October 17, 2012

How to survive Thyroid WBS, preparation by Thyrogen

Thyrogen, AKA recombinant TSH is familiar to some of us.
This was my first encounter with Thyrogen- and I do not regret it.
Thyrogen is given as injections in a muscle, and I was lucky that colleagues at work could help. I guess one of the best and most recommended injection site is your buttocks.
Injection itself did not hurt much at all. Perhaps because some very skilled colleagues were there... There aren't much of Thyrogen in the syringe, and if it is given slowly, then there shouldn't be much pain. That's the good part of it. The very best part is of course that there is no need to come off Synthroid weeks before scan, suffer the low-iodine diet and feel miserable!
I would recommend Thyrogen, even if you are not fond of needles and injections. It is worth it.
I was prepared for side-effects too- nausea and vomiting weren't good options for me who had to fly to another city and hospital for the Thyroid WBS. No one likes nausea and vomiting anyway.. And then low iodine diet does not always stimulate appetite. Shame if it all was expelled out in an instant!
I had some nausea- I was on Zofran (ondansetron) and nausea was not an issue. Headache was. It was ever present, nothing seemed to help. Only when I fell asleep it was somewhat relieved on the following morning. No big deal really, compared to what weeks without Synthroid would do. Been there, done that too and never again want to go through the same. I would not wish it to my worst enemy either.

Thyroid WBS was pretty easy. Swallowing liquid iodine (tiny dose measured in a syringe) was easy, even for me who finds swallowing tablets very hard. I was told to SWALLOW it right away, not swirl it in my mouth, which I must have done, involuntarily and unintentionally. If someone tells you to swallow, not taste, of course there may be temptation to TASTE it too. Which is what I did, and I think it showed as increased uptake in the mouth and upper throat region. Perhaps this also explains the pain and discomfort I had in my mouth- salivary glands appeared swell up. But hey, not a big deal- I was on Thyrogen! My head felt very very round, congested, huge. On the following morning most of the weird sensations had gone. I was told to drink water and I did as if my life depended on it: close to 3 liters that day. Maybe more. All I know is that I was in the restroom numerous times!

Result of the scan is another topic for another blog post... I have a feeling radioactive iodine, mega high dose is expected... Good old RAI.

I'm not sure about whether or not insurance covers Thyrogen. Some may not.
I'm also not sure if Thyrogen is available everywhere- there have been reports of shortages.

This is what Thyrogen website says:

"In order to prepare you for ablation, your physician must stimulate remaining thyroid tissue to absorb the radioactive iodine that you ingest in the form of a pill or liquid. Stimulation can be achieved in two ways. The first method, withholding thyroid hormone, was used exclusively until Thyrogen was introduced. Withholding thyroid hormone replacement allowed thyroid hormone levels to drop before ablation, therefore making you hypothyroid. The second option involves the use of Thyrogen (recombinant human form of TSH) which can be injected into patients prior to ablation thus avoiding hypothyroidism. In essence, Thyrogen allows your physician to start you on thyroid hormone therapy right after your surgery, thereby avoiding the signs and symptoms of hypothyroidism."

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