Frequently asked questions
Feedback is very important to us so that we can continually improve our service. We therefore survey patients before and after their procedures. We have summarised the 10 most common questions and answers about radiofrequency ablation itself below, as well as about pre- and post-treatment and a few general matters.
Is RFA painful?
Most patients experience little or virtually no pain from RFA. This is because both the subcutaneous fat and the thyroid capsules are anaesthetised. Pain in the cervical spine can be caused by hyperextension of the neck during the procedure. We try to minimise this with special positioning aids.
How long do I have to avoid physical work and sport after the procedure?
Small bruises and swelling can result from the penetration of the needle through the neck muscles. We try to prevent this by administering anti-inflammatory drugs. Pain “similar to muscle cramp” have been reported. We recommend no sport or hard physical work for at least 2 days after the procedure. An extended period of sick leave is not necessary. In principle, the patient can return to normal office the following day.
What complications can arise with RFA?
Thankfully, complications are very rare and not comparable with those in surgical procedures. “Dangerous” areas near vessels or nerves are treated carefully or left out. Small bruises and slight swelling in the neck region are possible and easily treated by cooling the affected area with an ice pack. In very rare cases, the local anaesthetic can produce short-lived irritation of the vagus nerve. This feels similar to after having an injection at the dentist.
Do I have to take thyroid hormones after RFA?
RFA treats only the nodule or nodules, while the surrounding tissue is spared. In most cases, sufficient residual function of healthy tissue remains to maintain the metabolic state, and no hormone replacement therapy is necessary. Hormone injection may be necessary when the thyroid tissue is already damaged (which is the case with Hashimoto thyroiditis).
What examinations are required before RFA?
If you’ve already undergone preliminary examinations with colleagues, bring the results to your first consultation and Dr Lehner will check the procedure’s indications. If this is your first time at a thyroid practice then, after a comprehensive consultation, Dr Lehner will perform a detailed ultrasound scan, scintigraphy, blood test and a double fine needle puncture of the nodules to be treated. Once the examination results are available, a decision will be taken as to whether the procedure is possible and, if not, alternative therapy options will be discussed.
Which nodules can be treated with RFA?
Based on current scientific data and study results, Dr Lehner generally performs RFA on potentially benign nodules. Collaboration with an experienced pathologist is very important here. Most patients report difficulty swallowing or a globus sensation. So-called “hot” nodules, i.e. non-cancerous tumours which produce too many thyroid hormones independently of the body’s own regulatory system, can be functionally switched off with the help of RFA. Potentially malignant nodules should in any case be surgically removed.
Do I need an empty stomach for the procedure and can I take my medication?
As RFA is not performed under general anaesthetic and no medication known to be detrimental is administered, a small meal may certainly be had before the procedure. Daily long-term medication, such as anti-hypertensive medication, should also be taken. However, if you need blood-thinning medication, please make Dr Lehner aware of this at your first consultation. It will then be decided whether and for how long the treatment must be suspended.
How long is the total stay at the practice and is it possible for relatives to stay?
You should plan to spend a total of 2 hours at the thyroid practice. The procedure itself lasts between 30 and 60 minutes, depending on the size of the nodule. However, we would like to keep you in for observation for a while after the procedure. A separate waiting area with drinks and coffee is available for your relatives. You can park your car at the surrounding parking lot.
How much does radiofrequency ablation cost?
The total cost of RFA is € 2,700. We ask that you pay for the procedure immediately afterwards in cash or by debit card. You will be given a receipt straight away, which you can submit to your insurance provider as necessary. Unfortunately we cannot guarantee that you will be reimbursed by you insurer, but will be happy to assist you with your request.
Do I need to come for follow-up checks?
In principle, we would like to invite you to follow-up checks 3 and 12 months after the procedure and review the success of the treatment with you. If you are already being cared for by colleagues and are only visiting the thyroid practice for RFA, they can, of course, carry out your follow-up checks. In any case, we ask that you consult us immediately if any problems occur; there will be no charge for this.