Thursday, December 23, 2010

6 Months and 2 Days

It has been 6 months and 2 days since I've had my surgery to remove the cancer. It's hard to believe that the time went by so fast.

I'm feeling much better than I did, but still have a ways to go regarding the medication. I was depressed for about 2 months, and now that I've increased the dosage, I'm kind of in between. I feel anxious, but still have some hypo symptoms. I won't be getting blood work done again until just after January, when I FINALLY get to have insurance again.

Hopefully in the next couple months we can figure out the medicine and get it straightened out. I really wasn't expecting this part to be this hard, and it's hard asking for thoughts/prayers because they think it's all over with. It really shouldn't be, and it's been a hard 6 months, even though the hard part was in June/July. I would just love to not be exhausted after doing laundry or dishes, or anything else that takes relatively little effort.

I'll still keep you posted on how everything is going! There's not too much to update on at this point, other than blood work and medication changes, but I'll let you know what happens!

Thursday, October 21, 2010

Radioactive Precautions...Again

Yesterday I wrote about an AP article a friend sent me about people not taking enough precautions after receiving RAI treatment. Today, I saw the same article on a yahoo site, and an e-mail was sent out from the ATA (American Thyroid Association) about it! I can't believe that some places don't take enough precautions before letting people in the public, and I can't believe that some people just don't care!!

The e-mail from the ATA:
Joint Statement on Radioactive Precautions Following Radioactive Iodine Therapy
October 20, 2010 


The American Thyroid Association (ATA), The Endocrine Society (TES),
the Society of Nuclear Medicine (SNM),
the American Association of Clinical Endocrinologists (AACE)

Radioactive iodine (I-131) has been used for decades as an effective treatment for thyroid cancer. Throughout this time, one important aspect of such treatment has been the protection of the public, and more specifically household contacts, from theoretically dangerous exposure to residual radiation remaining in the patient's body after treatment. The Nuclear Regulatory Commission (NRC), an agency of the Federal government, sets the rules governing this aspect of I-131 treatment and revises them periodically1.

In 1997, the NRC modified these regulations to allow individualization of the procedure for preventing radiation exposure to the public after a patient is treated with I-131. A goal of this rule change was to avoid isolation of a patient in the hospital for prolonged periods if the patient's release to home would be safe for the patient, the patient's family and the public. This approach enhances patient satisfaction and is the current standard of medical practice.

In anticipation of the Nuclear Regulatory Commission (NRC) holding meetings this week related to the use of medical isotopes and other medical issues, Rep. Edward Markey, D-Mass., and Chairman of the Energy and Environment Subcommittee, wrote to the Chairman of the Nuclear Regulatory Commission and reported a "strong likelihood that members of the public have been unwittingly exposed to radiation from patients who are discharged after being treated with radioisotopes, and that this has occurred because of weak NRC regulations, ineffective oversight of those who administer these medical treatments, and the absence of clear guidance to patients and to physicians that provide procedures to ensure that such exposures do not occur".

The American Thyroid Association, The Endocrine Society, the Society of Nuclear Medicine, and the American Association of Clinical Endocrinologists believe that the current procedure, based on scientific evidence, is safe for patients, their families and the public when radiation safety instructions are followed (JAMA 283: 2272-2274, 2000). However, the ATA, TES, SNM and AACE would support reexamination of this issue if new data emerge that indicates concerns about public safety. Additionally, the American Thyroid Association has recently completed an examination of the current scientific evidence for any potential risks to the public from I-131 therapy of thyroid cancer. It is anticipated that the report will provide updated recommendations for best practices focusing on patient and public safety following I-131 treatment.

Our organizations are dedicated to adhering to the best medical practices for I-131 therapy so our patients, their families and the public remain safe. We look forward to discussing this important issue with relevant federal agencies. Until new regulations are released by the NRC, we recommend that physicians and patients should continue to follow current safety procedures.

For questions regarding the statement, please contact Bobbi Smith, Executive Director at the American Thyroid Association at bsmith@thyroid.org; Stephanie Kutler, Director of Government Affairs at The Endocrine Society at skutler@endo-society.org; Janette Merrill, Assistant Director, Health Policy & Regulatory Affairs at the Society for Nuclear Medicine at jmerrill@snm.org; Bryan Campbell, Director of Public and Media Relations at the American Association of Clinical Endocrinologists at bcampbell@aace.com.

Wednesday, October 20, 2010

RAI Cautions

The AP posted this story today about Thyroid Cancer patients and how they expose unknowing people to RAI, and can contaminate them and other things. It's a very interesting article.

Luckily, Strong Hospital was very cautious on sending someone with RAI out of the hospital, and making sure I wasn't going to contaminate people. The only thing I never thought of was the garbage setting of alarms and could possibly contaminating people.

Go check it out!

Friday, September 24, 2010

Bringing Sexy Out of the Thyloset



I can't believe it's been 2 weeks since I've put up my weak awareness post! This month has completely flown by. I was hoping to really do some awareness stuff this month, but between babysitting and getting my apartment ready, it's now the end of the month! I was going to paint my nails earlier in the week for Thyroid Cancer awareness (to show off in this post for you guys!), but I was too busy! Hopefully I'll have time today! Things have been quiet on the medical front. I failed and didn't post after my check up last week. I met with the surgeon for him to go do a check, and he says everything is good! I'm due back next June!


I came across a pretty cool blog a month or two ago. It's called Dear Thyroid, and people can write letters to their thyroids, doctors, whoever about their thyroid. I never knew what to write, but have wanted to participate some way on the site. So, when I saw that to celebrate Thyroid Cancer awareness month, they were having people do a little interview, I jumped on the chance to participate! So, here's my little interview with Dear Thyroid. Enjoy!





