I’m just getting over brachytherapy where 80 radioactive iodine (I-125) “seeds” were planted in my prostate. Both the radiation oncologist and a urologist were involved, as well as other OR people, I suppose.
I have been warned not to hold pets or kids in my lap nor hug my wife (or anybody’s wives, for that matter) for two months.
If the stuff is that powerful, how do the OR staff protect themselves for the one hour the procedure took?
I’ve read a lot about this but nothing was mentioned about protection.
I haven’t done it yet, but what we talked about in *nursing *class for radioactive therapy (brachytherapy) in general was time, *distance *and shielding. Lead lined toolkits and long handled forceps are used and lead aprons are worn by providers during the insertion. If you’re hospitalized post-procedure, each nurse can only provide care for only 30 minutes per shift, so they’ll try to “cluster care” to get you everything you need at once instead of coming in multiple times. You’ll have multiple caregivers if you need more assistance beyond that 30 minutes. Patients with radioactive inserts are placed in a private room and may not have visitors who are pregnant or trying to conceive or father a child. A piece of tape is placed around the bed 6 feet away and nurses and visitors will stand outside it whenever possible. They may wear stick on labels or rings which measure their cumulative radioactive exposure to keep it at a safe level. Dressing changes (which I don’t believe are needed for prostate brachytherapy, but are for some other radioactive procedures) are done by trained radiation technicians, not your regular RN. If any seeds are dislodged, they are placed into a lead lined container with long handled forceps, and radiation therapy comes to clean them up.
I assume these general guidelines - time, distance and shielding - are followed by MDs as well as nurses and other caregivers. The specifics will vary based on the insertion site and type of radioactive isotope used. As I understand it, prostate brachytherapy isn’t the most dangerous to care for, as it’s a fairly low level of radiation with a short half-life, so once they’re inserted, the primary caution is to avoid having people in direct contact with your lap, as you already know.
Thanks, WhyNot for the interesting information. Thinking about the surgeon inserting those things with long-handled forceps kind of gives me the willies now. Well, I guess they all got inserted in the right places. I had a CT scan the next day to be sure none had migrated.
I guess mine are relatively low-dose. It was an outpatient procedure, and after an hour in the recovery room, I was taken home. I’d also guess that all personnel wore dosimeters.
Those precautions for other cases, probably the thyroid is one, are really something. They must really be heavy doses of radiation.
Even with what you wrote, it seems that just lead aprons would not be sufficient. What about their heads, hands, etc? I’d hate to think of them inserting these using lead-lined mittens (like heavy oven-mitts, eh?).
They’re not worried about you bouncing a kid on your lap for a couple of minutes; they’re worried about a kid sitting in your lap for a half-hour every night for a month reading a bedtime story. The hour-long procedure to put them in wouldn’t really have exposed them to all that much of a dose. Anything that would put them at significant hazard from that sort an exposure would kill you, not just your cancer.
Also, of course, children are more vulnerable to radiation than adults.
I know that the radiation rooms on the endocrine ward (for thyroid patients) where I worked had separate plumbing- their toilets emptied into some sort of tank and the waste was removed on a regular basis.
Radioactive pee!
It was a total pain in the behind to have to put lead aprons and heavy gloves on to take their blood for the thyroid hormone checks too.
I am not at my most dextrous when wearing 8kg of lead.
It isn’t that the person was totally radioactive, it is more that the cumulative radioactivity for a staff member taking 5 blood samples a day 6 days a week for several years from radioactive patients would not be healthy.
I only worked there for a few weeks, so I’m probably good
I vaguely remember something about being told that if one of the radioactive patients had a cardiac arrest we were not to waste time putting on lead aprons for CPR, but that the entire arrest team would have to change after 20minutes so that no-one was in contact for a prolonged period of time. Never happened while I was there though.
