Don't be Afraid to Ask - Doctors Need to Know Your Concerns
Medical Editor:William C. Shiel, Jr., MD, FACP, FACR
I had an interesting patient come into my office last week. Young, bright, successful in both family and career- definitely someone who "had it together". She was referred to me for assessment of a nodule in her thyroid. She actually hadn't even noticed it herself, but rather, her daughter had pointed it out to her one evening at dinner. Since then, she sought out numerous professional opinions regarding what she should do about this nodule. It was during this quest for information that she wound up in my office.
The nodule was not causing her discomfort, or making her voice hoarse, or interfering with her swallowing. In fact, aside from being a small cosmetic nuisance, it was posing no problems at all. She really didn't know how long it had been there, and only noticed it when her daughter pointed it out about 6 weeks ago. We carefully reviewed the symptoms of hyper and hypo- thyroidism, of which she had none. "Well", she said with a sigh, " I REALLY hope you don't want me to have a biopsy. I can't deal with the thought of a huge needle in my neck."
The thought of a biopsy often scares patients, even those who seem to " have it all together", like this young woman. I suppose the thought of a needle in the neck (of all places!) doesn't help matters much. Many patients who present with thyroid nodules are physically well, and have no signs or symptoms of thyroid disease. This makes the need for a biopsy seems even more obscure. I looked at my patient and realized this was the perfect opportunity to put aside some of her fears, and explains the rationale for a biopsy in her case.