So Robb's radioactive iodine treatment has been completed. Like everything else in this thyroid cancer saga, the actual process was much less scary and less intrusive than our Internet research had led us to believe.
Here's Robb's explanation of the radiation procedure:
"The procedure was not as complicated as I had understood it to be; I was in a secure room, to be sure, but the attendant was not wearing a hazmat suit, or even a lead blanket, for that matter. I was presented with a metal box, and when the box was opened, there was a silver canister inside. The canister was removed, and the lid was taken off of it. Inside this thick little canister (called a "lead pig") was a small plastic tube. The technician, using forceps, removed the top of the plastic tube and placed it aside. I was then instructed to take the tube out of the lead pig, drop both pills into my mouth, drink some water, and swallow them both at once. The scariest part was that when I entered the room, there was a Geiger counter sitting on a shelf nearby, and it clicked slowly and softly, reminding us that there was some radioactivity going on in the room. When I removed the plastic tube containing my magic mystery pills, the Geiger counter went berserk. Swallowing the crystal clear capsules didn't help; the radiation was obviously not hampered by my flesh, regardless of quantity."
He came home and had a great weekend. Even though we couldn't spend extended amounts of time together, we could still hang out with appropriate space between us. It was a beautiful weekend and we worked on our garden. (More on our garden in a future post!) I was worried about Robb contaminating our soil and vegetables, but the Dr. claimed it would be fine for him to garden. (So, who wants veggies this summer?) And on Saturday night Robb could eat regular food again and was VERY happy. He ordered pizza that evening and carefully planned out his menu for the next couple of days. On his low-iodine diet he lost close to 15 pounds (which was okay because he had gained a fair amount since his thyroid was removed). It should be interesting to see how much he puts back on now that real food is allowed again.
Hopefully the last step in this process (for this year anyway) will be the full body scan he has next week. This hour and a half slow scan of his body will show where the radiation went. That will indicate if the thyroid cells have spread anywhere and if the radiation went where it should. If the cells have spread, it may mean more surgery in the future, but the Dr. indicated that was rare.
So we're almost done with the thyroid cancer saga for this year; hopefully just a few more days...
Thursday, April 23, 2009
Sunday, April 12, 2009
Green and Purple
The last weekend in March I celebrated my 26th birthday. We started our Saturday early and headed to Top Pot Doughnuts. This Seattle chain sends some of their doughnuts to the local Starbucks in the Puget Sound area, but we had been wanting to try the doughnuts in downtown Seattle. They were pretty good, but I don't know if they were more special then any other doughnut. But it was nice to finally try this local chain. 
After doughnuts and coffee we headed to the Green Festival. This giant expo was held at the Seattle Convention Center, which has beautiful views down to Pike Place Market and Puget Sound. There were hundreds of vendors, speakers, presentations, and nonprofits. We learned about gardening, organic cleaning, buying sustainably, living more simply, cloth diapers, bamboo utensils, paper made from elephant dung, etc. All of the food was vegetarian and organic. There were "Bag Monsters" walking around to demonstrate how many bags an average person uses in a year. There were food samples and coupons galore. It was an overwhelming and informative experience. Robb and I have really gotten into the "green" lifestyle, so this Green Fest was perfect for us. We learned some new things to incorporate into our life. Plus, for my birthday Robb got me gardening supplies and seeds. We have been planning to start a vegetable garden and I was able to make it to a couple of presentations on gardening and irrigating, which were very helpful!
After the Green Fest we walked to Cafe Ladro, Robb's favorite Seattle coffee house, to kill some time before our dinner reservation (and get a little caffeine power to make it through the rest of the day). 
Robb had made reservations at Purple for my birthday dinner. Purple is a wine-tasting bar and cafe. We decided to go the tapas (little appetizers) route and have appetizers with the suggested wine pairings. We had an amazing halibut ceviche, artichoke spread, beef carpaccio, and a trio of cheeses. We also finished the night with a flight of wines (sample of four Washington reds). It was really fun to try the different foods and wines and see how they complemented each other. The restaurant was a great experience. While the little square building was dwarfed by skyscrappers and seems very unassuming, it was decorated beautifully inside and we loved the urban feel. We don't get the chance to have dinner in Seattle very often, so it was a great time. 
