Re: ? about after treatment!!!!!

[Guest guest]

rocksteddybear@... wrote

> I am having my rai treatment Aug 24th could someone please tell me

> why i can't sleep in the same bed as my husband for 10 days after?

> If it won't kill me why should it hurt him? We are newlyweds and

> have never been apart...

Because your husband has a nice healthy thyroid gland that you do not

want to jeopardize....remember that RAI has an affinity to thyroid

tissue and you don't want the RAI to go towards his!

Marilyn (dx '94-pap w/lung metastases - 5 pos scans/435mCi's - scans 6 &

7 clean)

>

>

[Guest guest]

Rock,

Ok here goes my personal experience with RAI, the radiation we are given can be

absorbed by ppl near us for a few days, depending on the amount of RAI we are

given. Your husband could absorb some of that radiation and thus get thyroid

cancer. This is the reason for precaution during treatment. Sorry about not

being able to sleep together after treatment, but it is for his own good. My

Significant other slept in the bed and I used a blow up air mattress since that

was easier to store after treatment was finished, and I was only precautioned to

stay away from him for four days, using 75.? mCi for my treatment.

Jane

11/21/00 TT, Pap Thyca, 3.0 x 2.5 cm on Left Lobe and under a cm on the Right

lobe.

01/18/01 RAI 75 mCi, Lots of Remnant left.

01/20/01 Started Synthroid, with many adjustments.

06/18/01 TSH tested at .11 taking .150mcg per day.

06/18/01 Still Hypoparathyroid, taking 3000mg of Vit C+D a day.

06/21/01 Started 25mcg Cytomel twice a day.

07/18/01 Stopping Cytomel, Starting LID

08/09/01 Whole Body Scan. Possibly another RAI

? about after treatment!!!!!

hello all

I am having my rai treatment Aug 24th could someone please tell me

why i can't sleep in the same bed as my husband for 10 days after?

If it won't kill me why should it hurt him? We are newlyweds and

have never been apart...

Rock

had TT in 98 first treatment in 3 years

Tg is 25.3

RAI is gonna be 250 liquid radiation

For more information regarding thyroid cancer visit www.thyca.org. If you do

not wish to belong to this group, you may UNSUBSCRIBE by sending a blank email

to thyca-unsubscribe

[Guest guest]

rocksteddybear@... says:

> I am having my rai treatment Aug 24th could someone please tell me

> why i can't sleep in the same bed as my husband for 10 days after?

Because you will be radioactive.

> If it won't kill me why should it hurt him?

It will hurt him because he still has a thyroid, which can be

adversely affected by radiation. Togetherness is great, but I'm

sure you don't want to give your husband thyroid cancer!

If your husband has already had a total thyroidectomy, you probably

don't need to worry about this :-).

ellen

--

mailto:ellen@...

[Guest guest]

rocksteddybear@... says:

> I am having my rai treatment Aug 24th could someone please tell me

> why i can't sleep in the same bed as my husband for 10 days after?

Because you will be radioactive.

> If it won't kill me why should it hurt him?

It will hurt him because he still has a thyroid, which can be

adversely affected by radiation. Togetherness is great, but I'm

sure you don't want to give your husband thyroid cancer!

If your husband has already had a total thyroidectomy, you probably

don't need to worry about this :-).

ellen

--

mailto:ellen@...

[Guest guest]

--- rock wrote:

hello all

I am having my rai treatment Aug 24th could someone please tell

me why i can't sleep in the same bed as my husband for 10 days

after?

If it won't kill me why should it hurt him? We are newlyweds

and have never been apart...

Rock

had TT in 98 first treatment in 3 years

Tg is 25.3

RAI is gonna be 250 liquid radiation

Hi Rock,

My one and only experience with RAI was in 1982. So, unless

something has changed since then, my instructions were different

from what I have been reading today. My doctors explained it to

me this way: RAI leaves your body from every pore in addition to

the obvious. Everything I touch will have RAI on it, eg

furniture, anything. If another person comes along and touches

the furniture where my hand touched, the RAI can be absorbed

into their system, destroying part of their healthy thyroid.

Children are even more vulnerable because their systems are not

fully developed. My dose was 175 mCi. No one touched me for the

five days I was in isolation in the hospital and when I went

home, I was not to touch my children for another five days. I

was given reverse isolation materials for their protection.

Maybe I'm wrong, but I don't think the danger is giving your

husband thyroid cancer; rather by touching you and/or being in

close proximity to you, his body may absorb RAI and his thyroid

may take up the RAI and be destroyed, rendering him hypothyroid.

Either way, it is a small price to pay to keep your husband

healthy. It was realy hard to not be able to touch anyone,

especially my children for ten days, but they are healthy today

and I'm glad I followed the directions.

