How to survive post-RAI (radioactive iodine treatment) era

To be honest, I don't remember when exactly I had the RAI. 2010..? 2011? No, maybe it was in 2012.

Memories fade and I don't remember every single detail. I do remember some though: feeling sick to my stomach, taking three showers, because I felt I had to scrub the iodine out of my body. I drank a lot of water. I remember the plastic zip-lock bag, where my iPhone, the only link to the outside world, was sealed in.
I remember the nursing staff leaving my food tray outside the room and I didn't know it was waiting for me there. Needless to say, I was pissed off with that.

Now, years later, I've suffered from tooth decay and cavities, which I've never had before the RAI. I've looked after my teeth very very well all my life, visited the dentist, dental hygienist etc.  To my horror the dentist in Dubai last year discovered a cavity, the first ever and I'm close to 40 years! I wasn't supposed to have cavities or any sort of dental issues.
I'm convinced it was the RAI that changed something in my saliva... or did some other kind of damage.

I don't know what else it did to my body, but the teeth: please look after them. Make sure you do it even better than before and visit your dentist and the dental hygienist. Ask about dental hygiene before and after the RAI. Even better, keep a notebook with you and write your RAI doctors' and nurses instructions there in a language you understand.
I don't remember anyone mentioning dental issues, but if they did, it's long forgotten.

Eat well, sleep well, even after years from RAI.

Try to attend the follow-up appointments, so you are not left in the dark.
I made a decision not to have more scans, endocrine appointments, oncology appointments etc. My primary care doctor monitors the thyroid function tests and we are okay with that... but I am planning to ask for an appointment for endocrine follow-up next time I see my GP. Years pass by and even my conscious decisions and opinions change.

By the way, if you think counseling would help you post-RAI, please please get a referral. It has helped me tremendously. So many emotions surface just after RAI and it's so helpful to talk things through with someone.

How to survive your dentist visit Part 2

After my last visit to the dentist three or so days ago, I thought I'd need more time to process the news of two cavities and the overall condition of my teeth not being so great.. and having to resort to the inhalation of nitrous oxide to get through a simple dental cleaning.
I got over it, no major traumas and self-preservation kicked in: I do still like to keep my teeth and look after them. Email the dentist, try to recall the email, which failed and then I was still hoping that he would not be at the clinic today. Next thing I know: he replies and says c'mon in. Seriously? The whole cycle of anger, bargaining, sadness, acceptance and finally "ok, I'll go then", but not before researching every possible website of inhalation sedation, dental phobia, pain etc. Then I came across this website:
http://www.dentalfearcentral.org/help/sedation-dentistry/laughing-gas/
Some of the stories about nitrous oxide were not just informative, but entertaining too, that I was encouraged to just go ahead and try it once more.

My blood pressure was 150/90 so I was undeniably anxious. As I was sitting in the lobby, I thought I could still walk out, but as I was thinking about it, the dental nurse  was suddenly standing next to me (oh I bet you never thought you'd see me here again) and I no choice.. Sure, I could have made my excuses and left, but it would have been way too embarrassing.
I'll spare you from the details of what happened in the restroom. I already mentioned what the anxiety did to my BP. The same as it always does (madam, do you suffer from hypertension?)...

...and then, because it is easier to explain everything in order as it happened, here goes:

1. A chat with the dentist, whilst plotting the best escape route. He explains what he is planning to do.
2. Before I know it, I am sitting on the chair and can't escape. I look at the tray of the dental instruments, but can't figure out what each of them are used for.
3. They start administering the gas/oxygen mix via nasal mask. It feels weird at first, but then I get the "taste" of the gas and feel a lot more relaxed. I don't necessarily need to escape.
4. More gas.
5. And more. My legs feel heavy, I stop clenching my jaws and relax my grip of the dental chair armrests.
6. Anesthetic gel goes on and what else, I feel nothing.
7. Next moment the dentist says we will start drilling- but no wait, I'm still conscious and he has yet to give me the dreaded injection. He shows me the empty syringe and proves me wrong: he already gave it.
8. More gas please. Drilling goes ok, it just sounds funny. The drill is not a power tool, not the one they use in drilling oil or that Black&Decker you use in some DIY stuff at home.
9. At any time, I didn't feel like choking or drowning or being unable to swallow. I didn't taste blood or any other weird stuff. The local anesthetic gel  tasted something nice though: strawberry, raspberry, cherry... I'm not sure, but the effect of the taste made me see "red" shapes, which I think resembled Valentine's Day gifts and hearts.
10. Once the drilling was over, then they filled the cavity with a filling and some medication, because the cavity was quite large. Not the largest the dentist had seen, I asked him about it afterward.
11. At some stage- after drilling I think, they discontinued the gas and just let me breathe oxygen for a while. I was actually ok,  felt myself tensing up at times, but I was still feeling okay.
12. The dentist always asked me from time to time if I'm okay and let me clean my mouth with Kleenex. The dental nurse gave me a towel to hold, kind of for comfort you know, and it worked.
13. I'm not quite sure of what happened next- I kept hearing the dentist telling me multiple times "nearly done". At that time I started feeling I could leave.. soon.
14. Then it was all over: I got to rinse my mouth. I felt a bit dizzy, but the chair was elevated quite slowly so I managed to adjust. My mouth felt like rubber as if I was wearing a clown mask or something. It was almost impossible to speak at first.
15. I recalled some fun bits and pieces I had said inbetween the local anesthetic, drilling and all: "are you worried I'm going to bite your fingers off?" (to the dentist).
"I gave the local" to which I replied "show me the syringe". When he did, I said something along the lines "oh s**t, really, lol".
After he had indeed given the local,  he had said "you are doing very well, you won't need a general anesthetic" and me not realizing that he had had the Lidocaine syringe+needle in my mouth all this time.
16. Now almost 3.5 hours later I'm at home, eating ice cream, thankful I survived without pain and further embarrassment. The numbness and rubbery feeling have almost gone. I don't know what the new improved tooth feels like- I'm afraid to look or even touch it. I don't think there's any need to look at it at this stage.
17. Lesson learned: never underestimate the power of N2O. One of my favorite gases for sure.
18. The next step is to find a dentist, who can remove the remaining wisdom teeth under heavy IV sedation or general anesthesia.
In all honesty, I didn't expect anything to be wrong with my teeth and I got a shock of my life when I learned about the cavities. Almost at 40 I've never had cavities! No fillings, nothing. Anyway now I know better- there are always dentists and other healthcare professionals who treat their patients with respect and listen to you, help you to overcome your fears so you can get this done.
I came across this dentist in Facebook, where someone had posted an introductory video of him. I thought it might be a good idea to see a dentist, especially because I had missed my previous appointment in 2016 and because I knew I would have to get a thorough cleaning done. Now I'm glad I went.

