Re: saftey of being in the proximity of someone on RAI therapy

[John Jacobus <crispy_bird@YAHOO.COM>]

Steve,

Your friend is being treated with I-131 to ablate any

remaining thyroid tissue.  I-123 is an imaging agent,

which was probably used during a diagnostic scan to

assess her the extent of the cancerous thyroid and

uptake of iodine.



Because she no longer has a functioning thyroid,

various hormonal and physiological problems will

develop.  Eventually, she will be put on a synthetic

hormone that will have to be adjusted over time.  Too

little, and the patient is lethargic.  Too much, and

the patient is too hyper.  I assume they have not

started her on replacement therapy because the want to

ensure that all of the cancerous thyroid tissue has

been destroyed.



Your friends sinus problem may be a side effect of the

removal of the thyroid, or a totally unrelated effect.



There are a number of Web sites dealing with thyroid

cancer try

http://www.cancer.org/docroot/CRI/CRI_2_3x.asp?dt=43

and

http://cancernet.nci.nih.gov/cancertopics/types/thyroid/



With regard to at home care, the precautions she is

asked to take are to ensure that exposures to the

public and family members as the I-131 decays.  She

should have been given a date as to when she no longer

needs to follow these precautions.



The precautions you discussed with probably provide

minimal protect to you.  Potassium iodine would

protect your thyroid from uptake of radioiodine. 

However, patients do not excrete significant amounts

of iodine.  It is bound to the remanant throid tissue;

proper hand washing and sanitary activities, e.g.,

using separate eating utensils, precludes the spread

of contamination.  



The use of a leaded apron will provide no benefits to

protecting yourself from radiation emitted by your

friend. The radiation emitted by I-131 is high energy,

and the leaded apron protects against low energy x-ray

radiation.  The best way to protect yourself is to

stand or some distance from your friend, e.g., 3 to 6

feet, and not spend significant amounts of time.  I

would avoid spending whole evenings watching TV with

her.



It is also important to keep in mind that the

recommendation are precautionary.  No harmful effects

have ever been shown to occur to caregivers who have

worked with therapy patients.



--- Steve Packard <kb1ipd@HOTMAIL.COM> wrote:



> Hello.   I realize that this board is not normally

> concerned with nuclear 

> medicine, but perhaps someone with a good health

> physics background could 

> help me.

> 

> I have a very good friend who a few years ago was

> diagnosed with thyroid, 

> throat and lymphoid cancer.   Her thyroid was

> removed and since then she has 

> been given radiation therapy approximately every 6

> months.

> 

> Her therapy consists of direct gamma irradiation of

> the neck region and 

> ingestion of radioactive iodine.    I believe the

> isotope is iodine-123, but 

> she didn.t know for sure what isotope of iodine is

> used.    The iodine is 

> administered in an attempt to eliminate any

> remaining thyroid tissue.

> 

> The radiation therapy has the side effect of making

> her very ill, 

> immediately after it is administered, and has the

> long term effect of 

> causing her sinus problems.

> 

> Her sinuses are chronically clogged and painfully

> filled with fluid that is 

> impossible to drain.   She has sinus infections

> frequently and has been on 

> antibiotics so many times for sinus infections, that

> they are losing their 

> effectiveness.

> 

> I am not sure if it is the iodine treatment or the

> direct irritation which 

> has caused this damage to the sinus region.    

> However, clearly there has 

> been tissue damage from the radiation that is not

> healing.    Does anyone 

> know of any supplements, medications or techniques

> that are effective in 

> promoting the healing of radiation damaged tissue,

> such as that in the 

> sinuses?

> 

> 

> And on a related note:

> 

> When my friend is given the radioactive iodine, she

> is ordered to stay alone 

> in her home for over a week.   She is told she

> cannot be within 25 feet of 

> anyone else and cannot closely interact in any way. 

>   This is very 

> difficult for her, especially because she becomes

> ill and would benefit from 

> personal care.

> 

> Would it be safe to spend time with her if I did the

> following:  I Took 

> potassium-iodine before being around her (incase

> somehow iodine excreted 

> entered the environment),  I wore a 1 mm thick lead

> radiological apron, lead 

> kilt, thyroid protector, gonad protector,

> radiological lead-acrylic glasses, 

> and .5 mm equivalent full-arm lead-rubber gloves.  

> I also would wear a 

> digital alarm dosimeter to verify that my time would

> stay within reasonable 

> limits of safety.

> 

> If I took these protective steps, would I be safe to

> spend a period of a 

> couple hours a day with her?

> 

> . . .



=====

+++++++++++++++++++

"Everyone is ignorant, only on different subjects."

Will Rogers



-- John

John Jacobus, MS

Certified Health Physicist

e-mail:  crispy_bird@yahoo.com





		

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