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Upcoming RAI but still can't swallow pills

bkane101
Posts: 35
Joined: Apr 2011

I am supposed to do my RAI on April 18th but I can only swallow small pills still. I still have issues with my throat like still not having a voice and can only swallow sips of liquid at a time, not enough to swallow a large pill. I tried today a 1/2 a large pill and I spit it out and start choking. I don't think that would be good with a radioactive pill if I spit it out! I'm REALLY concerned about this and don't know what to do. I have no idea until I try it to see if I can swallow it. I also hate to be going hypo and doing the LID and then NOT be able to do the RAI! If those of you who have gone through RAI can describe the pill or relate it to a common one I may have taken before that would be great. They told me they do not offer it in a liquid form.

Baldy's picture
Baldy
Posts: 225
Joined: Mar 2011

Hi bkane,

I'm taking the tracer (I-123) dose pill tomorrow and the "zapper" (I-131) dose pills on Thursday. I'll let you know what I experience.

Alan

Baldy's picture
Baldy
Posts: 225
Joined: Mar 2011

The I-123 capsules {yes, plural, 10 of them, surprised me, I assumed one} were about the same size as a generic CVS Benedril capsule. Maybe 1/2 inch by 1/8 inch or a little wider. These are the only caps I have in the house to compare to, everything else is in tablets.

bkane101
Posts: 35
Joined: Apr 2011

10??!! Wow! I have no idea how many I'm taking and I'm taking I-131 100mg. I can handle a benadryll sized pill so that's good news. I'm also worried that I'm doing everything to prepare beforehand and during since I've received zero information from the doctor or radiaologist. I was just told to you on a low iodine diet and that's it! Thank God for the internet because I'm getting all my information online. I guess I need to have sour candies to suck on at home and they never said anything. It's not like I can just go out and buy it after I take the pill! And I do not even know what time I have to be there Monday or anything. Guess I need to take what little voice I have and call them.

Baldy's picture
Baldy
Posts: 225
Joined: Mar 2011

Yes, 10, but that is only for the I-123 not I-131. I think they give you so many because I-123 decays faster then I-131, so most of it decays between the time it's prepared and the time you take it.

A suggestion, though I may be duplicating someone else's. When I first saw my ENT surgeon and before I was diagnosed with thyroid cancer, he performed an endoscopy. He squirted something in my nose and down my throat. Not only was he able to get the endoscope {about as wide as a pencil} down my nose and around and around, he was able to stick his finger all the way to the back of my tongue feeling for lumps. I have a very well developed gag reflex and I had no trouble at all. My only suggestion is give it time to work before you start, he tried to feel my tongue right off and I kept gagging. About ten minutes later after he did the endoscopy, no problem. I don't know what this stuff was, but I bet it will help you if they have it.

Alan

Baldy's picture
Baldy
Posts: 225
Joined: Mar 2011

I also asked about the liquid. The tech who was serving me my pills told me it's not that easy to take. You have to suck it through a tube connected to a large bore needle. It's not in an open container that you drink.

Alan

alapah's picture
alapah
Posts: 258
Joined: Oct 2009

There is a liquid form of I-131 although I was unable to get it myself where I live - I did ask about it. I have a paralyzed vocal cord which makes swallowing large pills difficult. I had no option so ended up taking the pills - and they were kind of large, long pills as I recall. Lucky me, I had two because I had to postpone my RAI by three days so the original dose lost some umph through decay over the three days it had to sit - the nuclear med guys had to make up a second pill to have the entire dosage at the 100mci level. I was afraid I'd cough it up in mid swallow as I had experienced that with a pain med. I didn't though!

You may want to at least ask about the liquid version. Not sure how common it is.

bkane101
Posts: 35
Joined: Apr 2011

I have the paralyzed vocal cord as well which is why my voice is still barely there. I kind of sound like Mickey Mouse:) My doctor did say to turn my head to the right when I swallow and that opens up something in my throat better. I am having a 100 dosage so I don't know what the size of the pill will be. It was supposed to be 150 because my cancer was pretty agressive and had spread he lowered it to 100. I'm SO afraid of coughing it up! I can't swallow my 600mg calcium pills because they are too rounded so I have to take my calcium with Tums. Thanks for your input.

Barbara

sunnyaz
Posts: 582
Joined: Oct 2010

Hi bkane,

The pills are capsules so they are easier to swallow than a tablet. They are about the size of a Tylenol capsule. Depending on your dose there may be more than a few. One possibility is to have them give you a bit of Lidocaine gargle a few minutes before taking it so that you won't feel the capsules going down. Just a thought but they may be amendable to it. They gave me the Lidocaine gargle when they went down my throat with a scope and I didn't even feel it.

