Visit to the ENT Doctor and Subsequent Tests - Feb 15th '08 - Mar 18th '08

ENT VISIT
I was glad that I was going to get checked out by an ENT doctor. The discomfort felt more in the back of my throat, rather than a swallowing issue so I was anxious to see what she found. When I got to her office (on Feb 15th '08), I briefed her on what was happening and the discomfort I was feeling. Although the discomfort lessened a little bit since the endoscopy, it was still there and still worrying a bit. She felt my neck, looked up my nose, and used a flexible scope to look down my throat. Afterwards, she told me what she found. My sinuses were inflamed, my throat looked a little red, and my thyroid seemed enlarged. Any one of these things could have explained the discomfort I was having in my throat. I was a little relieved that I wasn't imagining the trouble with my throat and I was hoping that I had something that could easily be treated and I could move on. She gave me antibiotics to clear the inflammation in my sinuses (this was hopefully the cause of the inflammation in my throat), a sinus rinse, and ordered two radiology tests to check out my thyroid gland. In addition, she took my blood in her office to check on my thyroid hormone and function levels. I got a call the next day that my thyroid blood tests all came back normal, which I thought was a step in the right direction (evidently not). I read that most people who have thyroid nodules usually have normal function using the standard thyroid blood tests. You need to ask for specific thyroid hormones to be tested. I've asked Dr. B for these ever since my dad was diagnosed with Hashimoto's disease but they were never done.

After I left Dr. L's office, I called up Lenox Hill Radiology to schedule the following two tests: 1) an ultrasound to look at the size and shape of my thyroid in addition to any abnormal growths and 2) a thyroid 1-2-3 uptake exam to examine the function of my thyroid gland. The ultrasound was scheduled for Feb 25th and the uptake exam for Feb 26th. In the meantime before my tests, I did some reading on what the tests entailed and it didn't seem like anything too bad.

ULTRASOUND / THYROID UPTAKE SCAN AND RESULTS
I went in for the ultrasound on Feb 25th and it only took about a half hour to conduct. The technician placed the gel on my throat and swiped the wand back and forth over my thyroid gland. After the exam, I was told to take a radioactive iodine pill to be used as a tracer for the uptake exam which had to be administered 24 hours beforehand. The next day, I went in for the uptake exam which took about 20 minutes. I was placed on a table and there was a "MRI-like" machine placed on top of my throat taking scans at different angles. I wasn't allowed to move or swallow for minutes at a time in order to make sure that the scan wasn't compromised. After the test was over, I was told that I would have my results in a couple days.

I was reading all I could about thyroid testing, but I still was not really worried too much that there was anything seriously wrong. I started to get a little nervous once I got the initial results back from the ultrasound. My doctor called to tell me that they found three nodules (solid growths) on the right lobe of my thyroid gland (the thyroid gland looks like a butterfly with its wings open - with a right lobe and left lobe). She said that having multiple nodules was better news than having a single one. A single nodule can signify an abnormality, while multiple ones signify more of a functional problem in the thyroid that could be corrected with medication. For some reason, my body was attacking my gland. So, at least the news was somewhat encouraging. At this point, I was reading up on the Internet regarding the thyroid and thyroid nodules. Cancerous nodules are more common in women than men, hot and warm nodules are better than cold ones, multiple nodules were better than single nodules.

I was literally walking home from my uptake exam when I got a call from Dr. L regarding my ultrasound from the day before. She told me that even before the results came back from the uptake exam, it was recommended that I go in for a Fine Needle Aspiration. For this exam, the radiologist sticks an ultrasound guided needle into each of the dominant nodules to get a sample tissue to test. At this point, it seems as if we are further away from my throat problem being just "nothing" or something minor. I still didn't think that anything was severely wrong but I began to get a little more nervous with each test that was requested. I never got the results back from the uptake exam before the fine needle biopsy, which was a bit unnerving. I was thinking a few things: 1) they already ordered the biopsy so the uptake results were not relevant at the moment, 2) the uptake results confirmed that the nodules were suspicious and my doctor didn't want to make me nervous, or 3) they wouldn't be able to give me a confirmed diagnosis without the results from a biopsy so why call me up with information that would be speculation.

FINE NEEDLE ASPIRATION (FNA)
The FNA was scheduled for March 18th, almost three weeks after the ultrasound and the uptake exam. There wasn't anything I could do in the meantime except wait and read some more about thyroids and nodules. I was becoming a little bit of a mini-expert on the subject. Finally, the 18th came around and I took the day off from work to head to the radiologist's office once again. Although I knew that the FNA was a pretty minor test, it was a little unnerving knowing that needles were going to be stuck in an out of my neck. There was an ultrasound technician and pathologist in the room with the radiologist to make sure that the needles were going where they were supposed to and the radiologist gathered viable samples to be tested. Once again, I couldn't move or swallow once the needles were inserted, but this time it was only for about 10-20 seconds. It was a very weird sensation (the feeling of a very thin needle guided up and down your neck, while you are awake and laying perfectly still, and in the back of your throat). The entire exam only took about 10 minutes or so. The odds were still in my favor that the nodules were benign and everything would be OK. I read that over 90% of nodules are benign, so obviously that was what I was hoping for. There was nothing to do but wait for the results, which were supposed to be ready in about a day.