Best wishes,

from NE Ohio

=====

Irradiation to thymus as infant

3/25/65 tt Pap thyca w/lymph node mets

Hypoparathyroidism 3 days post radical tt

3/25/82 Recurrence in neck & R chest

Tx w/ 176 mCi RAI 131

hx kidney stones

No scan- 5/22/01 after TSH 38.2 & Tg <0.9 & TgAb <2.0

__________________________________________________

[Guest guest]

Hi Rock

A simple enough question, but a complicated answer, I'm afraid.

Firstly, any sort of medicine is a balance of advantage and disadvantage.

RAI will help you, but not anyone who doesn't have thyca. Medicines should be

taken by those who need them, and avoided by those who don't.

RAI, unlike antibiotics, painkillers and laxatives, gives out radiation which

has an effect at a distance. The rule for radiation exposure is ALARP - As

Low As Reasonably Practicable. You should apply this rule Reasonably - it's

not a law. If you need a cuddle, try to do without for the first 2 or 3 days

then keep it short. I don't know how old you are, but if you are young then I

suspect that 10 days is longer than you need. Some advice on this is given

below in something that Kate and I wrote a while back.

The biggest risk to your husband is from your body liquids, especially your

saliva. I would say No Kissing for those 10 days.

If you want to ask anything privately then feel free to write.

Ian

> hello all

>

> I am having my rai treatment Aug 24th could someone please tell me

> why i can't sleep in the same bed as my husband for 10 days after?

> If it won't kill me why should it hurt him? We are newlyweds and

> have never been apart...

>

> Rock

> had TT in 98 first treatment in 3 years

> Tg is 25.3

> RAI is gonna be 250 liquid radiation

================================================

The following was written by Ian Adam and Kate Kressmann-Kehoe,

and represents their opinions. If any of this appears to contradict your

own Doctors or other professionals it is not intended to do so, as this

text is generic and cannot take precedence over specific advice.

A lot of people have asked for more specifics about post-RAI precautions.

Here is another cut at it that might be useful. The risks to others from

RAI don't go away completely for a long time, but they do decline pretty

rapidly. It can help to think of the risks as having two phases:

PHASE ONE = early, high radiation, full precautions

PHASE TWO = later, residual radiation, minimal precautions

The line between the two phases is not clear-cut of course. You don't

suddenly go from being a menace on Wednesday to safe on Thursday. But this

may help give some idea of what is going on and why the generic

instructions you get are sometimes vague. Another thing to remember is

that the people giving the RAI have probably never had it themselves and

don't always understand the implications of their instructions.

FYI Most people seem to agree that the Phase One precautions are difficult

and stressful to follow if you have babies or children who are too young to

understand/remember why you are being distant. And/or if you have little

crawlers who take things out of the garbage, run their hands on the toilet

edge and then put them in their mouths etc. If you are in this situation,

you might want to look into whether it is possible for you and the children

to stay in separate houses for as much as possible of Phase One and until

you've had a chance to clean up the hottest areas.

(Also, I found it very hard to remember not to taste, cough etc while

cooking and hypo and radioactive. Although it is theoretically possible, I

don't recommend cooking for others until you are out of Phase Two, or at

least out of Phase One -- Kate).

How long will you stay in each phase?

---------------------------------------

The first thing to consider is that not everyone gets rid of surplus RAI at

the same rate. There are 2 big factors -- age and kidney function. So, an

elderly person with kidney problems will spend a longer time in Phase One

than a younger person without kidney problems. You can estimate rates for

yourself using the following age /kidney factors:

Age / kidney factors:

Normal Impaired

kidneys kidneys

Young (under 30) 0.4 0.7

Middle age (30-60) 0.7 1.0

Elderly (60-plus) 1.0 1.5

Relatively few people will come under the impaired kidneys column, and the

values given should be discussed with your Doctor.

Of course, a major thing to consider is how much RAI you got in the first

place. Obviously, the higher the dose, the greater the risks. If you had

only a tracer [scan] dose, you can go straight to Phase Two.

And, there is a final factor. Depending on the extent of any mets, and also

on how much thyroid tissue you have left, there will be a greater or lesser

amount of RAI that stays in your system for a longer period of time. You

can ask your doctors what level of uptake they are seeing, and therefore

what your level of RAI will be until that RAI decays, which is a slower

process. If you are having high levels of uptake, you will need to maintain

precautions for distance for a longer period.

Phase One: Early, high radiation, full precautions for both body fluids and

distance

----------------------------------------------------------------------------

Phase One starts immediately after the treatment dose. You might be

spending the first part of this phase in isolation, but this phase might

also last into the first days after you are released from the hospital. In

Phase One you are very radioactive and people should keep their distance

and spend very limited time close to you.

