Monday, 2 May 2016

Radioactive Health and Aged Tortoises


I've been a bit under the weather lately due to a long term thyroid issue that, it was determined by my endocrinologist, needs to be sorted out once and for all because the plan, started almost two years ago, to regain normal function has not panned out.  More drastic measures had to be taken.  My options were surgery or radioactive iodine.  What to do Pounamu?   I chose the latter largely because I have a couple of friends who had surgery here in Saudi, and lets just say the scar they carry around as a momento isn't pretty.  Vanity, it appears, is a bit of a thing with me.

My doctor agreed the 'atomic cocktail' was the way to go, so I was sent to see the bloke downstairs (quite a young bloke and, if I was looking, cute as well) who talked to me about a thyroid uptake scan to test how functional my thyroid actually was and, therefore, how much radioactive iodine would be required to treat it .  My thyroid meds had to be stopped about five days before the scan.  I also wasn't to eat fish of any description for three days prior, and breakfast was off the cards the day of the scan.  Bugger - I don't know about you, but I think breakfast is the most important meal of the day!

On the appointed date I turned up at Radiation Reception and met a friend who was booked in for the same test.  We sat and chatted, comparing thyroid function notes, as you do, until I got the call to follow a nurse to a smaller waiting room.  The doctor came in followed by four women dressed in white medical outfits and black veils who I presumed were nurses.  The whole procession was quite intimidating actually because only one of the ladies nodded a hello and smiled with her eyes.  They stood fanned out across the room, reminding me of a defensive line prepared to tackle me should I do a runner.

To lessen the tension, I asked the doctor if these young ladies were trainees?  It turns out they are employees at the hospital.  OK then.  This must be an awfully important part of the process to have this many in the room.  When the doctor left to get something he'd forgotten, the Line Up were just standing there, doing nothing at all, so I decided to speak with them starting with Smiley Eyes who was perfectly happy to chat.  She said they were all on placement in the radiation department and would be there for maybe a year.

On his return the doctor explained the process for the day.  I would be taking a tablet with a small amount of radioactive material and was to return four hours later for the actual scan.  Food was still off limits for another 2 hours.  Mentally calculating the time, that would make it midday before I could eat.  Eating, for me is a necessity.  When my blood sugars drop I can very quickly become an unhappy chappy.  Would I make it?

Doctor handed me a paper cup with a tablet and a bottle of water.  The Line Up gathered around as I took the tab.   All the heads turned my way and, as the masked faces watched me drain the water bottle, various horror story plots flashed across my mind complete with accompanying dramatic music - Invasion of the Body Snatchers was one plot, Hitchcocks Psycho provided the musical score.

Steak dinner at Gala Steak Inn.
You'd have thought with four hours to kill I would've managed to eat but the time seemed to disappear, lost in the drive home, the need to open the computer and answer a few emails and preparing a stacked lunch.  I was about to bite into my succulent, juicy, perfectly cooked steak with a side of creamy mushrooms, when the phone rang. The driver was here to take me back to the hospital.  He had come a little early because he had another pick up.  Sugar Plum Pie!  Stuffing food is not lady like, so instead I sliced off a piece of meat and carried it to the waiting car saving the rest for later.

The Dr told me the scan would take around 20 mins.  It is easy to feel quite claustrophobic when the huge scanning machinery starts whirring and thick slabs of metal descend toward your face while you're lying prone on the table.  I figured there is nothing I can do about this.  Might as well have a nap.  Sleep is a great healer for me.  If I can get myself to sleep, I can get through anything.  So I dozed off.

When I woke I was told all was done, and to come back again tomorrow.
What?
They have to compare scans, so you have to come back tomorrow.
Well, that was news to me, but what choice did I have.

It was after three by the time I headed out the door and, without having had anything substantial to eat all day, a migraine was threatening with the headache throbbing at my temples.  I knew I had to eat.  And not just anything.  I had to eat fries.

For some reason fries help to settle my headaches. And I mean fries, not crisps or baked potatoes.  Not sugar or chocolates either.  Fries.  Just down the road from the hospital is a burger joint and it was to there I rushed, ordered my meal and then sat upstairs in the almost empty dining area, closed my eyes and waited for my fries.

They arrived with a burger and thick shake.

I ate the fries, looked at the burger, sipped the shake.  When food is not appealing, I know I'm in a bad way.   Shutting my eyes again and leaning back in the booth, I waited for the effect of the fries to kick in and the headache to subside.

When my eyes reopened the only other people in the diner were a young Saudi couple sitting across the room having a bit of a snuggle.  It was cute.  The blinds on the windows were being wound up signalling the end of salah which meant I had dozed for at least half an hour.  The young couple stood and left.  My headache had eased slightly, but not gone.  It was time to go home, lay on my bed in a dark room with a cold cloth on my eyes and sleep.

The next morning I ate before going to the hospital.  Repeating yesterday was to be avoided.  It was a good call as we had to wait quite a while before the scan. (My friend was back too, so we chatted till scan time).

