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FNA biopsy New results, scared...

roseagn74
Posts: 7
Joined: Dec 2005

Hi everyone! I am so glad to be here!I am in need of some quick help though...
I've had a "pain" in the neck, lol, which started back in June (or before I think) with a dull ache in the lower left thyroid area (if you were looking at me), that of course I ignored, until in October I had to be seen for a small fender bender car accident I was in. My ARNP decided to palpate my neck due to the complaint I had that the pain and hoarseness was still there while she was examining me. She thought it may be a nervous condition called globus... but I assured her it was not. She sent me for an ultrasound, and when my D.O. saw the results he (and the nurses at the office) went up in arms wanting me to go to oncology, but I have not yet been diagnosed so they wouldn't see me, which is reasonable. My D.O. set me up for a thyroid nuclear scan and uptake and referred me to endocrinologist, who did labs, and all of the testing came out fine, all within limits (although I have always been on the low side for TSH). Endo set me up for a FNA biopsy with ultrasound guidance in his office the next week, with ultrasound guidance. The nodule had grown by then from 1.2cm to 1.5cm. The U.S tech saw that the nodule looked as though there was something inside it. When the endocrinologist came in to look at the screen he made a joke about my nodule having a baby, lol.
The FNA came back indeterminate for follicular neoplasm with a possibility of it being adenoma. So, he wants TT due to it being indeterminate. I went to Moffitt Cancer Center 6 hours away to meet with a surgeon specialist who does TT with the robot. I want to do this laprascopic if possible, so I can heal faster. He said I am not a candidate at this time for surgery. He wants to wait 6 mos. and do another ultrasound with a possible FNA. I spent a total of 10 min, maybe with him after driving 6 hours and he says wait, 6 mos! So, before he leaves the room I ask him why I am experiencing pain (which got worse with FNA done over a month before this) and he says wait a minute, no one told him about pain, so he thinks I have thyroiditis and to take Aleeve every day for 6 weeks and let him know. I read in the consult letter he was going to allow other pathologists at Moffit look my biopsy slides over, but I haven't heard anything.

It's been well over 6 weeks, as the visit to Moffitt was before Thanksgiving, and I am still having the dull ache. It wakes me up at night sometimes. I can eat fine, it dosen't get worse, just the same. I can feel it every time I swallow, but it's not difficult to swallow. I am aware of this every day. I suffer from intermittent hoarseness. I know what sinus drainage feels like and this is not it. It is not globus. It is only to the left of my lower windpipe (if you were looking at me). I am extremely frustrated, as I do not have the time with my work schedule to call around for new Dr's who take BCBS of Florida. I am a uterine cancer survivor 2005, and have had to be on HRT since 2006, and had BSO (ovaries removed) in 2007, due to complications. I am fatigued to no end, I have night sweats from time to time, and trust me, my HRT levels are perfect. I wish someone could just tell me what to do. I know I need to have the TT, as I have the 1.5cm nodule in question on the lower pole right lobe and 4mm nodule in the left midlobe in order for them to do the proper pathology. Anyone willing to take this on?

Ultrasound read:
hypoechoic noncystic nodule with vascular character 1.2cm maximum dia. in the lower pole right lobe of my thyroid gland. There is also a 4mm vascular nodule hypoechoic focus centrally observed in the left lobe. The gland is otherwise homogeneous in echotexture and normal in vascularity and normal in size. Thyroid Peroxidase Antibodies <10 (ref. range <35 IU/mL) Thyroglobulin Antibodies <20 (ref. range <20 IU/mL) Thyroglobulin 9.8 (ref range 2.0-35.0 ng/mL)

Fine Needle Biopsy read:
Clinical Data: RIGHT THYROID NODULE DIAGNOSIS: FNA, RIGHT THYROID NODULE: MICROFOLLICULAR PREDOMINANT PATTERN WITH ABUNDANT COLLOID.
MICROSCOPIC DESCRIPTION: It appears mostly microfollicular with nuclear overriding.
Classification: Indeterminate.
Due to the predominance of the microfollicular pattern a follicular neoplasm cannot be totally excluded.

It has been very difficult to find people to talk to with our problem... I have posted to several forums, to no avail. I work for a family practice as a nurse for a D.O. I run at work every day so I never get to take a lunch much less think about me :0)
Thanks in advance...
Deb :0)

rzemach's picture
rzemach
Posts: 33
Joined: Oct 2009

Hi:
I am not a doctor or have a medical background like you. It does seem like you should get a second opinion though. If you are so stressed out about this and in pain it is worth the time and effort to speak with another surgeon and/or oncologist.

I have found that equal to my physical well being is my emotional well being. It is hard to keep a positive attitude when you are in pain and don't know what it is from. Maybe going to someone else can help you to understand your situation a bit better.