After doughnuts and coffee we headed to the Green Festival. This giant expo was held at the Seattle Convention Center, which has beautiful views down to Pike Place Market and Puget Sound. There were hundreds of vendors, speakers, presentations, and nonprofits. We learned about gardening, organic cleaning, buying sustainably, living more simply, cloth diapers, bamboo utensils, paper made from elephant dung, etc. All of the food was vegetarian and organic. There were "Bag Monsters" walking around to demonstrate how many bags an average person uses in a year. There were food samples and coupons galore. It was an overwhelming and informative experience. Robb and I have really gotten into the "green" lifestyle, so this Green Fest was perfect for us. We learned some new things to incorporate into our life. Plus, for my birthday Robb got me gardening supplies and seeds. We have been planning to start a vegetable garden and I was able to make it to a couple of presentations on gardening and irrigating, which were very helpful! After the Green Fest we walked to Cafe Ladro, Robb's favorite Seattle coffee house, to kill some time before our dinner reservation (and get a little caffeine power to make it through the rest of the day). Robb had made reservations at Purple for my birthday dinner. Purple is a wine-tasting bar and cafe. We decided to go the tapas (little appetizers) route and have appetizers with the suggested wine pairings. We had an amazing halibut ceviche, artichoke spread, beef carpaccio, and a trio of cheeses. We also finished the night with a flight of wines (sample of four Washington reds). It was really fun to try the different foods and wines and see how they complemented each other. The restaurant was a great experience. While the little square building was dwarfed by skyscrappers and seems very unassuming, it was decorated beautifully inside and we loved the urban feel. We don't get the chance to have dinner in Seattle very often, so it was a great time. Saturday, April 4, 2009
Thyroid Cancer Update
We met with Robb's endocrinologist in late March for a long overdue explanation of his cancer diagnosis, treatments, and how this will affect the rest of his life. Robb has Stage One cancer, which is extremely treatable and his life expectancy is not affected by the cancer. His staging is so low and expectations so good because he is so young. His age trumps everything when it comes to looking at his cancer. So that's great.
Robb has multi-focal papillary carcinoma. He had one large tumor on one side of his thyroid. He had two smaller tumors on the other side of the thyroid. It could be that the first tumor spread. But it is more likely that Robb is prone to growing thyroid cancer and he had three separate cancers on his thyroid. The surgeon took out 7 lymph nodes and half of those showed that the cancer had spread to those nodes. That wasn't unexpected and doesn't change the treatment at this time.
After all this initial cancer-killing process is over, he will have to be tested for the rest of his life for recurrence. That will involve blood work and body scans. Recurrence of the cancer is most likely to happen within the first five years, but it can happen anytime. It is a very slow-growing cancer too, which means it may not be caught quickly and it's not really a huge risk if it starts growing back. He will also, obviously, be on thyroid medication for the rest of his life. It will take a few months to find the right balance of medicine. The past few weeks have been difficult for Robb. He has gained some weight, has experienced some depression, and has had to deal with brain fog (leaving keys in the door, forgetting what he's doing, etc.) These are classic sign of hypothyroidism (not having enough thyroid hormones.) The doctor described this as "cold, fat, and slow." So the doctor added some more medicine to his regimen, which will hopefully balance everything out soon.
Radiation will be much less disruptive then the Internet research had led us to believe. We thought an overnight hospital stay was in order, as well as at least a week of isolation. However, the biggest issue will be the low-iodine diet beforehand. The body needs to be starved of iodine so that when the radioactive iodine is administered it goes straight to any remaining thyroid cells in the body. That will kill those thyroid cells and also indicate if the thyroid cells (and cancer) has spread to any other parts of the body.
The radiation has been scheduled for April 17th. He will drink radioactive iodine and then go home. He will spend the 17th, 18th, and 19th at home, isolated. I will be able to see him an hour a day, at arm's length away from each other. There will be some minor activities that need to be done to prevent contamination. (For example, he'll have to wash his clothes and dishes separately. He'll have to flush the toilet twice. He needs to keep the cats away from him.) And after only three days, he'll be able to go back to work. He doesn't even have to go off his thyroid medications before the radiation, which is a fairly new procedure. So, all in all, a process that won't completely suck.
