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Old 09-02-2008, 03:13 PM   #1
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FNA-Hell -Just me or others too??

I just thought I would post my fna experience, it was about 2 months ago now. But, because I didn't feel adequately prepared on reading various comments here, I wanted to let others know what can happen.
I had a good, sensitive, and very experienced radiologist do the thyroid fna. He did 6 needles, each needle taking 20 tissue samples. Do the math and each needle went in 6 times then when in, pokes around to different places and you get 120 painful moments. It hurt like hell. And, I have a high tolerance for pain-that is what docs usually say when they give me shots and I don't wince at all -for hand surgery I had numerous(maybe up to 10) shots in the hand. The doc said many men would be just about in tears and I just sailed through it.
During the fna the doctor said are you ok? He was kind and said , could I go on. I just wanted him to get what he needed and said do what you need to do.
The nodule was 3 cm. Results benign, but saw an oncologist and due to the fact that I have besides the 3cm nodule -7 others. He says it is up to me--he cannot positively say just because of benign biopsy that there isn't cancer there. He says it is up to me. I am going to go with TT in a few months.
Others with smaller nodules may have less poking.
For me the fna experience was hideous. I don't know what I would do if I had to go through this again.That also figures into my decision , I cannot emotionally keep having u/s and biopsies--I need closure.
Subsequently I spoke with a woman who said she was in so much pain, she said just stop NOW.
I know others here do not have such an experience. But, to help others who may have to go through an FNA , it may not be easy street.
I hope that for anyone who has to go through this procedure that your experience is much better than mine but I just wanted to share so people can be ready "psychologically" if this situation happens for them. I just tried to concentrate on breathing deeply and just tried to zone out.
Also wondered if anyone else had such an intensely painful experience?

 
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Old 09-02-2008, 03:23 PM   #2
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Re: FNA-Hell -Just me or others too??

Sorry your experience was so terrible. Maybe the guy was experienced, but it doesn't sound right that you and the other person had such pain. I didn't even have pain from the surgery!

I wonder why you needed so many sticks? Was it hard to access---in a strange place? Mine was right in front and easy to get, maybe that was the difference?

I had one nodule biopsied by the ENT, I sat in the chair, no pain shot,the doctor did three or four draws to get the samples (no ultrasound).......and got enough cells for diagnosis, I think it's terrible that you had such a bad experience---I was in the room when my endo did a quick one on my mom, it took about 2 minutes, with ultrasound, I think what you experienced was the exception, not the norm.

 
Old 09-02-2008, 05:06 PM   #3
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Re: FNA-Hell -Just me or others too??

I hope it was the exception.It was u/s guided and on the side of the thyroid . I wasn't told it was in a hard place to biopsy. But, as I say , a friend of mine had a similar experience and said just stop now. Her husband is a doc and she assured me she went to a very good radiologist at a univ. for the biopsy.

 
Old 09-02-2008, 05:35 PM   #4
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Re: FNA-Hell -Just me or others too??

Mine wasn't too bad. I was stuck 9 times in three nodules then a few times in the goiter (I hate that word!) The worst part for me was the creepiness factor. The area was numb, so there wasn't much pain. It was the feeling inside my neck of the needles moving around to get the right spot that gave me the creeps. Mine was also indeterminable. So, instead of having to do it again (since it has to come out anyway)...I'm having the TT this Friday. Once it's out, they can do as they please with it. Hopefully all will come back benign. The Endo said I could rebiopsy, but most likely would still be indeterminable. He also said there is a presence of hurthle cells---Hashimoto's disease---and multiple nodules, large goiter, so it would have to come out. My thyroid seems to work twice as hard to do what it should, barely. Needless to say, it's not working right. I'm nervous about the surgery, but can't wait to get on some thyroid meds and start to get back to normal. I just want it fixed. I know it will take a while to regulate the meds, but at least I'm on the right track. I'm tired of being so tired all the time! Wish me luck!
--Thanks

mmmcoffee

 
Old 09-02-2008, 07:48 PM   #5
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Re: FNA-Hell -Just me or others too??

