Thursday, March 20, 2014

Thyroid Cancer Update: Radiation Week!

This is going to be a pretty long post while I explain more about the process leading up to being radioactive.  I decided there was just too much information to put everything together in one post.  Next post will be all about being radioactive!  As always, I am being so long-winded to inform and to give other thyroid cancer patients a detailed look at the process and what to expect.

DivineMrsDiva.com - Thyroid Cancer Update: Radiation Week!

The next step in my cancer journey is radiation.  For thyroid cancer, a radioactive iodine is ingested and used to kill any leftover thyroid cells (which may or may not contain cancer).  The thyroid must have iodine in order to make thyroid hormones, which affect every aspect of your body.  In order to start the process and ensure the radioactive iodine is taken up by the thyroid cells, one has to go on a Low Iodine Diet (or LID) for about two weeks prior to treatment. 

The LID forces you to eliminate all dairy, seafood, sea products, soy, anything made with whole eggs, and anything that uses iodized salt in order to starve the remaining thyroid cells of iodine they so desperately want.  For this reason, no meals from restaurants or pre-packaged foods are allowed. (Unless they specifically say they use non-iodized salt.  Trader Joe's has some no salt added salsa and tortilla chips we found towards the end of the two weeks.  I so needed a snack like that!) Because I was going to have to be very strict on the LID, I also decided to be really strict on my gluten-free and sugar-free regimen.  I was a little naughty after surgery and here and there throughout the beginning of the year.  I would also add grain-free, but I occasionally had quinoa with dinner and gluten-free oatmeal for breakfast. I won't bore you with listing everything I could and couldn't eat, so if you would like to know about the Low Iodine Diet you can find more information here.

I didn't have too much trouble with the LID because it was basically going back to how I was eating pre-surgery.  I had to get a little creative with some recipes, but that is where my Gluten Free Pinterest board came in handy.  The only downside is that there really isn't an easy and quick meal on the LID.  Everything has to be cooked at home and, when I'd leave the house, every snack I might need for my time out of the house had to be packed in a cooler and brought with us.  The constant thinking ahead was a bit exhausting.

After about two weeks on the LID, it is time to get the thyrogen shots.  Some doctors make their patients stop taking their thyroid hormone replacement pills prior to treatment.  This can cause you to become hypothyroid which brings on a whole slew of symptoms, all of which make you feel like total crap.  To circumvent this, many patients choose to get thyrogen shots prior to treatment so they can continue to take their thyroid hormone medication.  Thankfully, I was given this option. 

Thyrogen is a drug that mimics your body's natural Thyroid Stimulating Hormone, or TSH, which is produced by the pituitary gland.  It tells the thyroid gland to make and release thyroid hormones into the blood.  Basically, it puts your thyroid to work.  When I was diagnosed with Hashimoto's, my TSH was 3.68, which is almost normal. In fact, the first doctor I saw thought it was perfectly fine and wouldn't even test me for Hashi or any other thyroid-related issues.  With medication, I have been able to get my TSH down to .76, but because I am a thyroid cancer patient, that number needs to be all the way down to sort of shut down any thyroid cells that could be hanging out.

Getting the thyrogen shots shoots up your TSH and gets your remaining thyroid cells into overdrive.  This makes them take up the radioactive iodine that should eventually kill them off.  So essentially, we are starving these cells and then getting them all worked up so they go to town on the iodine.  After two rounds of shots, my TSH was 42.  There can certainly be symptoms from getting the shots - fatigue, dizziness, headache, nausea, and vomiting.  Thankfully, I had none of these symptoms.

On Monday, the 10th, I woke up in the wee hours of the morning to make it to me 7:30 AM appointment.  It was a pretty simple appointment where the nurse asked me questions about the medications and supplements I am on and then took my vitals. The doctor came in and talked to me about what was going to happen the next few days and answered a few of my questions.  Then she took my blood (OUCH, she is not good at that) and gave me my thyrogen shot in my butt.  If you are a very modest worry wart like me, don't worry.  No clothes had to come off.  You just pull the waistband of your pants down a little to expose the top area of your buttocks.  She was done with the shot before I even knew she was doing it.

Tuesday was another 7:30 AM appointment for vitals, blood work, and the second thyrogen shot.  The previous day's blood work explained that my innards were all working good, that my TSH and T4 were getting in good ranges (for every day) and that I am not pregnant.  Apparently the blood work they did on Tuesday was another pregnancy test and another TSH test.  I'd much rather them take my blood than have to pee in a cup for this mess.

After the appointment with the endo, I was off to Nuclear Medicine.  The nice lady I met with went over what was going to happen on Radiation Day, answered some questions, and gave me a list of precautions for being radioactive.  I'd like to point out that this DAY BEFORE radiation is the first time they gave me any list of precautions.  If I was some dumby with no internet, I would have been very ill-prepared.  Like it was, I am over-cautious and over-prepared and I like it that way.  But more on that next post.

The nice Nuclear Medicine lady then brought in a metal container with a smaller plastic container inside it.  The plastic container contained ten pills of a lesser form of radiation that was safe for me to have and still be around people.  I had to down all ten pills and then was free to leave.  These pills contained the tracer dose of radiation, so the next day's scan could show where my leftover thyroid cells were hanging out.

After having been in the house for two weeks working on cleaning and reorganizing, getting prepared for all the radiation crap, I was glad to have one last afternoon out.  Sean and I ran errands to pick up supplies at Target.  I also swung by Lane Bryant to make a return (and a purchase!).  If you follow me on Instagram, you know what I bought.  We came home and spent the rest of the evening (until 2AM), moving furniture out of the bedroom and covering everything in plastic.

It was almost time to get radioactive.






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