Candidate Screening for Thyroid RFA

In all the procedures I have done with RFA for nodules and cancer I was tricked into doing the procedure on 2 patients who failed to disclose they had a problem that would have resulted in problems if not known before hand.

1. Patient failed to list hypertension on the co-morbidity sheet. We would have asked her primary physician to clear her that the blood pressure was well under control.
2. She developed hypertensive crisis during the RFA procedure and it was aborted.
3. Patient 2 had life long problems with syncopal episodes with even the slightest procedures. Patient passed out on the toilet and had facial injuries and during FNA, blood testing, even when the family member was delivering a baby. Patient failed to disclose this before the procedure.
4. Halfway through the RFA nodule ablation there was a loud grunt and passed out with low BP sweats and needed 8 minutes to wake up. Elevation of the foot of the examine table and monitoring vital signs were done until they were back to normal. The patient did not remember anything during the episode.
5. The patient was not a candidate from the start if the problem had been revealed BEFORE the procedure, as this was outpatient procedure done under local only.
6. Referral to hospital centers that do general or conscious sedation was the correct initial plan if I knew about the problem.
7. The co-morbidity form is essential and the honest patient must reveal if there are any problems that would limit the use of RFA.
8. Some things like BP problems need a clearance from their physician.Others are a direct contraindication for RFA such as unstable cardiovascular condition or metal implanted like screws, or pacemakers.
9. Call me to see if you are a candidate for thyroid RFA.
10. 310-393-8860 email to thyroid.manager@thyroid.com
11. Ask for Alicia.
12. Dr.G.