S, the nurse, was very nice. I was there to talk with her about my upcoming treatment and how to prepare for it.
The very first thing I would have to do would be to stop breastfeeding my daughter. This is because the radioactive iodine they use to treat thyroid cancer can be absorbed into the breast milk, which could cause more problems for me down the road. I had known from the beginning that would have to happen, but I hadn't put much thought into it. My surgeon had said not to worry about it until I met with the endocrinologist. So, here I was. Officially worrying about it.
Dr. E had estimated that if I stopped breastfeeding by the end of June then we should be able to schedule my treatment for the middle of August. S wrote everything down on a calendar. I would get a breast scan at the end of July to make sure that I was no longer lactating. The next time I would come in would be to get a low dose of iodine on August 13, and then another low dose on August 14. These low doses of iodine would enable them to give me a body scan on the morning of the 15th. The body scan would show them where any remaining cancer was in my body. After the scan I would receive a large dose of radioactive iodine, and then I would go home for a week of isolation while the iodine went to work.
That was the basic plan. There were other details to note. About 2 weeks before treatment would start, I would have to go off my thyroid medication. Being in a hypothyroid state enables the remaining cancer cells to 'mop up' the iodine, and then the iodine kills the cancer cells. I would also have to be on a low iodine diet during this time. S went over the list of foods that I couldn't have. In addition to salt I couldn't eat seafood, beans, egg yolks, nuts, or dairy (I was surprised to learn that dairy farmers use an iodine solution to clean cow udders). I laughed when S told me the list. The only meat I eat is seafood, so I basically won't be able to have any of my usual protein sources. It's only a couple of weeks, so it really shouldn't be a big deal. But I think I'll probably end up eating chicken anyway.
When you have the iodine treatment people can't spend too much time in close proximity to you. It's especially bad for small children. The radiation you put off can harm their thyroids. The husband was going to have to go away with the kids. We had already talked about this and the plan was for them to go to my in-laws. Dr. E had said I only needed to be in isolation for five days. S suggested seven. 'Listen,' she said, 'any doctor in this office will tell you five days and I'm sure that if you did five days it would be perfectly safe. But I'm the one who takes the calls from mothers of small children, and they're always worried it's not enough time. I'm telling you for your peace of mind, make it seven if you can.' Duly noted.
I was also told that when I got the treatment, that the people giving it to me would be covered head to toe in large orange Haz-Mat suits. 'You shouldn't worry about it,' S said. 'It's not because your dose is so dangerous. It's because they give these to people every day.' For some reason I found the idea of two people in large orange suits coming at me with my iodine unnerving. I got a little choked up, but I tried to hide it from S. I had already cried over the talk about stopping breastfeeding and the thought of my family having to leave me for a week.
S gave me pamphlets and papers to take home. My treatment dates were on the calendar. S told me that someone from nuclear medicine would be calling me soon to give me more information about the process. 'She'll tell you to take notes, but you'll end up getting the same materials mailed to you in a packet anyway. Just so you know.' And that was it. I felt exhausted and overwhelmed by everything that I had just been told. I'd been at the hospital for close to three hours. I was ready to go home and not think about cancer for the rest of the day.