  - Out of Town
Patient Options -
For Minimally Invasive
Parathyroid Surgery
by James Norman, M.D.
UPDATED February 2006
 James Norman, M.D., F.A.C.S., is recognized as one of
world's foremost experts on parathyroid disease. He is a board certified
surgeon and a Fellow of the American College of Surgeons and a Fellow of
the American College of Endocrinology. He is recognized
as the 'inventor' of minimally invasive parathyroid surgery in the mid
1990s, and is largely credited with dramatically changing the way
parathyroid surgery is performed. Dr Norman currently limits his surgical
practice to parathyroid surgery through
the Norman Endocrine Surgery Clinic. (Click Here
to read more about Dr Norman).
You Can Have Dr Norman Perform Your Parathyroid Surgery
Because
of the demand for minimal parathyroid surgery, his expertise, and
exceptional results, Dr Norman operates on ten to twenty persons with
parathyroid disease from outside the state of Florida each week, and even more who come from
all over Florida. Because of this, we have developed a system which allows
for patients to be evaluated for mini - parathyroid surgery prior to taking
the trip
to Tampa. Our goal is to provide a safe and effective alternative to
the standard "old fashioned" neck exploration. We will help
arrange all aspects of the trip except the travel. Typically a
patient can fly to Tampa, have an operation, and return home in the same
time that he/she would be in the hospital if a standard operation was
performed. CLICK
HERE to read what patients say about having a mini-parathyroid operation
at the Norman Parathyroid Clinic. These are people just like you...
very good stories THIS IS A VERY POPULAR PAGE AND A MUST READ!
Endocrinologists and family doctors all over the US
(and throughout the world) are typically very happy to see the patient
postoperatively since there is so little that can go wrong and the results
are very predictable--thus the trip to Tampa can be for only one or two
days. Dr Norman will communicate directly with your doctors to assure
you get the best treatment available (they will get a copy of the
operative report and pathology report--and a letter from Dr. Norman). The best part, of course is that minimal parathyroid surgery
performed by Dr Norman has the highest cure rate of all parathyroid
operations (see medical
publications page for details), the risk of complications is
significantly lower, the incision is dramatically smaller, and
postoperative pain is significantly less. Our records show that over
98% of patients who come from other states for mini-parathyroid surgery by
Dr Norman are cured of their disease without any complications. (click
here to see our recently published data regarding differences in cure
rates according to surgeon experience).
Setting Up an Out of Town or
Out of State Visit at the
Norman Endocrine Surgery Clinic.
Dr. Norman operates out of "The Norman Endocrine Surgery Clinic".
He is no longer affiliated with the University of South Florida, but still
works with some of their great nuclear medicine doctors and operates at
Tampa General Hospital.
We encourage you to communicate with us at the Norman Endocrine Surgery Clinic
regarding the possibility of coming to Tampa for parathyroid surgery, or
having Dr Norman consult with you about your parathyroid disease prior to
surgery somewhere else. This is how you can contact us:
- Email Dr Norman's nurse Kelly Aronson, RN. Include your name,
age, phone number and email in addition to a short summary of your
parathyroid problem. Kelly will contact you directly via phone or
email within 48 hours. Kelly's Email is: kelly@parathyroid.com
Parathyroid surgery at the Norman
Parathyroid surgery clinic.
- Fax a short history of your problem to the office. Make sure
you include your email and/or phone number. Office Fax: 813.972.0077
Parathyroid surgery at the Norman Parathyroid
surgery clinic.
- Call Kelly on the phone. Our office hours for new
patients are 10:00 am to 2:00 pm EST Monday through Friday.
During all other hours you can leave a message and Kelly will return
your call ASAP.
Office Phone Number: 813.972.0000
Office Fax Number: 813.972.0077
Address for sending items via Federal Express / UPS / US
Mail:
Norman Endocrine Surgery Clinic
3238 Cove Bend Drive
Tampa, Florida 33613
What We Need to Accomplish
Prior to Your
Minimal Parathyroid Surgery
-
Remember, a Minimally Invasive Radioguided Parathyroid
operation (MIRP) can be performed if a sestamibi scan shows that you have a
single bad parathyroid gland...but Dr Norman can perform radioguided
mini-surgery on ALL parathyroid patients!!! DO NOT let your Sestamibi
scan results determine if you should have surgery or not... Find the
best surgeon you can... and get it taken care of.