Apparently after the radioactive iodine treatment, something changed and my mouth became dry, exposing my teeth to dental caries, higher risk of cavities etc so yes, I should have been more careful.

It's never ever going to be a walk in the park, visiting your dentist, but at least the "event" can be broken down into a manageable pieces and it can be done and we all survive somehow. If I can do it, anyone can.

If you are ever in Dubai needing dental treatment, see Dr David: http://valiantclinic.com/ourphysicians/dr-david-donelson/

 

Thyroid cancer revisited

List of unwelcome people, life events that suck and general needless stuff is endless. Cancer tops the list and will always have its safe Top 10 spot. Year ago I was undergoing series of tests (yes, those that have no end in sight) and was preparing two thyroid whole body scans and the radioactive iodine treatment. Year older and wiser now I can say it was "not that bad". Not nearly as bad as when compared to leukemia treatment. Not as bad as having long term illness that has no good prognosis, ever. 
But yes, of course it sucks. People around me had to watch me turning into a monster: all my favorite foods were on "banned" list, and lack of Synthroid just made me look like .. well, a monster. Puffy face cookie monster. Not horror movie kind of monster. Good thing was that it was gradual, not an overnight change. I did not really see- or want to see- anything being wrong. Mornings were hard, as if I had eaten junk food and been binge drinking and had not recovered from hangover. There is nothing make-up can't fix, so I thought, and since thyroid hormone was on a very low level in my blood, I was happy. Felt quite normal (tired normal) and drove to work.
It's only when I got there, I literally wanted to lie down on the floor and not get up at all. It was cold all the time, so I thought. When my menstrual period came (I so wish it had not!), I did not know whether the bleeding would ever stop. I did not even want to get up and walk for the fear that I would just bleed and bleed. No one warns you about these things- if someone did, or if I read it in somewhere, that information was long gone at the time when I needed it. So, in case it happens to you ladies, you know now.
Forewarned is forearmed. Don't worry if you forget, just go home and rest. Well, after the RAI, my period disappeared for four months. Fabulous. For the first time in years my hemoglobin was somewhere above 12.

Comparative study moment: which is worse; being off Synthroid or having to stick to low-iodine diet? Easy one! 
If I was off my meds, but could still eat whatever I fancied...
If I was on my meds, but had to become low-iodine kitchen guru...
Both have their ups and downs. I'd go for the 2nd option.
Where is the third option- meds, diet and THYROGEN? 

I've really not read many positive experiences being on Synthroid. Low iodine diet works for some ( I guess it's either that or starve). I don't spend much time in kitchen, but asked people their thoughts about low-iodine cooking. Completely eliminating salt was useful when my face started getting puffy (that is when I realized it was happening. Colleagues said later that no amount of make-up, cucumber face-masks and others could cover the damage). There were days, more toward the end, when I felt like one wrong word could start a war if I don't get the taste of that particular food I want. The truth is one bite would not have been enough. Yes, I remember having spaghetti and garlic bread once (twice...? but since underactive thyroid gland causes memory lapses..), and ate them without any guilt feelings. Nearly licked the plate so I could get all the sauce.

Year later I don't know if any research has been done about low-iodine diet- is it really the key to the success of RAI? Despite of my spaghetti dinner, RAI in my case was successful. Thyrogen still isn't available everywhere, and I would be so reluctant to have any scans done now without Thyrogen.

In hindsight it all sounds so easy. Should have done this, that etc. One thing is for sure: without support from family and friends it is much harder so do your best and don't push them away.

Today is a good day. I have not thought about cancer at all. I've not stood in front of the mirror examining the scar in my neck, because it is barely visible. I haven't talked about cancer, because it's not part of me and I've conquered one of my biggest fears.
Isn't that what they say: "Cancer, you chose the wrong bitch!"