Thanks so much Osteo. My philosophy is always expect the best but be prepared for the worst. My daughter is having a biospy next week. She figures with her wild long labors she should be able to cope with a 20-30 min procedure. I do know that some people have more pain receptors in certain areas than others.

How would you rate the pain from the biospy as opposed to the pain from a dental procedure or a absessed tooth? I had all five kids using lamaze breathing with no meds except for a local for the episotomy with my first child. Breathing worked perfect for me.

It doesn't for teeth, however. I can only take aspirin for pain & Drs don't want one to risk bleeding from that med. Also, the local lidocaine injections drop my b/p so hopefully I won't need one. Fam

 
Old 09-02-2008, 08:40 PM   #6
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Re: FNA-Hell -Just me or others too??

mmmcoffee-"cute screen name".Sure glad your biopsy went easier than mine. Well, our situations don't sound that different. I certainly do wish you a pain free and safe surgery. Come back for sure and let us know how surgery went and how you are doing. I have to go to bed soon and can't write much longer but--if you have time before surgery could you give a specific run down of your thyroid situation. I know you said you had hashi's and nodules--how many nodules and what sizes, also you said you have a goiter--what is the size of the goiter, are you having any breathing , swallowing issues. When they came back on the biopsy indeterminate did they say benign or did they say indeterminate?? Just trying to assess your situation with mine-where they are more or less now leaving the surgery decision up to me and while I want to close the book on the thyroid issues and fear of thyroid cancer--I am concerned about surgical complications.
Geez--none of this is easy and the biopsy was hell. I should add they did not give me a numbing shot prior to biopsy. I think the standard of care is not to numb with a shot because the numbing liquid can screw up the results of the biopsy???Anyone else read or heard this?

Last edited by osteoblast; 09-02-2008 at 08:40 PM.

 
Old 09-02-2008, 08:43 PM   #7
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Re: FNA-Hell -Just me or others too??

Fam-the biopsy compared to dental stuff was dental is nearly zero and on a scale of 10 with 10 worst, I think the biopsy was an 8 or so--real bad. But, with dental you get numbing shots, and as I said in a post above, I didn't get a numbing shot.So--there is the difference.
I hope it goes ok for your daughter. Best of luck to you both.

 
Old 09-02-2008, 08:57 PM   #8
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Re: FNA-Hell -Just me or others too??

Hey Osteo! Our biopsies sound similar (u/s guided, 6 passes, 15-20 sample pokes each pass) but the BIG difference is I was numbed. I don't know HOW I would have survived that w/o the numbing shots. Ironically, those shots didn't hurt too badly. But my entire neck and throat were SO sore afterwards; I couldn't bend my head back for nearly a week and every cough or sneeze during that time was torture. I had numerous growths (although they only biopsied the two biggest) that were to the side and down by my collar bone. Anyway, I'm SO sorry you didn't get numbed up for that.

Also, about the accuracy of FNA's: I don't know if numbing effects the accuracy or not, but it's an interesting question. In my case, it only showed cancer in one side and was "inconclusive" on the other. When they took it out, however, the ENTIRE THYROID was cancer. It didn't even stay in the tumors, it was just everywhere! The pathologist said he doesn't know how the other side didn't turn up as cancer during the FNA. He said there was hardly any normal thyroid tissue left. I wonder if anyone else has heard if the numbing shot brings down the accuracy or not?!?!
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Old 09-03-2008, 07:42 AM   #9
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Re: FNA-Hell -Just me or others too??

Osteo,

My Ent uses a lydocaine rub on the skin surface and a lydocaine shot if he has to go deep. The lydocaine should not interfere with the results. It is old school philosophy that numbing agents interfere with the biopsy. What was up with your MD? The reason you had so much pain was they didn't prep you at all! Dang girl! I would have ripped that MD a new one if they went digging about in my neck with out lydocaine. My mom and her sisters all got lydocaine with their biopsies. The worst is after the numbing agent wears off and you feel the inflammation and swelling of the procedure kick in... this pain can be eased by icing the throat down and drinking ice water (My ENTs recommendation). My ENT also recommended the use of ibuprofen 3-5 days post procedure to help with the swelling... but back to point is pain necessary to ensure the best results? NOT IN MY OPINION!