What kind of thyroid cancer were you diagnosed with? How many years have you been a survivor?
I was diagnosed with Papillary Thyroid Cancer. I'm not sure which stage it was, either 1 or 2. I have been a survivor for three MONTHS. 


September is thyroid cancer awareness month. What does that mean to you? Why do you think awareness is important? How do you spread awareness?
Awareness month means to show you're proud to be a survivor and happy to share your story. Awareness is important, because if we didn't try to raise awareness (for anything, not just ThyCa), then no one would have any idea anything exists, and it will make it harder to prevent, or have people think about these things. I try to spread awareness, it's hard since I really don't work or go many places right now where people don't already know. Luckily, my mom is a proud mom and shares with everyone, so she's my biggest awareness spreader. :) I try to always wear open shirts (mostly because I'm used to it), so people might notice (it's harder after the steri-strips are gone for people to notice), and I always wear my "Cancer Sucks" bracelet from Choose Hope. I've had a couple people ask me what it says or why I wear it, then I can explain. I hope someday to get a tattoo of the ribbon and butterfly.

Many thyroid cancer patients have been told, “If you have to get cancer, thyroid cancer is the one to get.”  What do you think of that statement? When you’re told this, how do you respond?
I know that people diagnosed with ThyCa hate this statement, so don't hate me when I answer: Honestly, it doesn't bother me. Heck, my doctor told me that, which I'm sure would make most people even more upset, but it comforted me. I had a VERY low stage of Papillary Cancer. All I had to do was surgery & the RAI. So for me, it WAS easy. I mean, it wasn't easy, but treatment-wise, I still have to do scans and everything, and I did have it in lymph nodes, so it wasn't NOTHING, but, compared to what a lot of other people go through (Thyroid & other cancers), I think it was "good" compared to what I could have had. I had graduated a month before my surgery, and was getting married 7 weeks after surgery. I couldn't take anything more serious. Yes, when people tell me that, I say that no cancer is easy. It's still hard, but I do tell them that I got lucky and had a very short and successful period of knowing I have it.

Dear Thyroid is constantly working to dispel the myth that thyroid cancer is the good cancer or the easy cancer. What other myth would you like to dispel regarding thyroid cancer?
I guess I haven't heard any other myths to dispel, but I keep reading that Thyroid Cancer grows more rapidly than any other cancer. I'm not sure why, but get checked. Even if you don't think it has to do with your Thyroid.

What one thing would you tell the world about thyroid cancer?
Tell your doctor about any symptoms you have. I went in thinking I had allergy problems, and it turned out that my Thyroid was enlarged. There was a very small nodule on it, and it's a very small chance that nodules are cancerous to begin with, let alone VERY small ones (under 1cm!) If your doctor does find something on your Thyroid, keep on top of it. Keep getting check ups. I went for a year check up, always being told that a good chunk of the population have these, and only about 5% are cancerous. They wanted to do a biopsy, so we said sure (even though I didn't want to). It was a shock to find out I had cancer, especially when I didn't expect it. You never know!

What advice would you give to a newly diagnosed thyroid cancer patient?
Get as much information as you can. Be VERY careful on the internet. Luckily, one of my friends is in med school, so she directed me to the best sites to look for information (the Mayo Clinic). Join groups like this online, so you can talk to people who have been through it before, but know that each situation is different.
Also, make sure you talk to your doctor about your surgeon. My surgeon specializes in Thyroid removals, and is the best in this area. I was the 6th scheduled on the day of my surgery before I was moved up.

Do you have a funny thyroid cancer-related story you are willing to share?
When I was going into surgery, I had my gown on and IV hooked up. Right before they wheeled me in they put on a blue cap. My brother took a picture of it, and I put it on Facebook the next day. Everyone kept telling me it could be my something blue for the wedding! I had to tell them that I woke up with out it, and I was actually disappointed that I couldn't take it home with me!






Information about Dear Thyroid to include in your post:
Dear Thyroid is a thyroid support community and literary brand. Our goal is to connect patients with each other, to create awareness for thyroid diseases and cancers, and to give all thyroid patients a voice. We come together as a united front to invoke change on behalf of thyroid patients worldwide. Thyroid patients are invited to submit letters to their thyroids, thyroid rants and raves, and other literary creations. Help us to create awareness for thyroid diseases and cancers by wearing your disease on your sleeve and by requesting one of our free awareness bands. Visit DearThyroid.org to learn more!

Friday, September 10, 2010

Thyroid Cancer Awareness Month!

September is Thyroid Cancer awareness month! I know I'm about 9 days late, but either way, show your support! This is a pretty lame awareness post, but I'm really busy at the moment, and am trying to do a million different things.

BUT!

I made a group on SU2C for Thyroid Cancer (ThyCa Warriors). Please go check it out and donate. Even if it's not for Thyroid Cancer, donate.

Thursday, July 29, 2010

The Important Body Scan

This morning I went in for my total body scan to see how the RAI is working.

I went right in, go the whole scan done, the neck scan, and went to wait. They said they wanted a chest picture done, so I went back and had to be put back under the machine to get a picture of my chest. I guess there was a couple of white spots on the total body scan, so they wanted to be sure there was nothing there.

After, I went back & spoke with the resident. The scan shows that the remaining thyroid tissue is taking in the RAI nicely! In 3-4 weeks, the tissue should be completely killed off! I'm so happy that this is working, and I can pretty much get past this!

I will need to be doing blood work every 6 weeks, mostly for my TSH & T4 levels for my medicine, and I'll have to repeat this scan (not the major dose week, just the first dose week) every 9-12 months.

