| To be given verbally and in writing and edited as appropriate for the patient. |
| Dear Patient (name): | Date: |
| With regard to your radioiodine therapy, please consider the following. |
| STEP 1: Talk with your doctor or a member of the Radioiodine Treatment Team about: |
- Why treated women must avoid pregnancy for a period of time and not breastfeed.
- When treated men can consider fathering a child.
- Who will give you the radioiodine therapy, and where and when this will happen.
|
| STEP 2: Make preparations before treatment, and talk with your doctor or a member of the Radioiodine Treatment Team about the following specific items. |
| Obtaining: |
- Wipes and/or toilet paper that can be flushed down the toilet.
- Disposable gloves if others will be helping to take care of you.
- Heavy-duty (doubled if possible), leak-proof, specified plastic trash bags for tissues, paper towels, and other things that may be contaminated and trashed.
|
| For your travel: |
- If you are well enough, it is best to drive yourself.
- If you ride with someone else, confirm she is not pregnant, and maintain a distance of >3 feet (use the back seat on opposite side of the driver).
- When and where you can take necessary trips.
- When it is safe to use public transportation.
|
| For home: |
- Living or working with a pregnant woman.
- Associations with children.
- Inability to control your urine or bowels.
- Using special medical equipment, such as catheters, ostomy bags, or anything that could be contaminated by your body fluids.
- Getting sick easily (throwing up or getting woozy).
- Not being able to go directly home; arrangements must be made through your treatment team. Hotel and motel stays are not recommended.
|
| STEP 3. Your doctor or member of the Radioiodine Treatment Team will discuss with you the following items and fill in the number of days related to each. |
- Days that you need to stay >3 feet away from your adult family members and caregivers for at least 18 hours a day, and at least 6 feet away as much as possible: ______________
- Days that you need to stay >6 feet away from babies, children younger than 16 years old, and pregnant women: ______________
- Days that you need to stay away from work and close contact with others in public places (movies, shopping, etc): ______________
- Days that you need to stay away from school or daycare (includes both teachers and students): ______________
|
| STEP 4. Recommendations for after therapy. |
| At home: Specific recommendations |
Ask your doctor for the number of days to: - Sleep alone in a bed that is >6 feet away from another person, and, if possible, use a separate bedroom or sleeping room all by yourself.
- Not kiss anyone.
- Not have sexual activity.
- Move your bowels every day and use a laxative if you need help.
- Empty your bladder (urinate) every hour or so during the day of and day after your radioiodine treatment; follow your doctor's advice on how much to drink.
- Use wipes (preferably flushable) to clean the toilet seat after use; men should sit down to urinate and use wipes to remove splatter of urine; wipe yourself dry after urinating so that you do not drip.
- For a phone you share with others, after use, wipe off the mouthpiece, or, while using, cover the phone with a plastic bag that, after use, is placed in specified plastic trash bag.
|
| At home: General recommendations, especially for patients sharing a bathroom |
- Flush the toilet after each time you use it; flush toilet paper and wipes.
- Always wash your hands well after using the toilet.
- Rinse the sink and wash your hands after brushing your teeth to wash away the saliva (spit).
- Do not share your toothbrush, razor, face cloth, towel, food or drinks, spoons, forks, glasses, and dishes.
- Shower every day for at least the first two days after your treatment.
- Do not cook for other people. If cooking is necessary, use plastic gloves and dispose of in the specified plastic trash bag.
- Wash your dishes in a dishwasher or by hand; it is better not to use disposable (throw-away) dishes, which must be put into a specified plastic trash bag.
- Try to flush any tissues or any other items that contain anything from your body, such as blood, down the toilet; items that cannot be flushed, such as menstrual pads, bandages, paper/plastic dishes, spoons, forks, and paper towels, should be put in the specified plastic trash bag.
- Wash your underwear, pajamas, sheets, and any clothes that contain sweat, blood, or urine by themselves. Use a standard washing machine; you do not need to use bleach and do not need extra rinses.
- Have anyone who helps you clean up vomit, blood, urine, or stool wear plastic gloves; the gloves should then be put in the specified trash plastic bag.
|
| Trash recommendations |
- Keep the specified plastic trash bags separate from other trash; keep the bags away from children and animals.
- A member of your Radioiodine Treatment Team will tell you how and when to get rid of the specified plastic trash bag. You may be asked to bring the bag back to your treatment facility, or, after 80 days, the bag may be removed as other trash bags.
|
| Pets |
- Usually pets will not receive enough radiation to harm them, but do not sleep with pets (ask your doctor for how long), since your saliva, perspiration, or other secretions may be carried away by the pet.
|
| Outside the home |
Ask your doctor or a member of the Radioiodine Treatment Team when: - It will be safe to eat out, go shopping, and attend events such as religious services, parties, and movies.
- You will be able to return to work and to care for or teach others.
- It would be safe to donate blood.
- Special or longer distance travel is possible. (Note: For up to 3 months or more following radioiodine treatment you may set off radiation detectors at national borders, airports, bus and train stations, tunnels, bridges, trash collection sites, and even your place of employment. A member of your Radioiodine Treatment Team will issue you a letter or card describing the therapy and the phone number of a person knowledgeable about your treatment [usually at the treating facility] in case local law enforcement agents need to check on this information. You should keep the letter or card containing the information with you whenever you are traveling for at least three months.)
|
| Emergency care |
- You will get an information card or letter at the time of your treatment that will show the date, type, and amount of radioiodine that you were treated with; carry this card with you at all times for at least three months following your treatment.
- If you are in a traffic accident or any other medical emergency during the first week after your treatment, you should show this card to the medical people to let them know about the date and dose of your radioiodine treatment.
|
| IMPORTANT INFORMATION FOR PATIENTS ON RISKS OF RADIATION |
| Radiation exposure to others should always be as low as reasonably achievable, a goal often abbreviated as ALARA. If you follow the above advice, the radiation from you to others is likely to be less than what they receive from radiation in nature over a year's time. Please phone us if you have any questions, and particularly if: - Any of the above instructions cannot be followed and/or if
- You see anything that may have accidentally or unavoidably increased exposure of others to radiation
We welcome your input on how we can improve our methods and advice to patients. |
| Phone: |
| Sincerely yours, |
