FINE NEEDLE BIOPSY OF MY THYROID

THIS IS A POST THAT I WROTE FOR MY OTHER BLOG JUSTME64. AT THE END I'VE INCLUDED LINK WHERE YOU CAN GO TO JUSTME64 TO READ ALL THE COMMENTS. IF YOU ARE PLANNING ON HAVING A BIOPSY DONE I WOULD HIGHLY RECOMMEND THAT YOU GO THERE AND READ THE COMMENTS. THERE ARE MANY POSITIVE EXPERIENCES AS WELL AS SOME NEGATIVE.

I've decided to describe what it felt like for me to have a needle biopsy done on my thyroid nodule. Before I had it done, I had looked to find out how much pain was involved and most sites downplayed how much it would hurt. I've come to understand that for some people it hurts a lot and for some people it barely hurts at all. So here is a narrative of MY experience.

I enter the darkened room, lit only by a recessed light shining down on the exam table. I am asked to sign a couple of forms. At that time I notice that my hand is a bit shaky. Remember, I've had this done before and I am aware of the pain involved. I'm told to lay down on the table and they comment that I've worn the perfect shirt, a v-neck. I joke and say that I wore it on purpose. They drape one of those paper "cloths" over my shirt leaving my neck exposed. There are two people in the room. The Ultrasound Technician and the Endocrinologist. The Ultrasound Technician gels up my neck and places the ultrasound thingy on the left side of my neck. She says she's just locating the nodule and having a look to see its size and placement. Then the Endocrinologist sprays something from an aerosol can onto my neck. Its cold and burns a bit but is not really painful. This is supposed to numb the skin of my neck by making it really cold. It helps for the first two or three pokes.

I don't look at the needle that she uses because I've been known to get a bit woozy from the thought of needles (I also pass out at the sight of my blood). The first time I had the needle biopsy done I was a bit worried that I would pass out just from the creepiness of having a needle stuck into my neck. I was not worried about that this time because I knew that focusing on the pain would divert all my attention away from the creepy factor.

I already know from the last time I had a biopsy that she wants me to slightly arch my neck so she can work more easily. The Ultrasound Technician places the ultrasound thing on my neck and the Endocrinologist pushes the needle in. As far as the surface of my skin, the pain feels like any other needle that would poke into you. I have never found the pain of needles that bad. She slowly works her way into the nodule, guided by the ultrasound. The first poke goes smoothly. She gets the needle into the nodule with ease. The pain is bearable. Its an inside pressure, an achy sort of feeling. If you've ever had a dentist inject Novocaine a little too fast you may know the kind of feeling. In order to get the sample she needs to move the needle in and out. She does this more slowly than last time, I assume because the last needle biopsy revealed that the samples were inadequate. On the surface of the skin, moving the needle in and out doesn't hurt at all, I only feel the touch of her fingers. Inside the pain is no different. The achy pressure is constant. She takes two more samples and the pain is at a similar level. My hopes are raised that this time will be different. I may walk out of here with the minimal pain she had described.

During the fourth sample the pain began to increase. She had explained to me that the neck has a lot of nerves in it and she may hit one. I'm sure this is true because the pain is in my teeth of my left jaw. Just like last time. She says that some people feel a pain in their ears. I can tell this is true since I can feel my ear too but it is definitely focused in my molars. That throbbing kind of pain. Each sample probably takes less than a minute so although the pain is quite high, I'm able to bear it. Once the needle is out the throbbing subsides but there is now a soreness that doesn't go away.

I ask how many samples she plans to take and she tells me only one more. Generally she takes three good samples for a biopsy. The focus is on the word good because last time she felt that the third sample was not good and she went in for a fourth. This time she had planned on five since the last biopsy came back "undiagnosable". Meaning she didn't get enough cells. I asked her how this had happened last time and she said that sometimes a nodule is very vascular and when the needle goes in it can hit a blood vessel and come back with only blood in it. Looking at a sample with the naked eye, you can not tell if it is good or not. The only way to guarantee that you are getting good samples, would be to do it in the hospital with a pathologist standing by with a microscope.

