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TClogo

In the posted dated September 25, 2012, I mentioned that I had been diagnosed with Thyroid Cancer – papillary carcinoma.

My surgery was successful and I have fully recovered and now I have a scar about 4 inches by 1/8 inches across the lower part of my neck.  They removed my thyroid totally, some lymph nodes and one parathyroid.  You have 4 parathyroids and now I am down to one.  If I get leg cramps it means I have to get more calcium in my diet.

Here is a link to the Thyroid Support organization for more information. They have news, information on various topics and a forum where you can sign up and read what others are concerned about, issues, questions and their experiences and ask your own questions.

http://www.thyca.org/

I was able to take care of the cats the day after the surgery which included feeding them, and doing kitty litter duty.  I was still a little groggy.  My wound was not bothering me all  so I think it was the anesthesia that was causing my slight nausea.  Because of that, I didn’t eat much the first day and into the second but by the 3rd I was ready for food.

A week later the bandages were removed by my surgeon and it was then that it hurt.  They had this plastic clear bandage across the smaller white bandage that covered my neck.  It caused some stinging when she removed the whole bandage.  It took about a day for that to settle down.

My bandages after thyroid surgery

My bandages after thyroid surgery

She had me return for a final check about two weeks later.  She liked what she saw and then shook my hand wished me well and then said “I  hope I won’t see you again for more neck surgery.”  She was concerned about the one lymph node that was cancerous, something about “chunky lymph nodes.”  I said thanks and goodbye to her.

Now that the surgery was over and I had healed, it was time to move forward on the thyroid cancer treatment schedule.  I made an appointment with the Nuclear Medicine department at Swedish  Hospital and received my schedule.

I was placed on the “withdrawal from thyroid meds” schedule leading to the RAI (Radioactive Iodine treatment).  I discussed the process with the Nuclear Medicine doctor on a visit there about a week later.    I also visited my Endocrinologist for my Cytomel prescription and a blood test on my thyroid levels.

The last Thursday of November I took my last thyroid meds pill (Cytomel) and am now entering the

NO THYROID MEDS ZONE!

They say that I may experience:

  • foggy brain which means a lack of focus, slow thinking, and possibility of other things going a little off like talking, writing and etc.
  • tiredness and this means I might sleep 18 hours a day like my cats
  • weakness which means I won’t be able to lift things or open a bottle
  • slowness of reaction time so I might not be able to drive myself
  • being cold which is interesting because I usually am cold but I was told I would be colder.
  • forgetfulness

The website “Fitsugar” had this article an explanation of foggy brain:

http://www.fitsugar.com/Foggy-Brain-Quick-Fixes-15106345

What does this mean for the cats, well it means that I might need help in remembering to feed them, do kitty litter duty and make sure I don’t leave Sneakers outside.

To get ready for the NO THYROID MEDS situation, I have purchased a good months worth of cat food and litter.  We should be covered till Christmas when I am back on regular food and thyroid medicine.

In about a week I will start the Low Iodine Diet (LID).  The goal is to starve any remaining thyroid cells.  This diet is really restrictive and you are not supposed to go on it more than two weeks.  It will be a challenge because I have to reduce my iodine intake drastically to 50 mcgs a day – five over or under.  Most people get 200-300 mcgs of iodine a day.  Most people get far too much salt in their diets.  So you can see how restrictive this diet is.

The problem and challenge are that the food manufacturers are not required to say which type of salt they are using so you have to stop eating a lot of foods as well as watch out for  some food additives.

Because of this diet I have been reading food labels and boy is there a lot of salt out there in foods and in unexpected places like Half N Half with 25 mgs, not mcgs.

In general the Low Iodine Diet (LID) means I cannot eat:

  • Seafood and fish and sea vegetables (seaweed)
  • Dairy products
  • Coffee and wine are suspected because of processing
  • Condiments like catsup, mustard etc.
  • Soybeans
  • no salt only non-iodized, no sea salt etc.
  • no bread or bakery goods unless they have no salt in them.
  • no canned food, lunch meats and foods in cans, bottles are okay
  • no chocolate, or molasses
  • non-iodized salt, no sea salt

I was given a pamphlet with a table showing what I can eat and what I can’t and some recipes to follow.  If you go to the thyroid cancer support link above you can learn more about this diet.  I have found that what the hospital pamphlet says versus what is online is very different and does not always agree.  So I suggest you follow your Nuclear Medicine doctor’s guidelines or call the nutrition office phone number.  I have decided to just use the pamphlet guidelines and stick to them.

I will be on that for about 8 days.  I get my tracer dose of RAI (Radioactive Iodine) four days into the diet and wait two days and then I have a WBS (Whole Body Scan) and then they give me the BIG DOSE of RAI.

This is where it gets tricky for the cats and my husband.

The RAI BIG DOSE means I am a DANGER to them and to my family.  I will have to follow RAI protocals for about 4 days after the dose and beyond.   There is a lot of confusion online about on how long to stay away from people and pets.  So ask questions and do your research.

The RAI protocols are necessary because if I  contaminate any surface with any of my body fluids and my cats or my hubby gets into contact with it they’re thyroid is at risk.  The RAI is meant to kill thyroid cells.

