Jun 2, 2014

Radioactive Iodine Treatment (RAI)

There is nothing wrong with having butterflies in your stomach.  
Providing you make them fly in formation...

On May 19th I began my low iodine diet in preparation for my RAI,
better known as Radioactive Iodine Treatment.  This is only used for
 Papillary and Follicular thyroid cancers. I have the Papillary kind.

Like ordinary iodine in the diet, radioactive iodine is taken up by any remaining 
normal thyroid cells and potentially by thyroid cancer cells as well. The radioactive 
form of iodine is used to destroy any remaining thyroid cells. 

Before this treatment can be given, the patient needs to be prepared 
so that the treatment stands 
the best chance of working, and in order to do that, it is recommended the low iodine diet.
This is recommended in order to get as much of the radioactive iodine to the treatment
 areas of the body and to stop iodine in the diet from interfering with the treatment. 

This diet is usually recommended for two weeks, but in my case because I am special,
I have to do it for a total of 20 days.  Sometimes being "special" is not all it's cut out to be.
Most of what I should eat and should not eat was found on Internet sites.  
Very helpful information.  This is the first step in preparation for RAI.

Step 2 is producing A High Level of Thyroid Stimulating Hormone (TSH)
There are 2 ways of getting this hormone level high enough in the blood to allow 
the radioactive iodine to do what it needs to do.

The first option is to stop thyroid hormone medication and allow the body to make a larger 
amount of TSH than usual. Many people struggle with this and can develop symptoms
 including tiredness, loss of appetite, weight gain, dry skin, greasy hair, constipation,
 mood changes and feeling cold.  

Here I have been lucky again. Unlike many, I did not have to stop taking my 
medication, but the weirdest thing is that I developed a few of the symptoms.
I am tired very fast, I go from hot to freezing cold withing second and if 
you ask Arvid, I have developed some mood changes.  

The second option applies to me.  It is to give the TSH in an artificial way by injections
 (recombinant human TSH, rhTSH, ‘Thyrogen’™). The injections are given on the 2 days
 before the radioactive iodine and are given by injection into the muscle in the buttock. 
This allows the patient to continue on their thyroid hormones throughout
 the preparation and treatment process.

I am not thrilled at all.  Not a coward, but just the thought of a needle being stabbed into
 my buttock is too much.  I can give blood all day long, and not be bothered, 
but an injection..ahhh another story altogether.

According to what I have read, side effects from rhTSH are uncommon and generally mild.
 Some people feel sick, have a headache or feel weak with aching muscles ( like having flu) 
after their injections. This is best managed with rest, plenty of fluids.
A few people have experienced a rash. Well what's a rash among friends these days?

Today I have the first shot.  Tomorrow the second and on Wednesday the radioactive
iodine pill.  Will see how it goes and how well I handle the injection.  I just hope
for my sake and for whoever is giving me the shot that they are gentle.  Otherwise I can't 
promise to stay quiet.  I know for my own good I should shut up!  Maybe my butt will puff up?

For now wishing you all a good day.  Mine is just starting.
It looks great so far.  Hopefully it remains this way for all our sakes.
Mine, Arvid's and Brutus'  Hahaha... 

Just from Arvid, "so how are we going to do this today?"
What do you mean, I ask? and he said, "am I going to go in with you in
 the room when they stick the needle in your ass or should I wait in the waiting room?"
Yep! it is going to be an interesting day today,  especially with someone as "special" as Arvid

Sometimes the bravest thing you can do 
is admit that you are scared...