Here is the question of the day:
Who had a numbing agent to ease their FNA/thyroid biopsy?

I can not say from personal experience yet.. but my mom and 3 of 4 of her sisters did. That is four women for numb it or thumb it MD! I am so sorry that your FNA was such a royal pain in the neck.

MG
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Last edited by mkgbrook; 09-03-2008 at 07:47 AM.

 
Old 09-03-2008, 08:36 AM   #10
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Re: FNA-Hell -Just me or others too??

I had my biopsy in April at MD Anderson and had a numbing shot both in the deep nodule and in the lymph node they biopsied. The numbing shot hurt and stung a bit, but the actual biopsy did not. I watched it on the ultrasound. I didn't notice how many passes they made, but it was just two needles, one for each site. They had me put pressure on each site for a few minutes and gave me an ice pack when we were done. My neck was sore for a few weeks afterwards.

 
Old 09-03-2008, 09:14 AM   #11
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Re: FNA-Hell -Just me or others too??

I had 2 FNA's both different experiences. First one, US guided, very small nodule, 5-6mm no numbing agents, was told that hurts worse than procedure, didn't "hurt", but was a "little" bit uncomfortable. Swollen neck and tender for a week afterward. Took about 10-15 min? Second one, no numbing again, US guided, this radiologist poked and poked and digged around in there for at least 45 min. the whole time the assistant had the drape over me and was talking and talking and the ? required me to answer her over and over again, thought that was odd, but maybe distracted me a bit, because that one was more painful to me. Still, not horrible. NOT like an abscessed tooth.....ouch!! I am a hygienist, and I felt empathy for my patients always, but after I had a toothache...wow, you can't function or focus on anything but the pain. The FNA was not even close to that!!! It is uncomfortable, not too bad in MY experiences, obviously everyone is different, the radiologists are different,the nodule obviously is located in different places, etc. Even my 2 experiences varied greatly!! Sorry it was so painful for you!!! At least when you have the TT you are "sleeping". Good luck to you!!!
Lori

Maybe I was numbed for the 2nd one, but I doubt it, because it hurt more than the 1st one, but the assistant talked so much, maybe I did have it numbed and didn't know?

Last edited by Lori123; 09-03-2008 at 10:09 AM. Reason: add something

 
Old 09-03-2008, 09:23 AM   #12
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Re: FNA-Hell -Just me or others too??

Osteo--

I did have copies of all my labs and the ranges, but don't have them anymore. The goiter was 6x5 mm (according to the surgeons notes after feeling my neck). That's on my left side. On the right, there are 4 nodules that showed on the US. One must be infront or large or something, because the surgeon also could feel that one. When he squeezed my neck and was checking it, it actually hurt more than the FNA. I had the numbing for that. I have always looked 'very full' in the neck area. Not sure when all of this began, as I haven't seen a doctor in about 10 yrs...(just started going back in May)...insurance/cost issues. Yes, trouble swallowing, things get stuck sometimes. Constantly coughing or clearing my throat, exhausted beyond belief....which is really bad when I have 2 kids to run around with..soccer, school etc etc. Just can't lose that extra 10lbs no matter how hard I try--(I did lose 30lbs a few yrs ago). My mother also had part of her thyroid removed years ago. She had Grave's disease. Thanks for your thoughts and response. I'll be around on Thurs, but going in on Friday. I'll keep you posted. Thanks again :-)
---mmmcoffee

Last edited by mmmcoffee; 09-03-2008 at 09:25 AM. Reason: typo

 
Old 09-03-2008, 11:48 AM   #13
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Re: FNA-Hell -Just me or others too??

So sorry to hear of your awful experience. I had an FNA 6 years ago for a small nodule. I don't remember the size but it wasn't really large. Mine was u/s guided and there was no pain at all. There was an uncomfortable feeling of pressure and the needle moving around to get the samples but not really any pain. I did have numbing on my neck for the procedure. I expected it to be awful and scheduled it around 1 PM so I could leave work at lunch time and take the rest of the afternoon off. As it turned out, it was so simple that I returned to work for the whole afternoon. I always prepare for the very worst, I figure that way anything better than the worst will be a pleasant surprise. I can honestly say my FNA was a peice of cake.

