Radioactive iodine treatment as an inpatient

Transcription

1 PATIENT INFORMATION Radioactive iodine treatment as an inpatient This leaflet explains the procedure for having radioactive iodine treatment while staying in the hospital, and the precautions you need to take. It aims to answer the main questions you re likely to have but please feel free to raise any other questions with your doctor or a member of the medical physics team. About radioactive iodine treatment Radioactive iodine treatment involves swallowing a capsule that contains radioactive iodine (I 131) powder. I 131 is a type of radioactive iodine used to treat diseases of the thyroid. The thyroid gland naturally absorbs iodine. When this iodine is radioactive, like I 131, the radiation it gives out will destroy cells in the thyroid. If the thyroid has been removed, some thyroid cells may be left behind after surgery. These cells will also absorb the I 131 and be destroyed. The amount of I 131 your doctor decides to use will depend on your condition. However, even a small amount of I 131 will make you slightly radioactive for a few days after treatment. When you go home you ll need to take some precautions to reduce the chance of exposing your family or friends to any remaining radioactivity. The precautions are based on how long it takes for the I 131 to leave your body, and are explained in more detail below. Because of the exposure to radiation, it s very important that: Women of childbearing age should not be pregnant at the time of treatment. Women must not become pregnant for at least six months following treatment. Breastfeeding stops before the treatment and shouldn t start again once treatment has finished. Men should not father children for four months after treatment. Preparing for radioactive iodine treatment Please make sure that your doctor is aware of the following: Any medication you are taking. He or she will tell you if you need to stop taking any medicines that may reduce the effectiveness of your treatment. Any special dietary needs you have. Certain foods are rich in iodine and you may need to stop eating them before your treatment. Your doctor will tell you if you need to do this. The I 131 capsule that you need to swallow is about the size of an antibiotic capsule. If you think you will have difficulty swallowing it, then please phone the medical physics department as soon as possible, and at least 10 days before your appointment. How long you need to stay in hospital will depend on how quickly the excess I 131 leaves your body. Please come prepared to stay for up to a week. You may want to bring books, magazines or other items with you. However, because of the risk of contamination from radiation you may not be able to take these home with you again. Coming to the hospital for your treatment At the hospital you will be staying in the Iodine Suite, in a specially protected room. It s important that you arrive at the hospital at the time stated on your admission letter. This will allow us to do any necessary tests before your treatment.

2 Your doctor will give you the I 131 capsule to swallow with warm water. A physicist will also be present to make sure that appropriate precautions are taken when handling the radioactive capsule. As soon as you swallow the capsule you will become slightly radioactive. After an hour or so, the I 131 will be absorbed into your body, and your bodily fluids (including blood, saliva, perspiration, urine and faeces) will become slightly radioactive. At this stage, the physicist will come back. He or she will use a meter (Geiger counter) to measure how radioactive you are. The amount of I 131 in your body will decrease over time, and you ll become less radioactive. We ll take measurements every day to work out when it s safe for you to be discharged. This usually takes about three to four days. Because the speed that the level of radioactivity falls is different for every person, we can t predict how long you ll need to stay in the Iodine Suite. Precautions while you are in hospital As your bodily fluids will be slightly radioactive, you could contaminate things that you touch. Good hygiene is very important to minimise the amount of contamination. Hospital staff All food and drink will be brought to your room on disposable plates with disposable cutlery in case they become contaminated. Staff will phone to let you know when your meals are in the lobby of your suite for you to collect. When you have finished your meal please leave the tray in the lobby for the nurses to clear away and monitor for any contamination. All staff have to wear overshoes and sometimes a disposable apron and rubber gloves when clearing up food or rubbish from your room. This is to minimise the spread of any radioactive contamination. Staff will only spend a limited amount of time with you so that they re not exposed to the radiation for long periods. They are not neglecting you but working to a schedule that depends on your level of radioactivity. There is a handset in your room with a button that you can press if you need any help. The door to your room must be kept closed, it is shielded to protect other people. Visitors Visiting times are strictly limited to 20 minutes each day. Children under 18 years and pregnant women are not allowed to visit. There is a visitor s chair in the room and a separate chair for you. The chairs are placed a safe distance apart (about 2 meters) and must not be moved closer together. Your visitors must not sit on the bed or your chair, and you must not sit in the chair reserved for them. In addition, visitors must not: Handle your belongings. Handle your food tray or drink from any cup you have used. Use your bathroom. Remove anything from the room, for example clothes for washing or rubbish. Unwanted items or waste must not be taken out of the room. You, and your visitors, must place any rubbish in the bin in your room. If it gets full, please ask one of the nursing staff to empty it.

