Rai

Hey there Sam, 

Some questions for you first if you don't mind. 

1. How do they know it's metastasised into the lungs if RAI hasn't happened yet? 
2. Are you sure they were told they'd have two lots of RAI, one for neck and one for lungs? If memory serves, you had RAI yourself, so you know it doesn't work that way. Was it radiotherapy they were suggesting? If so, without having had RAI, any idea why they'd be talking radiotherapy? Do you know what sort of thyroid cancer they have? 

Regarding timescales, as you know from your RAI, it depends on how much you drink, how fast your body processes it and expels it, and what your dose is as to what restrictions you're given when you leave the hospital. So noone can answer that one until the day they leave the hospital and their radiation levels are taken.

Lass

Xx

Hi Lass 

I didn’t have rai in the end so it’s all new to me. He had a CT scan before op and recently had another. 

So the results were T3b N1b M1 papillary

right lateral neck section and level v1 neck dissection 

extensive disease with ex capsular spread. Primary tumour in thyroid invading local strap muscle. Lymph nodes involved in left and right v1 largest deposit level v 62mm in size with ecs. 

1/2 cm positive tumour on innominate vein which couldn’t be removed safely. 

Multiple chest metasis

I didn’t think it worked like that either but as I never went through it. 

The specialist said it will be fine to be around pets after and of around another adult they can carry it but it would be like the radiation from an X-ray 

Ahhhh k. 

So, something has gone wrong somewhere. I don't know if the consultant was misunderstood, or if they misspoke. But here's how RAI works.... 

Most hospitals have patients on 2 weeks of LID, low iodine diet. There's still a lot of discussions happening about whether LID actually does anything or not, so lots advise to do it 'just in case'. If you're an omnivore in the UK, it's actually pretty easy to follow.

2 days before you go in for RAI, you usually have to go in for a thyrogen injection, then again the next day. One for each bum cheek! The alternative to the thyrogen injections is a month or more off your thyroxine. So thyrogen is def the preferred alternative. 

Then you go into hospital to be kept in isolation for a few days while the radiation moves through your body. So it's recommended to take some sour sweets in for after you've taken the RAI tablet, then drink a minimum of 2 litres of water a day, and have 2 showers a day with at least one hair wash. This helps get rid of the excess radiation so you've hopefully got no restrictions when you're discharged. 

The restrictions never apply to pets because pets generally aren't going to live long enough for any radiation to have an effect on them. However the restrictions very much include adults, not being around them too long or sharing a bed with them. So that's why we give the above tips on how to get rid of it ASAP. 

Now, how RAI itself works....

It's a clear tablet full of dessicated and irradiated iodine. Once that hits your stomach, it is digested and absorbed into the body like everything else you eat. 

One of the jobs of the thyroid is to mop up excess iodine in the body. So by starving the body of iodine your thyroid cells are like dried out sponges. This means when you flood the body with iodine, all those cells are empty and ready to absorb as much iodine as they can. And of course, because it's irradiated, they should hopefully then die off.

So as you can see, it doesn't matter where in the body the thyroid cells are. Neck, lungs, bones, liver, etc. Once the body is flooded with iodine, the thyroid cells will absorb it. So saying one dose will work on the neck and the second on the lungs makes no sense at all I'm afraid. 

Hope that helps, do please ask anything else you think of and I'll try to help if I can! 

Lass

Xx

That’s brilliant thank you so much. You helped me through my journey. 

If they have any questions I will get in contact again. 

Just another thing of an adult is near them then goes to a child can that be carried to the child. 

Thank you x

No problem at all. 

And yes. Radiation lingers. So if one person is, best word is probably infected, with it then they can transfer it to others.

So if someone is given restrictions when released from hospital, then they need to stick to them. It's not something worth cheating on, and it's why we're kept in isolation for the worst of it. To make sure we aren't spreading radiation around. 

Lass

Xx

Thank you so much x