CAUTION: DO NOT APPROACH!
There are essentially two phases to the period after taking the RAI dose. The length of time can vary depending on the dosage rate, but my plan of attack is specifically for the 50 mCi that I received.
Immediately after coming home, there are things that need to be done for the first 24-48 hours, according to most literature. I decided to carry these things on until Sunday night, which would put me more at 72 hours. They include:
- Constant drinking of water
While the point of RAI is for the iodine to latch on to all thyroid tissue, it goes without saying that not all of it will be needed. In fact, a majority of it won't be needed. So, what does the body do with all of that excess RAI? It excretes it through the kidneys, of course. Therefore, the first thing you've got to do after taking the dose is pound water. And pee it out. ASAP.
Of all the excess radioactivity that is expelled out of the body, urine is the one that harbors the most radioactivity, by far. Therefore, keeping the body hydrated so it can pee out the radioactivity is key. As soon as you gotta go, then go. No use keeping all that radioactivity swimming around in your bladder, which is a risky play to say the least. And you need to keep any of that urine from splashing around. For guys, that means peeing sitting down.
It's too bad, I really enjoy using the bottom right method.
Having your own bathroom that you don't share with someone else is key during the post-RAI isolation, which I luckily have at my parents house.
- Suck on sour candies
After urine, saliva is the next place that radioactivity can collect, putting the salivary glands at an elevated risk. Therefore, the best thing you can do is to keep the glands producing saliva, and continuously pumping the saliva out. If not, besides the obvious risk of radioactivity sitting idly in your salivary glands, you risk salivary gland swelling/tenderness, salivary gland stones/blockages, etc. So, I purchased some sugar-free lemon candies from the Dollar Tree, as well as some Ice Breakers Sours (important to avoid Red Dye #3, as I am still on the LID), also sugar-free. Figured if I was going to be tearing up my mouth with sour candies, might as well not be bombarding my body with sugar too.
Sadly, I could not find these at the supermarket.
My doctor advised me to start eating sour candies 2 hours after the RAI (I wasn't allowed to eat anything until 2 hours after the RAI, so that made sense), and to do it every few hours after that for the next 48 hours. While most doctors recommend this, there have been a few studies showing that the use of sour candies should be delayed, not starting until 24 hours after the RAI, since they found it actually increased radioactive uptake into the salivary glands. Here is a link to one such study: http://jnm.snmjournals.org/content/46/12/2119.full.pdf. However, according to the research that I did, there is no conclusive evidence either way, so generally the consensus is to do it right away. And that's what I did.
I've started to get a bit of tenderness/swelling under the left side of my tongue, but other than that, I think I've been OK on the salivary gland front so far.
- Shower...a lot
The next place radioactivity can be expelled is through sweat and body oils. It is because of this that my doctor recommended washing my clothes for the first few days separately, and then sequestering them for 2 weeks to allow all of the radioactivity to die off. Instead, I just wore old worn out clothes with the intent of throwing them away.
But, because of the trace radioactivity from sweat/oil, it is recommended that you shower at least 2x a day. So I did that, and felt fresh and clean. Although, with California in a draught, I felt a bit wasteful.
The struggle is real.
In addition, I have been eating off of paper plates with plastic utensils, and throwing them away afterward. I figured that was safer than spreading radioactivity all up on my parents' kitchen sink.
- Isolation
That's my soundtrack for the next week. While I've been talking about radioactivity as some kind of residue that exists in bodily fluids, there is also the simple danger of proximity. For the weekend, I've had to keep at least 3 feet away from everybody, other than quick, fleeting moments. So, while I've kept my bedroom door open to speak with my parents occasionally, I have definitely not been hanging out with them.
Starting tomorrow morning, I can be spend about an hour with people as long as they are at least 6 feet away from me, with Thursday morning being the official lifting of all proximity restrictions. Except for when pregnant women or children are involved. Literature varies as far as the safety time for that, but I'm going to go with the most that I've seen for my dosage level, which is 14 days.
So, it's been a weekend of web surfing, reading, eating and drinking water by myself in the room I grew up in. I thought it'd be a nice reset, a chance to just take it easy. But I'm getting kind of stir crazy, to be honest.
However, in addition to all the milestones that I am going to reach this week above, there is a big restriction that ends tonight. Starting tomorrow morning, I am no longer on the low iodine diet! Woohoo!
You said it, big guy.
That's pretty much it, my gameplan for the week. All restrictions (other than staying away from children and pregnant women) lift starting Thursday morning. Until then, it's just more hanging out by myself.
Next big thing is my post-RAI full body scan on Wednesday morning. It's actually potentially the last big thing. By scanning my body to see where the radioactive iodine has collected, that's where you can pretty accurately check if the cancer had metastasized anywhere else, like the lymph nodes, lungs, bone, etc. While all pathology and indications so far has concluded that such spread hasn't occurred, this will provide final conclusiveness. I'm pretty calm about it, since like I said, all the signs look pretty good, but I'll probably be nervous that morning.
Wish me luck!
-W
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