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.

ENT follow-up visit @2 months postop

I went to see my ENT surgeon yesterday.  He checked on my laryngeal nerves through the scope and it was fine.  The thyroidectomy wound is healing well.   The scar looks fine.  I also had blood test for calcium level to knoe if i still have to continue my calcium tablets.  Now im just waiting for the nurse's call to inform me if ill continue my calcium tablet.  . Four days to go and its RAI.

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.

Low iodine (LID) Butternut squash and string beans in coconut milk

Ingredients

Butternut squash (half)
string beans (about 10 strands)
coconut milk one cup
onion
garlic
rock salt
olive oil
pepper

Procedure

1.  Cut squash into cubes.
2.  Cut string beans into 1-2 inch size.
3.  heat olive oil
4.  Saute onion and garlic
5. Add coconut milk.  Bring to boil.
6.  Ass salt and pepper to taste.
7.  Put the squash.
8.  Simmer.
9.  Put the beans.
10.  Simmer until desired tenderness.
11. Serve with rice.

Beast mode vegetable roast with herb dressing (LID)

Ingredients

Any vegetable of your choice
olive oil
provence herbs
rock salt
pepper

for the herb dressing:
provence herb
garlic - lots of garlic
olive oil
pepper
1 tsp hhoney
balsalmic vinegar

Procedure:

1.  Place all vegetables in a pan.

2.  Pour olive oil, provence herbs, pepper and rock salt.
3.  Roast in oven until ready.

Dressing:

Mix all ingredients and blend.