Seven months post RAI

It's been seven months after my radioactive iodine therapy.  Yesterday, i went to my endocrinologist as I have been having palpitations the past two weeks.  There is also discomfort on the operated site.  I feel like scabs are developing inside my throat.

I had an ultrasound as ordered by my surgeon.  On the neck ultrasound, everything is as expected postoperatively and thank God no vascularity.  Though there is a benign lymph node that was seen.

To be sure, my endocrinologist ordered for Thyrogen stimulated RAI scan.  He said that it has smaller dose than what i had during the treatment, maybe about 4 mCi only and one day inpatient stay.

Still waiting for my insurance approval.

Post ablation whole body scan: The final step.

After one week from my RAI treatment, today I came back early morning to the Nuclear Medicine Department to have my post ablation scan.  I came early at 8:00 a.m.  I actually came earlier than the patient relation staff :).  When she came, I registered and paid the copay as this is insurance covered and I just had to pay for 5% of the total price.  I paid about 49 AED.  Then, I went to the PET/CT scan room.  I was given a gown to change.  removing the bra but keeping the panty on.  I was lead to the machine.  It was a huge machine.  I had to lie still on a very narrow bed.  I was strapped with cloth to prevent unnecessary movement.  First, the whole body scan and the last 20 minutes was the neck only scan.  It pays to memorize your prayers, as I was able to say my rosary, hail holy queen and memore.  I also sang few worship songs of course in my mind.  Then, had a conversation with God.  During the first part my heart was racing as i was covered with a plate about 2 inches or less away from my face.  I was catching my breath while hearing the technician saying, don't move, stay still.  As I continue my conversations with God, I slowly come to relaxation.  I kept my eyes closed by once in a while would open them.  This is the final stage of thyroid cancer treatment.  I praise God for the healing.  Now I am free!  I only have to maintain my levels and make sure that the cancer does not come back.  Fight like a girl!

 After the WBS, asked permission to take a selfie

The PET/CT

Freedom!

Just a few hours after I woke up on day three of my isolation, the radiation level came down to 9 uSV.  Today is my freedom day!!  I was discharged by Dr. Yang but to be continued to be isolated in my own room.  Below are my "aquarium selfie" collection with my visitors.

my very entertaining nurse :)

My nurse

Ablation day 3

Indeed  it is a good morning for my radioactive level is down to 18.3. Praise God.  It was a funny night last night because code red was called for my room.  Meaning: FIRE!!! Ha ha it was just me using the hot shower.  Apparently, the fire detector in the room has been acting like that  so it is not the first time that this happened.  It's funny i was in the shower enjoying my night shower when suddenly my phon kept ringing endlessly.  How am i supposed to answer that? Ha ha ha I took my towel and covered my body, went out and there i saw the nurses looking at me through the looking glass.  They were telling me we had a code red. The steam! Anyway today could be my freedom ha ha ha

Radiation level on day two

This is day two and my radiation level in the morning was 99 uSivh.  At about 10 am,  was asked to lie down to check again and it went down to 69.97 uSivh. Not bad ha. More water please.

Ablation day 2

Woke up at 2:38 a.m. because the autoflush of the toilet has been flushing every 15 seconds.  I had to stand up and walk to the toilet to check if thereg  is any ghost ha ha ha only to find out that the platic for my trash was being detected by th autoflush.  Afte taking the RAI pill, i had tp flush two to three times to totally flush the radiation.  Wide awake until 4 am.  Then slept again til 7 am ro take myThyroxine.

Now on day two.  Yesterday was a breeze.  No adverse effects except for the headache due to the extended fasting i did.  Last breakfast was 8:30 a.m. only with boiled white eggs and orange juice. 

My first meal was back to regular diet but still no seafoods. Fair enough.  I sipped lemons and finally ate a regular diet.  Nom nom.  The meal is placed in a box.  All are in disposables and there is a special refrigerator for my food trash. It's called the decay storage (see picture of the brown cabinet below). This is a freezer thta is covered in a brown cabinet.  And oh, did i tell you the room is all lead inside the walls.  The nurses also covered all handles with plastic cling wrap even the mobile phones.

I had breakfast as in bug breakfast.  I also changed my beddings and cleaned my toilet.  I was also able to chat with my family back home. After cleaning my room,  i took a long shower and sat down to watch but suddenly i felt my heart beating fast.  Palpitations? I called the nurse and she told me to takr a deep breath.  I was ok after a few minutes.

Ablation Day: Step 5 RAI

I am now in the ablation room ohee American Hospital Dubai.  After my second dose of Thyrogen earlier, this is it.  Three hours after the last dose of Thyrogen, bloods were extracted.

About 3:15 p.m. i took the RAI tablet. It is a white tablet sealed in a gray bucket all lead covered (see picture)  There is a tube like straw that the technician puts in the bucket to pick up the tablet.  But when picking up the tablet, i had to do it myself as the technician had to stay far away from me.

So i picked up the tube and put the other end of the tube in my mouth with tablet sliding through the tube to my mouth and with water i pushed it down my stomach. The dose was 105.2 mCi.

Dr. Yang, the technician and the nurse were all outside my room.
I was instructed to lie down for 10 minutes to measure my radiation level.

The level was 163 uSV wohoooo....

Second Thyrogen injection: Step 4 to RAI

Had my Thyrogen injection at 9:30 a.m. today.  This is my last of two injections.  So far, so good.  Continuously praising God for all of this as i await for another victory.

Full blast Low Iodine Diet: Step 2 to Radioactive Iodine therapy (RAI)

In the past week, i have already prepared myself for the LID and this week I am going full blast low-iodine diet in preparation for my RAI-131 ablation therapy.  I will be receiving 100 mCu on 17 November 2015.

Why go on LID or low iodine diet?

For the radioactive iodine treatment (RAI) I-131 to be effective,  a low iodine diet is recommended two weeks before the I-131 administration.  RAI is iodine, so for this treatment to be absorbed by the remnant thyroid, the body should be iodine hungry.  Being on low iodine diet gives a  more successful treatment with radioactive iodine.

For more information, visit thyca.com:

Radioiodine therapy

The main instruction of my doctor is NOT to eat seafood mainly.  When I was told by the nuclear medicine specialist to research on the preparation, I searched the net and found that the following should be avoided when on low iodine diet:

• seafood
• egg yolk
• potato skin
• iodized salt
• dairy

Otherwise, be very careful with foods with added salt, not necessarily sodium.

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.