Second FNA requested??

[stella5349]

Hello all - been a while since I posted a thread so................ tests results on the parathyroid issue

Calcium serum    9.5               range 8.4-10.2                normal
ionized calcuim 1.26                range 1.17-1.31              normal
Vit D                37.5                greater than 30               normal
**PTH               25                  range 14-72                    normal
Phosphorus      3.5                  range 2.5-4.5                 normal

So we are back to square one - no hyperparathroid issue.

I get the call from the Endo I saw (he was the unhappy one on the Armour Thyroid issues) He has recommended another FNA (remember the frist one was unsuccessful due to the deep location. 7 tries to pull a sample with no success)  No further treatment can/will be done with him unless another try on the FNA.

What should I do guys??? I am sick to think I will have to undergo that kind of pain again. it is so deep no dumbing shot touches were it is. I asked to have a seditive IF this was my only option and he will not Rx me anything to use. In fact the nurse ( you was the only one I talked to) said I would have to go to my MD for a sedative.

What do you think?  

[DLA]

You can also post on the Diabetes II board.  It's another endo and she seems to know what she's talking about.  She takes a lot more questions than Dr. Lupo so it's a lot easier to get on there.

Sorry for all you're going through.  Think I would be finding new endo.  Do they do the FNA with u/s guidance?  Don't know why on earth you couldn't have something stronger for the pain.  That's just STUPIDITY!!  Lay them down and poke them that many times and see how they like not having the pain managed!  Grrrrrrrrrrrrrrrrrr

[stella5349]

I totally followed Dr Lupo this morning while he was posting to get my situation on there. Everything is answered but the board is still full -

[ChitChatNine]

You okay today?  You are up very early?  Esp. being on vacation ?  C~

[stella5349]

You know - I totally interviewed the staff at the hospitol before the FNA too. Everyone had such confidence in this radiologist - I felt I was in good hands. Again - I suppose my bad judgement.

I just can't believe this whole ordeal that started 6 years ago should be such a hassle. I am so tired of being looked at like I'm the problem. DOn't they see - If I had the choice I DON't want to come to their offices - I have too.

My head just want to forget this whole thing.

[TDCRose]

I had to have a 2nd FNA done also.  I have three nodules all about 2 cm and none can be felt-can't really feel the thyroid either that is way 7 other drs. told me my thyroid was not enlarged.  US proved them all wrong.  My nodules are also back side lower part of lobes.  First FNA Dr had me clinging to the ceiling with discomfort. 7 sticks not one good sample.  I went to a different hospital and had some zanac in me and had 8 sticks
all of which were good samples.  2nd dr. was wonderful-took about 10 minutes from start to finish for samples.  1st dr took like 1 1/2 hours to 7 sticks.  It's all in the dr.  Good luck!

[ChitChatNine]

Are there any known risks going in this deep vs. a procedure that is better tolerated for most in other areas?  I would ask this Doc that ? .............. and/or ask Dr. Lupo, too as he really seems excellent and well-versed on the other board.

C~

[Thypatient]

I’m glad you wrote.  I’ve been thinking about your well-being.  I know it’s frustrating but I’m glad you didn’t have any issues with your parathyroids.  At your (younger) age it would have been more likely something really scary was going on.

It seems to me, if it’s already known that something is present and it’s enough that you feel it (something stuck) then it should at least studied.  On the other hand, if a little time goes by it might help the area settle down from your last experience and the next try could go easier.

The medical system can be a real …, don’t feel alone.  Between my own issues, managing my mother’s care and my father’s end-of-life care, oh boy, it’s amazing what goes on.

From my experiences, I think it’s not out of line saying you’d have to get a sedative from your MD.  I’m pretty sure that’s SOP.

Best wishes.

[stella5349]

It's easy for us as patients to bo "logical" in our thoughts - but now find a surgeon to do that. I thought I was going that route when I went directly to the ENT surgeon after the nodule was found - but he was the one who ordered the first FNA - now I haven't talked to him since he got no results.

[amela321]

Hmm, well, the waiting for the recheck seems useless cause it's not like it's going to magically disappear, right?  As far as the FNA, I wonder why your doctor thinks they'd have any better luck the second time than they did the first time.  I'm with you and think they should just go in and remove it.  Do you have the type of insurance where you can schedule an appt. with a surgeon or do you have to be referred.  If you can just see a surgeon, maybe you should go that route and bring all of your results with you.  If there's absolutely no way anyone will remove it without an FNA, I agree with the others that you should not agree to that unless someone gives you some kind of sedative you can take while you're getting the test.  

[stella5349]

I suppose right now I will wait until my appointment with my MD on April 10th . He was the one you didn't want to worry about it right away anyway.

amela321 - very short and easy story -- I had real stupid doctors in my past - no decent follows ups and had to switch doctors often - b/c I never got any answers on why I felt so bad. Found this new MD in Oct 2007 and he has helped medication wise. I constantly suffered this feeling of having something stuck in my thought - since the RAI in 2004. We'll a few members here suggested I get a US on the thyroid - Never had I know this was an ability to have let alone should be done yearly after RAI. I called my MD and asked to have one done - BAM there was the nodule. It is a 1cc solid hypoech and FNA was strongly recommended. The position of the nodule is listed above - so it makes it difficult to biopsy. I have two definate options and one more I'd like happen

1. Listen to the MD and hold off for another recheck
2  HAve another FNA in 4 weeks
3  (this is what I want) just bypass the whole FNA thing and go right for removal.

