House Arrest (and a favor to ask!)

As a part of my treatment, I will be undergoing radioiodine ablation on November 28^th. The goal is that the radioactive iodine will ablate, or destroy, any thyroid cells in my body. You might be confused at why there might be remaining thyroid cells when the purpose of my first two surgeries was to remove the thyroid gland: since it is a gland and not a solid organ, removing the thyroid is not like taking out kidney or a tooth. The thyroid is wrapped around your esophagus, so removing it is like trying to scrape room temperature butter off of corn on the cob: most of it is gone, but little fragments remain that are impossible to remove without damaging my esophagus, voice box, etc. I had a blood test done (thyroglobulin) which indicated that there is definitely thyroid tissue remaining somewhere in my body, but it is impossible at this point to tell if that number represents remnant thyroid cells in the thyroid bed (still some butter on the cob of corn) or if the cancer has metastasized into other areas like lymph nodes. If the treatment works, blowing all of the thyroid cells up with radioactive iodine will ablate that mystery thyroid tissue, wherever it is. The treatment is not supposed to be painful or bothersome, though some experience nausea, headaches, and achiness in their neck. There are rare scary possible side effects, just like there are with everything else, but nothing scarier than untreated cancer floating around my body. 

To prepare, I stop taking thyroid replacement medication. Yikes. You see, I have no thyroid – so my body depends on synthetic thyroid replacement to regulate things like metabolism, energy level, concentration, temperature regulation. Without that synthetic regulation for two weeks, I may become a very sluggish and confused version of myself. I am already cold all of the time, so poor Issac’s blood pressure is going to rise every time he walks by the thermostat for the next 2 weeks.  I have to take a few other medications in preparation as well--lithium and pilocarpine, for all of you medicine-curious folk—the former to possibly increase efficacy of the treatment and the latter to protect salivary glands from long term side effects. I now know my community pharmacist by name, and currently have a bag of vitamin and medicine bottles that would make a medicine reconciliation pharmacist nauseous.

Another way you prepare is via your diet. I outlined the basics last week. I have started my {crazy} iodine-free diet, which makes me appreciate the small arsenal of convenience foods we all use on a daily basis. Example: Last night I didn’t have a fresh lime (gasp!) as I wanted to add some lime juice to the corn/black bean/squash concoction that I made for dinner – but no luck, because even a bottle of lime juice has preservatives. No dairy or milk products. No soy. No bread, unless you make it yourself. Nothing preserved or packaged. If it says “salt” on the ingredient label, it’s out (because that salt could be iodized). Sodium is not a problem, but iodine is. Iodine isn’t listed on nutrition facts, so you just kind of have to know what products contain iodine (broccoli, spinach, strawberries, etc) and what doesn’t. It is pretty restrictive, but not impossible. Impossible if you’re trying to eat out or go to someone else’s house for dinner, however. I’m trying to come up with a sweet sack-lunch idea for our good friend’s wedding next weekend, but I did promise him I wouldn’t bring it in an Elmo lunchbox.  Thank heavens for my friend who delivered me her bread maker tonight, for now I will celebrate with a toast (pun fully intended). Three days without bread for this girl is UNHEARD of!

Anyway, I stay on this diet until three days after I become radioactive. I have already started my “first meals” wishlist. Oddly, the diet itself is not the problem – it is the combination of exhaustion from lack of thyroid hormones + having to cook everything from scratch. I don’t know anyone who says, “Hey.. I feel exhausted.. I think I’ll cook a meal from scratch!” It’s more like: “Hello, Cy’s Asian Bistro? I would like to order some take out.” Luckily, I have some awesome friends who promised to follow recipes to a T. I’m getting the feeling that I’m going to be forever indebted to many many many many people, which is a very new&awkward-yet-incredibly-comforting feeling.

The kicker of this whole treatment is “The Quarantine.”  You see, after I take this radioactive iodine, I will be radioactive. Like set-off-alarms-at-the-airport radioactive. This is dangerous to people I come into contact with, because my radioactive iodine can also harm their thyroid. I must maintain a distance of six feet away from another person for 8 days. I need to use a separate bed, bathroom, and eating area than that of other people. It is especially important to avoid small children, not because I will harm them more, but because they tend to get physically closer than other adults would (climbing in your lap, hugging, carrying, etc). I’m going to be very sad about being away from my girls for this long – but at the same time am very concerned about the potential risk to their little thyroids. As I have explained it to some, if I were instead leaving for a pharmacy convention I would miss them just the same, but the longing would be less because I would be busy with work and traveling and networking with others. Sitting in a room, alone, 15 minutes away from my house, 3 weeks from Christmas puts a bit of a different spin on it, but I am hoping to find a way to Skype or video chat with them somehow. I don’t know how much of this Amelia understands, but I can tell you that she is pretty gosh darn excited that Grandma Mary is coming to stay for more than a whole week. She even told the cashier at Target today about it!

I have lovingly displaced my sister from her studio apartment and will be camping out there solo for the duration of my quarantine.  The radiation oncologist I met with was extremely empathetic to my desire to “get it over with” and to be home and able to snuggle my family by December 19^th (Amelia’s third birthday). The routine chest xray and neck ultrasound on Tuesday came back clear, so everything should run on schedule so long as my TSH rises enough in the next week. If it doesn't, I will be relegated to taking two big & expensive shots in the behind the two days prior to ablation to ensure that my body is good to proceed with treatment.

 

If you know Issac, you know he isn’t a huge fan of Christmas décor. In lieu of a house full of holiday decorations, we just have one big tree. A compromise, of sorts, but we sure do adore our one big tall Christmas tree! Since I am going to miss out on two weeks of holiday happenings, I coerced him into putting our tree up a bit earlier than usual.  Though the tree is not fully trimmed, the two feet closest to the floor are covered in ornaments, and the girls had a blast!

So now.. the favor:

Just under two years ago, a good friend of mine was placed on bedrest. She was pregnant with her second and bedrest was the very last thing she wanted to be doing. At the time, I was working way too many hours a day, sleeping way too little at night, juggling Amelia’s newfound toddler-hood and had literally JUST found out I was pregnant with Ingrid. To me, bedrest seriously sounded like a vacation. I was actually jealous that she was going to have some “forced relaxation.” So jealous, in fact, that I sat down and wrote her a detailed list entitled, “Things I would do if I were on Bedrest:” and delivered it to her with a stack of magazines that I didn’t have time to read.

The grass is always greener, I suppose J In an effort to view it in a positive light instead of a negative, I’m less than two weeks away from embarking on a “forced relaxation” of my own. I am trying to prepare ahead of time, as I imagine the lack of thyroid hormone will start to wear on me more and more between now and the 28^th. If you were going to be locked in a room for eight days by yourself, what would you bring? Which books would you read? How would you keep busy to avoid thinking about the fact that you are locked in a room for eight days? Help me out here, people.