For now, I won't update too much, definitely not until after the wedding. Just on adjustments in medicine & any new information.

Tuesday, July 27, 2010

The LID

The LID (low iodine diet) is something that needs to be done when taking the RAI (radioiodine) treatments. Basically, you can't eat anything in preparation of the treatments, or during the treatments. The best place to go for information is here, where it explains what you can/can't eat, and you can print off a cookbook!


General Comments
  • Remember: LOW IODINE has NOTHING TO DO WITH SODIUM. The diet is a low-iodine diet, NOT a low-sodium diet. Sodium is in most foods. Table salt is sodium chloride, not sodium.
  • Sodium in any form is OK, as long as it is not provided as IODIZED salt. NON-IODIZED salt is OK for the diet, as long as it is not sea salt. As noted below, you should avoid any product or ingredient from the sea. That's because sea-based products are high in iodine.
  • Also, this is a "low-iodine" diet, NOT a "no-iodine" diet and NOT an "iodine-free" diet. A low-iodine diet reduces iodine consumptionc(on most diets to below 50 micrograms (mcg) of iodine per day (on some diets to below 80-100 mcg per day). The American Thyroid Association recommends that the low-iodine diet include less than 50 mcg of iodine per day. (The Recommended Daily Allowance of iodine is 150 mcg per day for adults. One teaspoon of iodized salt contains 400 mcg of iodine.)
  • During your time on the diet, you may freely eat any foods that are low in iodine (up to 5 mcg per serving). There are lots of foods that you can eat. Pages 10 and 11 have lists. However, avoid foods high in iodine (over 20 mcg per serving). Also, many thyroid cancer specialists' guidelines recommend limiting foods that are moderate in iodine (5 to 20 mcg per serving).
  • For recipes and a snack list, use ThyCa’s free Low Iodine Cookbook. You can download it free from our web site and print it out.
  • You also can adapt your favorite recipes from your own cookbooks to the low-iodine diet. To do this, eliminate ingredients that are high in iodine, or substitute ingredients from the list of foods and ingredients that are fine on the diet.
  • If you follow other dietary guidelines due to allergies, diabetes, other medical conditions, or other reasons, you can adapt your recipes and meal plans. Use the cookbook's lists and tips.
Avoid These Foods and Additives
Avoid the following foods, starting when instructed by your physician before your radioactive iodine test or treatment. Continue as instructed until after your radioactive iodine treatment (often for about 24 hours after). These foods and ingredients are high in iodine (over 20 mcg per serving, according to researchers' presentations at our conferences).
  • Iodized salt and sea salt and any foods containing iodized salt or sea salt. Non-iodized salt may be used. For example, Kosher salt is okay unless the label says that it is iodized or sea salt.The reason to avoid sea salt is that all products from the ocean tend to be high in iodine.You can usually find plain, non-iodized salt next to the iodized salt at your grocer. Read the label. (One teaspoon of iodized salt has 400 mcg of iodine.)
  • Seafood and sea products (fish, shellfish, seaweed, seaweed tablets, kelp). These are all very high in iodine and should be avoided.
  • Foods or products that contain these sea-based additives: carrageenan, agar-agar, algin, alginate, nori (these food additives are seaweed by-products).
  • Dairy products (milk, cheese, cream, yogurt, butter, ice cream, powdered dairy creamers, whey, casein, other dairy products). Note: Nondairy creamers often have iodine-containing ingredients, too. A study published in 2004 in the Journal of Clinical Endocrinology and Metabolism reported on tests of 18 brands of milk in the Boston, Massachusetts area. It reported that 250 ml of milk (about 8 ounces, or 1 cup, or 16 Tablespoons) contained from 88 to 168 micrograms of iodine and averaged 115 mcg. It noted that sources of iodine in milk include iodine in cattle feed, the products containing iodine used to clean teats and udders, and a small amount from equipment cleaning products. (Some low-iodine diets allow very small amounts of milk or other dairy, if not listed in the first three ingredients on a label. There is no dairy in any of the recipes in this cookbook.)
  • Egg yolks or whole eggs or foods containing whole eggs. Egg whites are acceptable, because they contain little or no iodine. (Some low- iodine diets allow foods with very small amounts of eggs, if not listed in the first three ingredients on a label. The recipes in this cookbook use only egg whites.)
  • Commercial bakery products. Avoid bread products that contain iodine/iodate dough conditioners (usually small bakery breads are safe; it’s best to bake it yourself or substitute with Matzos). If you read labels closely, you may also be able to find crackers made only with flour and water. While a few commercial bakery products have tested low in iodine, manufacturing processes can change over time. The study published in the Journal of Clinical Endocrinology and Metabolism in 2004 reported that the iodine content of single slices of 20 different brands of bread ranged from 2.2 mcg to 587 mcg.
  • Red Dye #3. However, Red Dye #40 is OK. We suggest that you avoid red, orange, or brown processed food, pills, and capsules. Many red, red-orange, and brown food dyes contain iodine and should be avoided. The problem with food colors is specific to Red Dye FD&C #3 (erythrosine) ONLY. However, the problem is that some food labels do not specify which red dyes are used. Better safe than sorry. For medications, the best source is the Physician’s Desk Reference (PDR), which clearly states the ingredients. For example, Rocaltrol in the 0.5 mcg size is NOT good for the diet because it contains FD&C Red Dye #3. However, Rocaltrol 0.25 mcg does not and is safe for the diet (you can take two of them to get to the 0.5 mcg dose). Please always check with your physician.
  • Most Chocolate (for its milk content). Cocoa powder and some dark chocolates are permitted. Check the label for other ingredients not allowed on the low-iodine diet. The ThyCa cookbook has recipes with permitted chocolate.
  • Some Molasses. Avoid if sulfured or blackstrap, which is concentrated and has a bitter taste. It's okay to use the milder, fairly sweet unsulfured molasses usually used in cooking and that is the type most often available in grocery stores in the USA. Sulfur is not related to iodine. However, it's a term used on molasses labels. Some diets don't make distinctions between kinds of molasses and say to avoid all molasses.
  • Soybeans and most soy products (soy sauce, soy milk, tofu). However, soy oil and soy lecithin are both okay.
  • Some beans besides soybeans.The National Institutes of Health diet says to avoid these beans: red kidney beans, lima beans, navy beans, pinto beans, and cowpeas. Other diets do not limit beans.
  • Some diets diets say to avoid rhubarb and potato skins. The inside of the potato is fine.
  • Iodine-Containing Vitamins, and Food Supplements. Also products containing iodate or iodide. Check the label and ingredients and discontinue completely if iodine is included. Most vitamins with minerals contain iodine.
  • If you are taking a Medication that contains iodine, check with your physician.
Limit the Amounts of these Foods
Some diets from thyroid cancer specialists and researchers recommend limiting the daily intake of foods that are moderate in iodine: 5 to 20 mcg per serving.
  • Fresh meats. Up to 5 ounces per day of fresh meats such as chicken, beef, pork, lamb, and veal are fine on the low-iodine diet. (Up to 6 ounces, according to one of the researchers, who noted that meat contains 25-130 mcg of iodine per pound.) Whole cuts tend to contain less iodine than do ground meats. Also, check the package label on meats, including whole turkeys, turkey breasts, turkey cutlets, chicken, and all pork products. Many food makers inject broths into turkey or chicken or pork. The label may not indicate whether the broth contains iodized salt. If you are not sure, go to your local butcher for fresh turkey, pork, or chicken.
  • Grains, cereals. Up to 4 servings per day of grains, cereals, pasta, and breads without iodine-containing ingredients are fine on this diet. The iodine content depends on the iodine content of the region where the grain was grown. Homemade baked goods and cereals are best on this diet. If you use processed foods, read the labels carefully to avoid iodine-containing ingredients. Also, remember that labels are not always accurate or up to date.
  • Rices. Like grains, rices vary in the amount of iodine depending on the region where grown, so rice should be eaten only in limited amounts. Some low-iodine diets recommend avoiding rice. Basmati rice has been mentioned as the best for the diet.

