Tuesday, September 4, 2012

Radioactive Me

The next step in the thyroid saga was to make a decision on the radioactive iodine (RAI). For many reasons, it is not a clear cut decision to use the radioactive iodine. The endocrinologist suggested that we think about it and plan, if we decide to proceed, to do it in March. I was glad to have the extra time to research and possibly get a visit with my parents in Texas before I get radioactive. Apparently, I can set off alarms at the airport for months after treatment.

The decision was difficult because it is the least aggressive form of thyroid cancer, they believed that the surgeon got it all, and the RAI can result in slightly increased rate of leukemia. Since I already have two cancers, that was a concern for me. RAI can also cause permanent changes to the salivary glands that result in dry mouth or taste changes. On the other hand, RAI  is only absorbed and concentrated by the thyroid. The treatment destroys any remaining thyroid tissue or cancer cells but does not harm other tissue in the body. It increases the survival rate of thyroid cancer patients.

Bruce and I prayed and talked about it, did the research and went back in to discuss with the endocrinologist. I even asked him what he would do in my place and he said it was a difficult decision and that he could support either choice. We decided to proceed with the I-131(RAI).

First, they put me on what I defined as the "no-food diet." It is actually a low iodine diet, but who knew how many foods that eliminates! No dairy, no egg, no cheese, no soy, no processed food of any kind-no bread, pancake mix, canned foods, NO CHOCOLATE!! I can have any fruit (except rhubarb) and any veggie (except potato skin) and 5 oz of meat per day. Yikes!  The only upside was the potential for weight loss. I have decided to will my body to science because after two weeks I lost ZERO pounds. How is that even possible? If they figure it out they can solve the energy crisis.

For two days prior to the radiation,  I went into the office for Thyrogen injections. This is recombinant human TSH (thyroid stimulating hormone.) The purpose of the diet is to starve any thyroid tissue of iodine and the purpose of the thyrogen is to make it hyperactive. This would give me the greatest chance of absorbing the most iodine possible so that the radiation is effective.

I opted not to do the diagnostic test first because it also requires I-131 (but a smaller dose) and is likely to be inconclusive anyway. It is effective if positive, but it is unlikely to give a reliable negative result. So, I'd probably end up doing the radiation anyway. And I would have to do the 2 week diet and the injections prior to the diagnostic test because if they decide to do the radiation after the test, they do it immediately.

Finally, I went in for the RAI. My endocrinologist met me at his office and took me through the clinic to an employee only area. We came to a door with a nuclear warning sign and he unlocked it and took me inside. He put on lead lined gloves and brought out a lead container.  He opened the container and there was  tiny pill in a small cup. 

He handed me a glass of water and I had a moment of panic when he told me to take the pill straight from the cup and not to touch it with my hands. I can't touch it but I can put it on my tongue and swallow? I steeled myself and swallowed it. Once I took it he hustled me out of there as if I were going to go off like a bomb.

I got out to my car, sat down and cried. It's not easy being radioactive. 

Scripture reference: Romans 8:38-39

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