| |
This is a short information sheet to help you understand the restrictions which will be placed on you after being given a treatment using radioactive iodine.
There are several precautions which you and your family must observe both during the time you are in hospital, and also after you have been discharged. These must be discussed fully with you, and they are outlined below to ensure that they are clear to you. The iodine cannot be administered unless you understand these restrictions and sign a consent to agree to adhere to them.
The treatment involves the administration of' radioactive iodine, which will probably be given in the form of a capsule. Since you will become radioactive after having been given the treatment and will emit radiation you will be required to remain within 'the radionuclide treatment suite' (RNR) until you are advised that it is safe to leave. This consists of a side room, shower / bath and toilet. You will excrete a considerable amount of radioactive iodine in urine, faeces, sweat, saliva and nasal mucous and it is therefore very important that these substances are not allowed to 'contaminate' other people, or areas outside the RNR. You may ONLY use the toilet, shower and washing facilities WITHIN the radionuclide suite.
Your meals should be transferred by the nursing staff to a set of crockery which will then remain within the RNR. (The crockery from the first meal will normally be kept for future use. you should wash all your own plates, cups and cutlery. These utensils may be removed from the RNR if they have been thoroughly washed. It is preferable that there are not many utensils to be checked at the end of, your treatment.
Any waste food should be disposed of via the 'macerator' so that it does not contaminate newspapers etc. which are within the bins. Rubbish may NOT be thrown away by anyone on the ward. Plastic yoghurt or ice cream containers or plastic cups should be rinsed prior to throwing away in a 'yellow bag'.You will be provided with an electric kettle, some coffee powder and some tea bags so that you may make your own drinks. There is also a small refrigerator in the room to keep milk or other cold drinks which you may desire. If you wish to have special drinks, you should bring your own.
It is advisable not to bring more money than you think you will require into the ward. If you would like the nursing staff to buy you papers daily, please give them some cash prior to the initiation of your treatment. If you are likely to have much excess money, it is wise to ask the nursing staff to lock it away until it is time for you to go home. The nurses will discuss this with you.
Any clothes which you wear may become contaminated with radioactive iodine. Ideally clothes worn while in the ward should be suitable to be laundered in a washing machine, these should be then taken home in a polythene bag and washed in a machine (launderette). Towels, wash cloths may equally become contaminated, but again should be machine washed. Frequently tooth brushes demonstrate a high level of contamination at the end of treatment. It is perfectly safe for you to take them home for your own use, but you should ensure other members of the family do not use them.
It is advisable not to bring too many personal belongings into hospital, since anything which may have been handled by you could be contaminated, however generally books and radio cassettes etc. remain free of contamination. (There is a television set within the RNR, and if personal radios or cassettes are brought in they must be battery operated).
You may be required to start taking some tablets prior to the administration of the iodine. This depends on the form of radioactive iodine which we are giving you. If you are on any medications you must inform your doctor - they could prevent the radioactive iodine from acting efficiently. Also if you have a scan of any sort prior to the treatment, we may (but not necessarily) have to defer your treatment.
It is important for you to drink as much fluid as possible, as this helps to keep the radiation dose to the bladder to a minimum, thus preventing a possible cystitis. It is also important not to be constipated, since this will lead to the stomach and bowel becoming unnecessarily irradiated, and keeps the residual whole body activity higher, thus possibly delaying your discharge.
You should use disposable tissues rather than handkerchiefs if possible, since nasal mucous tends to have a high radioactive content. These tissues MUST be disposed of in the macerator.
Either sodium thiosulphate crystals or potassium iodide powder should be sprinkled into the bowl after use, especially for the first 48 hours after administration of the treatment. This greatly reduces the level of background radiation being emitted from the toilet.
Should this require changing, the used linen should be placed in a bag and left within the suite. It MUST NOT be sent to the laundry. Any radioactive contamination can normally be washed out in a washing machine cycle, but this MUST be done under the control of a physicist.
This must be kept within the suite until dealt with by a physicist. This may involve storage prior to incineration in a licensed incinerator, storage until 'complete' decay of the contamination, or disposal via the macerator in the radionuclide suite (this is not designed to macerate bed-pans etc.)If you have to leave the suite - this should ONLY be for the purpose of a scan, or in an emergency - you should wear protective clothing - i.e. plastic aprons, shoes and gloves. These should be put on when leaving the room, and removed on re-entry to the suite. In an emergency, this may not be feasible if time is an issue.
It is permitted for you to have visitors provided that they comply with the regulations, and that neither children or pregnant persons visit you at any time. Visitors should generally keep their daily dose to 25 microSv - this can be measured by using a digital monitor, available outside the room. The greater distance, the longer it is safe for them to remain. It is therefore advisable for the comfortable chair within the suite to be sited at the far side of the room where possible.
Visitors should not need to wear protective clothing as they should NOT touch any items or yourself on the other side of the lead barrier
Visitors must NEVER eat, drink or smoke in the RNR.
Visitors may NOT use the toilet facilities in the RNR.
There are different levels of remaining activity at which we are allowed to discharge you depending on your home circumstances, and on your means of transport home. After two or three days (possibly longer, depending on the estimate of residual activity), we will measure the activity remaining within you, and then advise as to how many more days it may be necessary for you to stay. When you have been discharged, we may have to request you to observe several restrictions such as going to the cinema or mixing with children. These restrictions are very dependent on the radioactive levels and on the rate at which the radioactive iodine has been passing out of you.
In the event of any emergency the physicist concerned (or another from the Nuclear Medicine Department if necessary) should be contacted immediately.