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. Dependent on patient insurance:

- Baylor Clinic Nuclear department 6620 Main Street. Houston, TX 77030. phone 713.798.2300
- Memorial Hermann 6400 Fannin Houston, T.X. 77030. call to register at 713-704-6500
- Park Plaza. 1300 Binz Main Street. Emergency Room Entrance, ask for nuclear medicine. Houston, TX. phone scheduling 855-210.3570
- St Lukes Medical Center Hospital
- HMI- Houston Medical Imaging

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 SPECIFIED FACILITY