What Happens During a Thyroid Nodule FNA

I'm writing this mostly as a service-y type of thing, because there wasn't a whole lot of information about it anywhere else.

So, if you are scheduled to undergo a Fine Needle Aspiration (FNA) for a thyroid nodule, this is probably what is going to happen.

Try to wear a low-ish cut V-neck or scoop neck or some type of shirt that will allow your doctor to access your thyroid area without you having to change into one of those horrific hospital gowns.  Turtlenecks need not apply.

You will nervously check in to your appointment.  The anticipation of what might happen is not fun, and I feel for you as the nurse assistant chirpily says to you, "So, we're going to check for cancer today!"  You are totally excused from joining in her enthusiasm.

You will wait in the office, staring at the tray containing the needles, the specimen slides, and the topical anesthetic. 

Yup, a topical is all you are going to get.  Maybe if you beg for a local you might get one.  I guess it depends on the level of panic in your voice.

So the doctor will come in, reassure you of the routine-ness of this procedure, and ask you to lie down. For my particular visit, I was to have three needles.

At this point, I would recommend closing your eyes.  If you feel your doctor needs reminded, just ask for them to walk you through what they are doing.  If you've got a good doctor, this won't be necessary.

My doctor used an ultrasound machine to guide her in finding the nodule, and compared it with my diagnostic ultrasound.  Make sure your doctor uses an ultrasound machine.

The doctor will spray the topical anesthetic, which works very quickly.

DO NOT PEEK AT THE NEEDLES.  I'M SERIOUS. 

Just take their word for it that they are very small in gauge.

The doctor will tell you that they are ready to insert the first needle, and in it will go.

You will feel it.

But it isn't too bad.

You will be able to feel the needle "rocking" in your neck as the doctor digs out those cells, but it isn't enough to make you faint or anything.

Unless you faint easily, and then maybe it will.

The first needle should come out quickly and the doctor will then let you know they are ready to insert the second one.

You will feel this one, too.

For me, the second hurt worse than the first, but was bearable.  The second was in for a bit longer than the first. 

Then comes the third needle, and this one was by far the most painful.  I don't know if it is because the thyroid is now highly annoyed that it has been poked at three consecutive times, but it was not happy.

But, then it was over.  You might be bleeding a bit, and the doctor may ask you to apply some pressure to the area to calm the bleeding down.

For me, the entire procedure took less than ten minutes.  I imagine that your experience may vary due to the skill of your doctor and the placement of your nodule.

I was lucky in that my nodule was fairly easy to access, I'm going to take a guess and say that if it had been in a less accessible area on my thyroid, it would have hurt quite a bit more.

So, not any one's idea of a great time, but not the worst either.

I had someone drive me to my appointment and back, and I would highly recommend this.  As the topical anesthetic wears off, you will definitely start to feel discomfort.  The seat belt also happens to cross your neck at pretty much exactly where the needles went in, so it was nice not to have to fuss with the seat belt while trying to drive.

By the time I got home, I was in a pretty good amount of discomfort and I proceeded to apply an ice pack for about twenty minutes.  I also took an Advil.

My neck was stiff for the rest of the night and I had a bit of trouble finding a comfortable position to sleep in, but I've been through worse.

The next day my voice was very hoarse, which isn't a normal side effect.  I'm writing this on the day after, so I'll update if my voice gets worse.*


*Seems I was getting a bit sick with a cold, not a side effect of the FNA.