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= Females with hypocalcemia secondary to status post total thyroidectomy and telehealth = Post-operative hypocalcemia is the most common postoperative complication after undergoing a thyroidectomy, with an overall prevalence of 7–51%. Normal blood calcium levels should range from 8.8 - 10.7 mg/dL. Blood calcium levels will begin to drop postoperatively. Damage to the parathyroid gland is a cause of hypocalcemia.

Risks of females with hypocalcemia
Hypocalcemia secondary to status post-thyroidectomy is more common in women than in men. In one research, 23 studies were conducted. Out of 23 studies, 11 included postoperative thyroid function in women. The results proved that the probability of postoperative hypocalcemia in female patients was significantly higher than in male patients (P < 0.00001, OR = 1.49, 95% CI 1.41, 1.58) Another study found an increased risk of hypocalcemia in women which may be due to anatomical differences between women and men, genetic variations in cell signaling pathways, or the effects of sex steroids on PTH secretion.

Interventions
Patients who have received a total thyroidectomy are at risk of hypocalcemia. Patients should have their blood serum monitored. For prophylactic purposes, patients will be placed on oral calcium and vitamin D supplements. Studies suggest this combination has a significant decrease in the risk of transitory hypocalcemia compared to calcium alone or no supplements. Calcium and vitamin d supplements should be taken after meals out at bedtime with a full glass of water. If a patient’s phosphorus levels are high, the doctor may order aluminum hydroxide to decrease phosphorus levels which would increase calcium levels. Patients are also encouraged to eat foods that are high in calcium such as yogurt, sardines, cheese, spinach, collard greens, tofu, rhubarb, and milk.

Telehealth
Telehealth, sometimes called telemedicine is one way of receiving care from a healthcare provider. Telehealth allows you to see your healthcare provider without an in-person office visit. COVID-19 has dramatically impacted patient outcomes and the advancement of telehealth. There has been a positive transition in telehealth medicine since the pandemic. It has the convenience of being able to be seen primarily online from anywhere with internet access on your computer, tablet, or smartphone and saves travel time. There are also some disadvantages of telehealth. Physical examinations are limited so diagnosis may not always be accurate or there could also be a potential delay or missed diagnosis. Patients that are not computer literate may have a hard time being able to use telehealth services and internet service is always required. Post-care can be monitored through telehealth after the patient has been treated and the hypocalcemia is well under control.

Conclusion
Hypocalcemia is a comparatively infrequent adverse effect of a total thyroidectomy. Middle-aged White women experience this challenge more often than the general population. A patient's fluctuating calcium levels are linked to an ICG score of 2 prior to surgery. Managing hypocalcemia is made simpler by in-person medical care. Inadequate physical care after a complete thyroidectomy could result in adverse side effects for the patient. Telehealth monitoring of post-care is possible after the patient has been treated and the hypocalcemia is entirely under control. COVID-19 has had a substantial impact on both the growth of telemedicine and patient outcomes. The pandemic has helped telemedicine develop richly. Utilizing comprehensive telemedicine can benefit and treat patients undergoing thyroid and parathyroid surgery. When dealing with hypocalcemia, patients feel more at ease talking with their medical team from home. When carried out by a qualified surgeon, thyroidectomy is a safe procedure with just minor complications. There is no association between age, gender, kind of surgery, and type of thyroid disease.

References