Mike Salsbury’s Blog

On Tuesday, I took a “tracer” dose of radioactive iodine.  On Wednesday, I took another.  Thursday I underwent two scans to see where the tracer doses went.  As expected and hoped, the scans showed that the radiation was pretty much confined to my remaining thyroid tissue.

Based on the result of those scans, the doctor set my “big” dose of radioactive iodine to 75 millicuries.  In terms of the range of potential doses used to treat thyroid cancer, it’s in the lowest range of doses.

On Friday morning, I took a 76 millicurie dose of radioactive iodine.  Apparently, I also contracted a cold and cough.  Since the radiation, lack of thyroid hormone (part of the treatment), and restrictive diet most likely reduced the overall effectiveness of my immune system, I now have a sinus and chest cold on top of the symptoms of hypothyroidism and radiation treatment.  I’m sneezing and coughing on a pretty regular basis, and feeling exhausted and tired much of the rest of the time.

I know this is nothing compared to what other cancer patients like my mother (who died earlier this year from melanoma) have gone through, and I am both respectful of that and grateful that my situation isn’t worse than it is.  Still, it’s not an exaggeration to say that I feel worse than I can remember feeling in a long, long time… if not the worst ever.  While I will probably never understand what my mother went through in her final days, I think I have a greater appreciation of it than I ever did before.

Tomorrow morning, I look forward to being off the low-iodine diet.  That means I can have things with dairy (like my morning coffee with milk), sandwiches with cheese, and pizza again.  I can have sushi, Chinese food, Indian food, and more.  Perhaps even better than that, I’ll once again be back on the synthetic thyroid hormone. That should be the end of the severely dry skin, muscle weakness, unexplained muscle cramps, shortness of breath, and other symptoms I’ve had to endure since before Thanksgiving.

This coming Friday (12/26) is another set of scans for radiation, to determine where the last “big” dose went. Friday’s scan is supposed to be “more revealing” in some way than the one I had last Thursday.

After that, I’ll be working with the endocrinologist to regulate the dose of synthroid I’ll be taking from now on to give me a “normal” level of thyroid hormone in my blood.  I guess you could say that the end is in sight, at least as much as there is an end to this.  I’ll be having tests each year from now to confirm that the cancer hasn’t returned, so in a sense it will never be truly “behind me” and will always be somewhere out there in the distance.

admin Life hypothyroidism, low iodine diet, papillary carcinoma, radioactive iodine, radioiodine, thyroid cancer

I was told to stop taking my thyroid hormone the day before Thanksgiving.  It began to take a toll on me pretty early on, and it’s only gotten worse.  According to endocrineweb.com, low thyroid hormone (also called hypothyroidism) carries with it a lovely list of symptoms:

