thyroid nodule, pregnant, fna scheduled

Hi Dr-
I am currently 17 weeks pregnant, on Synthroid 75 mcg for postpartum Thyroidosis from my 1st pregnancy. My new endo said I have a nodule (about 1.5cm) I had ultrasound which showed nothing at all, and radiologist felt nothing either. I am seeing top notch FNA person to get FNA done and I am terrified of the procedure. The dr uses ice to numb, not local anesthetic. Can you let me know what to expect and if this sounds like the right course of action? In addition, what do you think of the fact that the ultrasound was clear? I guess I need FNA done, but for some reason the needles going into my neck is stressing me out big time!

[Mark Lupo, M.D.]

Ultrasound should have shown a nodule if one is present.  Often in thyroiditis there can be some swelling and inflammation of the thyroid that can seems like a nodule.  Even if there is a nodule and the FNA is suspicious, surgery should be postponed until after delivery.  The FNA should be done under ultrasound guidance - if ultrasound shows a nodule -- I use local anesthesia, not ice - but ice should provide some numbing.