Josefina Farra, MD, FACS

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Parathyroid glands….Tiny but they pack a punch! Recently I’ve seen many patients with significantly high calcium from h...
02/16/2023

Parathyroid glands….Tiny but they pack a punch!

Recently I’ve seen many patients with significantly high calcium from hyperparathyroidism so I thought I’d share a little on primary hyperparathyroidism!

Did you know that the parathyroid glands are one of the smallest organs in the body. However, when enlarged and non functioning properly they can cause osteoporosis, kidney stones, impaired kidney function amongst other symptoms!!!

Each parathyroid gland is normally about the size of a grain of rice (about 3-5 millimeters in diameter and 30 - 60 milligrams in weight). Although the thyroid and parathyroid glands are physically near each other and are both part of your body's endocrine system, their functions are unrelated.

Primary hyperparathyroidism (PHPT) is a condition in which one (or more) of your parathyroid glands produces too much parathyroid hormone and releases it in the bloodstream, often leading to high calcium levels.  

The primary treatment for primary hyperparathyroidism is surgery to remove the enlarged parathyroid gland.

The second and third pictures both are examples of hyperfunctioning parathyroid glands. They can be mildly enlarged or very enlarged and still cause high levels of calcium and PTH and symptoms for the patient.

Who would have thought an organ that small could cause so many problems!

Happy Wednesday! This morning a happy post op patient of mine asked to take a photo together before she went home after ...
02/08/2023

Happy Wednesday! This morning a happy post op patient of mine asked to take a photo together before she went home after her total thyroidectomy yesterday. As you can see she is happy and feeling great the morning after surgery.

She is able to eat, speak, and move her neck completely normal immediately after surgery. She has only a small incision which is covered by sterri strips. Once I remove them in my office the she will have a very thin barely visible scar which will fade with time.

Thank you for brightening my morning with your beautiful smile!
(Posted with permission)

Happy National Woman Physicians Day! Surrounded by amazing female physicians and trainees and happy to be able to contin...
02/03/2023

Happy National Woman Physicians Day!

Surrounded by amazing female physicians and trainees and happy to be able to continue on the path that was started by Elizabeth Blackwell!

This day marks the birthday of Dr. Elizabeth Blackwell, the first woman to receive a medical degree in the United States in 1849. Dr. Blackwell initiated the movement that helped women gain entry and equality in the field of medicine.

“If society will not admit of a woman’s free development, then society must be remodeled.”~ Dr. Elizabeth Blackwell

We wear pink in October so of course the newest accessory of the season—the mask— needed a pink update!! Early detection...
10/09/2020

We wear pink in October so of course the newest accessory of the season—the mask— needed a pink update!! Early detection is key so remember to get your mammograms!! And just because it’s October and we focus on breast cancer, let’s not forget about thyroid cancer! Check your neck!!



Lifelong learning is a cornerstone in the field of medicine and teaching the next generation of physicians is one of our...
10/03/2020

Lifelong learning is a cornerstone in the field of medicine and teaching the next generation of physicians is one of our important missions. I feel it is an honor to teach and one of the reasons I am faculty at the University of Miami.

Here I am teaching my resident and medical student about surgeon performed ultrasound. It is a pleasure to teach when they are eager and interested, like and

I perform an ultrasound on ever patient I see. When the surgeon performs the ultrasound, one can identify specific and critical information that would not otherwise be available for optimizing surgical approach. This is an important skill set which takes experience to perfect.

Thyroid Thursday!! Today I had a full day of thyroid cases and, as an added bonus, with an all female team! Now let’s le...
10/01/2020

Thyroid Thursday!! Today I had a full day of thyroid cases and, as an added bonus, with an all female team!

Now let’s learn a little bit about the thyroid gland.... swipe left for some thyroid pictures (warning the final picture is the real deal!)

The thyroid is a butterfly-shaped gland that sits low on the front of the neck. Your thyroid lies below your Adam’s apple, along the front of the windpipe. The thyroid secretes several hormones, collectively called thyroid hormones. The main hormone is thyroxine, also called T4. Thyroid hormones act throughout the body, influencing metabolism, growth and development, and body temperature.

The thyroid comes in all shapes and sizes and there are many reasons why someone may need to have surgery on their thyroid.

* Goiter: A general term for thyroid swelling. Goiters can be harmless, or can represent iodine deficiency or a condition associated with thyroid inflammation. When very large, patients may experience symptoms of compression on the trachea or esophagus which may be an indication for surgery.
* Thyroiditis: Inflammation of the thyroid, usually from a viral infection or autoimmune condition. Thyroiditis can be painful, or have no symptoms at all.
* Hyperthyroidism: Excessive thyroid hormone production. Hyperthyroidism is most often caused by Graves disease or an overactive thyroid nodule.
* Hypothyroidism: Low production of thyroid hormone. Thyroid damage caused by autoimmune disease is the most common cause of hypothyroidism.
* Graves disease: An autoimmune condition in which the thyroid is overstimulated, causing hyperthyroidism.
* Thyroid cancer: The most common endocrine cancer, thyroid cancer is usually curable. Surgery, radiation, and hormone treatments may be used to treat thyroid cancer.
* Thyroid nodule: A small abnormal mass or lump in the thyroid gland. Thyroid nodules are extremely common and can be present in 50-75% of patients. Only 10-15% of these are cancerous. They may secrete excess hormones, causing hyperthyroidism, or cause no problems. 

Thyroid cancer, the most common endocrine cancer, originates in thyroid nodules. The majority of these are papillary and...
10/01/2020

Thyroid cancer, the most common endocrine cancer, originates in thyroid nodules. The majority of these are papillary and follicular thyroid cancer which are very curable. In younger patients, less than 50 years of age, both papillary and follicular cancers have a more than 98% cure rate if treated appropriately. Thyroid cancer is typically treated with at least complete removal of the lobe of the thyroid gland that harbors cancer And sometimes complete removal of the thyroid gland. Only expert thyroid surgeons should perform thyroid surgery for nodules that may be cancers or patients with known thyroid malignancy.  Expert evaluation of patients with thyroid nodules and cancers combined with expert thyroid surgery provides patients with the best outcomes. 

Please visit this link for a patient profile video of a patient of mine with thyroid cancer. (Link also in bio)

https://news.umiamihealth.org/en/a-small-scar-a-big-smile-and-a-positive-outcome-after-thyroid-cancer-surgery/

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5555 Ponce De Leon Blvd
Coral Gables, FL
33146

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