2011-08-12

Ablation

Hi folks

Time for your infrequent update.

First off, the bad news. We have received confirmation that the three lymph nodes taken by the surgeon during the procedure have all tested positive for cancer cells. This is apparently not uncommon with this type of cancer, and doesn't actually change the immediate future.

The better news.

We have also received the schedule for the next set of procedures. The first step is a radiation uptake test, where they inject a small amount of radioactive iodine in me and then a day later measure my neck for how much gets absorbed. The purpose of this is to detect "atopic" thyroid tissue, ie thyroid growths outside of the "normal" thyroid. This would be a rare occurrence, but if positive would require us to stop this procedure and re-engage with the surgeon to have these removed.

Assuming I pass this, a week later I'll get the "ablation" treatment. This is a large dose of radioactive iodine intended to kill any small clusters of thyroid tissue still in my system.

To prepare for this I have to stop my thyroid medication starting the beginning of September and go on the low-iodine (effectively, low-salt) diet. Once I go off the medication I won't be permitted to drive and will have all kinds of side effects.

For the five days following the ablation I will be literally radioactive and will have to be relatively isolated. Although the risk to other people is low, the doctors want me to keep away from people in general and from children in particular.

After the ablation I will get a full body scan, which is where they feed me into a machine and try to decide if any of the mysterious dark spots are more cancer. This is probably where we'll get a feel for the mid-term prognosis -- if the cancer has been removed and we're waiting for re-occurrence, or if it won't come back and I'll have beaten it.

So during four of those five weeks I'll be on effectively a no-salt diet. If you have ideas about what might be edible without any salt (this pamphlet here: http://www.thyroidcancercanada.org/userfiles/files/LID_pamphlet_PDF.pdf illustrates what the restrictions are) I would like to hear them -- even if my finicky food eating habits make this might be even harder.

It is expected that I won't be able to work due to the side effects of not taking the thyroid medication during most of this procedure which will last about five weeks -- two weeks to prepare, a week between the uptake test and the ablation, then two weeks to recover. I'm working with my employer to structure things so that if I can be productive, I will, but without there being visible dependencies on what I am doing. Right now my return-to-work target date is October 10th.

Thanks everyone for your kind words of support through this, and I hope we'll only have better news as we proceed.