Information for GPs

Results needed for consultation

Thyroid nodules:

• Biopsy for nodules over 1cm
• Thyroid ultrasound
• Thyroid function tests
• Calcium and corrected levels

Graves’s disease:

• Thyroid function tests
• Thyroid ultrasound or Nuclear Medicine Scan

Hyperparathyroidism:

• Sestamibi scan
• Parathyroid hormone levels
• Calcium and corrected calcium levels
• Albumin levels
• Vitamin D level blood test

Adrenal:

• CT scan
• 24 hour urinary Catecholamines, Metanephrines and 24 hour urinary Free Cortisol
• Serum aldosterone/Renin ration test
• DHEAS
• Serum Electrolytes

Post Operative care and medication reduction…

Wound dressing – Patients are asked to leave their wound dressing on for about 2 weeks. If this is removed or falls off please advise patients to replace it using ‘Micropore’ tape. This needs to be changed every 2-3 days.

Infection – If patient presents with any signs of infection please arrange review with myself and consider the need for antibiotics.

Hematoma – If patient presents with a hematoma please arrange an urgent review with myself or refer patient to the closest Emergency Department.

Post operative blood work – Patients are asked to visit their GP on a weekly basis after thyroid and parathyroid surgery to monitor their calcium and thyroid function levels.

If your patient has been discharged on just Caltrate tablets:

• On discharge they will normally be on 2 Caltrate twice a day
• If calcium is normal at one week reduce to 1 Caltrate twice a day
• If calcium is normal the next week reduce to 1 Caltrate daily
• If calcium is normal the next week cease Caltrate

If your patient has been discharged on just Caltrate & Rocaltrol:

• On discharge they will normally be on 2 Caltrate + 2 Rocaltrol twice a day
• If calcium is normal at one week reduce to 1 Caltrate twice a daily + 1 Rocaltrol twice a day
• If calcium is normal the next week reduce to 1 Caltrate daily + 1 Rocaltrol daily
• If calcium is normal the next week reduce to 1 Caltrate daily
• If calcium is normal the next week reduce Cease Caltrate