Robin

roseagn74
Posts: 7
Joined: Dec 2005

I went to work this morning, knowing I had to leave early to take my daughter to the ENT today for preop for tonsillectomy,andenoidectomy, and turbinate (sp?) reduction. My office refers to this particular ENT all the time since he is top notch. I have not heard anything negative about him. So, I phoned over to see if they could get me in to get established at the same time we had to pick up my daughter's paperwork to take to the surgery center. To my surprise they could! I knew I needed to get a second opinion about the follicular adenoma/neoplasm since it has been three months since going to Moffitt Cancer Center Endocrine Tumor Program. I brought all of my test results and he looked everything over. He asked how it all started last April... I said with pain (dull constant ache). He agreed with endogrinologist that the lobe should be removed. He spent quite a bit of time listening to me and noted the growth in the nodule when he palpated. He validated my pain by saying that it was a way to let me know my body was responding to something that should not be there. He has all records except my slides and films, which are at Moffitt, but I do not think he needs them since he has the reports. I simply asked him what would he suggest I do and he said it definately needed to come out and I agreed to let him be my surgeon. I asked him how he planned to do the surgery and he told me he does the traditional cut. He explained that way may be best so he could place a drain to control a possible hematoma since I have developed them after every surgery so far. He walked me to the surgery scheduler's office and chatted with her while I waited and she asked me to come in and told me he wanted the first available date. I did not expect to be scheduled so quickly, I guess, since I just went in for a second opinion and to discuss my case. At first I kinda freaked that there was an opening on the 26th (my anniversary) so I asked her if we might be able to PENCIL it in for the following month, because I needed to talk to my family and my job, and she did. We decided on March 2nd and that was the latest she wanted me to go out. I was able to sit and discuss all the details with my husband. He had a lot of questions of course and he said to go ahead with Feb. 26th. He dosen't want to wait. I called the Scheduler with him and she said that would be fine but she would be at my chosen hospital on the 16th (Feb.) with Dr. for surgeries that morning. They perform surgery at two hospitals in the area and he also works at a free standing surgery center where he is part owner. She told me he may be able to cancel his office visits, or clinic to be able to do it that afternoon. I was shocked that he would do that! I told her that I would wait until the 26th and she said the 16th would be fine and to give her 10 minutes so she could text him! Wow, I felt odd, lol. She called me back in five and told me he said it was a go and to be back there on Monday for preop at 1pm AND told me she was going to book me to see him, which is not heard of! He is cancelling his clinic for that afternoon! She said to gather all the questions and bring them in and he will patiently answer all of them. So! Surgery is set for Feb 16th 2010. I am comfortable with this as I am very tired of dealing with the achiness in my throas and the other symptoms. I am not ready for the healing time and the wait for pathology to come back, even though I KNOW God is performing miracles and all WILL come back fine! I have had to deal with surgical menopause and hate the idea of another hormone shift. However this has been going on since last April-May and this too shall pass, right?

sandykr's picture
sandykr
Posts: 57
Joined: Jan 2010

It is reassuring to see that somethings work the way they are supposed to! Feel good!

roseagn74
Posts: 7
Joined: Dec 2005

I will keep in touch on here soon! ;0)

BellsAngel69
Posts: 102
Joined: Dec 2009

everything went well with your surgery and you're healing fast. My thoughts and prayers are with you. Please let use know the outcome.

roseagn74
Posts: 7
Joined: Dec 2005

My pathology came back, however, they only did a FROZEN (sigh) section in the operating room, which means... dum dum dum dummmmmmm, INCONCLUSIVE, AGAIN!!! ...
Ok, ok, calm down I said to myself!... it does show Follicilar nodule with degenerative changes. Layman's terms; if it is not a full blown carcinoma, it would have been very soon. I heard and read it is so important NOT to do JUST frozen sections to look for any variant of follicular carcinoma. Well there is a papillary with a follicular variant but it is still papillary.
I went to get my labs drawn today, TSH, FreeT3, FreeT4,CBC,CMP,blah, blah,blah... then went to eat, gave drive by kisses to my hubby, then off to the Hosp. for records release paperwork then to the ENT. The ENT's clinical mgr. knows I am not too happy about the frozen section being the only path the hosp. did, so, I signed the release to have all my records, path reports, slides, specimens, tissue, and two remaining cassetts to MOFFITT Cancer Center, where I started with this whole mess last October.
I placed a call to the Endocrine Tumor Clinic where I am a patient and left a msg. for Dr Carter's nurse to please call me. I also got in touch with a nice RN at BCBS who is getting me a Case Manager to expedite appts. and Doctors and possible oncology/hematology clinics there at Moffitt. The Case mgr./RN for Dr. Carter called me this morning and said they would be happy to take all the items from here and go through them with a fine toothed comb. I broke down on her. Then after my appt, with ENT, the Case mgr. with BCBS of Fl., who also happens to be THE Liason for Moffitt and BCBS, got things under control and told me every step I need to take at this point in time. I am being referred back to Moffitt for; 2nd opinion on this pathology at the Endocrine Tumor Clinic. Dr Carter is there. I am being referred to hematology/oncology to do a thorough search for Non Hodgkin's as I have textbook symptoms, Dr Carter may take this on, I'm waiting for a call from his RN to let me know what he decides. Finally I am to meet with a genetic specialist for BRCA1, BRCA2,and other family cancer syndromes, so my little ones won't have to face these health problems as they arise but hit them head on as they see fit when they get older. So dear family, friends, acquaintances, and colleagues please remember my family in prayer. In Him, Deb

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