A week later it was time to receive my dose of radioactive iodine.  The Nuclear Medicine anteroom was crowded so I got stuck in a smaller side room, more like a closet, which might have bothered me except there was a dental chair in there that just begged to be played with.  Fiddling with the controls, lifting myself up and down, and laying myself flat and back again made Hubster, who had come with me on this trip, look on with disapproval at my childish antics.  (As I get that look quite often it tends to have little effect these days).

Soon enough we were led off to chat with the Radiation Doctor who went through the list of do's and don't's related to taking radioactive iodine.  He mentioned the ability to set of airport alarms.  I thought that was cool and asked Hubster if we could fly somewhere.  He gave me one of those disapproving, don't be ridiculous looks.

Isolation from the elderly, the very young and the pregnant was a must for a few days, according to Dr Radiation.  And Hubster and I were to keep our distance as much as possible too, so for three days he slept on the couch and wouldn't let me in the kitchen near his food.  He prepped all the evening meals.  There was no complaint from me.

The radioactive iodine came in two tablets which were delivered in two thick metal containers.  Dr Radiation used his gloved hands to tip them, one at a time, into a paper cup then stood well back, out of my way, after I had downed them.  It appeared that staying away from people was to start immediately.

My doctor did say that hyperthyroid symptoms would get worse before they improved - but that little tidbit of info didn't really register at the time.  Naively I presumed that health improvement would be almost immediate once the weekend long stand down period for being radioactive was over.  So I planned a trip to Made'in Saleh with a Kiwi friend and his visiting parents for the following weekend


It turns out that climbing up mountains and rock hewn stairways, or anything remotely resembling an incline, to look at the view was not the best plan at this point.  It had been three weeks since I'd been off my thyroid meds and the doctor instructed me to keep off them for the next month.  My heart obviously hadn't received the message that it was to supposed to start behaving after a dose of radiation and was objecting to excess effort.  (In fact, by the end of the weekend the heart and body were objecting to any effort at all, which was majorly annoying and ever so slightly frightening).

Any normal person with wobbly hearts would have said, 'It's OK.  I don't need to come look at the view with you today.  You guys can tell me all about it when you get back'.  It seems 'Fear of Missing Out' is also a thing with me.  Buggered or not, I was going.  So I'd hang on to the Hubster's belt and he would drag me up the hills and stairs.  Slowly but surely, like a couple of aged tortoises, we got there.

The doctors instruction to revisit him a month after taking two nuked tabs for a blood test to see how things were going was welcomed gladly because it didn't feel like there had been much improvement in my thyroid function at all.  I was actually feeling like crap.  The heart was doing flip flops even with the Beta Blockers, I had internal tremors, the body temp was all over the place with subsequent sweating being very unlady-like, and the bowels had a timetable all of their own, usually marked "URGENT!"

When I called the doc for my blood test results his exact words were:
Are you sure you had radioactive iodine?
Yes
Was there a period of isolation?
Yes
Mmmmmm...I'll have to call the radiation department to see what they gave you and how much because according to the blood test, you are still very hyper-thyroidic.  Do you still have thyroid tablets, he asked.
Yes I said.
Go straight home and take some now.  Take four a day. Call me next week.

Oh great! (which is not exactly what I was thinking, but you get the point).  You mean this treatment hasn't worked!  Well, at least there was a reason for feeling worn out most of the time for the past month and wanting to do very little except lie on my couch.  It wasn't all in my imagination.  I wasn't being paranoid.  My concerns about feeling like a wilting daisy needing attention were well founded  because I was actually wilting and in need of attention but not in a hopeless, spoilt, demading way, of course.

What tends to happen when I'm not feeling the best, is that I go into what I call a 'Caving Phase'.  I like to hide in my home, go nowhere, do nothing, and see only a select few people.  Me and the cat just hang out, him sleeping on top of the back rest of my couch, me surfing the net or dozing.  Going out to do anything, even shopping for supplies, takes a huge force of will.

The husband tends to get concerned when I Cave.  He thinks it quite unhealthy.  I beg to differ.  I know what my mind and body needs, and when I'm off color rest and a certain amount of isolation are what is called for.  It's the isolation that makes people think I'm terribly unsociable and possibly depressed.  I prefer to call Caving my way of looking after myself.

Except for my little jaunt to northern Saudi, and occasional forays into the office to appease concerned husbands and show I'm still alive, I'd been caving quite a bit the month after the dose of radiation.  Hence my lack of blog posting.  I just couldn't seem to get my head into it.  But I'm back on my meds now and feeling so much better.  Provided the country doesn't run out of my meds again (and you can read about that on my post 'Riyadhs Run Out Of My Meds'), everything should be fine.

Eventually, one way or another, the thyroid will get sorted and this time I'll be prepared for the effects.  Hubster thinks I should be using this current down time to stay put until my health is 100% improved.  I think that's nonsense now that things are looking up, so am attempting to talk him into a trip next weekend - to a mountain with rock pools.



Ka Kite,
Kiwi





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