No ultrasound yet, oh my! This might change your decision a little. This is what I learned just recently as I went through this. The ultrasound is necessary to reveal the location and size of the nodules. If you have a cold nodule(s) that are large enough they will want to biopsy them. If (God forbid) they are cancer that will change way your thyroidectomy will be performed – that comes straight from the specialist I went to who performed my biopsy. So there’s value in having that info before going into surgery.