Monday, July 26, 2010

RAI: 100mCi

Today I got my "big" dose of 100mCi. I'm feeling really good, and kind of looking forward to being able to relax and be alone for a few days. At this point, I'm still feeling normal, just having to be taking all of my precautions, which I'll share next time. I'll update in the next couple days on how I'm feeling!

Wednesday, July 21, 2010

First Total Body Scan

Today I had my first total body (TB) scan. It was actually kind of scary. The scariest body scan I've ever had.

The machine was kind of like a CAT scan machine, just part of a machine. I laid on a really small metal platform that had a thin pad and a pillow on it. The scanner part was flat, and could be moved up and down. It was placed about an inch away from my face. I'm not claustrophobic, but I was nervous when it was over my face. The TB scan took about 15 minutes, and went down my whole body (duhh). After the machine was past my face, she moved it down so it was closer to my body. After that, there was a 5 minute scan of my face. She moved the scanner up, and then towards my face. It was scary because she didn't move it up enough, so I had to ask her to move it.

After that, we waited about 10 minutes or so for the doctor to come back and talk to us. I don't think he's a doctor yet, but he knows what he's doing (I hope). They couldn't see any cancer cells floating around anywhere, they only saw what was left of the thyroid after the surgery. That is basically just tissues/cells left around the vocal chord area. I'll be doing the real RAI treatment starting on Monday. I had the option of not doing it, but it seems best to just kill it off. And, I've been preparing for it, so we might as well do it and see what happens. I'll be getting 100mci of RAI (this past Monday, I received 5mci for the diagnosis).

Next Thursday, I'll go back for another TB Scan next Thursday. Hopefully it won't be as scary...

So, I got to get those wonderful TSH injections again on Saturday and Sunday. Luckily, after that, I can wait until April/May 2011 when I have to do the scan again. Yup, I get to do all of this (LID diet, TSH injections, take 5mci of RAI and the scan) every year for a few years.

I'll post again on Monday, after I drink some more RAI!

Monday, July 19, 2010

Treatment is Underway!

I am currently beginning my treatment to cure the cancer for good! A week and a half ago, I met with the nuclear medicine department at Strong and after that, I began my LID (Low Iodine Diet). Honestly, that has been about the worst part of the whole treatment! I'm finding it hard to eat. I get sick of things easily, and I'm not really trying to hard to find anything. We'll hopefully be getting more low salt items and things I can use to make the next 2 weeks bearable.

This weekend I started my TSH injections. They. Were. Horrible! I hate that I still have to have them done two more times! It hurt really bad, and the second one bled and bruised! Both arms still hurt when they're touched. Hopefully this week that goes away, just in time for two more. So, I lied. THIS is the worst part of the entire thing! The most painful shot I've ever gotten!

Today I finally got the first dose of the RAI! It was kind of scary. I got there, and had blood work done to check the TSH levels and to make sure I'm not preggo (which I'm not). We waited around a while, then I finally got to go back and drink it out of this metal container, which has a vial in it. I drank out of this plastic tube, and the resident filled it with water using a syringe twice. It basically tasted like water, but you could taste the plastic from the tube. Gross.

