I am a candidate for the RAI. CAn some one tell me how long they were in the hospital. With a low dose of radioactive iodine does one get nauseous? How long did you have to stay away from people. Im concerned about all these things and cant find a good answer.
I am a cadidate for RAI because the doctor found follicular cancer cells(low grade) in my thyroid and removed the entire thyroid. RAI is the initial treatment to ensure there arent any other cells still there.Therefore, I am wondering how long a patient must be isolated from other people.And how long it takes to no longer be radioacative.And how do the doctors know when you are no longer radioactive? Thanks!
It all depends on the hospital and their protocols as to whether or not you are hospitalized. Here in Utah RAI does not require hospitalization - you spend your 3-5 days of isolation at home (or in a hotel like my sister did). Others in different areas have been required to spend a few days in isolation in the hospital. Typical isolation rules are 5 days for close contact.
The scan dose is quite low (about 4 mCi) and, depending on the results, you may have to have the treatment dose (my treatment dose was 100mCi - others have had much larger).
I wasn't nauseated for my first scan or treatment dose last year but the scan dose this year did make me nauseated.
Here is a good site - drill down through the cancer portion until you get to the I-131 (RAI) information. http://www.endocrineweb.com/thyroid.html
Also contact the nuclear medicine department at the hospital. They will have specific diet information for you and will give you a list of the precautions you will need to take after. They can also tell you if you will need to be hospitalized.
I believe the half life of the radiation can be a few months (you may set off detectors at the airport for up to a year I was warned). After the heavy dose of radiation you will be scanned (about 5 days later) to determine how much radiation is being absorbed in your body.
I just had RAI, 75 mCi. I was not required to be hospitalized nor was I in any kind of isolation. I was told that I could come to work, as long as it was not with children, and I was even allowed to prepare food. For 24 hours I was not supposed to ride on public transportation and I had to sleep alone for 2 nights (I must confess that I did NOT miss having my dog sleeping on my head.) I did not get sick, although I felt and still feel a bit "funky", but I felt that way occasionally before all of the thyroid stuff started so I don't really think it is related, but I guess it could be. All in all, not too bad.
In my case, they aren't doing a post-therapeutic scan. I started meds again the same day as the therapeutic dose of RAI and I see the endo in 2 months. It's actually a bit anticlimactic to have them basically just slap me on the rump and say "see ya".
My husband hugged me today and I tried to warn him off, but he said "It's ok. You're decaying." That hurt, but, I guess it's true in more ways than one. LOL. Whatever.
I have found a ton of info on RAI both before and since I had mine. I went in on the 19th of November to receive the "large-dose" (had cancer, TT in September). Sorry, I never asked what the "large-dose" consisted of, but they said even though my low dose uptake was only concentrated in the thyroid area, they wouldn't "go easy" on me. It would be a normal RAI dose, again with the cancer thing...
On the 19th of November, as I was getting my gown on, my husband was reading USA Today. In that issue in the "Life" section there were articles about RAI and just how safe it was to let RAI treated patients be around loved ones and "treat at home", and the effect of the risidual radiation on our loved ones and I guess anyone around you..., or should that be a manditory hospital stay. I found it SO IRONIC that these articles were in the paper the very day I was being admitted for THAT treatment. I also found it ironic that the doctors doing the RAI had given me the option to do it at home and created a doubt in my mind (that sent panic through my heart) that my insurance wouldn't pay for the in-hospital stay, just weeks prior! I was terrified to do it at home (I have a 5 year old) and a few dozen calls insued trying to find out exactly what would and would not be covered.
Turns out everything was covered, especially because I had a child at home, but I worry that people who don't have good coverage and a low understanding of the precautionary details, will unwittingly expose those who are most at risk! I have a daughter who previously had no thyroid risk; no family history, no radiation exposure, etc. In one fell swoop, I've given her "the family history" (and granted it was as low as possible, as I did the hospital "time", and stayed away from her as much as I could once I got home), but also the exposure. :-O I'd just seriously upped her risk for thyroid cancer!!! And, if I'd stayed home to treat, ARRRRRGGGGG!
Just today again, my husband called me from work and said that there had been letters to the editor of USA Today on the subject as well. I have previously posted some of this info on the forum and got little response, most thinking that if it weren't safe, the doctors wouldn't let us do it... To that end, I will say this: In the late 50's and early 60's doctors thought that kids and adults should have their tonsils out and then be *radiated* as "treatment", thus causing a TON of these thyroid cancers in the first place, so look what doctors ~did~ then... Of course, we all know that to be "wrong" now...
ALSO: as a post from one of my fellow forum friends said, and I quote: "I've worked with radioactive iodine before, and yes, the stuff comes in what are called lead "pigs". My husband also works with the stuff and told me that if he poured as much of that down the drain at work as we will be excreting (via the RAI treatments) into our toilets, he would be arrested. Interesting."
Just another thought. Pep88 has a good point. I had no small children at home and sleeping alone wasn't a problem at all. I did my own laundry separately, have my own bathroom, and used paper/plastic dinnerware. My sister, on the other hand, had a very small baby, a dog, a cat, and a husband all in a 1-bedroom home. Hence why she opted to stay in a hotel.
I was told that even my small scan dose (4mCi) was considered a "treatment" dose on people who have healthy thyroids - meaning that exposure to me on that small of a dose could fry someone's thyroid.
Keep in mind that, while there is some risk involved in exposure to I131, the risk is quite minimal compared to the X-rays that were administered when some of us were children, which is a much higher dose of ionizing radiation. In the case of RAI, most of the iodine that is going to be taken up by the thyroid tissue is absorbed within 30 minutes after dosing. The rest (actually the vast majority) is excreted in urine and stool. The risks to others are 1) ingestion of excreted I131, which can then be incorporated into their own thyroid and 2) exposure to the gamma radiation be emited by the iodine retained in the patient's thyroid cells. The first can be minimized by "exquisite hygiene", i.e. handwashing, excessive toilet flushing, and keeping linens, towels, etc separate. The second is minimized by increasing distance from the source (i.e. you) for a couple of days. Also, keep in mind that the half life of I131 is only 8 days, so every 8 days the amount remaining in you or on you drops in half. I am absolutely unaware of any studies that indicate that there is a proven increase of thyroid cancer in family members exposed to an RAI treated individual if these minimal precautions are taken and I have been adhering to them rigorously. The genetic risk, in my opinion, is far greater and I have been warning my siblings that they should be aware of their increased risk. Of course, I can be fairly complacent because most of my I131 is in St Louis by now I suppose.
Anyway, I also wanted to mention that I now am feeling quite nauseated. Ugh. I'm glad I was warned that it might take a few days, so I was prepared. Still, my meds aren't quite up to the job so I've called the Dr for something stronger. Oh well, I was afraid my "good luck" wouldn't hold forever.
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