To FNB or not to FNB?

Reasons to include, according to the ENT doc I saw on Thursday:

  • microcalcifications on one of the smaller thyroid nodules
  • size of the largest of the three nodules

I would add, based on my readings (peer reviewed, not just googled web-junk)

  • largest being taller than wide
  • family history of “thyroid” (oh the old ladies in my family were diagnosed with “thryoid” long before doctors felt the need to explain details to patients, especially female patients)
  • my most troubling symptoms of diarrhea (which is in high gear right now, I’ve lost 13 lbs since July) and flushing/”heat intolerance”

Reasons not to include (in addition to all the normal risks of the procedure and the fact that it does not always yield correct results):

  • vasovagal
  • vasovagal
  • vasovagal

I am a “vagaler”.  I explained this to the ENT doctor in the following way:  “Let me tell you about the time the radiology staff tried to place a PICC line.  I asked for sedation because I tend to not to well with needles.  They told me ‘oh it’s not part of the protocol.  No one needs a sedative for this.’  Two sweaty, convulsive hours later, I came out of the suite with the line in the wrong arm since they only got as far as half way to my shoulder before the awful, slow, ugly passing out started.  I don’t go out easy or quickly.  I go out slow and bad, so I remember coming to and going out many times, with nurses and techs laying across me and monitors being hastily slapped on my sweaty body.”

Er, would valium help?  Not sure.  Maybe.  I’m game.  I’ll try it.

He also said I should tell them about this so they will know what to expect.

And now I wait for calls to be made and appointments to be scheduled.  If I didn’t feel like such shit, I’d very promptly say “oh let’s just wait and reimage the thyroid in a few months, ok?”  Few things would make me happier than to postpone or avoid a needle being dug around in my neck.  However, it seems irresponsible given the current state of my body.  I did mention I’d lost 13 pounds.  I’ve been late for work nearly every day because I’m spending so long in the bathroom in the AM, and getting up earlier just means more poop, not finishing it any sooner.  I think the only thing I could do is either not eat dinner or eat very early.  Which sucks because dinner is my only full meal of the day.  AM eating brings horrible pain and diarrhea.  Afternoon eating is at work, and I am delayed and interrupted consistently by work stuff.  So my only real meal is dinner.  The flushing is also totally out of control.  In addition to it dictating that I can wear only skirts, lightweight short sleeved or sleeveless tops and sandal-like shoes; that I can work only in an ice cave (everyone comments on how cold my office is); that I can’t go sit at the beach until after the sun has gone down; that grocery shopping is right out because inevitably I overheat while standing in line near the exhaust from the soda coolers or the heat lamps from the rotisserie chicken bin; I’m starting to have a hard time with sex because of it.  Way to kill a mood = feeling like you’re wrapped in a wool blanket on a 98 degree day.  You just want to lay there and do nothing.

If this is a possible explanation for those things, or conversely, if those symptoms are symptoms of thyroid cancer, I need to get it checked out even if only to rule it out and narrow the field of possible explanations.

And in the meantime, I need to call my PCP to find out about all those damned thyroid function tests.

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