Radioactive Quarantine: Here we go..

First of all: thankyouthankyouthankyouthankyou for all of the outstanding book, movie and activity suggestions. More on what has been keeping me busy in a minute, but I wanted to make sure that if you only read one thing, it was that I THANK YOU for your thoughtful messages and suggestions!

Since my last post, I have done quite a bit of waiting. I don't like idle time, though, so I certainly was not waiting in my house. Between appointments and bloodwork, the girls and I did some preparing for the holidays and tried to get out and go for walks before I was relegated to solitary confinement. The girls have been handling all of this extremely well and Amelia loves to see my bandaids when I get home (which makes her more courageous than her very squeamish father). After a few lengthy waiting room experiences, I finally packed an "Appointment Tote" containing a few snacks, some of my own magazines (thanks, Kim!), my smartphone, and a small knitting project. Of course, now that I am somewhat prepared, I haven't had as many long waits -- go figure!

One of the things we had been hoping for was that my TSH (a thyroid hormone) would be high enough that I could avoid the painful and expensive injection alternative. If you take out someone's thyroid and/or they stop taking their thyroid replacement medication and/or the thyroid is not working as hard as it should, the body responds by making more of something called TSH (thyroid-stimulating-hormone). So they took out my thyroid, I stopped taking the medication, and we hoped the number would come up to 30. At 30, your body is ready for the radioactive iodine treatment. Week 1, the number was 14, which was very promising.. but at Week 2 we were only at 18, so injections it was. Alternatively, I could have waited a few more weeks for the TSH to come up on its own, but then we ran the risk of these December treatments and followup scans running into Amelia's birthday, Christmas, and (importantly) the New Year. Certainly we will have plenty of fun followups and things in 2013, but I prefer to pack as many as possible into this deductible-satistfied 2012. And as it turned out, the injections in my rear end were not as painful as I would have imagined, but as one of my friends reminded me: "I wouldn't say that they weren't painful until you see the bill for them." Funny.

In addition to the pokes, my radiation oncologist added two additional medications to my regimen to prepare for radioactive iodine treatment: lithium and pilocarpine. Quick story: When I was in pharmacy school, I did a summer internship in a community pharmacy. The pharmacist used to say that he was going to sweep the pharmacy floors every evening and the interns had to try any tablets or capsules he found and try to guess what they were based off of how they made them feel. He was joking (I think??) because none of us ever did this, but this story certainly stuck in my memory this past week.

When I picked up my prescriptions, I  glazed over the information I had seen a hundred times, "may cause upset stomach if taken on empty stomach.." .. "may cause blurred vision, use caution when operating a vehicle.." Pharmacies are mandated to give you this laundry list of side effects that could possibly happen.. it is so extensive that I might bet that you can find "nausea" listed for ANY medication. I knew this stuff. I knew these medications. But I didn't. In my case, lithium is certainly not anything hope to ever be on again. The first couple of days were fine (thank goodness, because we were able to fully enjoy and celebrate the wedding of our dear friends!!) but by day 2.5 or 3, I was dizzy and nauseous to the point that thinking about taking my next dose made me dizzy and nauseous. Last evening was my final dose, and I am just now starting to feel less dizzy.... and more capable to jump into one of the books that I brought along!

For those who are wondering, the lithium was used to augment the radioactive iodine treatment. It takes some time to build up to a therapeutic level of lithium in the blood stream, so I started it five days before treatment. There are frequent blood tests to monitor if levels are too low or too high, and once that was fine tuned I was ready for treatment. The pilocarpine is used to protect the glands from radioactive iodine. It helps to flush out radioactive iodine from the salivary and sweat glands. It can cause side effects like flushing, sweating, et cetera; but the most bothersome-but-expected side effect was excess saliva. Nausea + Excess Saliva made for an overall unpleasant couple of days. But that's done now, so hooray for that!

So, I'm radioactive right now. Apparently. I don't feel any different than I did when I walked into that metal walled room, but I trust that something is going on. The nuclear treatment portion of this process was quite streamlined: walk in. get pregnancy test. wait for results. sign wavier saying you won't get pregnant for at least a year because you might harm baby. go over rules of being radioactive. take pill. go hide in proverbial cave for 8 days.

Now, if you have to be locked in a room for over a week, I hope you have an awesome sister with an adorable little studio apartment who is willing to displace herself. Isn't she a great decorator?

As I mentioned.. I'm feeling better today. Monday and Tuesday were not my favorite. Wednesday and Thursday I was very dizzy and nauseous, so I watched some mindless television and a few mindless movies. Today I am starting to feel more like myself! I have a stack of books and articles that I have been looking forward to, and a few Christmas projects as well.

I am sad to be missing some awesome events this weekend, but looking forward to the ones that I WILL be able to be a part of. We are beyond thankful for some friends who generously gifted us a trip to Wisconsin Dells a few days after I return back home. Aside from being an incredibly awesome gesture, this is also serving as something that Amelia has to look forward to during a tough time. She knows that I am gone and that we can talk on Skype, but this has still been sad for her. She gets very excited when we talk about going swimming after mom gets home!! A thousand hugs to Minnesota to the Brezinkas!