Some tips for swallowing medication. Point the tip down toward your throat and open your throat as wide as possible placing the pill as far back on your tongue as possible and round your tongue so that it forms a cup for the capsule. Keep your throat open and tilt your head back while pouring the water down your throat and then swallow. Don't take the liquid in your mouth first. Let the water wash it down instead of trying to force it down.

I hope this helps a little. Maybe you could practice with Tylenol caps this week. Remember not to take more than 1000 mg's every eight hours though. Wishing you the best of luck. You can do this!

Blessings,
Julie-SunnyAZ

bkane101
Posts: 35
Joined: Apr 2011

Julie,
Thanks for your advise. I am having 100mg of I-131 so hopefully the pill isn't too large. I did just swallow a Tylenol pill today so that's a start! My problem is if they are too rounded on top, if that makes sense. I'll ask about the stuff that numbs the throat because maybe that'll help with the spasms that happen and I spit pills out. My poor boyfriend was a victim! :)

Barbara

nasher
Posts: 507
Joined: Apr 2010

they are able to give it to you in liquid format

they normaly do it in pill format cause its easyer on them and reduced the risk of contaminating the area they are giveing you the Radioactive iodine but it is also relitivly easy for them to give it to you in its liquid format but it takes some precautions on there side so tell them about your problem before hand and it wont be a problem i am sure

Craig

EuropeanGirl
Posts: 9
Joined: Jan 2011

I got the liquid. It was 10 ml that I had to suck through a straw. Then they put 10 ml of clean water into the container (to wash out the rest) and I had to drink that as well.

They did not offer me any RAI-pill

Baldy's picture
Baldy
Posts: 225
Joined: Mar 2011

Hi bkane101,

Just took my I-131. For me it was one capsule same size as the I-123 capsules. My dose was 75 mCi.

Alan

warriormum
Posts: 20
Joined: Mar 2011

Hope the RAI goes easiy for you.

nasher
Posts: 507
Joined: Apr 2010

yes hope the RAI goes easy for you as well... it still supprises me the variance in doses they give people myself i got 175mCi.

Primetimern
Posts: 1
Joined: Apr 2011

I have an advanced case of thyroid cancer with metastasis and had surgery Jan 6, 2011. As a result my salivary glands, taste and swallowing ability were impaired. As far as swallowing, use the technique used for stroke patients - tuck your chin down and swallow. This opens up the esophagus.
A little relaxation technique would help as well. I know my throat seems to tighten up when I know I have to swallow anything big. It worked for me. I also had I 131 200 Mci on Feb 24. My capsules were no larger than a Benadryl and I had no trouble swallowing them. My husband and I found the thyca.org web site very helpful especially with the lo iodine diet. Somewhat tastless but I couldn't taste much anyway. I was just grateful to be able to take the I 131 which is the best known treatment for thyroid cancer.

As far as your not getting enough direction, I can only suggest - ask questions and more questions when you don't understand. And don't feel foolish. Your caregivers have thousands of people to think about and You only have You. So keep on asking and check out the thyca.org website.

Baldy's picture
Baldy
Posts: 225
Joined: Mar 2011

Craig,

They said the small dose was due to minimal thyroglobulin levels [.5 ng/mL], only one hot spot right where the thyroid was on the I-123 scan {apparently a piece the surgeon couldn't get} and a small amount of uptake shown by the scan [.3%].

===

All,

So far so good. I notice if I go a while without drinking water {when I'm driving somewhere, I keep forgetting to fill up a bottle} I start to get an odd taste and a headache as well. But as long as I'm staying well hydrated, no side effects. All the water is making me run to the lav often. The flush two times rule is a good thing, while I wait for the tank to refill, I throw down a glass of water. I'm guessing 48 to 72 hours post pill, I won't need to drink as much.

Thanks for the thoughts and wishes,
Alan

bkane101
Posts: 35
Joined: Apr 2011

Well yesterday was the day and the pill was the size of a tylenol so easy to swallow...thank God! I've had no side effects except the swollen salivary glands due to no water or sour candy during the night. I didn't buy sugar free so I'm not liking all the sugar I'm intaking. My body is feeling a little weird and a slight headache because of it. It's weird as I sit here alone in my house for a week that even though I can't see it I'm contaminating my house! But at least it fades away soon but it is just kind of weird. And I can go off the LID tomorrow which is nice! I get my PET scan Monday so I hope they find nothing!

alapah's picture
alapah
Posts: 258
Joined: Oct 2009

nice to hear it was a non event. hoping your scan goes well. BTW, i imagine you are not getting a PET scan but rather a WBS, or "whole body scan". the WBS does not expose you to radiation, it simply picks up the radiation emitted from the areas of your body that took up the radioactive iodine. a PET scan is a very different scan - it's used to test for cancers but along with RAI and it's not often needed for thyroid cancer patients, thankfully. enjoy that LID free life!

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