My thyroid nodule is shrinking”.
I would like to thank Dr. Richard Guttler, a pioneer in the field of interventional endocrinology, for saving my thyroid. Dr. Guttler performed non-surgical RFA (radiofrequency ablation) treatment on my large benign thyroid nodule (mixed cystic and solid components, spongiform type) end of October 2019, and at my 3 month follow-up ultrasound yesterday he gave me the best news that I have heard in almost two years since discovering the lump on my neck–
My thyroid nodule is shrinking.
Dr. Guttler has given me back my life. I am not being melodramatic when I say this. Thyroid nodules, even benign ones, can cause problems, and mine was ruining my quality of life.
The biggest my nodule got was 3.6 cm (this is the nodule length, which is usually the largest dimension) with a volume of 16 mL. I had choking symptoms. Swallowing food was difficult, and I had to avoid eating foods or drinks (carbonated beverages, coffee) that gave me acid reflux, which made the choking feeling worse. I could not sleep well because if my neck wasn’t positioned just so, I felt like I couldn’t breathe.
My nodule was getting bigger and nothing I tried would stop the growth. My anxiety and feelings of hopelessness were increasing daily.
The worst part of the entire situation is the fact that medical care in the state of Illinois failed me. I was told by my endocinologist that I shouldn’t be having difficulty swallowing or breathing because people have cysts much larger than mine and are fine.
I was told by several ENT’s and surgeons that a partial thyroidectomy, or removal of the right lobe, was the best option. I was told by my endocrinologist to wait it out. When I mentioned ablation techniques, such as ethanol injection (PEI), I was told that no one in Illinois did this. To check with Mayo.
Through countless google searches and internet research, I came across Dr. Guttler’s website and contacted his office. He personally emailed back the same day and told me that there were non-surgical options available, particularly ethanol injection or RFA, and told me to send my ultrasound images for futher review.
Ethanol ablation was not going to work with a spongiform, mixed nodule like mine, as multiple doctors, including Dr. Guttler, later informed me. But thank goodness Dr. Guttler trained with RFA experts in other countries, including Italy and Korea, and has brought RFA to the United States.
Most importantly, thank goodness Dr. Guttler is making RFA affordable to people like me who live pay check to pay check. My HMO insurance in Illinois would’ve covered a thyroid lobectomy. It would not cover RFA. Mayo does do RFA and has local anesthesia or general anesthesia options but costs 2 to 3x more than what a trained interventional radiologist or endocrinologist like Dr. Guttler would charge, depending on whether you chose to use general anesthesia or not.
By using local anesthesia and having the procedure done in his office, you are done within 30 to 45 min plus the hour or so of observation. Dr. Guttler has the training and expertise I desire in a physician minus all of the unnecessary hospital expenses. Plus, he does everything else along the way–the fine needle thyroid biopsy, the cytopathology and tissue examination from the biopsy, the ultrasounds, and of course the RFA procedure itself.
Yesterday, Dr. Guttler showed me my 3 month post-RFA thyroid nodule ultrasound images, measurements, and volume. This is more meaningul to me than words can express. In Illinois, my thyroid ultrasounds are performed by technicians and a report is written later by a radiologist who relays the information to my primary care physician. Each of my 3 reports has been written by a different radiologist and nodule measurements are inconsistent at best.
A couple of visits prior, Dr. Guttler showed me an image of the entire nodule. Showed me the amount of fluid taken out from the biopsy. From day 1, told me that RFA is possible even with nodules like mine that are mainly cystic (greater than 50%) yet are too septated to make ethanol injection an option. Gave me accurate information that has been missing from countless visits with countless doctors in multiple states. Took the time to discuss ablation research with me. Answered dozens of questions that no one else could. Sent me a form to give my insurance which outlines the validity of RFA as a treatment option. Because he cares about future coverage for patients.
Most importantly, Dr. Guttler confirmed that these are real and valid symptoms that I have been dealing with the past two years and made me feel like a completelty reasonable and informed human being for wanting to keep my thyroid.
Thank you, Dr. Guttler, for your dedication to helping patients who seek non-surgical thyroid solutions. And thank you for your contributions to thyroidology and interventional endocrinology in the United States. It has made all of the difference to a patient like me.