Nuclear medicine counseling: Step 1 to Radioactive Iodine therapy (RAI)

Today, I had an almost one hour counseling session with the nuclear specialist of the American Hospital Dubai, Dr. Hua Yang.  She answered all my questions and discussed the plan for my thyroid ablation.

 Do's and don'ts

 Ablation plan

The treatment will start with Thyrogen injection on 16 November 2015 which is the first dose of two doses.  This is usually done on an outpatient basis.  The next day, after 24 hours, I will have another Thyrogen injection. 

Thyrogen is a recombinant form of human thyroid-stimulating hormone (TSH). It works by binding to TSH receptors on normal thyroid cells or on thyroid cancer tissue. This helps to determine if there are any thyroid cells or thyroid cancer cells remaining.

If Thyrogen is given before RAI (radioactive iodine), there is no need to stop the Thyroxine or other medications.  The low iodine diet is the only preparation needed.  

In the afternoon after the second dose of Thyrogen, I will be admitted.  It is important not to have any food before that admission, so breakfast is encouraged, so from lunch will be fasting.  At liunch time, I-131 will be given in capsule form.  Two hours after the capsule is administered, NO drinking and NO eating but can drink water only.

I will be admitted for three days, in isolation until the scan shows that I am in a safe radioactive level.  But after I come home, I still have to isolate my self in my own room, using my own bathroom and not preparing food.

Post ablation discharge instructions for Iodine-131 therapy:

During the first three days, you should

• not touch anyone, keep a distance of 2  meters at all times between you and the next person.
• not sleep with anyone else in the same bed.
• not travel by mass transit (planes, trains, ships, buses, etc)
• not be in public places such as cinemas, restaurants, malls, etc
• not travel in a car with children or pregnant mothers.
• not share a bathroom with anyone else.
• drink plenty of non-dairy fluids.
• flush toilet twice after each use.
• urinate frequently.
• take daily showers.
• brush teeth at least three times a day.
• eat meat with no bones
• eat small meals and try not to have leftovers.
• use separate disposable plates and utensils and rinse them thoroughly before dispensing.

During the first 7 days, you should

• not have any intimate contact with another person
• not be around children
• not be around pregnant mothers
• not share meals with anyone
• not prepare meals for anyone
• maintain a distance from others

Thoroughly clean the bathroom and bedroom in three days.

• wipe all surfaces of the bathroom with damp sponge or cloth twice.
• wash all sheets, towels, pillowcases and clothes together in a washing machine twice.

You may return to work after

• three days if you have your own office or cubicle and i your work involves contact with adults only
• seven days if your work involves contact with children and pregnant mothers.

I have also signed the consent for the ablation therapy.

Continuing on low Iodine diet.