Unfortunately I am not winning on what I want here on #3

[kipland]

Oh boy, Stella.  I'm so sorry that you have to deal with all of this while trying to find out what's going on with your body!

If I were you, I'd probably have the FNA done again.  But like we talked before, I would make darned sure that you have something to take the edge off.  Will your MD do that for you?  

I also liked Kelli's suggestion to talk to the radiologist that did it the first time to see what his thoughts are.  I know from the comment that he made to you, that he didn't think you should have it done in the first place.  I'd be curious to see what his reaction would be to this?

Know that we're here for you!!!

[amela321]

I'm so sorry for all that you're going through.  I tried to look through your posts to find out how you originally found the node, but you've posted so many times, I couldn't find it, lol.  Anyway, if you don't mind me asking, what is your history?  Have you had your thyroid out?  If you just want to point me to a post where you gave this info, I'd like to read it over so I know what's gone on with you.  I did see the post where you had the first FNA and it sounded awful.

I am a person who is not of the "watch and wait" school, so I know I would do the second FNA.  However, I'm not the one who went through the first one that you did.  Mine was very uncomfortable, but luckily they got it on the second try.  Unfortunately, it came back positive for recurrent papillary thyroid cancer.

I feel like I can't really give an opinion on what you should do without knowing your history, but I just wanted to offer my support.  I've had some difficult dealings with the medical community myself, so I can certainly empathize with what you're going through.

[ChitChatNine]

I am not sure; maybe I'd go and see what a different radiologist has to say and/or demand to be seen by the Chief of Radiology that day and have tons of meds in you already or laughing gas as suggested above ????  

My gut would tell me to give it another try and say [ stop ] if the going is rough again .. and even before 7 attempts.

I feel so bad for you .. BUT I see the cat is back in you ... growl ... growl @ 'em all!!!!

C~

[AR-10]

I like your cat. :^)

[AR-10]

I don't have any good advice for you, Stella, but you have my prayers.

[KelDC]

They gave me a Valium before my FNA - it is standard procedure here.  They should have NO problem giving you a sedative.  Especially with what you went through the first time.  

Will you see the same radiologist to do it? Can he tell them that he cannot get a sample? Does that help?

When they did mine they did 3 nodules.  Cell samples from all, and tissue samples from only 2 - the radiologist said he would not even attempt to take tissue from the 3rd one based on its location.

I'm sorry for the tough time you are having, and I wish I had more knowledge to offer.  I'm sending good karma your way!

[898]

They suppose to use special tilt away table which can allow the patients' neck to be fully extended and head firmly supported, or, at least, they should place the hard pillow under your neck.
The laughing gas N2O can be used as seductive.

[stella5349]

Gee -------after the horrific FNA March 3--- I think my MD thinks I am nuts. I have an appt April 10th to go to him for a follow up on my new dosage of thyroid meds.  I suppose I'll know then if he will do that.

I do find this endo pretty "matter of fact" and slightly obnoxious. He is very well thought of and is referred often. I have only seen him once and he was very curt and not very friendly at all.  NOR COMPASSIONATE to anything that happened with the first FNA.

I feel the medical community is looking at me like a wimp - but come on - SEVEN ATTEMPTS with no sample - if anyone here has had a nodule the is NOT visable and located in the back lower( and I mean way LOWER) left  lobe that is only1cc. I pray they have a better senerio to share than I have.

Literally I felt the radiologist knuckles pressing on my throat digging that needle into the area of this nodule. That is how deep it was. I was bruised for a week from my adam's apple to my lower left collar bone after that attempt. - I thought it was going to look like a hickey -

yeah right - if that was a hickey .......... I had to have gotten it from a big mouth bass.

I usually am very strong and can take alot. but todays conversation literally left me  to the point I was going to throw up when the nurse called and said I needed to do another one. I just can't put my mind there yet.

Should I just give up? and go on the we'll see approach??

What anyone's thoughts... I really need my buddies on their input here.

[ChitChatNine]

I asked about taking Ativan ahead of time and it was ok ..although I didn't take it .. stay away from NSAID's (Motrin) and of the like, though, as they cause bleeding ....

I can just imagine how you feel about all this right now ...

What prompted him to call .. the bloodwork, Stella?  I thought he wrote you off bcz of the Armour?

Geez, tough decision .... thoughts are with you!

[worriedinmd]

I can't believe the endo is being so obnoxious, though. Perhaps you can negotiate ... he can do another FNA on you IF you get to do one on him first ;-)

But seriously, a sedative sounds like the way to go. Will your MD prescribe one for you?

- Viv