It all started last April 17 when I went to Alexandra Hospital for check up and to get prescription for maintenance med for my hypertension. Alexandra hospital is the nearest hospital in our place, 10 min walk from our condo. I called the hospital for appointment. Dr. Chitra, a senior consultant at Alexandra hospital was assigned to be my doctor. Since it was my first check up with her, she asked a lot of questions about my medical history. I like Dr. Chitra. She is warm, friendly, and she spends time getting to know her patients. Then she asked me "Do you have goiter?". I replied I don't know. She said she noticed a lump on my neck. She thinks I have goiter so she sent me for thyroid blood test and advised me to come back for follow-up check up after three months.
As soon as I got home, I looked at the mirror and checked my neck. That was the time that I noticed that I indeed have a lump on the left side. I had never noticed it before.
I then checked my previous annual health check results from Kobe Kaisei Hospital Japan the past 3 yrs. There was no indication of lump or goiter in my 2011 and 2012 results. I wonder why the doctors at Kobe Kaisei Hospital did not detect it. Maybe it was not noticeable at that time so it was not detected. I found out it was detected in my last annual health check last Dec as suspected mild goiter. I overlooked it due to crazy sched last Dec, working on my relocation to Singapore on top of my crazy work load. Then we flew to Singapore on Dec. 30, 2013 and never had the chance to have follow up consultation at Kobe Kaisei hospital.
Lesson learned: Don't take for granted your annual health check. This is very important !!
Fast forward, I had my follow up check up with Dr. Chitra on the 31st of July. She told me that my blood test result came back normal, so it's not goiter. I asked what it is if it's not goiter. She said I need to have an ultrasound to find out. She sent me for ultrasound and told me to come back for the result after 2 weeks. I knew they saw something in my ultrasound based on the reaction of the one who did my ultrasound. My heart was beating so fast when I walked to Dr. Chitra's office on the 28th of Aug. As I anticipated, Dr. Chitra told me that a large 4cm solid nodule was found in my thyroid gland occupying the left lobe. She was surprised why it was not detected in my previous annual health checks. She said my nodule is large and maybe it has been there for years already. Since she is not an expert on thyroid issues, she consulted her Endo friend by phone on what to do next. The Endo recommended to do FNAC to rule out cancer. I'm loving Dr. Chitra, she really cares for her patients.
Fast forward, I had my follow up check up with Dr. Chitra on the 31st of July. She told me that my blood test result came back normal, so it's not goiter. I asked what it is if it's not goiter. She said I need to have an ultrasound to find out. She sent me for ultrasound and told me to come back for the result after 2 weeks. I knew they saw something in my ultrasound based on the reaction of the one who did my ultrasound. My heart was beating so fast when I walked to Dr. Chitra's office on the 28th of Aug. As I anticipated, Dr. Chitra told me that a large 4cm solid nodule was found in my thyroid gland occupying the left lobe. She was surprised why it was not detected in my previous annual health checks. She said my nodule is large and maybe it has been there for years already. Since she is not an expert on thyroid issues, she consulted her Endo friend by phone on what to do next. The Endo recommended to do FNAC to rule out cancer. I'm loving Dr. Chitra, she really cares for her patients.
According to Wiki*
Fine-needle aspiration biopsy (FNAB, FNA or NAB), or fine-needle aspiration cytology (FNAC), is a diagnostic procedure used to investigate superficial (just under the skin) lumps or masses. In this technique, a thin, hollow needle is inserted into the mass for sampling of cells that, after being stained, will be examined under a microscope.
Before my FNA, I made a mistake of watching on YouTube how the FNA procedure is done. Big mistake! I was freaking out when I went for FNA on the 4th of Sept. I knew my blood pressure was also high. The nurse told me to relax. She said it's just FNA, not surgery. I did deep breathing and I managed to relax after a few minutes (Now I know that deep breathing is also JSJ - Jin Shin Jyutsu).
Then Dr. Lim Choo and the Pathologist proceeded with the FNA procedure guided by ultrasound. I was told to hold my breath and not to swallow while they were taking samples from my nodule. I was praying so hard that I wouldn't feel so much pain. My neck was poked 4 times. It felt like I was bitten by a big mosquito 4 times. I was so relieved when they told me it's finished. It was not as painful as I imagined, but it was uncomfortable.
I called the hospital 2 weeks later but I was told that the result is not yet in and it usually takes 2-3 weeks to get the final report. That was so frustrating! It would have been faster if I had my FNA done at a private hospital.
When I called again, they scheduled me to see Dr. Chitra on the 6th of Oct (a month after my FNA). It was so stressful waiting for the result. I prayed so hard that God will give me the strength to deal with this trial. I asked my family, brothers, and sis-in-law to pray for me. I also prepared myself for the worst. I was so ready when I went to see Dr. Chitra, only to find out that my FNA result was inconclusive :(. She was not able to explain to me the result well because this is not her expertise (she's an internist).
Diagnosis:
FNA Atypical; Follicular lesion of undetermined significance.
Comments:
A definitive cytological diagnosis is difficult on this sample. Follow-up and a repeat FNA after 2 months may be helpful.
She referred me to an endocrinologist who would be able to explain to me my FNA result. I was supposed to go to the endo on the 4th of Nov. but I decided to cancel my appointment. I didn't want to wait for another 2 months to have repeat FNA, then wait again for another month to get the result.
I prayed so hard for God's guidance to lead me to the right direction. I came up with the decision to consult a specialist at the Mt Elizabeth Medical Centre. Too bad I wasn't able to get a copy of my blood test and ultrasound, but I managed to take a photo of my FNA result using my phone.
To be continued in my next post ...
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