Before The Procedure
There are no special preparations required prior to your procedure. Similar to a thyroid nodule biopsy, we ask that all blood thinning medications such as aspirin, coumadin, Xarelto, and Eliquis be safely stopped five days prior to the procedure, unless directed otherwise by your doctor. You may eat and drink normally up until your appointment.
Please note that you will be required to lay flat with your head tilted slightly back for the full duration of the procedure, which can exacerbate some medical conditions such as acid reflux, and therefore, it may be more comfortable not to eat a meal immediately prior to your procedure.
Day Of The Procedure
On the day of the procedure, you will arrive and check in at the front desk similarly to your initial consult appointment. After check in, please take 400mg of ibuprofen (or 500mg of Tylenol if not able to take NSAIDs) with a small sip of water.
You will then be escorted to our procedure room where a gown will be provided for you to change into. If you are having a radiofrequency ablation procedure, two grounding pads will be placed on each of your thighs as well as a blood pressure cuff and oxygen saturation monitor.
The procedure will start with a diagnostic neck ultrasound. At the start of the procedure, a small needle will be used to inject local anesthetic underneath the skin and around the thyroid or lymph node capsule to make the procedure more comfortable for you. You will be fully awake during the entirety of the procedure and you will be asked questions throughout the procedure to help us monitor our progress. Although you should not feel pain after the injection of local anesthetic, it is not uncommon to continue to feel a little bit of pressure or have some intermittent discomfort in the shoulder or ear during the ablation procedure. If you are having a radiofrequency ablation procedure, you may also hear some ‘popping’ sounds as the tissue is being ablated.
The duration of the procedure is largely dependent on the size of the nodule or lymph node that needs to be ablated and can vary from 30-60 minutes on average.
Once the procedure is done, we will give you an ice pack to place over the puncture site. Please keep the ice pack on the site for a minimum of 30 minutes. The use of an ice pack intermittently over the first 24 hours as tolerated is recommended to minimize swelling that can result from the procedure. Additionally, we recommend that you continue routine intake of ibuprofen or Tylenol around the clock for the first 24 hours for the same reason.
Patients may feel a little dizzy or light-headed after the procedure, especially those who are prone to vertigo. All patients should come to their procedure appointment with a companion who can accompany the patient home. We will ask that all patients remain on the medical campus for a minimum of 1-2 hours after the procedure for monitoring, and to please check in quickly with the doctor’s team prior to going home.
After The Procedure
There are no eating or activity restrictions after the procedure.
It is not uncommon to have a little bit of swelling after the procedure within the first 1-2 days.
Usual follow-up after the procedure involves ultrasound and/or bloodwork performed at 1 month, 6 month, and 12 months after the procedure.
If you are interested in either radiofrequency ablation or ethanol ablation and would like to see if you would be a good candidate, please contact The Columbia Thyroid Center at (212) 305-0444.