Distance: The risk declines exponentially with distance, so every foot

farther away you can be helps. For instance, in the same amount of time,

supervising a child's bath from 2 feet away gives 1/4 the exposure as

feeding him or her dinner from 1 foot away. Better yet, share watching a

video from chairs at opposite ends of the room. In Phase One you should

sleep alone.

The risk also depends on the duration of the exposure, so if someone needs

to be close to you (for instance to drive you home) it should be for only a

short while. If they can be far away, it can be for a longer time. To give

some examples:

10 min @ 1 foot gives the same radiation exposure as

40 min @ 2 feet

1.5 hours @ 3 feet

6 hours @ 6 feet

17 hours @ 10 feet

Body fluids: Your body liquids are radioactive and very dangerous to

people, so you should be very fastidious about your saliva, urine, tears,

nose and chest mucus. You should be especially careful about coughing or

sneezing on or near people, and the things that go in your mouth such as

pencils, toothbrushes, spoons, etc. You don't want anyway else swallowing

RAI, so [no] kissing, tasting food you are cooking etc. As far as sweat,

etc,

normal washing practices are perfectly adequate for removing RAI, but you

should wash your clothes and sheets separately.

If you live in a small apartment with a big family then you will have

bigger problems following the precautions in this phase than if you live in

a house where you can have your own room and bathroom.

Phase One ends somewhere around the 5mCi level. But, since few people have

access to the equipment to measure how radioactive they are, you can use

the following calculations to guess how radioactive you are:

Millicuries of RAI multiplied by the age / kidney factor = hours in phase

1.

So, a young person with normal kidneys (0.4) having had 150mCi will be in

Phase One for: 0.4 * 150 = 60 hours or 2 1/2 days.

An elderly person with normal kidneys having had 150mCi will be in Phase One

for: 1 * 150 = 150 hours or 6 days.

Phase Two: Later, residual radiation, minimal precautions. mainly for

body fluids

----------------------------------------------------------------------------

After Phase One, most people don't have much RAI in their system. There is

some left in your saliva and urine, but it is only a risk to those who

might ingest it through their mouth, so any form of sexual activity

involving the mouth (other than 'dry' kissing) should wait. Also, you

should avoid putting the spoon back in after tasting while cooking, kissing

children near the mouth, etc. Normal levels of hygiene will take the risk

out of other activities.

While it probably OK to sleep next to an adult at this point, sleeping next

to children or babies is probably best avoided, especially if you drool on

your pillow (which almost everyone does, I know, I've monitored them --

Ian.)

5 days * the age / kidney factor used above = days in phase 2.

So, a young person without kidney problems (0.4) be in Phase Two for:

5 * 0.4 = 2 days.

An elderly person without kidney problems (1.2) will be in Phase Two for:

5 * 1 = 5 days.

Special Case : Extensive uptake

------------------------------------

The switch from Phase One to Phase Two precautions is slower if you have

had significant uptake due to extensive remnant thyroid tissue or mets. If

you are in this situation, you also still need to take some precautions for

distance, especially distance from your throat or other locations of mets.

You also should avoid sitting, staying or sleeping, next to the same person

for another few days. An extreme case of extensive uptake was patient who

couldn't take surgery for a TT, so they ablated the thyroid with RAI only.

She held onto about half the (sizeable) dose and couldn't go home for a

long time - purely on distance grounds.

Example

---------------------------------------------------------

Here is an example of what thyroid and blood levels of RAI might be for

someone with minimal thyroid tissue to ablate.

Blood Thyroid

values uptake

Day 0: 200mCi 0mCi

Day 1: 50mCi 0.95mCi*

Day 2: 12.5mCi 1.0mCi*

Day 3: 3mCi 0.92mCi

Day 4: 0.75mCi 0.84mCi

Day 5: 0.2mCi 0.77mCi

Day 6: 0.05mCi 0.71mCi

Day 7: 0.0125mCi 0.65mCi

Day 8: 0.0031mCi 0.59mCi

Day 9: 0.0008mCi 0.55mCi

Day 10: 0.0002mCi 0.50mCi

This is a youngish person so Phase One would end after 3 days (day 4).

There is still 0.75 mCi of 'free' RAI which will be excreted over the next

5days, hence the precautions about saliva and urine. There is also 0.84 +

0.75 of total RAI which will irradiate their bed partner.

Hope this helps

Ian Adam

Radiation Safety Officer

The Institute of Cancer Research

Cotswold Road

Sutton

Surrey

SM2 5NG

Tel: 020 8722 4250

Fax: 020 8722 4300

EMail: iana@...