Thyroid Cancer - Part 4: Iodine Radiation Therapy

(This is part 4 of a series. Click here to read part 1)

 Did you know there is a branch in the medical field called nuclear medicine?  I didn't until today. Cool, huh?

So a week ago I received a call from my endocrinologist to tell me my Thyroid Stimulation Hormone (TSH) levels were high enough that we could go forward with the radioactive iodine therapy. Shortly after that I received a call from the hospital to schedule, and not wanting to miss my first week of teaching seminary, we settled on today.  

So the way the radioactive iodine therapy works (as I understand it) is like this: 

1. The thyroid is the only body tissue that uses iodine. It sucks up iodine (which usually comes as an additive to salt, but also could come from fish or daily vitamins) and uses it to produce hormones and stuff.
2. When the hormones the thyroid usually produces (T3 and T4) get too low (for example, if the thyroid gets removed and all the T3 and T4 it produced before it was removed get used up) the pituitary gland starts producing TSH to say "Hey thyroid, wake up and start doing your job!" If the thyroid doesn't perk up (because it isn't there anymore) and start doing its job, then more TSH gets produced. Any remaining thyroid cells that might have been missed in surgery or rogue cancerous cells that may have migrated to other parts of the body will feel the need to start working.
3. The doctor puts the patient on an iodine free diet for a little while so there isn't any extra iodine floating around and the remaining thyroid particles are saying, "Yeah, pituitary gland, we know you want us to produce, but there is no iodine to use. We can't do our job without it!"
4. The folks in the nuclear medicine field make a tiny bit of iodine radioactive and have the patient swallow it, thus making the patient radioactive. Since the thyroid is the only organ that uses iodine, the thyroid is the only organ affected.
5. The rogue thyroid particles say, "Hey! Here's some iodine! We can use it to do our job now!" and they suck up the iodine, not realizing that it is radioactive and it will kill them. 
6. In theory, all the remaining thyroid tissue is destroyed, the patient takes synthetic thyroid replacement hormones and lives happily for the rest of her life.

(At Steven's urging I asked if, while I am radioactive, I am likely to glow in the dark and the guy laughed and told me no, I wouldn't glow in the dark and I wouldn't develop super powers, but I would set off the radiation monitors at the airport.)

Anyway, this morning I went to the hospital and checked in and filled out some paperwork. Then a guy from radiology came and brought me to a small room where I sat in a chair. He went over my health history and stuff in the paperwork, then gave me a list of instructions.

For the next five days I need to:

• Sleep alone
• Not share a bathroom
• Flush twice and rinse sinks and tubs after use
• Not come any closer than 3 feet from other humans or pets, especially pregnant women or small children
• Avoid public places as much as possible
• Not share dishes, utensils, towels, or washcloths.
• Wash my dishes promptly after using
• Not prepare meals for others
• Drink lots of water to flush the unused iodine out of my system
• Some other stuff along those same lines...

The radiologist made sure I understood the instructions and would be able to follow them. He even had me sign something to say I understood.

Then he left the room and came back in with a cylindrical metal canister about the size of a softball. He opened the canister to reveal a glass vial containing a pill. He handed me the glass vial and had me dump the pill directly into my mouth from the vial and then follow it up with some water. After the pill had been swallowed, he hustled me out of the hospital as fast as he could. I was only at the hospital a little over half an hour total.

So here I am enjoying a room of my own for the first time in over 20 years. I have my phone for calls or texts. I have a tablet for reading ebooks and browsing Facebook. (And, incidentally, for trying to write a blog on its little keyboard.) Both phone and tablet contain games. I have borrowed Josh's chrome book for watching movies on Netflix. I have a blanket I am knitting. I have books and paper and pens.

The Relief Society has provided us with a couple of freezer meals and my men folk are planning what other meals they want to make.

Besides feeling tired (which has become my new normal the last few weeks) I feel fine: no nausea or anything. To quote a song: "...I got no deeds to do, No promises to keep, I'm dappled and drowsy and ready to sleep... "

- The 59th Street Bridge Song (Feelin' Groovy) by Simon & Garfunkel

Next week I get to go back to the hospital for a full body scan to see how the iodine was absorbed. So....

*** to be continued***