A fine needle biopsy (FNB) also know as a fine needle aspiration biopsy (FNAB) is just what it says--cells withdrawn from your body using a very fine needle. An alternative to a fine needle biopsy would be a core needle biopsy. The core needle is like taking the core out of an apple, but not quite that large. It is obviously a larger sample. The other main type of biopsy is surgical biopsy where the surgeon actually removes all or part of the area, which could be an organ itself, like the thyroid. In any case, the purpose of the biopsy is to remove cells, so they can be analyzed to determine if there is a malignancy in the tumor.
I laid back on the exam table at Dr. Wotten's office. Dr. Wotten said I had to make my thyroid pronounced to make the fine needle biopsy easier to obtain. I did this by laying my head back off the edge of the table and then arching my neck and back. Dr. Wotten helped by putting a couple of pillows under my head. It was uncomfortable in this position. The thyroid was already obviously enlarged, pushing on my esophagus, making it hard to breath, and to talk. My voice was already much deeper than it should be, but friends and family had become used to my voice and thought it was normal. Like flexing a muscle, I was doing the same thing with my thyroid, making it even more difficult and uncomfortable. In addition, I was anticipating a needle piercing my neck several times, so, mentally, at least on the inside, I was a little shaken.
Dr. Wotten said he was first going to numb the skin area by rubbing lidocaine over my neck, which he did. Unlike the numbness you feel when you obtain anesthesia from the dentist and have a have a cavity filled, the numbness from the lidocaine was minimal. Not knowing what pain I would feel from the fine needle were greater, but there was not much I could do, or say, at at that time. Dr. Wotten turned to a table behind him and grabbed a syringe. That's when I saw that "fine needle" that was going to be stuck in my neck. It was very fine. Almost invisible, but it was also very long. Yikes! But, being raised to be tough, I just bit my tongue and did not say a word.
Dr. Wotten leaned over my neck, and said. You are going to feel a small prick. Trying to lighten the situation, I said "not today thank you". I am not sure if he ever figured out the connotation I was referring to--he never laughed, so I just shut up and allowed the procedure to begin.
It was indeed a small prick, but most of the pain was just the discomfort because of the pressure on my neck and thyroid. The needle was inserted fairly deeply and then Dr. Wotten wiggled it around slightly in an attempt to dislodge cells from my thyroid and then withdraw them through the syringe. After about 10 seconds total, the needle was withdrawn, with part of me inside the syringe.
Then, Dr. Wooten did this again. And again. He said "Just a few more times, and we will be done." I said "a few"? The word "few" is one of those terms that can mean from 3-12 to some people. I asked--"How many is a few?" Dr. Wotten said "three more". This meant that in about a minute, I would be done. Each time, the needle was inserted, it was wiggled around, and then withdrawn.
Done. Finally. Then, I sat up, realized that I was dizzy and needed to sit there for a few minutes to recover. Dr. Wotten helped me to a chair outside, where three other people who had FNBs were sitting. Each one held a cold pack next to their neck. I joined the crowd and did the same. Dr. Wotten said we needed to wait for about 15-20 minutes to make sure the bleeding had stopped and that we would be OK to leave.
It made me feel comfortable seeing other people who just had a FNB. Hey, I thought--maybe this thyroid thing is common. I was thinking that here I was, with three other people who had the same procedure on the same day--the same hour.
In about fifteen minutes, Dr. Wotten visited me, took a look at my neck and said "you are free to go. I will call you in a few days with the outcome".
