare cases, a nerve is injured during surgery. This can cause a permanent weak or hoarse voice or difficulty breathing. Fortunately, we know where these nerves are located and how to protect them. 

Lifestyle Management

To improve comfort, we may recommend that you: 

  • Avoid calcium supplements.
  • Take vitamin D supplements, usually 800 to 1,000 international units (IUs) each day.
  • Drink 6 to 8 glasses of water every day to reduce the risk of kidney stones.
  • Exercise regularly to maintain strong bones.
  • Avoid smoking. It may increase bone loss and serious health problems. If you are ready to quit, we can recommend one of our stop smoking programs.
  • Avoid diuretics, lithium, and other drugs that can raise calcium levels. 

Your Care with Me

If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms. If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day.

When You See Me

During your office visit, we will discuss your medical and family history and I will perform a physical exam. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options based on the findings.

Lab resources

We will also discuss the results of any tests ordered by your personal physician. If further tests are needed I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice.

  • When the results are ready, you can view most of them online, along with any comments that I have attached to explain them.
  • If your results are normal, I will also send the results in the mail.
  • If they are outside the normal range, I will call you to discuss the results.
Pharmacy resources

If medications are warranted, I will prescribe them and work with you to minimize side effects. If refills are indicated in the future, you can order them online from my home page or by phone using the pharmacy refill number on your prescription label.

  • You can also arrange to have your refill mailed to you at no extra cost. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
  • You can choose to pick up your medications at the pharmacy or have them delivered by mail at no extra cost.
After Visit Summary

At the end of our visit, you will receive a document called the After Visit Summary that will summarize the issues we discussed during your visit. You can also view it online from this site.  The online version is called Past Visits.

  • This summary includes my name and the date and time of your visit, your vital signs, my test orders and your medications or immunizations.
  • It often includes the instructions I have given you during our visit and follow-up information.
  • You can refer to your After Visit Summary if you forget what we discussed, or if you just want to recheck your vital signs and weight.
Coordinating your care

Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology and health education, makes getting your care easier for you. Another major benefit is our comprehensive electronic medical record system in which all of the doctors and clinicians involved in your care can stay connected on your health status and collaborate with each other as appropriate. When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.

Preparing for Surgery

If surgery is indicated, I will ask you to review an online educational program called Preparing for Your Procedure (Emmi). This online program is available on this site. It will help you decide whether surgery is right for you. It will also provide information about how to prepare and what to expect.

If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a pre-operative medical evaluation that will assure that you are properly prepared for your surgery.

Contacting Me

If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.

If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.

If you are experiencing an emergency, call 911 or go to the nearest Emergency Room.

Related Health Tools:

Prepare for Your Procedure

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If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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