3 Please don t place newspapers, magazines or books in the bin. They may not be contaminated and can be put in the recycling bin provided. Other information about your stay in hospital Clothing You won t need to remain in bed during your stay, so you may wish to bring some light, comfortable clothing to wear during the day. We suggest that you bring old clothes for wearing day and night. Ideally they should be items that you don t mind throwing away if they become radioactive. Please don t bring excessive luggage as storage space is limited and the floor must be kept clear. There is a wardrobe that you can use to store your suitcase and the clean clothing you plan to wear when you leave the hospital. Entertainment You will have a television (with teletext and radio) and a VCR/DVD player in your room. A Wi-Fi connection is available if you want to bring your laptop computer. You can order newspapers from the hospital. You can bring books, DVDs, playing cards and even some work with you but remember they may become contaminated. This also applies to personal items such as your computer or mobile phone. For this reason we advise you not to bring anything valuable with you. Checking for contamination Before you leave the hospital, a physicist will check your possessions for any radioactive contamination. Contaminated items may need to be kept at the hospital after you leave and returned to you at a later date when they are no longer radioactive. Any toiletries you bring may need to be thrown away before you leave. Eating and drinking Drink two to three litres of liquid a day (of which two litres should be water) to flush out any I 131 that has not been absorbed into your system. It s important not to become dehydrated during your treatment. It s also important that you empty your bladder frequently. Eat lots of fresh fruit and vegetables and include plenty of fibre in your diet, such as wholegrain rice and pasta or wholemeal bread. This is important to stop you becoming constipated during your treatment. Side effects of radioactive iodine treatment Tiredness You may feel tired because you re not taking your usual thyroid medicine. You re likely to continue to feel tired during your stay in hospital but you ll usually be able to restart your medicine on the day you re discharged. Sore throat You may have a sore throat or pain under your jaw (from swelling of your salivary glands). This is caused by the radioactive iodine treatment and is temporary. If you need pain relief, then ask the nursing staff.

4 Sharp-tasting boiled sweets or fresh lemon slices stimulate the production of saliva and are helpful to alleviate any discomfort in your salivary glands. If you need to, you should start sucking these sweets the day after taking the capsule. Nausea You may feel sick after your treatment, although this is rare. If you do feel sick, tell the nursing staff so that they can give you anti-sickness medicine. Precautions to take after going home Any medicines that you need to take will be prescribed before you leave. Before you leave the hospital we will give you a special instruction card. You must carry this card with you at all times. It gives details of the precautions you must take after treatment and how long you need to wait before you can get back to your normal activities. The following table gives some typical examples of what will be included on your card. However, your card may be different, depending on your personal circumstances. Travelling on public transport Going to places such as the cinema or theatre Prolonged close contact with adults and children over 5 years Prolonged close contact with pregnant women and children under 5 years Return to work* 1 day 1 day 2 days 4 days 2 days* * The restrictions on when you can return to work will depend on your working environment and the estimated dose other people around you may receive. If you work closely with children, pregnant women or in a radiation-sensitive environment, much longer restrictions may apply. The physicist will discuss this with you in detail. If you feel unable to return to work due to your illness, you should talk to your doctor. Air travel is not allowed until the restrictions on prolonged close contact with adults have passed (usually four days). If you plan to travel between countries in the six months after your treatment, please remember to take your instruction card with you. There will be a tiny, but measurable, amount of I 131 in your body several months after treatment and you may be asked by border security staff to explain why they can detect radiation. Show the security staff your instruction card so that they can see you have been treated with I 131. Follow-up You will be scanned in the Nuclear Medicine department, usually on the Friday following your treatment. The scan will show where the I 131 has been absorbed in your body. Your doctor will normally want to see you a few days after this scan. Contact If you have any questions about your treatment, speak to your doctor or contact the medical physics team on +44 (0) , or fax +44 (0) The department is open Monday to Friday between 9.00am and 5.30pm.

5 Bupa Cromwell Hospital Cromwell Road London SW5 0TU +44 (0) (hospital switchboard) bupacromwellhospital.com Published: Septemeber 2015 Review: September 2017 Ref: PI-039 Issue 5 This information is published by Bupa Cromwell Hospital and is based on reputable sources of medical evidence and experience from over 30 years of treating patients. It has been peer reviewed by Bupa Cromwell Hospital doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. If you have any feedback on the content of this patient information document please info@cromwellhospital.com or telephone