 
Old 09-03-2008, 07:16 PM   #14
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Re: FNA-Hell -Just me or others too??

After being on the board over 2 years now I have noticed most people post about their FNA that was a good experience......the bad experiences come up time to time but I think people do not want to scare other people so they are not shared as often.......

I know of several bad experiences from FNAs, one that was a large hematoma in the throat afterwards.....you CAN have a bad experience and not everyone breezes through it. One person on here had a hypotensive episode from the pain and almost had to be admitted to the hospital afterwards. She says she would never have another one. Everyone is different and eveyone's pain threshold is different...some breeze through it some not.

I once had a female type biopsy that affected me like what you went through......I was depressed for weeks.....the Doctor was so cold and amazed when I claimed it hurt me so badly but it did....it still hurts when I think of it. I went into the procedure thinking it would be easy and was shocked at the pain.

I am glad you shared this because mainly it is good for your own healing to talk about this experience that was so traumatic for you....I can tell you are still amazed at how horrible it was.. I am sorry you experienced this. That is alot of needle sticking for a neck.......too much if you ask me. But sticking only one is not going to give you much information.

I would like to point out that you can monitor your nodules in a different way if you do not want to have a TT or anymore FNAs. I myself avoid the FNA at all costs since I have so many nodules and frankly they can miss the cancerous portion so???? I feel it is a painful experience that might miss the cancer anyway. But that is just my opinion.

I have 6 dominant nodules and more than 12 nodules total , probably more than that......I get an ultrasound every 6 months to a year........and an uptake scan to check for hot and cold nodules......if any of them look suspicious then I would have that nodule looked at..........so far so good.

I want to keep my thyroid......so I go for my labs, ultrasound and scan once a year.......I am on medication for suppression..........it works for me.....
Know you have some options and an FNA does not have to be part of your care....I am happy with my care.. It was recommended to me 2 years ago to have a TT......4 Endos later I still have my thyroid and am pretty sure now that I have Hashimoto's and that is the cause of my nodules......everyone was in such a hurry to take it out, I am glad now that I waited.

I know there are people on this board who did have cancer or do have cancer and they can probably tell you another side to it....and they are knowlegable....so listen to everyone's experience and it will help you make your decision....

The Best to you...

I hope this helps you .........Oleander

 
Old 09-03-2008, 08:25 PM   #15
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Re: FNA-Hell -Just me or others too??

Hi Osteo - I too am sorry your experience was so terrible. Let's see...........My FNA was u/s guided, back in March. They did numb me with lydocaine..............I had been warned by my endo & subsequently the radiologist that it was probably going to be difficult to get samples, as my nodules were calcified (yup - they had been there a long time - over 20 years and nope - until January 2008 no one had paid much attention to them). The first poke nearly took my breath away (and I too, have a high pain threshold). It didn't necessarily "hurt," although it sort of did, but it ***stunned*** me!!! I wasn't prepared for the ***force*** of the entry if you will. Turns out he was a very skilled doctor, and had to do that to pierce that calcified shell.

I went in for the u/s for one nodule - about 2.5cm. While I was laying on the table, the doctor said they discovered a second nodule, and could they have my permission to biopsy it as well? I said "of course," although I must admit, it was at that moment that I suspected I did, indeed, have cancer. Only one nodule came back cancer, so that was enough to go ahead with the TT. This is where my story closely parallels Desert Rose. Once they had me opened up, they discovered a large cancerous tumor that had broken out beyond the thyroid (5 foci on the thyroid), and also had gone into my lymph nodes (5 out of 15 lymph nodes cancer).

I have to echo Oleander though. By FAR the MOST painful procedure I've ever had done was a uterine biopsy in 2005. OMG!!!! No numbing of any kind - and excruciating pain!!! It makes me sick to my stomach to even think about it now! My FNA wasn't in the same ballpark, but as others have said, we're all different. I mainly wanted to share my experience with you because of my results/outcome. As it turns out there was so much more cancer than anyone knew, or any test revealed. The cancer even had wrapped itself around my right laryngeal nerve, so I have had swallowing/breathing/speaking complications. My voice is permanently altered, but at least they got the cancer OUT!!!

 
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