Up next: Tomorrow I will begin the thyroid replacement medication that I will take for the rest of my life: a simple-but-important little tablet taken (on an empty stomach) each morning. It contains synthetic thyroid hormone to replace the work that my thyroid would be doing if it was still around.

Equally important, tomorrow I will also be reunited with coffee creamer!! And other things, obviously, but that tiny splash of coffee creamer has been one of the most painful concessions. The low iodine diet that I have been on for the past 3 weeks will conclude tomorrow and I am free to eat whatever I like.  Those of you who know me well: I haven't had a piece of bread in three weeks. ME. No bread. Unheard of!!

Low Iodine Dinner at the Van Handel Wedding!

The limitations of the diet were not so bothersome until Wednesday. All of a sudden I started craving things (Egg McMuffins?!? Chipotle?! Lasagna!!) that I could not have, and my only option was to make a Wishlist for Saturday and beyond. I hope my bathing suit still fits in Wisconsin Dells!

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.

12 Days of {Olson} Christmas

Happy {Belated} Holidays from the Olsons! 

We had a whirlwind holiday, celebrating with friends and family alike. 

Below is a quick synopsis of the 12 Days of Olson Christmas 

-- one photo from each day--

No turtle doves, or golden rings

How do we know the holidays were a success? 

Easily measured by the difficulty we found in choosing just one photo from each day

::December 21::

Amelia and Ingrid celebrated Christmas with some of her best buds as a brave mom invited twelve little people under age 3 into her friendly home! (Special shout out to Brynn for the sweet Santa pajamas!)

::December 22::

Amelia spent the day with Grandma Judes and Grandpa Paul as Nicole & Ingrid spent some quality time together and packed for our Christmas traveling adventures.

::December 23::

These next four days were particularly hard to choose just one photo. This day, the girls and I spent with Judy as Paul and Issac finished up the week's work before the holiday. We made and decorated cookies. Amelia tried--and loved--eggnog. {Who knew?!?!} And Issac was finally inducted into that eve-before-Christmas tradition of parents assembling children's gifts putting together Amelia's balance bike from Grandma and Grandpa Olson!  

::December 24::

Christmas Eve Morning Brunch with Grandma and Grandpa Olson and Auntie Heidi. Santa! Visiting with the Olson/Blatz families. Many wonderful memories made. More eggnog. 

::December 25::

Amelia was so proud to give Ingrid the stuffed bunny that she made for her at Build-a-Bear. Santa surprised the girls with a little slide, and Amelia's wish came true for Elmo and Super Grover stickers. We spent Christmas morning at home with the girls, then were off to Grandma & Grandpa Niggemann's house for more Christmas celebrating with family. Three hours of arguing with the antenna and we (Issac+Grandpa Bill) achieved in finding reception to watch the Sunday evening Packer Game that Uncle Bill and Auntie Lindsay were at!

::December 26::

Another day of celebrating Christmas with the Niggemann family! Though she wasn't as interested in 'tearing wrapping paper' as everyone thought, she did love to deliver the gifts under the tree to their respective owners.

::December 27::

Today was devoted to playing with our new toys and unpacking. 

The glasses from Ingrid's new stuffed bunny proved most entertaining for Amelia.

::December 28::

Practicing taking turns on the slide, in preparation for sharing with our friends (and our sister).

::December 29::

Definitely not her first smile, but the first caught on film!

Ingrid, at 14 weeks old.

::December 30::

Our good friends Chris + Jen brought their stunning little man Evan to our "Bring-Your-Own-Baby" New Year's Eve weekend. We were thrilled with their company, per usual! Even though Amelia pushed him down the slide a few times, their friendship was rekindled when he willingly shared his iPad and the "Monster at the End of This Book" app.

::December 31::

New recipe + 2 dads + 1970s waffle maker = cereal for breakfast.

I had to laugh, this is one of the only photos from the weekend that included any adults. I'd like to say that it was because the kids were being so gosh-darn adorable the whole time, but it also could have been because Issac & myself were seldom in anything but pajamas :)

::January 1::

Amelia starts off 2012 with some horticulture:

Anyone who visits will undoubtedly be asked by Amelia to play 'The Apple Game' with her.

Over. And over. And over.

It was her 2nd birthday present from mom&dad, and is absolutely toddler-approved!

She figured out the rules in about ten minutes and we are excited to have an interactive game we can all play together. Auntie Lindsay rolled a raven: "Uh-Oh... Way-Ven!!!" 

{for those of you who have asked - here is a link to the game I'm referencing}

What a wonderful two weeks of fun and memories made with friends and family. Thanks to everyone who made this our most eventful holiday season yet!

Stationery card

Niggemann Family Christmas Card