# Have a diagnostic body scan yet for next week



## sportdan30 (Apr 18, 2012)

I was curious if others have experienced the same preparation for a body scan.

I'm told I don't have to go off my synthroid, which I thought for sure I would. Nor do I have to adhere to any type of diet restrictions until the last day of prep.

Here is my schedule for next week:

Monday: thyrogen injection

Tuesday: thyrogen injection

Wednesday: arrive for an appointment to take a low tracer dosage of radioactive iodine

Thursday: nothing, although told to take a laxative in the evening

Friday: take additional meds if laxative didn't fully work (feel like I'm prepping for a colonoscopy!) stay on liquid diet and have scan done at 2 pm.

Does this sound normal?


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## joplin1975 (Jul 21, 2011)

Here was my schedule:

Two weeks prior to the start, low iodine diet
Monday: Thyrogen injection #1
Tuesday; Thyrogen injection #2 + blood work
Wednesday: Tracer Dose
Thursday: nothing
Friday: WBS and (if needed (which I did NOT need this year) another round of RAI) (Edited to add: my scan was done at 8:00am and I also had a neck u/s to make sure I didn't have an reactive nodes...I did have node mets, so they were being cautious.)

I've never heard of a laxative use in WBS.


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## sportdan30 (Apr 18, 2012)

Thanks for the quick reply. I failed to mention that I need to make sure they take blood work on that Friday. That was emphasized to me twice.

It just seems strange that I don't have to go off my synthroid, but most of all the annoyance about having to take a laxative and adhere to the liquid diet. I only assume the reason for the laxative is to make sure they get all the tracer dose of iodine out of my system.


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## bluemoonguy (Apr 22, 2012)

The Thyrogen is the reason why you don't have to get off your Synthroid. I just scheduled my 2nd round with a whole body scan for May 3rd and made absolutely sure that it was a Thyrogen whole body scan. If I had to be taken off of my Naturethroid, I'm sure I would pass out all the time (I'm already frequently tired and light-headed as it is. Not sure why).

Anyway, the laxative thing is what I find most puzzling. I'd ask them why you need this as I've never heard of an endocrinologist asking for something like that.

FYI, here's my upcoming schedule for my whole body scan:

April 30th (Tue): 1st Thyrogen injection
May 1st (Wed): 2nd Thyrogen injection
May 2nd (Thu): I-123 dose
May 3rd (Fri): Whole body scan

Hopefully I won't need another round of the dreaded I-131...

Again, I'd ask why the laxative is necessary. It seems like different endocrinologists have slightly different procedures. Unlike Joplin, I'm apparently not required to have any blood drawn during this procedure, either.


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## sportdan30 (Apr 18, 2012)

I spoke to the nurse and she said they do this because if you're not completely cleaned out, it could appear as if the disease is present in a mass or whatever. I just find it odd that it's not a consistent requirement. To me, this more of a nuisance than anything, but I'll oblige so I get an accurate test.

Bluemoonguy, did you have a second dose of radioactive iodine? The reason I ask is because my RO wanted to immediately do a second dose, but I consulted with my ED first. Thus, I'm going the route of the WBS although with my luck, I'm sure I'm going to have to do a second dose anyway!


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## joplin1975 (Jul 21, 2011)

I think the blood draw is critical for two reasons:

1) you need to make sure the thyrogen is working and your TSH is high enough to make the scan accurate; and,
2) you really need a stimulated (either via thyrogen or going hypo the old fashioned way) thyroglobulin number. The scans are good but not perfect - you really want that stimulated Tg number in your back pocket.


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## Andros (Aug 26, 2009)

sportdan30 said:


> I was curious if others have experienced the same preparation for a body scan.
> 
> I'm told I don't have to go off my synthroid, which I thought for sure I would. Nor do I have to adhere to any type of diet restrictions until the last day of prep.
> 
> ...


I am grateful that we have such experienced and knowledgable posters on this board. I know you appreciate their input greatly.

Dropped by to wish you all the best on your whole body scan. And, I see the point to having to clean out your system. It makes a lot of sense.


