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Where to stay after RAI?

teamwink
Posts: 97
Joined: May 2011

Where did you stay after RAI? I have two small children and can't really go home to them afterward, until I know that I am totally safe. As a psychologist, I don't want to have to push them away for hugs, etc when they come jump on me :( My doc suggested a hotel, but are there precautions for this? I would imagine so, but could use advice!

nasher
Posts: 507
Joined: Apr 2010

Hotel is a bad idea for you…

the reason is simple you want to make sure you do not spread radiation to anyone else... hotels may not launder sheets and such good enough to prevent spread plus you are subjecting the maid to the extra radiation with no idea she/he will be receiving it.

The big question is when are you getting the radiation vs. when are you kids in school.

Ok here are some snippets from thyca.org ( http://www.thyca.org/rai.htm#after )
------
What do I do at home?
If you go home immediately after a treatment dose, use the following guidelines regarding distance, time, and hygiene.

Minimize contact (less than 3 feet or 0.6 meter for more than 1 hour each day) with everyone for the first five days and with small children or pregnant women for eight days.
Do not sit next to someone in an automobile for more than one hour.
Sleep in a separate room and use separate bath linen and launder these and underclothing separately for one week.
Wash your hands with soap and plenty of water every time you use the toilet.
Rinse the sink and tub thoroughly after using them.
Use separate eating utensils or disposable eating utensils. Wash eating utensils separately for one week. Do not prepare food for others.
Flush toilet 2-3 times after use for two weeks after discharge.
Males should sit when urinating to avoid splashing for one week.
Discuss with your doctor how long you should wait before starting a pregnancy after your treatment (usually at least two months for males and six months for females).
If you are breastfeeding, it should be discontinued, but can be resumed for subsequent childbirths.
-------

Is it possible to…
1) Send the kids to camp?
2) Have your spouse take the kids on a vacation?
3) Another option is have the kids do sleepovers or the like?
4) The kids and your spouse could spend the time in a hotel
5) (depending on insurance coverage and such) you could stay in the hospital for a few days they kept me in the hospital for 3 days due to the dose size (175 mCi)
I am sure there are lots of other options

Other questions for you

Can you do the same precautions for when you are sick?
What do you consider totally safe?
How old are the kids (how much can they understand about the situation)?

you can do minimal contact with your kids and such (quick hugs and such) a suggestion might be have your spouse put another layer of clothing on you (including gloves) just before your kids want to hug you and such then have your spouse take them off and put them in the laundry (that way you reduce the risk of transfer of RAI from perspiration.

As for safe and the like realize that the first few days your body will be passing out the extra RAI that your thyroid tissue doesn’t absorb through perspiration and using the toilet.

So the first 48 hours is the time that most of the radiation that is not staying with you will leave after that we can use the half-life of radiation to determine how much is there

- - - Calculation time - - -
I-131 t1/2= 8.02 days (will use 8 for ease of math)
Assume you get the same dose i got 175 mCi
Assume 100% is absorbed by thyroid tissue (I don’t know how much you absorb but it’s much less)

So immediately after treatment you have 175 mCi of I-131
1 hour 174.4 mCi
6 hours 171.2 mCi
12 hours 168 mCi
18 hours 164 mCi
24 hours 160 mCi
48 hours 147 mCi
3 days 135 mCi
4 days 124 mCi
5 days 114 mCi
1 week 96 mCi
2 weeks 52 mCi
3 weeks 28 mCi
4 weeks 16 mCi (less than 1/10 of what you originally got)
5 weeks 8.4 mCi
6 weeks 4.6 mCi
7 weeks 2.5 mCi
8 weeks 1.4 mCi (less than 1/100 of what you originally got)

As you can see it decays away quickly

in actuality the majority of the radiation will leave the body in 3 days and only a small amount will actually stay in the body but I cannot tell you the average amount your body will take so I cannot give you any idea how much actually will be left.

- - - - -

Ok for basic on radiation there are three ways to minimize exposure
1) time
2) distance
3) shielding

For all intents and purposes shielding is not going to be a factor for contact with family so we are left with time and distance

If you actually feel like calculating the distance equation it can be found at http://www.wright.edu/admin/ehs/documents/EquationsforRadiationSafety.pdf
But basically radiation falls off very rapidly at distance...

again using myself for the first 24 hours people were allowed up to 1 hour at 6 feet away and unlimited at 12 feet away. After the 3rd day I was allowed to have people at 2 feet for up to 4 hours a day and unlimited at 6 feet. At 1 week I had no contact restrictions with adults but it was recommended that i limit my exposure with children to less than 2 hours a day close contact.