• Fatigue
  Boy, have I noticed this one. Yesterday I walked a distance I used to walk every day without breathing hard, and wasn’t sure I would make it to the end between feeling worn out and in pain.
• Weakness
  I’ve experienced this one as well.  I don’t have the strength or endurance I had just a few weeks ago.
• Weight gain or increased difficulty losing weight
  This started even before the surgeon removed my thyroid, and I’ve been keeping a close eye on it. I don’t think I’ve gained anything in the last couple of weeks, and may have even lost a pound or two.
• Coarse, dry hair
  So far, I haven’t noticed this problem.
• Dry, rough pale skin
  The skin on my hands definitely mirrors this.  It’s much drier than it’s ever been, even to the point of almost cracking in places.
• Hair loss
  Fortunately, I haven’t see any of this yet.
• Cold intolerance (can’t tolerate the cold like those around you)
  Got this one in spades.  Doesn’t help that my office is in a renovated part of the building where the techs haven’t got the heating working just right yet, and that it’s now December. There was a long part of today where I couldn’t feel my feet and my hands were almost numb with the cold.  I’m the guy who could go outside in short sleeves for 10-15 minutes in the dead of winter, and now I can barely stand my indoor, heated office.
• Muscle cramps and frequent muscle aches
  This was the first thing I noticed, and it’s been getting worse.  Tuesday, I gently set my laptop bag on the floor in the den and really irritated the muscles and joint in my shoulder.  It caused intense pain for several minutes.  Other muscles and joints got in on the act later, to the point that I took two prescription pain killers and a muscle relaxer to try to counteract it.  It helped some.  Wednesday, my back decided to flare up and cause trouble.  Most every morning I’ve woken up with cramps in my hands that are so severe I can’t hold much of anything in them.  Even sitting here typing, my shoulders and arms are hurting.  I’m looking forward to the weekend when I can relax and move a minimal amount.  It’s not an exaggeration to say that stretching, twisting, or exerting any muscle scares me.  Most of the time, those actions cause pain comparable to a “charley horse” that lingers around for a while afterward.
• Constipation
  So far, so good on this one.
• Depression
  How anyone could have any of the above symptoms, combined with the knowledge that they have cancer, combined with the recent death of a parent, and not have some level of depression is beyond me.
• Irritability
  I hadn’t noticed, but apparently I do have this.  I said something I thought was slightly humorous but supportive, but dropped the jaws of everyone in the room because it was apparently “out of character” and mean.  I accidentally said something rude to a co-worker, too, in response to a comment she made… and I didn’t mean to be rude then, either. So while I may not be FEELING irritable, I must be based on the way others are reacting to me.
• Memory loss
  Yesterday, I would have said “no” to this one.  It started to be a problem today.  I’ve forgotten several things, sometimes very basic things like words I use often, and just couldn’t recall them.  I’m starting to understand what Denny Crane (William Shatner) on Boston Legal experiences with his Alzheimer’s.
• Abnormal menstrual cycles
  If this starts being a problem for me, it’ll be time to call the Guinness Book of World Records and maybe The National Enquirer…
  
  
• Decreased libido
  My wife probably wishes this was true.  I don’t think my libido has changed, but my desire to act on it has certainly diminished based on the cramps, aches, pains, and weakness I feel.

In addition to the above, I’ve noticed my voice having trouble today.  It sounds very weak and crackly to me. I can only imagine what it sounds like to others.  According to Wikipedia, that’s a symptom, too.  In fact, their list is a bit longer and indicates that I’m probably in the “late symptoms” category now. Oh, goody.

Monday I start the low-iodine diet.  This will probably take care of any potential weight gain because it eliminates nearly everything I can and do eat.  Fortunately, it does allow for an occasional beer and (homemade) popcorn.  On the serious side, it eliminates dairy products, seafood and sea-based foods, anything with iodized salt, anything with red dye #3, virtually all baked goods (due to iodine based dough conditioners in use), certain beans, more than 6 ounces of meat a day, and lots of other stuff.  What’s left is mostly raw fruits and vegetables, small amounts of home cooked meats without salt, popcorn, unsalted nuts, and homemade foods that you’re positive don’t include iodized salt or red dye #3.

Later in the week, I go in for blood work.

The week after that, I go in for a small dose of radioactive iodine. The next day, a scan. The next day, more tests (I think). That Friday, the “big dose” of radioactive iodine intended to kill any remaining thyroid cells or cancer cells.  For 6 days after that, I’m supposed to keep at least a 5-6 foot distance from others to avoid exposing them to radiation.  Thanks to the two surgeries and my mother’s illness earlier this year, I have no sick time left and barely any vacation days, so I’ll have to work at least one day while I’m in this “radioactive” state.  I’ll try to find a place away from my colleagues and as far as possible from others.  In a company of 1200 people that may not be easy.

On the 22nd, the worst of it should be over, as I’ll start taking the permanent thyroid hormone replacement and eating my normal diet again.  By Christmas, I’ll no longer be (dangerously) radioactive so I won’t be excluded from the festivities.

That’s all for this round. I’ll share more once the diet starts.

admin Life low iodine diet, radioactive iodine, radioiodine, thyroid cancer