Path 4

This is patient-specific information and should only be followed depending on the individual instructions given to you by the physician. 

"Path 4" Scenario: 
Patient had surgery, needs to remain on thyroid hormone replacement, and use of thyrogen is indicated for thyroid cancer thyrogen stimulated in-house treatment and post treatment scanning.

Preparation during clinic visit for "Path 4" 
a.  Instructions to stay on synthroid
b.
  Low iodine diet instructions 
c.  Call backs dates
d.  Lab slips (pre-treatment labs only). 
 Where to go for labs. 
e.  Treatment and whole body scan order faxed to Methodist
f.   Schedule follow up appointment

Proper steps to complete Path 4:
Locations: 
a. Methodist Hospital 6445 Main Street.  Houston, TX 77030.  phone  713 394 6805
b. Houston Thyroid and Endocrine Specialists. 6624 Fannin Street. Suite 2260. Houston, TX 77030. phone 713 795 0770


Overview:
1. Start low iodine diet 2 weeks prior to thyrogen injection as per
 http://www.houstonendocrine.com/what-is-endocrinology/thyroid-cancer-information/low-iodine-diet 
2. Continue to take thyroid hormone
3. Get blood work done a 7-10 days prior to scan 

Specifics:
DAY1: Monday 
First thyrogen injection in the morning. 
DAY2: Tues
Second thyrogen injection in the morning.  
DAY3: Wednesday 
Treatment dose of I-131 will be given in the morning at Houston Thyroid and Endocrine Specialists office
DAY5 - Friday 
Come back to our office for blood work again to check your stimulated thyroglobulin level. 
DAY11:
Post treatment whole body scan
DAY3-15:
You need at least 10 days of isolation after a treatment with I-131
Make a follow up appointment for thyroid hormone dosing adjustment in 6-8 weeks with your endocrinologist
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