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



Giving out records would not necessarily be how they trace it.  If the material is in a trash bag with a get well card to Aunt Hildegarde that has her address, the presumptive conclusion would be that she disposed of it.



Dave Neil



-----Original Message-----

From: daleboyce@charter.net [mailto:daleboyce@charter.net]

Sent: Thursday, August 19, 2004 2:30 PM

To: Philip Egidi; kb1ipd@HOTMAIL.COM; owner-radsafe@list.vanderbilt.edu;

radsafe@list.vanderbilt.edu; crispy_bird@YAHOO.COM

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





Phil,



If the suits show up with a bill, I think the lawsuit against the hospital

for giving out confidential medical records would more than cover it! ;)



Dale

daleboyce@charter.net





----- Original Message ----- 

From: "Philip Egidi" <phil.egidi@state.co.us>

To: <kb1ipd@HOTMAIL.COM>; <owner-radsafe@list.Vanderbilt.Edu>;

<radsafe@list.Vanderbilt.Edu>; <crispy_bird@YAHOO.COM>

Sent: Thursday, August 19, 2004 12:52 PM

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





> And PLEASE have your friend follow the instructions given (hopefully) by

> the doctor/clinic/hospital as to disposal of wastes that may contain the

> I-131 after she is released from patient care.  Do NOT just throw paper

> towels or anything that may contain body fluid (feces, urine, sweat,

> vomit, etc), in the trash - it may set off alarms at the local landfill.

> Your friendly state regulator (or less friendly hazmat response team)

> may end up dumping the load looking for the offending trash in order to

> deal with it appropriately/  If the responders can trace the radioactive

> trash back to your friend, she may get a visit from the suits, and

> perhaps a bill for the effort.

>

> Thanks,

> Phil Egidi

> Colorado

>

> >>> John Jacobus <crispy_bird@YAHOO.COM> 08/19/04 07:42 AM >>>

> 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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