What I thought the radioactive iodine treatment would be like

What I thought the radioactive iodine treatment would be like

March 19, 2008

Hello, friends and family!
Some of you have been asking for details on my
upcoming radioactive iodine treatment. Others of you
have not, but I'm sending you this in case you crave a
short education on this particular field of nuclear
medicine. (Who doesn't pine for such a thing? After
all, it makes for great bedtime reading if you want
weird, Silkwood/Three Mile Island/Chernobyl-influenced
dreams.)

First of all, I'm scheduled to check into Irvine
Regional Hospital on Monday, March 24 (the day after
Easter), at 8:30 am. Sometime around 10:30 am, after
I'm out of my normal, cute clothes and dressed in 2
delightfully chic hospital gowns (don't want anyone
getting a glimpse of me olde cheeks, if you know what
I mean), the nuclear medicine radiologists will send
me into a hospital room in the nuclear medicine wing
of the hospital, where a pill-bottle-sized tungsten
cylinder will be waiting for me.

Inside the cylinder will be a capsule filled with 150
millicuries (mCi) of radioactive iodine (RAI). I will
"pour" the pill into the tungsten cylinder cap, and
then swallow the capsule with a glass of water, being
sure not to let the capsule touch my hands or get
lodged in my mouth between my teeth and gums. (This is
what I've been told, anyway.) I shouldn't feel too
weird or have a negative reaction, but of course, all
bets are off when you're swallowing radioactive
*anything.* For months afterwards, you can have a
metallic taste in your mouth, have a dulled sense of
taste, have salivary gland issues...etc...all of which
I am prepared for and I will do everything in my power
to prevent...Baking soda rinses, lemon drops, Biotene
toothpaste...

[Incidentally, I owe thanks for most of my education
on this disease NOT TO MY DOCTORS but to
www.thyca.org. Check it out if you're interested.]

I'll stay in the hospital for one or two nights while
the nurses watch me glow (hardy har har) and basically
avoid me. If they have to talk to me, they will stand
behind a lead shield to protect themselves from my
highly radioactive state. Obviously, I don't get to
have visitors. They will periodically use a Geiger
counter (I kid you not--they use a Geiger counter) to
"read" my radioactivity levels, and when I am emitting
(not sure if this is the right word) 30 mCi of
radioactive iodine or less, they will discharge me
from the hospital. My mom is going to give me a ride
home from the hospital; she is the most logical choice
for a chauffeur because she has a thyroid that no
longer functions at all, due to her own complicated
thyroid history, so any exposure to me, even in this
30-mCi state, is completely safe for her. Exposure to
radioactive iodine only harms the thyroid because
thyroid cells are the only cells in our bodies that
want/need/can use iodine.

I will spend approximately 6 days in total isolation
(this includes hospital time and time here at home)
while Pommy and Jack go on a 3-day trip to Indian
Wells and then stay at my parents' house for 2 nights.
(Our dog, Taco, will spend the entire time at my
parents' house.) Pommy, Jack and Taco will rejoin me
at home Sunday night, March 30, after I have cleaned
all areas of the house I spent time in during their
absence. Although I will still have to take a few
precautions around the house for the next several
days, it will be safe for us to be together again, and
every day that passes thereafter will result in a
progressively lower level of radioactive iodine in my
body. (Estimates for this dose say the level of
radioactive iodine 10 days after administration is
about 0.0002 mCi for me.)

Radioactive iodine kills remaining thyroid tissue that
even the most complete thyroidectomy can't get rid of.
(They have to leave some thyroid tissue around your 4
parathyroids because they're so delicate.)
Administering RAI is a standard practice whenever
there is a finding of malignancy in one or both lobes
of the thyroid. In my case, there was only malignancy
in the right lobe of my thyroid, but they take the
entire thing out if there's multifocal malignancy (more than one focus of cancer), because in the
long run, testing and tracking and screening for any
recurrences is much easier if there is NO thyroid
tissue left anywhere in the body.

I'll have annual or 6-month whole-body scans and
blood tests to check for any signs of recurrence, and
eventually, they'll probably stop doing the whole-body
scans and just rely on blood tests.

I'm sure this is more than you all wanted to know, but
there it is, all laid out for you--like I said before,
in case you're into this kind of thing. I have to
admit, I find it all a bit fascinating. That they let
people out of the hospital emitting 30 mCi of
radioactive iodine is a shock to me, but I'm one of
the "lucky" ones. The protocol at Irvine Regional
Hospital is to keep patients until they are down to 30
mCi; some hospitals administer RAI on an outpatient
basis and send people home right after the 150 mCi (or
200 mCi or whatever their exact dose was). This leaves the
responsibility of protecting the general public in the hands of
the individual patient, and as you all know, not
everybody really cares or educates themselves about
the danger they may pose to others. Sorry--I'm getting
a tad political.

Anyhoo, that's the scoop. I'm sure I'll be writing
about the experience as it really happens (not just
how I'm picturing it now, based on what I've been told
and read), and I'll send my treatise your way if you
want me to when the time comes. I keep thinking maybe
I'll write the great American novel that week with
everybody out of the house, but maybe I'll just nap a
lot!

Thank you all for your prayers and support. I know God
is taking care of me, and there have been many
positive changes in my life as a direct result of the
diagnosis, so I truly believe that He meant for me to
discover this now, and that His plan for me is totally
awesome and way better than anything I could possibly
dream up.

Love to you all and Happy Easter!
Lynn