Every hospital will have it's own policies and philosophies about isolation. Some are extremely strict and some are ridiculously lenient. Try calling or stopping by and asking them all the questions you would like to have answered. You might even want to take a peek at the room where you will be staying.
Below, are questions I asked of the hospital where my daughter had her RAI. I've included the answers from the hospital, along with an example of another view, more in keeping with the doctors and/or members of our online thyroid cancer group. Between the two, you'll get an idea of the possibilities. Not all questions will have "alternative" answers. If you would like to supply some, please email me at jill@rlsrebel.com
#1 HOW LONG DOES A PERSON USUALLY STAY IN ISOLATION FOR 150mCi?
Answer: 2-3 days
Example of alternative answer: Doses of I-131 under 120 mCi are given as outpatients. Higher doses, but under 500 mCi, may be only 24-hour admission. Doses between 500 and 700 mCi may be a 48-hour admission. Doses above 700 mCi may result in an admission based on dosimetry studies.
#2 HOW DO YOU DETERMINE WHEN THEY CAN LEAVE?
Answer: We have a survey meter and let them go when they meet 5 or below.
Example of alternative answer: Many places base discharge on the amount of original dose, rather than on a meter or instrument reading.
#3 DO YOU PUSH FLUIDS?
Answer: We ask for no food or drink for one hour before and one hour after the dose. Then, we encourage the patient to drink a lot, in order to move the RAI through the system. Note: Julie did NOT push fluids, and her radiation level still went from 35 to 12 in the first 24hrs, and down to 5 by 48 hrs.
Example of alternative answer: Many believe reuptake of I-131 into thyroid tumor tissue will be complete after the first 24 hrs. It is also believed by many, that it is better to NOT push fluids, because 1) radiation will naturally decline on it's own in the first 24 hrs, 2) too many fluids can cause low serum sodium and nausea, and 3) the function of the bladder is naturally slowed while the TSH is raised, so there's no reason to be forcing it to work harder. One theory is, "Drink when thirsty, but don't push it."
#4 WHAT DO YOU DO ABOUT NAUSEA?
Answer: As long as they hold down the RAI for the first hour, they have what they need. If they throw up after that, we figure they still got their dose. If it continues, then the doctor has to prescribe something.
Example of alternative answer: Many people never experience nausea from I-131. Some will have slight nausea, but no vomiting. Others will experience vomiting, although it's not known for sure whether it's caused by the I-131, or perhaps by nervousness. Anti nausea drugs, such as Phenergan or Compazine might be prescribed. Some people get permission to use Dramamine. Keeping a slightly empty stomach might help...using crackers to absorb. Drink ginger ale (from a bottle, of course, to keep it LID safe.) Sleep will sometimes help with nausea caused by nervousness.
#5 WHAT TIME OF DAY DO YOU ADMINISTER THE RAI?
Answer: Usually we have them come in around mid-morning and we give it to them around noon. But that's not set in stone.
Example of alternative answer:
#6 DO YOU RESTRICT FOODS, DURING OR AFTER RAI...DO YOU USE A LOW IODINE DIET? CAN WE BRING IN OUR OWN LID FOODS? IS THERE A REFRIGERATOR/MICROWAVE I CAN USE FOR MY SPECIAL LID FOODS?
Answer: Just no eating or drinking for an hour before and an hour afterwards. No, our staff does not follow the LID. You may bring in your own foods, as long as they are in throwaway containers.
Example of alternative answer: Many doctors advise their patients to maintain the LID (low iodine diet) for at least the first 24 hrs after RAI treatment.
#7 DO YOU HAVE PRINTED MATERIAL ON YOUR PROCEDURES OR RULES?
Answer: Yes, but it's really just on precautions for when you go home.
Example of alternative answer:
#8 DO YOU CARE WHAT IS BROUGHT IN OR TAKEN OUT OF THE ROOM?
Answer: Not really. Maybe just to keep it to a minimum. They can take home what they want, but if it's something that got their saliva or sweat on it, then we tell them to wash it carefully or put it away from other people for a week or two. We will use the measuring device to check things before they are taken out.
Example of alternative answer: Some places will limit the amount of things taken in (so as to minimize their toxic waste disposal) and they will not let you take anything out when you go.
#9 DO YOU PUSH SHOWERING OR CHANGING OF CLOTHES?
Answer: No, not really. They can do whatever they want. If they feel better sleeping, they do that. If they feel better showering, that's fine, too.
Example of alternative answer: Some places won't allow showers. Some will encourage them.
#10 HOW MANY RAI'S DO YOU PERFORM AND WHAT DO YOU THINK YOUR SUCCESS RATE IS?
Answer: Ohhhhh, maybe 2-3 a month...maybe about 20 or more a year, not sure. I've only seen two people come for repeat RAI's in the 20 years I've been here.
Example of alternative answer:
11. TO WHAT EXTENT DO YOU RESTRICT VISITORS OR NURSES FROM BEING NEAR THE RAI PATIENT?
Answer: Nurses will make brief visits several times during the day. Visitors should be encouraged to not come inside the door of the room, but it's okay, after the first day, if they sit on the other side of the room for no more than 15 minutes.
Alternate Answer: There are MANY variations of this, from one extreme to the other.
#12 CAN I PRE-ADMIT TO THE HOSPITAL SO I DON'T NEED TO BRING INSURANCE CARDS OR WORRY ABOUT PRE-AUTHORIZATIONS?
Disclaimer: The above is intended for informational purposes only. It is not intended to be medical advice or a substitute for what your doctor prescribes or recommends.