Path 5

Path 5

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

"Path 5" 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 5" 
a.  Instructions to stay on synthroid / levothyroxine post surgery
b.
  Low iodine diet instructions 
c.  Call backs dates
d.  Lab slips (pre-treatment labs only). 
 Where to go for labs. 
e.  Office orders thyrogen via ThyrogenOne paperwork
f.   Schedule follow up appointments

Proper steps to complete Path 4:
Locations: 
a. Baylor Clinic Nuclear department  6620 Main Street. Houston, TX 77030.  phone 713.798.2300
b. Houston Thyroid and Endocrine Specialists. 6624 Fannin Street. Suite 2260. Houston, TX 77030. phone 713 795 0770


Overview:
1. We will need to order thyrogen from the company directly. Patient will receive a phone call from the ThyrogenOne team to inform you of the costs based on your insurance plan. The costs can range from $0 to more than $3000 depending on your particular insurance plan. The thyrogen will be sent to the Houston Thyroid and Endocrine office when or if approved.
2. 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 
3. Continue to take thyroid hormone after surgery
4. Get blood work done at the indicated times.

Specifics:
DAY1: Monday 
First thyrogen injection in the morning at Houston Thyroid and Endocrine
DAY2: Tues
Second thyrogen injection in the morning at Houston Thyroid and Endocrine.  
DAY3: Wednesday 
Treatment dose of I-131 will be given in the morning at Houston Thyroid and Endocrine Specialists office
DAY3-15:
You need at least 2 days of complete isolation with separate bathroom and bedroom and then 7-10 days of variable isolation after a treatment with I-131
Make a follow up appointment for thyroid hormone dosing adjustment in 6-8 weeks with your endocrinologist
DAY5 - Friday 
Come back to our office or specified lab for blood work again to check your stimulated thyroglobulin level. 
DAY11:
Post treatment whole body scan to be done at Baylor Clinic Nuclear department

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