Met with Dr. N today to figure out the next step, and we have a plan! The only real treatment for thyroid cancer is to remove the thyroid (check!), and then blast the bejeezus out of any remaining thyroid tissue and cancer with radioactive iodine (RAI). That's supposed to kill off any cells that remain and cut down on chances of recurrence.
In order to do the RAI, I have to go to Hypothyroidism Hell for a few weeks. I am soooooo not looking forward to that. I've been hypo before and it really is hell. The complete fatigue, brain fog and weight gain are the worst. The apathy doesn't help either. The TSH (thyroid stimulating hormone) that they measure is considered normal when it's between 0.3 and 3.0. In order to do the RAI, it has to go to 40. Dr. N got a good laugh out of that--"You feel awful at 2.0, so God knows what you will feel like at 40. Ha ha ha." I didn't really laugh; in fact I think my eyes bugged out of my head and I coughed. I might be incapacitated much sooner than I thought.....
Right now I take 125 mcg a day of Levoxyl to make up for what the thyroid used to produce. I am feeling pretty good on that right now. I have to stop taking it for the next two weeks and take cytomel instead. The doctor explained why and it made sense--I'm not sure I can explain it clearly here. I'd have to go look it up to make sure!
After two weeks, I stop the cytomel, have my blood levels checked to see how close I am to being at 40, and then they'll schedule the RAI. 10-14 days before I'm supposed to go on a low-iodine diet. By driving up the TSH and lowering the iodine, my body is supposed to suck up the RAI and make it more likely that it will kill off what's left. And hopefully cut down on the chances of the cancer coming back.
The RAI comes in a capsule. I go to the hospital as an outpatient, swallow a large radioactive capsule, go home and glow alone for about 72 hours. And pray. And hope I don't have icky side effects. Mr. Wonderful will have to keep his distance and sleep on the couch. I haven't figured out what to do with my two emotionally needy cats.
Then, I get to go back on the levoxyl that I love and hopefully start feeling better again. Dr. N said she'll do a full body scan 5 days after the RAI, and then again in a year to see if there is anything there. She said I'll be watched closely given my history.
Overall, she said that the cancer could come back. It's not like other cancers in that you aren't considered cured after 5 years of being cancer-free. Sounds to me like it's more of a chronic condition that I'll have to monitor for the rest of my life. Yeah, thyroid cancer won't kill me, but it will make life a little less tranquil. I'd like to think that I'll fall into the 2/3 of people who have no recurrence, but I tend to get the weird stuff.
I'll probably have to be out of school again, 4-5 days at least after the RAI, and possibly the week before depending on how I'm feeling.
While I'm not looking forward to any of this, I'm glad I'm going to get it done and over with soon. Dr. N asked us if we wanted to wait three months to see if I could get pregnant since maybe the thyroid was a bigger factor than anyone thought; if a miracle happened and I did get pregnant, she said the higher estrogen levels could make the cancer worse, and it would be a fairly big risk to take. Problem is you can't try to get pregnant for 6-9 months after doing RAI. Since I'm not sure if it's even possible, I don't see the point of risking it. The cancer trumps infertility. Maybe it would be different if I were in my 30s and didn't have other issues.
So that's the plan cap'n. Mom always told me that if she had to get through something (and God knows she had plenty of experience in that department), she would pick a time or date afterwards and tell herself that it would be all over by then. That means that this should be all over by the middle to the end of May. Not that I want to wish my life away, but I think I can hope the next two months fly by...we're hoping to book in some road trips during my vacation week next week too. A change of scenery always helps.
Off to bed...I have a couple of weeks before I'm in full battle mode. Need some sleep!
That is so funny about Mum picking time and dates because I do the same exact thing and never consciously realized that was her strategy as well. Funny.
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