Thursday, December 16, 2004
A post-biopsy report....
Before I got started on the biopsy, I talked with the doc who would be performing it....he said it was far more likely that I had Hashimoto's thyroiditis than cancer. Hashimoto's is directly linked to Sjgoren's syndrome, and both ailments can exacerbate swelling in the thyroid and surrounding lymph nodes. I already knew all this from my research, but it's always good to hear it in person from a doctor.
When he got a good look at my neck with the ultrasound, he thought it was probably a very large lymph node (the swollen area is a few INCHES long) that is causing my hoarseness, cough and occasional trouble swallowing, rather than the thyroid nodule which is behind and slightly below it. He then told me I could opt not to do the biopsy at this point as long as I continued to monitor the nodule for any changes. I decided to proceed anyway, my reasoning being that if the lymph nodes got even more swollen, I might not be able to do a needle biopsy of the thryoid in the future if I needed to.
So they put lidocaine on the area to numb it and at my request gave me a bit more time to get numb than the average person (for some reason I don't get numb very fast). They used the smallest possible needle to get the sample but had considerable trouble getting around the lymph node. The pathologist was right there and took a peek and informed them that they didn't have enough cells for an accurate diagnosis, so they had to try again with a larger needle. I think a person without fibromyalgia would find this procedure painless or very nearly so, but I was moderately uncomfortable, especially when they used a larger needle. They were careful not to hurt me any more than necessary, though, and the doc said if the sample with the larger needle was still inadequate that he would not recommend trying again because they would have to resort to something more invasive and probably not worthwhile given the liklihood of this being cancerous is less than 10 percent. I agreed.
I really liked the doc's assistant....her hair was my favorite shade of violet black. We talked a bit about snowboarding, something I'd always wanted to try but couldn't due to being deaf in one ear (making me permanently off-balance). It was good to have the distraction (although I mostly listened rather than talked since they were working on my neck after all).
I decided to take off work tonight since they instructed me to do nothing strenuous for 24 hours. I took one of my emergency pain meds when I got home, not because I was in a huge amount of pain yet, but because I know from past experience that even a small trauma to my bod usually results in at least a brief fibromyalgia flareup unless I do something to prevent it. It worked well enough to let me take a 4 hour nap. Now it's a bit red on my neck due to irritation from adhesives, and the muscles on the left side of my neck are sore and twitchy, but I think if I behave myself tonight and ice this properly, I'll probably be back to normal tomorrow.
Oh, and the doc asked how my thyroid hormones had been lately. I told him how they were bouncing like a ping pong ball, first too low and then suddenly too high. He said Hashimoto's will do that in some people and that my endocrinologist could help me wtith that. Again, that's what I figured was going on, but it was a relief to hear it anyway.
So I will follow up with the endocrinologist when I can get in to see her. I figure if nothing else, this test can serve as a baseline in case something suddenly does change. And I of course will ask if there's anything I can or should do about these pesky lymph nodes.
Time for me to get some ice on my neck and maybe watch "A Christmas Carol" on DVD. I have the version with Alistair Sim, my favorite. I just love it when he gets the uncontrollable giggles at the end....
Pain level: 7
Fatigue level: 6
When he got a good look at my neck with the ultrasound, he thought it was probably a very large lymph node (the swollen area is a few INCHES long) that is causing my hoarseness, cough and occasional trouble swallowing, rather than the thyroid nodule which is behind and slightly below it. He then told me I could opt not to do the biopsy at this point as long as I continued to monitor the nodule for any changes. I decided to proceed anyway, my reasoning being that if the lymph nodes got even more swollen, I might not be able to do a needle biopsy of the thryoid in the future if I needed to.
So they put lidocaine on the area to numb it and at my request gave me a bit more time to get numb than the average person (for some reason I don't get numb very fast). They used the smallest possible needle to get the sample but had considerable trouble getting around the lymph node. The pathologist was right there and took a peek and informed them that they didn't have enough cells for an accurate diagnosis, so they had to try again with a larger needle. I think a person without fibromyalgia would find this procedure painless or very nearly so, but I was moderately uncomfortable, especially when they used a larger needle. They were careful not to hurt me any more than necessary, though, and the doc said if the sample with the larger needle was still inadequate that he would not recommend trying again because they would have to resort to something more invasive and probably not worthwhile given the liklihood of this being cancerous is less than 10 percent. I agreed.
I really liked the doc's assistant....her hair was my favorite shade of violet black. We talked a bit about snowboarding, something I'd always wanted to try but couldn't due to being deaf in one ear (making me permanently off-balance). It was good to have the distraction (although I mostly listened rather than talked since they were working on my neck after all).
I decided to take off work tonight since they instructed me to do nothing strenuous for 24 hours. I took one of my emergency pain meds when I got home, not because I was in a huge amount of pain yet, but because I know from past experience that even a small trauma to my bod usually results in at least a brief fibromyalgia flareup unless I do something to prevent it. It worked well enough to let me take a 4 hour nap. Now it's a bit red on my neck due to irritation from adhesives, and the muscles on the left side of my neck are sore and twitchy, but I think if I behave myself tonight and ice this properly, I'll probably be back to normal tomorrow.
Oh, and the doc asked how my thyroid hormones had been lately. I told him how they were bouncing like a ping pong ball, first too low and then suddenly too high. He said Hashimoto's will do that in some people and that my endocrinologist could help me wtith that. Again, that's what I figured was going on, but it was a relief to hear it anyway.
So I will follow up with the endocrinologist when I can get in to see her. I figure if nothing else, this test can serve as a baseline in case something suddenly does change. And I of course will ask if there's anything I can or should do about these pesky lymph nodes.
Time for me to get some ice on my neck and maybe watch "A Christmas Carol" on DVD. I have the version with Alistair Sim, my favorite. I just love it when he gets the uncontrollable giggles at the end....
Pain level: 7
Fatigue level: 6
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