Getting here took longer than I thought. You need to take at least an hour more than you think to get here because of traffic and parking. Your first visit, you can valet park for free one time only, which is normally $10/day. Don't forget to take your ticket with you.
Things you don't want to forget:
1. Your eight page patient questionnaire (filled out, of course. This took me about an hour to complete)
2. If you have a living will and power of attorney, bring it with you.
3. You will have to provide a letter that states that you wish to be/or wish NOT to be resuscitated if you fall outside the building, in an ambulance, etc. If you don't have one, you will have to bring it next time.
Notes:
Dr. Fareau - endocrinologist - fellow. He's leaving.
Dr. Busaidy - associate professor - endorcriologist
Behaves as Papillary Thyroid Cancer, not follicular.
5% - familial
10% - radioactive exposure
90% - unknown
Mostly women
Radioactive Iodine - recommends if more than 1 cm and in more than 1 area even if full body scan is negative.
Hypothyroid makes thyroid hungry for iodine.
Need to wait 2 months after CT Scan with cold iodine (due to cellulitis) before Radioactive Iodine.
TSH Suppression - keep cancer away. - Slightly Hyper thyroid. - Be hungrier cuz metabolism quickens
thyroglobulin should be 0. 30% have antibodies to thyroglobulin. I am 30+. They want it both to go to 0. Can persist up to 2 years. Not as helpful to use Thyrogen for people who are antibodies. Just harder to follow when you are positive. Not harder to treat.
How to prepare for radioactive iodine treatment:
Old: No thyroid hormone.
3-4 weeks Cytomel - T3 hormone (active form) short acting. t4 takes a couple weeks to come out. Helps to take the edge off of hypothyroid. More for feel.
Can do 24 urine test to check iodine levels. Special "white" bag. Has two urine holders that you MUST keep cool, either in it's own refrigerator (like me) or in a ice chest, and a urine catcher. It measures how much and has an easy pour spout.
Thursday - Call AM May 31st. Email RE: results and when to schedule radioactive iodine. 6 months after - ultrasound and blood work. June 2008. 6 mo/6mo/1 year of all negative. 1 year annually for life. Synthroid the day after radioactive iodine treatment (drink).
Whole body iodine scan. 30 minutes roughly time.
Whole week of fun.
Start your pee test in AM. Discard your first. End 24 hours later....but need the first morning pee the second day. Keep it cool in refrig. Need to give within 2 hours after your last pee or you will have to do it again. You have to get it to the lab ONTIME!!! Must have your label on the top or side with your full name and patient number and doctor. In order to drop it off you go to the lab on the second floor and sign in for the drop-off. Then you set it behind the counter when called. You get the results from your nurse in about three days.
Bring to 2nd floor - diagnostic center.
Nurse - Linda Bracks - we like her. She has been there for a while you can tell, happy, informative, pleasant to be around.
Tuesday, May 22, 2007
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