Thursday, January 10, 2008

To RAI or not to RAI

I have a few really important things on my mind - it happens occasionally.

First - I have cookie dough in my fridge that is calling me names (pansy, wimp, &*#$, etc). I really want to show it a thing or two! I can just imagine forming the scrumptious dough into little tasty clusters and placing them ever-so-perfectly onto an ungreased cookie sheet and... Sorry. I'm just saying.

Second - I am the YW basketball coach in my ward and we had practice the other night. The girls didn't know anything about playing positions (guard, forward), the 3-second rule in the key, etc etc. I mean - what are schools teaching kids these days? Reading? Math? Pfft!

Third - Why does my beloved cat, Creature, seem so depressed all the time lately? We play. I feed him. I give him lots of luv loves. I have strategically placed baskets throughout my house because they are the only places he will sleep. I brush his beautiful black fur lovingly. Can cats get depressed? Is it the snow? Hmmm, worth researching. I'll let you know.

Here is my beautiful ebony-furred boy:

Lastly, and certainly the least important thought on my mind - should I or should I not have the RAI treatment for my thyroid cancer. Mind if we go there for a minute?

The typical protocol a patient follows when diagnosed with thyroid cancer resembles the following outline:

1) Surgery to remove the pesky thyroid (done that - check!)
2) Start an interim thyroid medication such as Cytomel (Check!)
3) About a month or so after surgery - meet with Endocrinologist (Scheduled for next Tuesday)
4) Stop all thyroid medication until after RAI - (This is where I have my hangup - see rant below)
5) Begin Low Iodine Diet, aka LID - (I can do this if i have to - though I may kick, scream, and throw snowballs at people eating Crazy Bread and/or other delicious iodine-riddled treats)
6) RAI treatment (radio-active iodine) - all of the above steps lead up to this treatment.
7) Remain in isolation for a few days and then limited contact with others for 2 weeks.
7) Begin long-term medication such as Synthroid
8) Have yearly checkups and labs - possibly more RAI down the road

Refer back to #4.

The simple phrase 'stop all thyroid medication' can have huge ramifications on a person. The optimal plan is to send yourself into a 'hypothyroid state' and starve the body of iodine preceeding the radioactive iodine treatment. Then, a person takes a radioactive iodine pill and remains isolated until the radioactive traces have been eliminated. Because the body has been starved of iodine, the thyroid remnants absorb the RAI like a sponge, thus, any remaining thyroid tissue is killed - which is a good thing since that is where the cancer cells were found. By killing the thyroid tissue that the surgeon was unable to get to - the chance of cancer recurring or spreading is greatly reduced.

I have no problem being isolated after the RAI - actually it sounds kind of nice. After all, I do have teenagers. It's the hypothyroid state that leaves me troubled.

Here are some of the symptoms according to
Fatigue, weakness, intolerance to cold, depression, WEIGHT GAIN, muscle aches and cramps

Also, according to my ThyCa group, one should not drive while in a hypothyroid state. Most people I've talked to tell me being hypo and then RAI are the hardest phases of beating thyroid cancer.

Okay, I'm being whiney. After all, I just viewed a website from someone who has gone through colorectal cancer. I would not want to go through that. I am grateful my cancer was contained in the thyroid. It didn't spread to lymph nodes or anywhere else. The cancer was also very small.

Which is why I'm having difficulty with the RAI and hypothyroid state. Apparently, and I'll know more on Tuesday when I meet with the endocrinologist, my cancer is small enough and was caught early enough that I don't technically need to have the RAI treatment, thus avoiding being hypothyroid.

Decisions. Decisions.

I'm really looking forward to my appt on Tuesday. So many questions will be answered.

So, back to the cookie dough. I self-destructed and ate one. Well, two. Okay, I ate 4! I'm so unworthy!! This can never happen again. Have I mentioned that I'm an emotional eater?!

Here's to a better tomorrow.


Anonymous said...

As your loving husband (who has no excuse for his weigh-gain) is thankful for the missing four, or so, cookies that didn't become ingested into my big, fat, never-ending mouth. The snowblower hasn't afforded me the opportunity to get a good work-out this winter. I would have to say that you have been home a bit more and stitch is just getting use to the idea of seeing you more often. He isn't depressed, he's just bored. If only I could teach him how to use the snowblower. I say the best bet is the RAI. It will be hard but you will have peace-of-mind afterwards. Love Ya,

Bean said...

I agree that RAI sounds the safest but if the doctor says it's not necessary maybe it will be fine. I would ask the doctor what he/she would do and then do it. And i'd stop writing about my cat so much. But that's just me.