Wednesday, August 20, 2014

The consequences of being radioactive

A door in Barcelona taken by my niece who has a research project in Madrid but is given plenty of time to travel

Fruit jelly collection in  La Boqueria : my favorite market of all times. I love fruit jellies
About twenty years ago, I was given a few drops of a salty liquid designed to destroy my thyroid by beta rays. I had Graves' Disease, an autoimmune condition that produces antibodies that stimulate the thyroid to overproduce leading to a whole host of annoying conditions, the worst being possible heart failure. I had taken an antithyroid drug for a year, which seemed to work but the 'standard of care' was to see if the condition still existed (sometimes Graves' Disease just resolves on its own) and if it did, the thyroid needed to be destroyed either by surgery or radiation. I don't recall being given a choice but I was nervous destroying a body part. What other damage would be done? There are C cells inside the thyroid that produce calcitonin that probably will be destroyed too. Calcitonin is thought to regulate Ca absorption but people exist happily with very low levels or very high levels. It didn't seem important. How about the parathyroids sitting on top of the thyroid? The hormone they produce also regulates Ca levels. Now this level is important and I have since read that Ca levels should be checked yearly after being treated with radioactive iodine. Has this been suggested to me? No!!!!!!!

Radioactive iodine is effective because mainly the thyroid absorbs it. There was a warning that my salivary glands might absorb some of it too leading to dry mouth but it would be temporary. Also I was to avoid being around small children and pregnant ladies as I would be emitting radiation. But aside from that, I was told that this was absolutely safe! And recently I looked and that's still what patients are told, no worries!

But guess what? Breast tissue also absorbs iodine and now they are finding that the patients that opted for the iodine treatment versus the surgery have a 53% increase in breast cancer (@#$@#!!!!) ten to twenty years later. Having thyroid antibodies in itself is a huge risk factor for breast cancer so I am double screwed. This on top of the many risk factors I already had (genetics, tall, overweight, took estrogens, etc).

Not much I can do about this now but I wish I was given a truly informed consent.

I am waiting for the traffic to clear (ever increasing amounts!) so that I can do my bike ride. The daily thunderstorms predicted for almost every day this week won't happen until this afternoon. Plus today is the only day I don't have something scheduled (until tonight...I haven't forgotten).


Elephant's Child said...

Truly informed consent to medical procedures ought to be a given. And so rarely is.

Teri Bernstein said...

Doctors have no idea what truly informed consent really means to a patient who wants to know. We are all still going to "The Knick." (new TV show about surgery circa 1900 or thereabouts, starring Clive Owens) But it is the patient who has to live with the consequences...Hopefully live...


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