Monday, January 21, 2008

This week

Here are the basics:

1. The doctors need to see if the cancer has spread out of my neck area. They give me a small dose of radioactive iodine tomorrow.
2. They give this a couple of days to circulate in my body.
3. I take laxatives on Wednesday and Thursday to clean out my colon. The colon can absorb some of the iodine, so we want to clean it out to get a clean scan.
4. On Friday, I arrive at 7:30 AM. This is a full body scan--it takes an hour.
5. The thyroid cells in my body will have absorbed the radioactive iodine. The radioactivity is then picked up by the scan.
6. They calculate the dose of radioactive iodine for treatment, versus the scan. The scan is 4 millicuries of iodine. The treatment could be from 30 to 200. If it is a high dose--180+, I will probably stay in the hospital for 2 days. Otherwise, I go home and try to stay away from people for a few days.
7. Getting the radioactive iodine is not by opening a cabinet and pulling out a bottle. It is housed offsite for a lot of hospitals. So, it will be a 3-4 hour wait for the radioactive iodine to be brought in. In two minutes, it is down my throat and out the door. This big dose is designed to be absorbed again by the thyroid cells, still seeking out iodine. But, the radiation is much higher. It is supposed to kill the cells.

Problems:

  • Hurthle cells don't absorb iodine too well.
  • I could have a "clean" scan--no observed cancer cells, and they could still be there.
  • Because Hurthle cells don't absorb iodine too well, they may not die.

I return in two weeks for another scan to see if there is remaining cancer.

At this point, I am not sure if I take another dose of radioactive iodine for the second scan, or if there is enough residual iodine from the first scan to "light me up".
I am also not sure if I am on the low iodine diet for two more weeks (I doubt it).
And, I am not sure if I stay off my thyroid medicine for the two weeks (I doubt it.)

So I question if the second scan is accurate.