Wednesday, I go back for the body scan. Then they'll tell us what the dosage will be next week, when I have to go back for injections and drinking more RAI.

I can't wait to be done. 12 more days and everything will be back to normal.

Friday, July 9, 2010

Cancer Awareness Items

I've been going around the internets looking for some cool Thyroid Cancer awareness things to wear and show off. The best I've found so far is Choose Hope. They have stuff for all types of cancers (some things they have more items than others), and a lot of different things. They have magnets, pins, hats, apparel, and bracelets among everything else. My personal favorite section is the Cancer Sucks section, because, well, it just does! They also ship pretty quickly, even if you do the cheapest shipping!

Hope and Dreams also has a section on different cancers, and there's a large selection of Thyroid Cancer awareness shirts and stuff!

Go out there and get the awareness out!

RAI Consultation

I had a consultation for the RAI Treatment, and I'm able to do it this month! I have a whole schedule, and it will be about two weeks long.

The first week, I'll start on Saturday, July 17th. I'll get a TSH injection that day, a TSH injection on Sunday July 18th, and then on Monday I have blood work and take the first small dose of RAI, and on Wednesday I'll have more blood work and a full body scan to diagnose if and where there is any left over cancer cells.  If that shows up that there is no cells anywhere, we won't have to do week two. I can be around people as usual, but I'll be treating it as a trial run for week two.

If we do week two, it will be the same schedule. Saturday, July 24th I'll have a TSH injection, Sunday, July 25th I'll have the second TSH injection, then Monday I'll have the higher dose of RAI. That next Thursday I'll go back for a body scan. Week two, I can't be around people between Monday and Saturday. The doctor said that on Saturday, July 31, I can go back to normal! Just in time for wedding madness!

Luckily, I don't have to be extremely strict with the low iodine diet, but I will follow it as close as I can, so it all works the best. I will have to be careful on week two, cleaning up a lot, and being no closer than 15 feet to anyone. I'll pretty much hang out in my room all week, so hopefully it won't be too bad.

I'm so happy this is working out to be done before the wedding, and hopefully this treatment will (and should) be the only treatment needed to take care of this!

Thursday, July 8, 2010

Steri-Strip Free!

I finally got the steri-strips off the incision! It looks great, & I kept getting comments on how good the surgeon did. Tomorrow I have a consultation about the RAI, so I'll post again after I get back from that appointment.

Tuesday, July 6, 2010

RAI Consultation

On Friday I have a consultation with the radiology department of Strong Memorial Hospital. There I'll go and talk to someone about what to expect, get all the info I need, and when I'll be starting the treatment. Right now, I have a feeling it's going to be on the 19th, but I don't really know for sure. I'll know a lot more after Friday's appointment.

Tuesday, June 29, 2010

Information on Radioactive Iodine

Because the cancer was in the lymph nodes, I have to take the radioactive iodine treatment. As of right now, if I have a job, I'll be doing the treatment after the wedding and honeymoon. Here's some information I found online about it. I have not talked to a medical specialist about what will happen in my case, or what I will be doing.

From the Mayo Clinic:

Radioactive iodine treatment uses large doses of a form of iodine that's radioactive. Radioactive iodine treatment is often used after thyroidectomy to kill any remaining healthy thyroid tissue, as well as microscopic areas of thyroid cancer that weren't removed during surgery. Radioactive iodine treatment may also be used to treat thyroid cancer that recurs after treatment or that spreads to other areas of the body.
Radioactive iodine treatment comes as a capsule or liquid that you swallow. The radioactive iodine is taken up primarily by thyroid cells and thyroid cancer cells, so there's a low risk of harming other cells in your body.
Side effects may include:
  • Nausea
  • Dry mouth
  • Dry eyes
  • Altered sense of taste or smell
  • Pain where thyroid cancer cells have spread, such as the neck or chest
Most of the radioactive iodine leaves your body in your urine in the first few days after treatment. During that time you'll need to take precautions to protect other people from the radiation. For instance, you may be asked to temporarily avoid close contact with other people, especially children and pregnant women.

From Endocrine Web:
Thyroid cells are unique in that they have the cellular mechanism to absorb iodine. The iodine is used by thyroid cells to make thyroid hormone. No other cell in the body can absorb or concentrate iodine. Physicians can take advantage of this fact and give radioactive iodine to patients with thyroid cancer. There are several types of radioactive iodine, with one type being toxic to cells. Papillary cancer cells absorb iodine and therefore they can be targeted for death by giving the toxic isotope (I-131). Once again, not everybody with papillary thyroid cancer needs this therapy, but those with larger tumors, spread to lymph nodes or other areas, tumors which appear aggressive microscopically, and older patients may benefit from this therapy. This is extremely individualized and no recommendations are being made here or elsewhere on this web site...too many variables are involved. But, this is an extremely effective type of "chemotherapy" will little or no potential down-sides (no hair loss, nausea, weight loss, etc.).

Uptake is enhanced by high TSH levels; thus patients should be off of thyroid replacement and on a low iodine diet for at least one to two weeks prior to therapy. It is usually given 6 weeks post surgery (this is variable) can be repeated every 6 months if necessary (within certain dose limits).


There's also some information WebMD, which tells you what to expect:

Radioactive iodine, given in a liquid form, is absorbed and concentrated by the thyroid gland. The treatment destroys thyroid tissue but does not harm other tissue in the body.
See an illustration of the thyroid gland .
While radiation can cause thyroid cancer, treatment of hyperthyroidism with radioactive iodine does not increase your chances of getting thyroid cancer.