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## bluemoonguy (Apr 22, 2012)

joplin1975 said:


> I think the blood draw is critical for two reasons:
> 
> 1) you need to make sure the thyrogen is working and your TSH is high enough to make the scan accurate; and,
> 2) you really need a stimulated (either via thyrogen or going hypo the old fashioned way) thyroglobulin number. The scans are good but not perfect - you really want that stimulated Tg number in your back pocket.


Yeah, sounds right to me. I just got a hold of my endocrinologist's office and apparently they -do- want me to stop in before my full body scan this Friday for some lab work. Looks like I am going to get stabbed with a needle 3 times in 6 weeks. Lovely!  I was hoping I could avoid it.

Thanks for the info, Joplin.


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## joplin1975 (Jul 21, 2011)

Good, I'm glad to hear it! Wait, just to be clear, I'm not glad you are getting stabbed, but am glad they are being thorough. 

Good luck to both of you and please let us know how it all shakes out!


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## sportdan30 (Apr 18, 2012)

Well, I had my body scan on Friday and had not heard anything, so I called the doctor's office this morning. I spoke to the nurse and she said that the bodyscan came back clear....negative! They are still waiting on the bloodwork along with the next step from the doctor.

Am I correct in assuming this bloodwork was to test the TSH level? What is it that they are looking for?

Thank you.


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## Octavia (Aug 1, 2011)

That's great news, sportdan!

Probably not looking at TSH...not sure what they were looking for in the bloodwork. (Was the bloodwork the same day as the scan?)


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## joplin1975 (Jul 21, 2011)

Congrats on the clear scan!

I would assume they are waiting on the Tg and TgAB numbers. Without those, the scan is considered "incomplete."


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## Octavia (Aug 1, 2011)

Yeah, I was thinking thyroglobulin...looks like we're on the same page, joplin.


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## sportdan30 (Apr 18, 2012)

Good news. Bad news. So, I spoke with the doctor at length about a half hour ago. He said the bloodwork looked good as well. No antibodies present and along with the thryoglobulin test I had three or four months ago which also looked fine, he thinks my outlook is positive. He spoke with my Endo, who resides in the same hospital. They both agreed a post therapeutic scan would be recommended to ensure there's no nodules or mass present. Apparently, the diganostic scan of which I just had is not a good indicator of seeing that. The RO goes back to the first initial scan I did after treatment. There was uptake in the neck and chest area. He said that the possibility still exists that there are microscopic cells the diagnostic scan wouldn't have detected. Not to mention I fit the criteria in which the disease is more aggressive (being male and fairly young of 40 years old).

So, my question is why in the bloody hell did I put myself through the diagnostic scan, when the RO pretty much knew all along I'd have to have a retreatment? It's very frustrating.

The Endo and RO feel confident that this next scan will be clean as well, and they will then just monitor me going forward. That's my hope too.

In any case, I'm going to put a call in to my Endo and get his take on all of this. I feel like I just wasted my time with this last scan.


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## joplin1975 (Jul 21, 2011)

Uh?

Ok, three things pop out at me that are concerning:

1) Thryoglobulin from a few months ago is...sorta kinda useless. I mean, first, you need to look at the trend of those numbers over time so relying on a number from four months ago instead of today is...odd. More importantly, if you ask me, is to know if that Tg numbers was stimulated. Meaning, did you either go off your replacement medication OR have thyogen when that blood was drawn? If not, the number is useless because your TSH is suppose to be suppressed, therefore any residual thyroid tissue would be more or less in active, therefore those cells wouldn't be producing detectable Tg.

2) RAI works over the course of a few months. Some say three months, others say six. Regardless, the scan post-therapy dose is suppose to show that the treatment is *working* but it will not show the final results of the treatment. Therefore, the one year (or, for some, six month) scan is essential.

3) If the current radioiodine scan is clear, what is he wanting to treat?


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## Octavia (Aug 1, 2011)

Sounds like somebody didn't think this through very well. ???


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## sportdan30 (Apr 18, 2012)

I did have two thyrogen injections prior to the scan. I will have to confirm if they did indeed do a thyrogloblin test. They took vials of blood, so I'm quite certain they did a thorough job.


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