If you already have this scan then let
us know. If you haven't had a scan yet, talk to your physician and
have him/her call us if there are any questions. We will be quite
happy to discuss your case with your doctors so have them call if you
like. Remember, if your scan is NOT positive YOU CAN STILL HAVE MINIMAL
PARATHYROID SURGERY !!! Most patients elect to have a scan performed
in their home city prior to coming to Florida, but some decide that
they want Dr Norman to operate on them regardless of the scan results
so they get their first Sestamibi scan in Tampa the morning of the
operation.
-
E-mail or call Kelly--she will will be
with you through every part this process. Kelly will put together a patient profile for you which
includes all the information listed below, including a patient check list and disease profile for you.
Kelly will also be able to coordinate the
entire visit once things have progressed to that point.
Parathyroid surgery at the Norman
Parathyroid surgery clinic.
-
Once all of your clinical information is put together,
Kelly and Dr Norman will go over your case in detail and one or both
of them will call you on the phone to discuss your parathyroid problem
and what we think the best options are. Parathyroid surgery at the Norman
Parathyroid surgery clinic.
What we need from you.
In order for us to determine
the best parathyroid operation for you and if you are a candidate for a
MIRP mini-parathyroid operation (or a Modified standard operation using
radioguided surgery techniques), then we need
you to send us a number of items. This shouldn't be too hard and
usually can be done by you over the phone. Most of this CAN NOT legally be
done by us.
-
Send us a copy of your parathyroid
sestamibi scan. We will review it and determine if it
is of high enough quality to make a decision about proceeding with
minimal parathyroid surgery (the vast majority are). To do this, go to
the hospital or clinic where you had the scan, and request that it be
sent to us. Its that simple. Use the address above for mailing or
FedEx / UPS of your x-rays. If you haven't had a scan yet, ask your doctor to get
one or have him/her call us so we can discuss it with them.
-
Send us a copy of all
your lab work. Specifically we want to see what your
calcium level is currently and what it was in the recent past (and
distant past if available). The more calcium levels we have the
better! We also need to know what your parathyroid hormone is
currently and in the past, and again, the more we have the
better...(but we will settle for just two parathyroid hormone levels if they show what is
expected). Other labs will be helpful as well, so send them as
well...don't just send the calcium and parathyroid hormone levels. We want a
good, safe outcome, so we need to know all of your
important medical history. Also, if we have recent labs, we will
typically not need to have any labs done on you while you are here.
Parathyroid surgery at the Norman
Parathyroid surgery clinic.
-
Send us a copy of your
doctor's notes. The doctor (or doctors) which has been
working up your parathyroid problem will have "clinic notes"
about you where he/she has been noting the parathyroid problem and
other problems you may have as well. We want these notes. Simply
ask them to send them to us and they will do so. Use the fax or
mail addresses below. Again, its better to send us too much than to
send us only part of the picture. If you have multiple medical
problems, it will almost surely be necessary for us to discuss this
with your doctor(s).
Parathyroid surgery at the Norman
Parathyroid surgery clinic.
-
Write a brief clinical
history of yourself. Tell us your problems
in your own words and correlate them to what your doctor's have told
you and the results of your lab tests. Give us a picture of you're
overall health.
Parathyroid surgery at the Norman
Parathyroid surgery clinic. calcium problem.
-
Make a list of your
current medications. We need to know what medicines
you take, so make a list and get it to us. We need to know the dosages
and how often you take them.
Parathyroid disease and parathyroid
problems treated by parathyroid s
-
Insurance coverage
will also need to be addressed by Kelly to help make
the arrangements. This is usually easier than you may think but it
will be delayed until we know that you will be coming to Tampa for
your parathyroid operation.
Parathyroid disease and parathyroid
problems treated by parathyroid s
-
Pick a day for the
procedure and then make travel arrangements. Kelly will help you decide which day will be best for you
to come to Tampa and will book your operation at that time. You will
need to arrive in Tampa the afternoon prior,
and can leave the morning after, or sometimes, the evening of the
surgery. We have arrangements with several local
hotels where you can stay the night before. Usually
it is best if you get into town the afternoon prior to the operation
by 2:00 PM so you can have time to meet your anesthesiologist. If you
are not the first or second case of the day, then this is less of a
problem since you can meet everyone in the morning prior to the
operation. The case will be discussed with you in detail at these
times and your new x-rays (see number 8) will be discussed with you as
well.