Body fluids include saliva, vomit, urine, stools, sweat, and blowing the nose etc.  You really don’t realize how many places, surfaces and things you touch in a day, so washing my hands will be a big priority as well as wearing latex/vinyl gloves.  I also have masks to cover my mouth and nose in case I sneeze.

UPDATE 12/31/2012 – I really didn’t use the gloves as much as I thought I would so I now have a lifetime supply of them.  I washed my hands regularly before and after I handled food, plates etc. 

So with the guidelines given me by the Nuclear Medicine doctor and what I have read online, I will make my choices and err on caution.  I also attended the local thyroid cancer support group meeting and learned about other problems with the radioactivity of the iodine and how long you have to follow the protocols.  UPDATE 12/31/2012:  Be very careful with the information you get off the internet and from others.  I learned to late to call the Radioactive Safety Officer of Swedish Hospital on some of these comments made by others.

On the Thyroid Cancer group link above and other websites I have seen how others have tried to deal with the care of their pets during this RAI Treatment.

I have a problem, my house is very small.  It is about 1000 square feet and there is only one small bathroom. I cannot go to a hotel/motel, nor stay with family or friends because I put them in jeopardy.  People who have septic tanks would not be able to pump for six months after I used it.  UPDATE 12/31/2012:  I called the Radiation Safety Officer of Swedish Hospital and was told that I did not need to worry about septic tanks.  They are massive and well underground so that means they are safe.  The amount of radioactive iodine is so small and the 1/2 life is 8 days so anyone with a septic tank is okay and can pump after 8 days from the time of the large dosage which in my case would be Christmas Day.  

So I am staying home and here is my checklist for handling my pets during the RAI protocols:

  • Decide how to isolate myself from them.
    • I will stay in the bedroom and isolate myself as much as possible and sleeping alone for the duration.
    • Staying 3 feet from them and limiting exposure to 15 minutes a day.
    • I have added a hook and eye to my bedroom door because Ebony is clever enough to pull the louvered door open.
    • My sister loaned me a pet gate which will cover the hallway door so I can access the bathroom.  This will keep Sneakers out who likes to follow me around.  Keep Ebony from slipping into the bedroom area.  It means I have to remember to open a door, close it behind me, etc.
  • Do not touch them, hug or pet them.
  • Use latex gloves to feed, clean the litter or get someone else to do it.  Washing your hands regularly before and after you handle their plates works especially during the 4 days you are to follow the radioactive protocols. 
  • Do not let them lick you – especially dogs for your sweat is dangerous.
  • Do no kiss them your saliva is dangerous.

Some people board their pets.  This would really cause Ebony, Sneakers and me a great deal of stress so I decided not to.  The idea of taking them to my sisters and putting them in her basement, but that would upset her cats and she has been having cat potty issues.  I feel keeping them home along with my isolation and retreating to the bedroom will work.

Most people have others take care of the pets when they are going through this process.  I have limited people nearby so I will have to take care of them myself with help from my husband and have a nice supply of vinyl gloves to use.  Of course, they will be contaminated and become part of my trash that I have to collect.  I have been told it will have to be held for 3 months before going into the garbage collection.  My hubby and I will keep it till the end of January 2013 and then dispose of it.  It will go through 4 half lives till then and be of little significance for the radioactivity. 

In preparation, I have created two cubicles in the living room for Ebony to hide in.  They are on the bottom shelf of two bookcases.  They have towels and rug pieces for comfort.  I then took two hand towels and made a little curtain so Ebony can hide out.  When my hubby uses the Futon to sleep on in the living room that will cause some problems for Ebony.  Ebony usually sleeps on the Futon at night and stays in the bedroom throughout the day.  Hopefully the cubicles will help.  Ebony really likes the one by the cat gym in the living room.

You can see the towel hanging down and a little glint of Ebony’s eye.

DSC05728

DSC05729

Sneakers will sleep any where he likes.  He will be a problem because he likes to be close to me.  He likes the end of the bed and climbing in between us in the morning.  He is like my shadow.  We have evening cuddle time.

Sneakers & Ebony

Sneakers cuddling

He likes to sit next to me on the plastic rolling storage cart that we have set up next to my desk in the dining room.  He is about 2 feet from me exactly at this moment on my left.  I can reach him with my left hand easily.  That is too close.  It will have to be moved.

The idea of bringing in a lite weight lawn chair to use in the living room will isolate me from the Futon and make it harder for Sneakers to get close to me.  It will also help my husband who will be using the furniture.

This does not solve the problem of the two cats coming near on the floor, but I can move the lite chair around easily, keeping my distance as well, then follow the 15 minutes per day rule.

Try this link from Med Help to learn how it may affect your pets and some ideas on what to do.  Also the Thyroid Cancer link above.

http://www.medhelp.org/posts/Thyroid-Disorders/RAI-and-pet-saftey/show/402210

My sister-in-law is calling me daily to see how I am doing.  So if she thinks that I am not keeping up because of the foggy brain she can alert my husband to the situation.  Of course, my husband will be in an out throughout the day checking on me and the cats and keeping his distance.

Meanwhile if you have or know someone with a thyroid condition say to them: CHECK YOUR NECK for lumps.   It was Ebony who helped me, I was playing with him on the floor in the living room and reached up to scratch my neck and found the lump.

Sneakers & Ebony

Sneakers & Ebony

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