Planning the trip

One drive down, done properly.

Visalia is about 200 miles from the office on CA-99 and the I-5 south over the Grapevine, normally three to three and a half hours. That is a real drive, so the point is to make it once and go home with the answer already moving.

01

Book the first slot of the day

An early appointment means an easier run in both directions and you are home well before evening.

02

Bring the imaging you have

Any ultrasound, mammogram or CT report from a Visalia clinic. It tells Dr. Nadelman what she is looking for before the needle goes anywhere.

03

The biopsy and the microscope

Ultrasound, local anesthesia, a few passes with a fine needle, then the slides stained and read in the office lab while you are still there.

04

Drive home with it settled

If the sample is thin she takes another the same visit. Preliminary findings usually reach you within 24 hours.

Why make the drive

Who reads the slides changes the timeline.

There are hospitals and imaging closer to Visalia, and for plenty of things they are the right answer. A fine needle aspiration is the case where the person reading the slides changes how long it takes, because the reading is the diagnosis.

What the drive gets you

  • One trip instead of two. The sample and the reading happen in the same visit.
  • The specialist holds the needle. Dr. Nadelman is board certified in cytopathology and performs the aspiration herself.
  • A thin sample caught on the day. She knows in minutes and repeats it there and then.
  • Preliminary results within 24 hours. Sent to you and to your Visalia physician.

When it is not worth the drive

  • It is clearly a simple cyst. Your own doctor may be able to settle that locally with imaging alone.
  • You cannot travel. House calls are available anywhere in California, so ask before ruling it out.
  • It needs more tissue than a needle takes. Some diagnoses need a core or surgical biopsy, and she will say so.
  • You already have a clear answer. If a prior FNA settled it, a second opinion on the existing slides may be enough.

Ask before you drive. A short phone call establishes whether a fine needle aspiration is the right test for what your doctor found, and whether a house call makes more sense than the trip.

What are we sampling

The three biopsies Visalia patients come here for.

A fine needle aspiration uses a needle thinner than the one used to draw blood. No incision, no stitches, local anesthesia only.

Thyroid

Thyroid nodule biopsy

Only 4 to 6 percent of thyroid nodules turn out to be cancer. Ultrasound guided sampling, graded on the Bethesda system, read on site. Thyroid biopsy

Breast

Breast lump biopsy

Most breast lumps are benign. If it is a cyst, draining it with the same needle often makes the lump disappear during the visit. Breast biopsy

Lymph nodes

Lymph node biopsy

Usually a node is simply doing its job. When it is hard, fixed, or has not gone away, cells answer the question in one appointment. Lymph node biopsy

Two routes from Visalia

The difference is who reads your slides.

If your Visalia physician finds a thyroid nodule, a breast lump or a swollen lymph node, the referral almost always goes to a hospital radiology department. A radiologist takes the sample, and a pathologist you never meet reads it days later.

The hospital referral

Two visits, two specialists, two waits

  • Day 0. Referral and imaging
  • Day 3. A radiologist takes the sample
  • Day 12 to 14. Pathology report reaches your doctor
  • If the sample is short. You find out two weeks later and start over

About two weeks of waiting

With Dr. Nadelman

One appointment

One visit, one specialist, one trip

  • Day 0. Ultrasound, biopsy, slides read on site, consultation
  • Same day. If the sample is short she knows immediately and takes another
  • Within 24 hours. Preliminary results to you and your doctor
  • No second trip. You talk to the person who made the diagnosis

An answer inside of two days

If 200 miles is not possible, she comes to you.

Dr. Nadelman performs house call FNA biopsies anywhere in California. She brings the ultrasound and the staining setup, so a homebound patient in Visalia gets the same procedure and the same turnaround at home.

310.702.6701

1125 S. Beverly Drive, Suite 602
Los Angeles, CA 90035
Monday to Friday, 10 to 6

Visalia questions

Asked before the trip.

How far is the office from Visalia?

It is about 200 miles from Visalia, normally three to three and a half hours on CA-99 and the I-5 south over the Grapevine. The office is at 1125 S. Beverly Drive, Suite 602, in Los Angeles, with parking in the building garage.

Less than most people expect. The needle is thinner than the one used for a blood draw, the area is numbed first, and there is no incision, so there is nothing to stitch and nothing to heal.

She takes another one in the same visit. The slides are examined in the office while you are still there, so a short sample is caught in minutes rather than discovered by an outside lab two weeks later. That is the single biggest reason it is worth making the trip once rather than twice.

Next-day appointments are usually available and same day is often possible. That is the practical difference from a hospital radiology referral, where the first opening is frequently weeks out.

Waiting is the worst part. It does not have to take two weeks.

Next-day appointments are usually available, and house calls are available anywhere in California.

310.702.6701

1125 S. Beverly Drive, Suite 602
Los Angeles, CA 90035
Monday to Friday, 10 to 6

CELINA NADELMAN, M.D.

  • Biopsy and interpretation by a Board Certified Cytopathologist

  • Ultrasound-guided and palpation-guided FNAs

  • Preliminary diagnosis within 24 hours in most cases

  • Next day appointments available

  • We accept most major PPO insurances and Medicare.

  • Patient and physician time savings

  • Relief of patient anxiety

  • Medical, technical and fiscal resource conservation

  • Appropriate and expeditious triage of the patient and their sample

  • Diagnostic ultrasound services

WE ARE HERE TO HELP

Request an appointment with The Cancer Biopsy Doctor, Celina M. Nadelman, M.D. today.

Did you know we do house calls in the state of California? We can travel to you anywhere in California! Speak to our office about the details.