Hope some of this helps if you have any more questions please ask them

Sorry for the LONG post

Craig

teamwink
Posts: 97
Joined: May 2011

I appreciate your feedback! I am in a pickle because my kids are 2 and 3 and they still are very very attached to mommy (I am the primary caregiver and work from home). I don't have a spare room in my home and kids will be at home full time this summer with me (no camp, no preschool or day care). We have no family around, so it is just us.

It is so odd that my endo of all people suggested I stay in a hotel after the RAI treatment. I wondered about that, but she said that is what she'd do (so I assumed it would be safe enough). Hmmm... now I'm a bit apprehensive about my options, besides sleeping in a tent outside (lol).

nasher
Posts: 507
Joined: Apr 2010

It is my pleasure to help others and it helps me with my day to day life after THE BIG C.

I can see why it is going to be tough

Yes at 2 and 3 they probably will not understand why mommy cannot be with them. Also with their age they are probably more sensitive to radioactive iodine.

Do you know how much they plan to give you (treatment dose)?
Is there a way they can put you in the hospital for a few days?
Do you have a separate bathroom that you can use?
How far away can your kids be from you and feel safe (12 feet + would be optimal)
Remember you do not want to prepare there food for the first week +

I am guessing your doctor decided on a hotel because they can’t put you in the hospital and were trying to come up with an easy solution to keep you and the kids apart.

oh and I did consider sleeping outside in a tent when I was trying to figure out things but my wife just decided to visit her mother so that solved the problem. They put me in the hospital for 3 days as well so I was much lower risk once I got home.

I would ask if your husband could take a few days off work to take care of the kids for a few days...

Another option is frequent showers (no baths) to wash as much radiation that has left the body do to perspiration (hopefully you have a separate bathroom and shower you can use.

If your husband can take the time off then he could take them to a hotel or such... if so and if you have a laptop for him he could even do video conferences with you and the kids.

Treat it the same as if you have a bad flu or the measles or such and your kids don’t.

I don’t know how many days your kids will be ok with you not being near them but each day you can make it (up to 2 weeks) will greatly reduce the risk to your children and the first few days are the most important.

from the research I have done it looks like within 3 days most of the radiation that will not stay in the thyroid tissue has left the body and within a week it’s pretty much just what’s left in the thyroid so you then have much less chance to spread loose radiation and are just dealing with what’s left in your thyroid tissue.

Again if the doc said a hotel was a good option for you just reverse it and have your family go there instead. If they can put you in the hospital for a few days it will minimize the chance give your kids’ unwanted radiation.

Remember no way is perfect and you are doing what you can to minimize the spread.

the only other thing I can think of that might reduce the exposure to your kids more is what one of my friends who is in alternative lifestyles did... she wore a metal collar around her neck for 2 weeks (yea I know a bit extreme there hu)

Also I don’t know if it was mentioned but you should not try to get pregnant for at least 6 months either.

Please ask thousands of questions hopefully we will be able to answer most of them for you

Craig

teamwink
Posts: 97
Joined: May 2011

What is the collar for? I'm not totally sure that I understand what that does - my endo has not informed me much about things outside of her office. She send me to the RAI folks and they do their thing, but I don't know much about specifically what that is... these boards have been helpful to learn more.

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

Craig,

I understand the collar for the first three days when the 3 foot rule is in effect. My understanding is, what I-131 that isn't taken up in the first 48 hours {99% according to my endo} is expelled in a person's urine. So, only 1% of your dose is in you after 48 hours and Beta particle emmission is greatly reduced by then. After that, the main danger is stray I-131 atoms. Did your friend also wear a cloth mask? That would have been more to the point and effective. Mainly the danger is I-131 in a person's urine, hence the 2-3 flush rule. After that, I-131 in a person's saliva and then I guess persperation as well.

Alan

nasher
Posts: 507
Joined: Apr 2010

no cloth mask but the collar was a full neck one... shrug... i think it was just an excuse to were a collar

thanks for the info about 99% being gone in 48 hours... shows why they say the first 72 hours are the most important (that way people will have 48 hours at least before they start sliping on the distance)

so there you go within 48 hours most of the iodine is gone so that reduces the risk alot

so if you can plan for you kids to be away for 72 hours and then try to keep the distance except for brief hugs and such it should limit the exposure to them

TopOverU
Posts: 2
Joined: May 2012

Dr. Ain served as one of the first ThyCa medical advisers and has been the ThyCa listserve medical adviser for over 12 years. He now runs his own Yahoo listserve to service thyroid cancer patients’ specific questions. The group is called ThyroidCancerHelp.