What To Expect After Treatment

Within days, the radioactive iodine passes out of your body in your urine.
To avoid exposing other people to radioactivity, it is important to do the following for the first 5 days after your treatment:
  • Drink plenty of fluids.
  • Avoid spending a lot of time around others, especially children and pregnant women.
  • Do not sit next to someone in a motor vehicle for more than 1 hour.
  • Avoid kissing or sexual intercourse.
  • Sleep in your own room.
  • Use separate towels, washcloths, and sheets. Wash these and your personal clothing separately for 1 week.
To further reduce the chance of exposing other people to radioactivity:
  • Wash your hands with soap and lots of water each time you use the toilet.
  • Keep the toilet very clean. Men should urinate sitting down to avoid splashing. Also, flush the toilet 2 or 3 times after each use.
  • Rinse the bathroom sink and tub thoroughly after using them.
  • Use separate (or disposable) eating utensils for the first few days and wash them separately.

Why It Is Done

Radioactive iodine may be used to treat hyperthyroidism in people who have noncancerous (benign) thyroid nodules that make too much thyroid hormone.
Radioactive iodine is also used if you have your thyroid removed (thyroidectomy) because of thyroid cancer. Radioactive iodine therapy destroys any remaining thyroid tissue or cancer cells that were not removed during surgery.

How Well It Works

In almost all cases, your thyroid hormone levels will return to normal or below normal after radioactive iodine treatment. This may take 8 to 12 weeks or longer. If your thyroid hormone level does not go down after 6 months, you may need another dose of radioactive iodine.
If you have thyroid cancer and you are treated with radioactive iodine, it may take from several weeks to many months for your body to get rid of any remaining cancer cells.
Your thyroid nodule is unlikely to grow after being treated with radioactive iodine.

Risks

The risks from radioactive iodine treatment include:
  • Metallic taste in your mouth.
  • Dry mouth.
  • Sore throat.
  • Neck pain. Radioactive iodine treatment can make your neck swell up or hurt.
  • Nausea or vomiting, which is usually mild.
  • Constipation or diarrhea.
  • Fatigue.
  • Unusually low (hypothyroidism) or unusually high (hyperthyroidism) thyroid levels

Monday, June 28, 2010

Pictures

I have some pictures from the surgery & after that I wanted to share:

Pre-surgery


The ceiling had stars on random tiles!


Balloons from one of my friends


Balloon and flowers from my family


The dressing and drainage tube


The incision site


Looking good!

Well-Wishes: Pathology Results

After letting everyone know about the pathology results, I got tons of texts and messages from family & friends.



Paula can officially say she's a cancer survivor. It's all out!



Sue: 
Woo Hoo!! Go Paula..Go Paula.. ( :


Mary: 
Love! Praise God from whom all blessings flow! HUGS!


Matt: 
Thats what I said Sue...Run Paula Run...So happy for you!


Heather: 
awww congrats paula.


Terry: 
I cried.


Jennifer: 
yay! I'm so happy for you!!


Steve:  
I am so happy to hear that. It is another positive answer to prayers.


Paula, awesome news that they got it all. I have a friend that has gone through the treatment...you'll do great!!! Love you girl

~Aunt Sherrie, Josh's family

Words can not express the joy that I am feeling for you today and for Josh and for all who love you! A tear came to my eye and praise to my lips for God's watching over you from the discovery of the concern and now through the treatment to come!
Continued prayers on your behalf will be said and much love and hugs are sent to you!

~Mary, Josh's sister

Thanks for keeping us informed. I am sorry to hear it was cancerous, but happy to hear that that they got all of it out. You are such a kind, precious person...I feel confident that it will work out well for you. You remain in my thoughts and prayers.
~Aunt Mary, Josh's Family

In addition to praying for you, I will pray for Daisy, she will miss you.
~Clint, Church Family


Pathology Results

Last night I got a call from Dr. Caldwell with the results of the surgery: I can officially say I'm a cancer survivor!

The nodule was cancerous, and it spread to 3 of the lymph nodes. I need to do radioactive iodine treatments, and I'm hoping I can get in to my specialist's (Dr. Freedman) office ASAP.

For the most part, it confirms what we've suspected. I thought it was going to come back cancerous, but never dreamed that it had gone to any lymph nodes. I am so thankful to Dr. Chamberlain (my primary doctor) for feeling the thyroid, and even though almost every test came back normal, he continued to pursue it. I am also so glad we decided to do a biopsy, even though it grew only a small amount. If we waited another year to do this, it could be too late, or way more difficult to cure or fight.

This entire experience, even though it's not over, has been so wonderful. No, I would never ask for this to happen, but in the experience, I came out of a mini depression seeing all the friends and family that truly love, support and care for me, I saw that Josh is the right man for me (not that I ever doubted it, it just reassured me that Josh is the one that will take care of me in sickness and in health), and I got my own experience with God. I always believed, but never had a moment where I said, this is what it means to be a Christian, and this is my moment where I know that He IS here, and He is helping me through everything. This has done so much for my faith, and I'm hoping to write a blog or journal, or perhaps just a regular blog centered on it, about my faith. I'm not sure what I want to do yet, or how I will, but I'll let you know (I'll also take suggestions!).

Thank you so much for your prayers and love!

Thursday, June 24, 2010

Well-Wishes: Surgery

I have had so many friends support me through e-mails, facebook messages, visits in the hospital or at my house. One family even sent me an edible arrangement! I was so excited! I have the best friends and family ever, and so glad that so many people sent us messages, let us know they were praying, and willing to visit me.

