Driving to my RAI appt was the first time I've cried about my situation in a few weeks. Started when I gave hugs to my parents and gave Frankie a pat on the head on my way out the door. Three miles away from my house I was crying and driving, which seems to be just as dangerous as texting while driving as I almost plowed into a semi truck while trying to wipe the tears from my eyes. I know, this is just part of my thyroid cancer treatment, but it doesn't make it easier knowing I will pretty much be in isolation for a least week. The Radiologist will be giving me additional info, such as how much longer I may have to stay on the low-iodine diet and other restrictions I may have to follow while in isolation. Wow - I was just told that my dosage is at 1:30pm, not 12pm. Well, they told me not to eat after 8am, so I assumed my dosage was at 12pm. Will see what happens.
Was able to run a few errands on the way home. As I drove down the street, got a call from Radiology. She said my pregnancy test came back negative (of course), so she was going to go ahead and make my dosage pill for 150 mCi. Then she went over the precautions I need to take to prevent exposure to others, to write down any additional questions I have for the Radiologist, then told me to be back at the hospital at 1:4pm for my therapy dosage.
I had to wait a few minutes for the Radiologist to arrive. It was cold in that room. He explained why I am having the procedure, and told me a few new things about HCC and the therapy that I didn't know:
1. Sometimes HCC doesn't produce Thyroglobulin, the tumor marker
2. If a good thyroid cell is next to a thyroid cancer cell, the radiation kills the cancer cell because it is next to the good cell that was killed by the isotope. I can't remember the exact term he used, but that is the theory. It's not a guarantee, but it usually happens that way.
3. If I get pregnant within the year after RAI, I have a higher chance of miscarriage, but if a baby is carried to full term, the radiation will not have a negative affect on the baby
4. I may start menopause a year earlier.
5. The radiation will stay in my body for a few more months, so I can set off alarms at the airport and boarder crossings. I have to carry a card with me with my therapy info so the authorities can call to confirm why I set off the radiation alarms.
6. Any tears I shed during my treatment will be radioactive. As such, the tear ducts may be affected and close up. If later I notice that my tears run over my lower lids instead of the inner corner of my eye, my opthamalogist can dilate my tear ducts to re-open them.
7. I may experience pain in my cheeks and jaw area (salivary glands affected), or in my neck. In any of these cases, I have to contact my ENDO.
8. I will have a little higher risk of developing leukemia from RAI
9. It takes 90 minutes for the radiation to be absorbed in my body
As for the precautions for reducing external exposure to others, his info seemed even less restrictive than everything I've read online and in books:
1. Put all my bed linens and under garments in a bag and wash at the end of the week (not every day)
2. Not necessary to throw out my toothbrush after isolation
3. Ok to throw out my disposable utensils/plates/cups with the trash next week
4. Didn't mention anything about having to shower each day or launder my clothes and bed linens each day
5. I cannot share the same toilet with anyone for a week. Shower and sink are Ok, not necessary to rinse after each use, but the toilet is most important because the primary way the radiation is excreted from my body is through my urine. So, the more I pee, the faster it will leave my body. And of course, flush twice each time.
6. Driving - Ok to drive myself. I should wipe the steering wheel with a moist wipe after so I don't leave any residual radiation on it.
He did stress that under no circumstances am I to prepare food for anyone (or pets, I assume). I asked if I could attend a 4th of July picnic and parade, which is over 48 hours after my therapy dose. He said I could attend, but not to spend more than 5 mins with each person; if it is longer, then stay at least three feet away from that person, and make sure I am drinking a lot of water (porta-potties are Ok to use). Pet exposure - he said the dogs would be fine due to their ages (12 and 13), but the cat would probably be better off being boarded. I think just to be safe I'm going to have the dogs boarded next weekend anyway when my parents are out of town - better to be safe than sorry.
Other instructions:
1. Do not eat or drink anything for two hours after the dosage - best way to make sure I don't vomit. If I do vomit within 12 hours after the dosage, call the Radiology dept so they can come to my house to clean it up.
2. After four hours, start drinking a lot of fluids; I should be peeing at least once an hour, and it should be clear or have very little color to it.
3. After 24 hours start sucking on lemons or hard candies to activate the salivary glands. Fresh lemons is best, just make sure I rinse with water since lemon juice is highly acidic. These two (#2 and #3) are the fuzzy ones for me. I thought this was the instruction, but the tech said she thought it didn't make sense, and it was the other way around (lemons after 4 hours, water after 24hrs). My Radiologist was already gone, so a different one had to clarify.
That's about it. It's getting close to 5pm, when I can eat and drink something. I haven't eaten since 7:58am, so I'm ready for food. My Radiologist was good at explaining things, but I am glad he took the time to do so and to answer my questions as well. I felt more at ease about the therapy as he talked to me about it. And thank goodness his external exposure guidelines are not as bad as what everyone else was telling me. I will still shower daily, launder my lines, clothes etc. each day, and rinse the tub and sink after I use them, just to be on the safe side. Last thing I need to do is unknowingly expose either one of my parents or our pets. So glad I'm not stuck at home for 4th of July, but I think I still have an excuse to show up, get food, then go home - I'd rather not have to use a porta-pottie. I may even swing by the froyo place to get my own frozen yogurt, to go!
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