What does suck is the low-iodine diet that he started April 1st. He has to be on this diet through his radiation. Among the banned foods are anything from the sea, anything colored with Red #3 (red, orange, brown food), potato skins, processed or manufactured foods, anything from restaurants, salt, sea salt, foods prepared where an iodine-based sanitizer was used to clean equipment, all dairy, chocolate, baked goods, etc. He can have 5oz. of meat a day. If you start thinking about it, just about everything has salt in it. He's eating a lot of fruit and veggies. He's hoping that during the next two weeks he'll at least lose the weight he gained since the surgery. Robb's already trying to decide what he's going to eat after his diet restrictions are lifted.
We're looking forward to this whole thing being over soon. Robb's first doctor appointment was in November for breathing issues. The surgeries, radiation, medicine changes, diet, etc. have been exhausting. I'm hoping that things will start getting back to normal in May...
Robb has multi-focal papillary carcinoma. He had one large tumor on one side of his thyroid. He had two smaller tumors on the other side of the thyroid. It could be that the first tumor spread. But it is more likely that Robb is prone to growing thyroid cancer and he had three separate cancers on his thyroid. The surgeon took out 7 lymph nodes and half of those showed that the cancer had spread to those nodes. That wasn't unexpected and doesn't change the treatment at this time.
After all this initial cancer-killing process is over, he will have to be tested for the rest of his life for recurrence. That will involve blood work and body scans. Recurrence of the cancer is most likely to happen within the first five years, but it can happen anytime. It is a very slow-growing cancer too, which means it may not be caught quickly and it's not really a huge risk if it starts growing back. He will also, obviously, be on thyroid medication for the rest of his life. It will take a few months to find the right balance of medicine. The past few weeks have been difficult for Robb. He has gained some weight, has experienced some depression, and has had to deal with brain fog (leaving keys in the door, forgetting what he's doing, etc.) These are classic sign of hypothyroidism (not having enough thyroid hormones.) The doctor described this as "cold, fat, and slow." So the doctor added some more medicine to his regimen, which will hopefully balance everything out soon.
Radiation will be much less disruptive then the Internet research had led us to believe. We thought an overnight hospital stay was in order, as well as at least a week of isolation. However, the biggest issue will be the low-iodine diet beforehand. The body needs to be starved of iodine so that when the radioactive iodine is administered it goes straight to any remaining thyroid cells in the body. That will kill those thyroid cells and also indicate if the thyroid cells (and cancer) has spread to any other parts of the body.
The radiation has been scheduled for April 17th. He will drink radioactive iodine and then go home. He will spend the 17th, 18th, and 19th at home, isolated. I will be able to see him an hour a day, at arm's length away from each other. There will be some minor activities that need to be done to prevent contamination. (For example, he'll have to wash his clothes and dishes separately. He'll have to flush the toilet twice. He needs to keep the cats away from him.) And after only three days, he'll be able to go back to work. He doesn't even have to go off his thyroid medications before the radiation, which is a fairly new procedure. So, all in all, a process that won't completely suck.
What does suck is the low-iodine diet that he started April 1st. He has to be on this diet through his radiation. Among the banned foods are anything from the sea, anything colored with Red #3 (red, orange, brown food), potato skins, processed or manufactured foods, anything from restaurants, salt, sea salt, foods prepared where an iodine-based sanitizer was used to clean equipment, all dairy, chocolate, baked goods, etc. He can have 5oz. of meat a day. If you start thinking about it, just about everything has salt in it. He's eating a lot of fruit and veggies. He's hoping that during the next two weeks he'll at least lose the weight he gained since the surgery. Robb's already trying to decide what he's going to eat after his diet restrictions are lifted.
We're looking forward to this whole thing being over soon. Robb's first doctor appointment was in November for breathing issues. The surgeries, radiation, medicine changes, diet, etc. have been exhausting. I'm hoping that things will start getting back to normal in May...
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