Fired Up

Both times that I’ve received radioactive iodine treatment, I’ve had to stay in a quarantined, lead-lined room in the hospital for a night, followed by a week on my own in our spare bedroom. No kids, no pets, no innocent bystanders around.

The isolation sucked. You might remember such self-pitying posts as this one. The hospital is cold, covered in paper and plastic, and filled with weird noises, bad showers, and crappy towels. Being stuck in our spare bedroom is marginally better but still crazy-making.

None of that matters. Not one tiny bit, if by staying away from B and Clar and everyone else I care about — and plenty of people I’ve never met — I spared them from my radioactivity. I probably took my precautions even a little too far and too long, but the peace of mind was worth it.

So I get riled up when I hear about people who knowingly don’t follow doctors’ orders to go straight home after receiving RAI treatment. (Never mind the doctors who don’t even give the orders.) I get frustrated when I hear that they get in cabs and on buses, and go through the Lincoln Tunnel. But I get incensed when I hear about them staying in hotels.

This week, after a series of hearings, studies and surveys, the Nuclear Regulatory Commission “strongly discouraged” patients from staying in hotels after receiving RAI.

That’s a step in the right direction. But it doesn’t go nearly far enough. People who receive RAI should be in hospitals, not hotels.

After you receive RAI, radioactivity seeps through your pores and collects in your saliva. It collects on your towel after a shower and on your sheets while you sleep. It’s in the sink after you brush your teeth, and on utensils after you eat.

All that isn’t that big a deal if you’re confined to your own space, where others aren’t sharing a bed or cleaning up after you.

You can see how this gets complicated if someone stays in a hotel. Even if they don’t accept housekeeping services while they’re there, they can’t possibly know whether there might be a pregnant woman or small child in the room next door — or staying in the very same room after the RAI patient checks out. Unassuming hotel workers take out that person’s radioactive trash, wash their radioactive linens, and mop up their radioactive bathrooms.

But the rules aren’t always clear to patients — because they’re suggestions, not rules. I’ve had fellow patients tell me that they opted to stay in hotels to spare their families the inconvenience of having to go somewhere else during the post-RAI days. (They seemed not to realize that in protecting their own families, they were endangering others’.) Other patients have nowhere else to go, having traveled long distances for treatment, or because they are receiving treatment doses too small to qualify for insurance coverage of inpatient treatment.

There will be more than 40,000 cases of thyroid cancer diagnosed this year; many thousands of that group will receive radioactive iodine therapy. That should be enough potential exposure to radiation to stiffen the NRC’s resolve beyond “strong discouragement,” and to convince insurers to pay for in-hospital care.

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