My 7th Fine Needle Aspiration in one month

Today marks the 7th needle prick into my neck to aspirate some cells for cancer tests. It all started with a strange feeling in the throat after many weeks of virus war. With my Graves Disease history, it wasn't difficult to request for a thyroid ultrasound. And voila they found two ~5mm nodules. One is likely to be a cyst, and the other with signs of micro-calcification which is a suspicious characteristic for papillary thyroid cancer. Apparently lots of people have thyroid nodules and most are benign, based on statistics. But well, low chance doesn't mean no chance. Just like how low fat milk doesn't mean no fat or that it’s a good thing.

First FNA biopsy experience was a lousy one, executed by a stand-in doctor with the name that sounds like Aileen at MDI Manningham Medical Centre. First question to me was 'Do you speak English?' Just because I don't have a western name doesn't mean I don't.  No hello. No addressing my name. She's of Asian skin, just like my yellow skin. Key phrases 'oh that's dangerous it's near the carotid', 'oh its quite small it'll be difficult', changing her mind twice while trying to decide which one she wants to poke first. Decision is sooo difficult because one is not suspicious but in a dangerous spot while the other one is suspicious but too difficult because it is too small, also dangerous. <Multiple Slaps!> No advise on how will the procedure be. Was not friendly to the radiologist assistant. Then just like that, she was holding the needle in her hands and asking me to swallow and not to swallow after. That's it. In and out (one for each nodule) and cells in a container of liquid, not stretched on slides. After the first prick she told someone to hold the cotton to my neck and said it twice. The assistance was doing other stuff. So i lifted my hand towards my neck assuming it's me and she said in an unfriendly tone 'not you'. Well maybe you should address your assistant with her name. She did say 'sometimes sample is not sufficient so may need to come back again'. So do it properly and more times then, BITCH! Sounds to me you have low care factor and know what you did was rubbish effort. All you wanted is to get the money for nothing.

And so, as predicted by both me and her, the >$350 procedure of obtaining the sample from the suspicious nodule was a waste. So I had to do it again. This time I made sure I get the regular doctor.  Dr. Pryde. Even the receptionist was fast to ensure that she doesn’t book me on his day off for this repeat biopsy. It was definitely an improved experience. He did explain the procedure briefly (maybe because it was my second time in) and mentioned that it may be tricky because the nodule was quite small but nothing unconvincing and wasn't disrespectful towards me or the assistant. Three samples taken and it seems like he did spent some time getting enough samples while the needle is in there. I don't remember too much of a pain. Just the feeling of needle prick, like drawing blood and a little wriggle while the sample is drawn. He told me “no charge this time, fair deal?” (duh it was for the flop that the centre did, they better not charge!). But it was such a big lie of statement. What he actually meant was there won't be any out of pocket for his service. But he still charged the full amount to Medicare (that's taxpayers money which means my money too!) and I got a separate invoice from the pathology. Fortunately the sample was sufficient. Unfortunately they found out it was papillary cancer.

Today I had my 6th and 7th needle inserted into my neck region, this time on an abnormal lymph node to identify if it has spread. This time, the Procedure was done at the Melbourne Royal Private Imaging centre.. Very old looking building, old interior, and extremely bad time management. I think that's to the extent of bad comments. Oh, and more expensive too. I waited half an hour for my turn. I lied on bed prepped for more than half hour, maybe more. Even had the time to find out that the nurse had 3 sons, how old, marital status, no kids, where she lived growing up, stories about her 2 very smart friends, upcoming travel to London, kayaking in New Zealand and other random topics. The assistant radiologist and nurse had to try to get the doctor multiple times. And well, he was busy getting a report done but kept getting interrupted by many others. So yeah very bad time management. 

The experience of the procedure however, was good. It was in a big room. The radiologist assistant was not overly friendly but she wasn’t unfriendly. She knew what she was doing, did good homework on my previous scan and found the abnormal chain of lymph node in no time. The doctor spoke rather slowly (sounds tired) but explained a fair bit of stuff regarding the procedure. There was an option to use local anaesthetic because lymph node biopsy is a little tricky but there is risk of it going to the blood stream for the baby (if I was pregnant). Nurse was a nice nurse, very motherly. She held my hands during the procedure. Perhaps a little unnecessary for me (I felt weird initially) but I thank her for the gesture of comfort. If it was my first time doing it I would feel quite relieved. But because it was my 6th and 7th time and the thought of knowing that the cancer may have spread, I got a little emotional. I started tearing up when the doctor was trying so hard to find the needle through the scan. And when he did I could see him poking into it repeatedly to try to get the sample. My right eye got a little teary looking at the screen at that time. I would have like my first ultrasound to be pregnancy ultrasound, and not looking at a screen of thyroid ultrasound (2x), lymph nodes ultrasound (1x), FNA guided ultrasound (3x), and a pelvic ultrasound (but that’s a different story). Because my head was turned towards the right, the little bit of tears started to flow from my right eye down towards the bed. The ladies notice it. One grabbed a tissue. One held my hand tighter. They asked if I was all right. It made me more emotional and more tears came. Left eye started to tear too. In fact I no longer feel the needle pain on my neck. It was more emotional than pain. I told them that and the doctor commented it is the analyst in me saying that. (???). I was trying hard to stop tearing but more came! It felt so weird. When it was all done, doctor said nothing, showed no emotion.  Then when he was done, he walked out without saying anything to me. Not sure why. Maybe he felt a little guilty for not locating the needle easily. Maybe my tears scared him. Maybe it's just his style when the job is done. There was a cytologist (I think that's what he is called - the person from pathology who examines the samples). He didn't say much. I didn't even see his face. It was good that they had him there to ensure that the sample is sufficient so no repeat biopsy required. So that was it. The 34 weeks pregnant radiologist assistant and the motherly nurse wished me well and hope I was pregnant. I hoped for the same too. But what would it mean then? So what’s next if indeed there is metastasis of my cancer and if I'm indeed pregnant? I guess we’ll just wait and see.

So that's it about my FNA experience. Hope yours was simpler and seamless.