From http://www.thyroidcancerdoctor.com/help.html

"COMMON SENSE REGARDING RADIATION SAFETY AFTER RADIOACTIVE IODINE TREATMENTS
Radiation safety precautions are based upon a very reasonable consensus public policy that individuals, who do not require exposure to radiation for their own health, should have the least exposure to radiation as is reasonably achievable. The acronym that is commonly applied is "ALARA" (As Low As Reasonably Achievable).

Such precautions have been designed because of this PUBLIC POLICY and NOT because health professionals expect radioactive iodine patients to be dangerous or harmful to anyone else. In fact, I can conceive of only three examples of situations in which a radioactive iodine therapy patient could "endanger" or cause "harm" to someone else: 1) If a cannibal should chance to devour the patient immediately upon discharge, this cannibal might experience dysfunction of their thyroid gland; 2) If someone would try to drink all of the urine produced by a patient for the two days following discharge, they might also expect dysfunction of their thyroid gland; and 3) If a patient would breast-feed a child within two weeks of such a therapy the radioactive iodine might be likely to damage the infant's thyroid gland. Lactation during therapy would also provide excessive radiation to the patient's breasts and is an additional reason why lactation must be discontinued for a couple of months prior to receiving radioactive iodine treatment.

Besides the three situations listed above, it is NOT CONCEIVABLE that any MEASURABLE HARM could result from a radioiodine therapy patient. The general precautions given to every patient after such therapy, below, are provided solely to support the reasonable ALARA public policy.

Please maintain simple radiation safety precautions for the next 14 days. Do not exchange bodily fluids with anyone (no sex, wet kissing, sharing utensils, etc.). Please urinate while sitting (instead of standing). You may use normal non-porous eating utensils and dishes/cups, but wash them before anyone else handles them. Dispose of your toothbrush after 14 days. Try to place a reasonable bit of distance between yourself and others. One useful technique is to imagine that you have a "streptococcal throat infection"; the distance that others should keep from you would be similar, as would the bodily fluid precautions. Do not sleep in the same bed as others for this time. There is no need for these precautions after 14 days.

Although these precautions, listed above, may differ from the specific instructions provided by different radiation
safety agencies, they embody the same principles and same respect for the ALARA policy.

No one should go to absurd measures of isolating themselves from everyone else for days on end. Patients need not place their children in foster care. It is supremely foolish to try to "disinfect" things (radioactive iodine is not alive and is not a germ nor virus); a little soap and water suffice for items that have been dampened by radioactive bodily fluids. Do not fear eating in restaurants. If restaurant employees follow the required public health policies for washing utensils, dishes and cups, they will not be exposed to radiation. If they fail to follow these policies, they're at far greater risk from gonorrhea, syphilis, herpes and other contaminants of customers' saliva than they are from a trace amount of radioactive iodine. Likewise, the employees of hotels in their handling of towels and linens are far more at risk from their guests' influenza viruses and sexually transmitted diseases on bed-sheets if they mishandle them, than they ever could be from trace radioactivity.

As in most things regarding health and safety, common sense and intelligent behavior trumps fear and neurotic excesses every time."

TopOverU
Posts: 2
Joined: May 2012

Dated March 1, 2011 from:

http://www.ascopost.com/articles/march-1-2011/how-can-patients-who-receive-radioactive-iodine-treatment/

Dr. Richard T. Kloos, MD writes:

"Staying in a hotel 'can be done safely and reasonably,' Dr. Kloos agreed, but physicians need to discuss with patients some additional risk-reduction strategies. These measures include checking in before treatment so they can go directly to their room afterwards and avoiding interactions in the lobby."

Read the whole article. There are some tips and tricks as to how to stay at a hotel safely. Thinking about it, if it's perfectly safe to stay at home (so long as you follow the precautions), why exactly would those precautions fail at a hotel? Putting it another way, wouldn't the same precautions that keep family members safe also keep hotel workers and hotel guests safe? In fact, if it is safe to expose the same people at home continuously for two weeks, why isn't it safe to expose individual hotel workers and guests for just a few minutes?

The fact is it safe to stay at a hotel (if you follow the precautions you've been given), but there is a small chance that radiation detectors will go off if a guest stays in your room following you and they work at a facility that has sensitive detectors. The example used to advise against hotel stays is the time a nuclear power plant worker stayed in the same hotel room as an RAI patient. Then, returning to work that power plant worker set off the radiation detectors. I've seen lots of reports of this happening and never once a report that there was any actual danger. This seems to be much more a case of the detectors being extremely sensitive and not a case of the RAI being dangerous to the public.

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