The fifth sample she takes from a difficult angle and seems to poke around quite a bit before the Ultrasound Technician says she's into the nodule. With the needle in my neck my teeth are throbbing once more and ironically I think I am gritting my teeth waiting for it to be over. After they are done, I'm glad that the Ultrasound Technician is taking a few moments wiping my neck and opening a band aid to put on the tiny holes. I am afraid that if I get up to soon, I may get dizzy.

I am only in the room about 15 minutes altogether. As I said before, I would guess that each sample takes less than a minute. Setting up and cleaning up only take a few minutes. There's a couple minutes in between each sample in order to prepare it to be sent out for analysis.

I'm now ready to leave. My teeth are still quite sore and I take three ibuprofen (Advil) while I wait to check out. It hurts to swallow. My neck is sore. It feels like I slept on it wrong and I have a stiff neck. I feel like I want to wrap it up in warmth. I have brought my hooded sweatshirt on purpose even though the day is pretty warm. I put it on and pull it up close to my neck. Once I start driving home I realize that the skin is also sore, probably from the spray. I want to get the band aid off because the skin on the neck is delicate and its pulling and pinching. I yank it off. I'm one of those people who believe in one quick pull when it comes to band aids! It takes about an hour for the ibuprofen to calm down my teeth and make the neck feel a bit better. It doesn't help the pain with swallowing so I plan on a light supper. The pain after the procedure is bearable. My home is 45 minutes away but I have no trouble driving myself. I was able to stop at the store on the way home to pick up a couple of things. However, I mostly felt that I just wanted to get home and lie in bed and watch TV. Before my first biopsy the doctor had told me that there would be some pain but not very much. This had made me think that I could attend my kids cross country running meet directly after the biopsy. This turned out to be a mistake that I obviously remedied this time around. I knew that I would need time just to lay down and let things calm down. This was an even more fortunate choice since I began to get a stress induced migraine after stopping at the store.

I came home and took migraine medicine and laid down. After about an hour, I got up and looked at my neck. The skin was red and I could see tiny little spots where the needle had gone in. It was also a bit swollen with a visible lump. The morning after, my teeth felt fine but there was still a little stiffness in my neck and swallowing was still hard.

Now I wait for the results. I had the test done Tuesday and she said if I don't hear from her by Monday to give her a call. From what I've read it is quite common to have trouble getting enough cells to diagnose the nodule so I am hoping she got enough this time. She felt that there was a 98% chance that she would get a good sample this time. I also understand that there are a significant number of biopsies where they can not tell if its benign or cancerous (even though they get enough cells). Also, if I remember right, its not out of the question to come back as a false positive. Showing that its cancer but upon removal finding out it was actually benign. In researching this I was quite surprised to find out there are so many things that can go wrong with these thyroid nodule biopsy results. I am in a low risk category so I am not wringing my hands in anticipation of bad news. I just hope that they can read the sample and I can be done with these needle biopsies!

Overall the amount of pain would not be a deal breaker. I still feel that a needle biopsy is a relatively easy procedure to undergo but I think that they purposely downplay the amount of pain. It can hurt quite a bit. I am not trying to scare anyone away from having one done. If I had only needed to have three samples taken the pain would have been minimal. I think that people should be aware of the possible pain and brace themselves for it but not let it influence them in their decision to have a needle biopsy. The information that they get from a biopsy is invaluable. Its great that they don't have to put you to sleep and cut you open.

THIS IS THE LINK TO BE ABLE TO VIEW ALL THE ORIGINAL COMMENTS:

http://justme64.blogspot.com/2007/05/needle-biopsy-of-my-thyroid-nodule.html

I AM NOT ALLOWING COMMENTS TO BE MADE HERE, PLEASE COMMENT AT THE OTHER BLOG BY CLICKING ON THE LINK ABOVE - IT GETS TOO CONFUSING TO HAVE COMMENTS AT BOTH PLACES!!