When tetany calls!

12/4/2014

I can remember the first time I experienced a tetany attack. It was the second day after my operation in 2001, post operatively during my recovery after total thyroidectomy surgery. I had no idea what was going on! I hadn't been warned this sort of thing could happen to me, I had been enjoying relaxing at the private hospital enjoying a wine with dinner. However on the day my life would change phenomenally, the morning started the same as any other. I had gone to the toilet around 10am, when all of a sudden a rushing sensation (you know the one!) started in both of my legs as I was sitting there. My feet then started arching under until only my big toes were left touching the floor. The muscle pain was excruciating as my hamstrings and calves stretched way out of their comfort zones! I hit the buzzer for the nurse! Her response "oh that's just your calcium, we've been wondering if that would happen to you"!! The look of disbelief on my face must have been evident to her, 'my calcium" I exclaimed. "I've never had a problem with calcium or bones in my life"! And with that the journey into the land of hypoparathyroidism began...

1 Comment

Sue Motley

13/4/2019 12:51:16 am

Wednesday 2/6/10 I was admitted into St Andrews War Memorial Hospital for a total Thyroidectomy and was discharged Saturday 5/6/10.
Before I left the hospital my ENT specialist, who was the surgeon for my
Thyroidectomy, rang my room and asked me to ask the nurse to do a blood test, he wanted a calcium
iodonised test, the test was done just before I was discharged, this was the first blood test I had had since my operation on 2/6/10.
While I was in hospital I was getting pins and needles in my hands and feet and numbness around my mouth and lips, and when I took the first bite of any food I experienced a severe pain in my jaw just below the ear on both sides, I assumed this was due to the operation so did not mention to the nursing
staff or doctor.
After arriving home I was feeling very tired and noticed my face was slightly drooping on the left side, in the early evening my eyesight became very blurred and my speech slurred, I mentioned this to my husband and we both decided it was due to being tired so I went to bed early, around 9pm.
I woke around 11pm with severe painful cramps in my hands and feet I tried to go back to sleep but was in too much pain, I got out of bed so I wouldn’t disturb my husband. I got a blanket and tried to sleep on the lounge but the pain in my hands and feet was becoming unbearable and I felt very ill, my
hands had started to claw and the cramps were now up the leg and arms and my whole body was aching, I felt very frightened and had the feeling that my body was being denied something but wasn’t sure what. I switched on my laptop and started to Google “thyroidectomy” and “complications” and the search engine brought up an article entitled “Nursing Interventions for
Potential Complications After Thyroidectomy”,
Hypoparathyroidism is another complication that may occur following thyroid surgery. Injury to the
parathyroid glands may result from excision of the gland(s) during surgery, devascularization of the
glands, or destruction from capsular hematoma. This complication manifests itself as hypocalcemia
and is usually transient. While the patient may be initially asymptomatic after surgery, symptoms
eventually occur 24 to 72 hours post-operatively (Litwack-Saleh, 1992). The patient may complain of
numbness and tingling of the hands, feet, and lips. If calcium levels are not restored, seizures and laryngeal stridor are imminent.

Figure 3: A positive Trousseau's Figure 4: A positive Chvostek's sign.

I came to this paragraph and pictures and realised what was wrong with me, I was frantic by then and felt like my body was shutting down, I can only liken it to an out of body experience, I felt like I was looking down on myself. I woke my husband and he rang the hospital, I explained my symptoms to
the nurse and she told me to come in to emergency straight away, my husband drove me in to St Andrews, I was seen by a Doctor , they took a blood sample and said my calcium levels had been dangerously low when I was discharged from the hospital and now it was critical, she said the blood test sat in the in tray unchecked and unfortunately they couldn’t bring my calcium levels up too quickly or it could damage my heart or cause heart failure, I was put on an intravenous Calcium drip.
Later that morning I was admitted back into hospital and then taken to Intensive Care so my heart could be monitored until my calcium levels where stable, I stayed in ICU for 4 nights until 9th June 2010 then went back to the ward for 2 more nights and was discharged 11th June 2010.
I was not given any literature on possible complications or signs to watch out for and feel that if I had have been made aware of classic symptoms to watch out for i.e. tingling and pins and needles in the hands and feet, pain in the jaw and numbness around the mouth and my blood test had have been
checked before I left hospital it would have saved my family and me a lot of pain and suffering. I also feel that the ongoing complications have been exacerbated because my calcium levels were allowed to drop so low.

16 July 2010, 6 weeks since my operation, my Parathyroid’s are still not working/ evident and my calcium levels are being maintained by massive amounts of calcium, 9 Caltrate tablets and 1 Cacitrol, per day,
I have blood tests every week, last week my calcium had dropped and my potassium was up so they are now worried about kidney problems so I am doing a 24hr urine test Sunday 18 July 2010. The high amount of calcium I am taking is causing problems with my stomach and bowels, I also now
have insomnia which I have never had before and have been prescribed sleeping pills.
30/7/10 PTH (Parathyroid Hormone) levels is still only 1 Calcium level 1.98, the doctor has emailed to adjust my medication, reduce Caltrate to 2 twice daily and increase Calcitrol to 2 twice daily.
That was my diary 9 years ago, during my time in ICU I heard my Surgeon and
Physic

Tom Revlic

Hypopara Australia is a not for profit charity ran exclusively by volunteers, who themselves are living with hypoparathyroidism. Our volunteers live all around Australia. We have long recognised the need to provide an information service to patients living in Australia with this rare endocrine condition. We welcome your questions and contributions via our facebook page!

When tetany calls!

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Tom Revlic

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