Here are some more well wishes that I got in response to going in to surgery:


Josh, Paula is and will continue to be in our prayers (as well as YOU!) Ray & I prayed together this morning before he left for work and I am going to call him now to give him the updated info.God Bless,
~Sue & Ray, Church Family
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Definitely praying for Paula. Love you both very much! With JOY in Him,
That's good news Josh, praising God that every thing went well! Please give Paula our love!
~Brenda, Church Family
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Yes, of course, we will be praying for Paula this morning. Thank you for letting us know. I'm sure she will do well, but sorry she has to do this now. No surgery is easy. We just want her to be well and be able to enjoy both weddings, Quinn's & yours!! Love you both,
~Grandma & Charlie, Josh's Family
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My prayers are with you! May everything work out just fine.

~Aunt Mary, Josh's Family
__________________________________________________________________

Thanks for the update. It was good to hear that the surgery was over and went well for Paula.

~Laurie, Church Family
___________________________________________________________________

Josh:: PAULA'S SURGERY IS AT 11AM TODAY INSTEAD OF 6:30 PM. pray for Paula the doctor and us all waiting that everything goes smoothe please :-)
Deb::Thoughts with you Josh..
Mary:: praying...hugs!
Tammy:: Prayers coming your way :)
Dawn:: lots of prayers!!!!!!!
Ann:: whoa, it's 11:00 right now. Prayiing
__________________________________________________________________

Josh Merrill PAULAS OUT OF SURGURY. ONE HOUR RECOVERY THEN WE SEE HER!!!
6 People like this

Mary:: Sharing in your happiness and relief Josh! Will keep praying... hugs!
Michelle::  :)
Mary:: Woo Hoo! God is good, all the time! Just think she still at this time of day would still not have been able to eat and anticipating going in, if not for the cancellation. Praise God for His perfect timing in getting this surgery scheduled promptly and her surgery time being moved up. God is in the details! Hugs!
Sherrie:: Give her our Love Josh!
Josh:: so so true. will do
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Josh Merrill We just got to go see her she's tired but looks really good and isnt in much pain at all. She's doing very well thank-you for all your thoughts and prayers!
4 People like this

Dawn:: thank god!!!! we will keep praying for her.
Chrissy:: yay! Give her all of my love for me! :)
Bob:: glad paula is doing good
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Paula Sarma Is enjoying the last full day with a thyroid. Happy father's day!
Dawn:: we will be praying for you tomorrow
Allyson:: :( love ya good luck... everything will be fine
Susan:: OH NO! Sorry to hear/see this! Good luck with all, we'll be thinking of you tomorrow and hope to get an update asap!
Paula::Thanks! I know! I'll just be happier when I wake up after! Not looking forward to the IV, and hopefully I'll be much better after.
Laurie:: I'll be praying for God's comfort for you tomorrow and for the God's guidance in the skill of the surgeon.
Lori:: I will be praying extra hard for you tomorrow morning. My preacher is praying for you as well.
Paula: Thank you everyone! :)
_________________________________________________________________

Jennifer:: i'll be thinking and praying about u!! i ♥ ya
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Sherrie:: Praying for you! Have Pam calling me as soon as you are out! I am especially covering the IV part.
Paula:: Thanks! Just gotta deal with all of the shits and blood work now.

Paula:: Haha shots. That's the touch screen for you...
Sherrie:: maybe your first word is the correct one :-)
Paula:: haha true!
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Paula 's surgery was moved up to around 11am. Going in asap
Judy Lynn:: Good luck! i'll be keeping you in my thoughts and prayers all day :-)
Jennifer:: good luck Paula everything will be fine! Thoughts and prayers are with you! ♥ ya
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Deb:: Hey..thoughts and prayers are with you...remember..just a little nap and you will be good to go...your a strong beautiful woman..just a little bump in the road...xo
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Josh:: Your doing great god is watching over you my bride
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Paula:: Is in her room relaxing and resting. Just a sore throat
6 People like this
Tammy:: So glad to hear this :) We will keep praying for a quick recov
Mary:: ...not just like, love! Hugs!
Jennifer:: thats awesome! Jen && i were gunna stop by later 2 c u 4 a lil bit
Amanda:: Yay, glad everything is going well!
Shannon :: Huzzah!
Peter:: Good to hear youre home keep resting
Kristin:: Considering you're texting you must not feel that bad. :)
Crystal:: PTL! Glad to hear everything went well so far. praying for an easy recovery!
Paula::Well I'm not home but feeling pretty good. Doing pretty well too.. just hoping the drainage tube can come out. Not enjoying the shots and blood draws either.
Dawn:: glad all is well. feel better soon.
Bob::glad to hear your doing ok i prayed for ya. Get better soon
Sue:: So happy to hear everything went smoothly!!
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Rick:: not gonna lie, uncool for not seeking my opinion first about this surgery thing. Everything is for the most part fine until rick goes of the grid for a weekend, way to be considerate of others. That being said, GLAD YOUR DOING WELL!
Paula:: Haha sorry. It was all a little short notice. Thanks! :)
_______________________________________________________________________
 
Amy:: So happy it went well. Let me know when your settled at home and I can come bother you!
Paula:: Haha ok! Maybe on wed you can come over after I'm settled
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Paula:: is finally home!
19 People like this
Jennifer:: I hope your doing good!
Amy:: YAY!
Sue::That's awesome!!
Kelsey:: yay!
Cathryn:: Yeah!
Shannon:: Yay! Drain?
Myke:: Bark! Bark! Bark! (a direct quote from your daughter, Daisy.)
Dawn:: glad to hear it!!!!
Chrissy::I hope you get to feeling 100% soon, ma'am! I love you! ♥
Mary:: Wait Dad, I hear Monet and Bella barking also...oh that was yesterday at the picnic. LOL!
Mary:: I am glad to hear that all went well. God is good.
Susan:: Our prayers have been answered! Our God is an awesome God! We will continue to pray for you for a speedy recovery!
Cristen:: i hope all went well and i hope u have a gppd recovery
Paula:: ahaha! My daughter went crazy yesterday! :) Unfortunately, I do have a drain...not excited about that. Hopefully on Thurs or Fri it can come out!
Kelsey:: yay! get lots of rest dear :) let me know if you need anything
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I feel so blessed to have so many people out there praying and thinking about me!