Parathyroid disease and parathyroid
problems treated by pa
-
The morning of the
procedure you will get a high
resolution parathyroid sestamibi scan. We do a large amount of these scans so
we're better at it than anybody else in the world (we invented many of
the techniques used!). We'll even give you a copy of the scan you get
here so you can take it back to your doctors and prove it!. This scan will provide a good 3-dimensional view
of where your parathyroid tumor is. It also
makes the parathyroid tumor radioactive for a few hours so we can use our probe to
find the darn thing! This scan takes only about 20 minutes to
complete. You will have plenty of time to discuss your case and have any additional
questions answered before we go into the operating room.
Parathyroid disease and parathyroid
problems treated by
-
Staying in town after
the procedure. If you want to stay in a
hotel the night of the procedure, that is ok and is what most people
do (if they don't have family or friends in the central Florida
area).... Under optimum conditions,
you could stay in the Tampa / St. Petersburg / Orlando area for a few days and
soak up some sun. Important! As discussed in #7 above, Tampa
General Hospital has special deals with more than 8 local hotels
which are fairly close by and quite inexpensive. NOTE: More
information is on PARATHYROID.COM web site... CLICK
HERE to go to a list of Hotels that we use!
parathyroid surgery by expert parathyroid
surgeons.
-
Follow Up.
You will need to be seen after the operation, at about one week. We
will discuss this with your physician prior to the
procedure to make these arrangements. This visit is simple since there are
no stitches to remove and we have never had a problem with our very
small wounds. This visit almost never requires you to fly back to
Tampa--NOBODY does this!. The most important aspect of this time period is that someone
needs to be available to you to follow your calcium levels. Your
elevated calcium levels will drop after the operation and you will
need to take calcium pills for a few weeks (gradually decreasing
amounts). If you have symptoms of low calcium (tingling in the hands,
feet, or around the lips and nose) then you need to take some more
calcium...but we (or your doctor at home) need to know (this is a
problem in less than 10% of patients...cured by taking a few more
pills for a day or two). These follow-up arrangements need to be made
prior to your visit. Remember, a small quick operation is not any good
if we have problems...the number one goal is SAFETY...nothing else is
more important. Obviously, if we do 400 - 500 parathyroid
operations per year, we know what we are doing and we know how to make
this very safe and very effective.
Dr Norman is
recognized as one of the most experienced endocrine surgeons in the world,
and for the past decade has limited his surgical practice to parathyroid operations
(95-96 %) and thyroid operations (4-5 %). He now does parathyroid
operations EXCLUSIVELY. He does not perform any other type of
surgery. It is widely accepted that Dr Norman performs more parathyroid operations than any other surgeon,
about 1800 per year.
Dr Norman has held
several important academic positions, including Professor of Surgery and
Professor of Internal Medicine (with tenure) at the University of South
Florida. He also held the position of Director of Endocrine
Surgery at USF. Dr Norman recently left USF to open the Norman
Endocrine Surgery Clinic. He is a member of more than 20
prestigious medical societies, including the American Association for
Endocrine Surgeons, the American Association for Clinical Endocrinology, the Society of University Surgeons, the South-Eastern
Surgical Congress, the American College of Surgeons, the Association for
Academic Surgeons, the Society for Laparoendoscopic Surgeons, AOA medical
honor society,
and many more. Dr Norman has published more than 250 medical
journal articles as well as 12 books and/or book chapters. Most of
Dr. Norman's publications revolve around his extensive work with endocrine
disorders including
parathyroid glands, parathyroid surgery and pancreas disorders. A full
copy of Dr Norman's curriculum vitae (resume') is online in PDF format--Click
Here to view. (Note, this requires Adobe Acrobat
software to read)
Dr. Norman is a frequent
speaker on the topic of parathyroid surgery, giving talks around the US on
a frequent basis. He has been an invited speaker on the topic of
minimal parathyroid surgery at the American College of Surgeons Annual
Meeting each of the past 5 years (including October 2002). Dr
Norman holds 9 US and foreign patents (with another 5 patents pending),
including the patent for the technique of radioguided
parathyroidectomy. It is important to note that Dr Norman has made this
patent and the techniques of minimal parathyroid surgery available to all
surgeons, patients, hospitals, clinics and all healthcare providers.
He has NO financial interest whatsoever in this patent... it simply
recognizes his contributions to minimal parathyroid surgery. Dr
Norman has taught radioguided parathyroid surgery to surgeons
from around the world who have come to Moffitt Cancer Center in Tampa FL
to take Moffitt's renowned Radioguided Surgery Course.
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Return to Endocrine Disorders Home Page.
Return to Parathyroid Introduction.
Return to Minimally Invasive Parathyroidectomy.
How a MIRP is performed (written for
EndocrineWeb.com by Dr. Norman).
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