Day of Your Operation

Going for a scan

We do a lot of scans!

We perform nearly 4,000 sestamibi scans annually, nearly 25 times the number performed at any other hospital in the world. Of course we are better at it. Many of the techniques used for these scans were developed here by Dr Norman and his team back in the 1990’s (yes, he is that old!).

If you had a scan somewhere else, they probably did some scans on you, then sent you away for a while and then scanned you again later. We never do that—it wastes time and doesn’t accomplish anything. Some of you may have had one scan, and then moved to a different machine to do a different type of scan (a SPECT/CT). This is also unnecessary for 99.5% of folks and is what doctors do when they don’t do this very often. They are trying very hard to find the parathyroid tumor because they are not going to look at any other gland.

We have unquestionably the best scans in the world performed by the most experienced technicians in the world. About 90% of the scans done at other places are worthless, which is why we don’t want to see any scans you had before coming here.

No worries! No claustrophobia. 

Some of our patients are afraid that they will be uncomfortable during the scan or afraid that they will be claustrophobic. This won’t happen with our scans. We don’t put you inside of the big round doughnut like those other guys do. Trust us, this scan is so easy that you won’t believe that the rest of the world does it wrong.

Most people get 3 or 4 pictures taken, and it takes 5 minutes to take one picture. Thus, this scan will take 15 or 20 minutes in most people. If you had a failed operation previously and you are here for your second (or third, or fourth!) operation, you will most likely have 6 pictures taken and it takes about 40 minutes.

Your wheelchair transport team

When it is time to go for your scan, one member of our transport team will show up with a wheelchair and take you on ride to the nuclear medicine department. Once you are done, they will come pick you up and bring you back to pre-post area.

Please remember that we don’t care if your scan is “positive” or “negative”. If you had scans before, they were trying to find the tumor and everybody gets excited when it is positive and disappointed when it is negative. We have learned from doing tens of thousands of these operations that scans are way over-rated and far too much emphasis is put on scan results by nearly all doctors.

What does my scan show?

Patients often ask us “what does my scan show?” It’s funny question to us because the patients typically are hoping for a “positive” scan, and yet we couldn’t care less if the scan is positive. We really don’t care if the scan is positive or negative. You will get the same operation if the scan is positive or negative–it is no different. We often laugh, because often patients with a “negative” scan have the quickest, easiest operations!

We don’t really use the scan to find the tumor. Instead we use the scan to tell us lots of things about you that help us plan our surgical approach, things like: how big your thyroid is, if you have a goiter, if you have a goiter or big nodule on one side and not the other, if you have a small thyroid because you have been on thyroid hormone for many years, if your thyroid is higher or lower in the neck than usual, etc. We can learn a lot about you that helps us plan the operation from this scan. Read more about this in the very next section: Why Do I Get a Sestamibi Scan Today?

Looking on both sides of the neck

Remember, almost all of our patients will get the parathyroid glands on both sides of the neck looked at so we can make sure that you don’t have two or more bad glands (almost 30% of people with primary hyperparathyroidism will have more than one bad gland that is over-producing hormone).

Patients that have two parathyroid tumors typically have a negative scan or the scan shows just one. So please don’t ask if your scan showed two—it never does. Scans are not accurate to tell if you have more than one parathyroid tumor and that is why you are here with us!

About 1-2% of our patients do not get the parathyroid glands examined on both sides of the neck. The reason for doing this is almost always for your safety due to circumstances of anatomy, nerves, tumor age, tumor location, thyroid cancer, etc. Sometimes we are operating on people who have had previous parathyroid surgery (or two, or three, or four!) at some other hospital and often they will have several parathyroid glands removed already–so obviously we aren’t going to dissect and hunt for glands that have already been removed.

Bottom line
Many of the techniques for sestamibi scan were developed here with us. We’ve done more than 20 times the number of these scans of any other institution world wide and we can get a huge amount of information using the techniques that we do. We don’t care if it is positive or negative, so please don’t worry. It doesn’t matter–that is not why we get these scans.