Surgery

This past Monday, I was scheduled to be at the hospital at 4pm for a 6:30pm surgery. Monday morning, I got a phone call from the hospital at 7:30 am asking to come in ASAP so they can start by 11am! I was completely freaked out, and was so nervous, but it was best to do it ASAP, so I wasn't waiting around all day.

We got all situated and got to the hospital by 9am, where they took me back to get my IV in, and by 10am, the surgery was starting.

Me before the surgery, with my cool hat....that I didn't have when I woke up.

At 11:30am I was being woken up and brought into recovery, and around 12:30pm, Josh and my mom were able to come see me. They had to search around to find me a room, since I came in so early, and by 1pm, they brought me up to my room. (When I can upload my photos easier I'll post them up)

It really wasn't that bad, since the only thing I was awake for was the IV. The recovery is actually the harder part. I haven't been in a huge amount of pain, so the most I've really taken is Ibuprofin. I've been very tired, expression-less, and it's just been hard to move with all of the bandages and the drainage tube being in still (oh yeah, I have that...it's not really that fun). I'm hoping that can come out today or tomorrow. I'd assume tomorrow, but I just want it out so I can feel better. When I go in to get the tube out, they'll take off the bandages, and we'll see what it looks like!

For now, that's all I really have to say about the surgery. Easy on my part. I'll post more after I get the drainage tube out!

Wednesday, June 23, 2010

I'm Home Recovering!

Sorry for not updating in the hospital (I was on Facebook a lot of the time). I'm now home and resting and recovering from the surgery! I'm doing very well now. I'll post in a couple days about how everything went. Actually, on Monday morning I got a call to come in so they can do the surgery around 11am! The whole morning early! It worked out so much better, and I had extra recovery time.

Don't worry, I'll post more details and such in the next few days. I have so much mail to check and things to catch up on!

Saturday, June 19, 2010

Pre-Op Appointment

Yesterday I went in for my Pre-Op appointment at the Pre-Admission Testing Center at Rochester General Hospital. It wasn't too bad, but we were there two and a half hours! I got blood work done, had to give a urine sample, got a chest x-ray, and talked to lots of people!

We got a ton of information on what will be happening on Monday there, and it calmed my nerves a lot. I'm still really only nervous about the IVs & anestesia, but I don't really have any choices, so I have to deal. We talked about what they would be doing with the surgery, the process and a little bit about what will happen when I'm there overnight, and a little about medications and what to eat/drink before.

I can't eat solid foods after midnight on Sunday, and can only drink water, apple juice, and black coffee or tea until 2:30pm Monday. Oh! I got an exact surgery time: 6:30pm. The paperwork said it will take about two to two and a half hours, but I think that's by the time in back in my room (which I'll most likely be sharing, I can't have a private room).

After that Pre-Admission appointment, I went back over to Dr. Caldwell's office to talk to the RPA, Stephanie. She talked about what will happen before, during and after the surgery, filling us in on anything else we didn't know at that point. She gave me prescriptions for my hormone replacement therapy pills, and told me what to get for after (Tums, to prevent any kind of calcium problems).

I still have to read over all of the papers I was given yesterday, so I'm sure I'll get more information there. I've felt better each time I've met with a doctor about this, but I'm still scared of this surgery!

I'll have my iPod with me on Monday and Tuesday, so I'll be able to write a little post about what happened the day after the surgery, if I'm up to it.

Wednesday, June 16, 2010

Surgery News

At 1:00 pm yesterday, I had my consultation with the surgeon. After a lot of waiting, a lot of questions were answered and we walked out with a surgery appointment!

I spoke with the nurse practitioner, and told her what's been going on and why I was there. She was even all excited about the wedding! When we said that and how I wouldn't be on the insurance after that day, she said she'd put me at the top of the list!

I then spoke with the surgeon, Dr. Caldwell (after some more waiting). We talked about what was going on, what he wants done (well, what the specialist wants done), and briefly explaining what he's going to be doing. He'll be taking out the whole thyroid and some lymph nodes in the area. Apparently, the thyroid is almost the whole length of the neck! He'll make a cut at the bottom of my neck, and take the thyroid and lymph nodes out. I'll have a drainage tube after for a couple days (it looks like a straw sticking out! It's weird!), and staying at least overnight. I'm hoping they take out the tube so I don't have to worry about it!
So, Friday I'll be going to RGH for lab work and a chest x-ray, then going back to the Linden Oaks Office to talk about pre-, during, and post- surgery with the RPA (I forgot what it stands for). More questions will be answered. Monday evening I'll be going to RGH for my surgery!

It's a weird feeling. I don't feel nervous at all, but I am nervous. I'm sure I'll feel it on Monday! It's such a great thing to have it done this early! A true answer to a prayer! I hoped we could get it done before the end of June so I could have maximum healing time before the wedding, but didn't think I'd actually be able to do it, and this soon! I could have gone in on Friday to do the surgery if I really wanted!

I'll be the 6th thryoid removal of the day on Monday, so he'll be all warmed up! :)