Friday 11 November 2022

Medicine drives me nuclear

Medecines are developed to treat medical problems but they can have some pretty nasty side effects. We know this but often doctors simply do what they are used to prescribing and give little thought to consequences, or hope for the best further down the line. If we are in an acute situation, such as open heart surgery, we don't know what later effects medicines may have as doctors don't tell us.

Six weeks after two open heart surgeries I was back in the hospital because the mountain of medicines I was expected to take was wrecking my gastrointestinal system. Doctors ummed and ahhed as to what might be causing my pain symptoms and nausea but it was me, the patient, who ended up nudging their considerations into medicine issues. I was proven right after 2/3 of my meds were discontinued or dosages reduced and I finally started to get better. 

I thought I was past the worst and that from now on I would only improve but five months after surgery I felt I was sliding backward with massive palpitations, fatigue, two instances of nearly losing conciousness while doing moderate exercise. I found myself spending more time on the sofa and had to give up my exercise classes at the sports centre and the aquatic centre. By the time I was seven months post-op I knew I had better alert my GP. Blood tests were done

They came back abnormal for thyroid function and very low vitamin D (which was surprising for a gardener like myself), In future I will cover up a bit less when outside. It's a fine line for we spritely elders getting enough UV for Vitamin D production and too much UV leading to skin cancer. I was now hyperthyroid with the associated heart symptoms.

Further tests ruled out Graves disease which is autoimmune. Specialists revealed my thyroid troubles had been caused by Amiodorone, a powerful antiarhythmia drug which can cause damage long after it is discontinued as its mega-iodine effect stays in the human body for up to a year, causing havoc in some of us. Key consequences can be a stuffed up thyoid, heart damage, osteoporosis and even pulmonary fibrosis, a terminal lung condition whereby you die within weeks, months but certainly within three years. There is a class action law suit forming in the US against this drug due to the nasty side effects.

I may have dodged a bullet as that second hospital stay saw Amiodorone discontinued though clearly the effects are with me. At least I have minimised the length of time I was on it. It's very worrying for patients when something like this comes out of the blue, the fault of a drug prescribed by doctors.

I am now on another medicine to help my thyroid normalise but we have to be careful in case it tips my thyroid into becoming hypo  and thus requiring lifelong medication. Sheesh! My thyroid needed further investigation and since there is a 4 month waiting list for the thyroid clinic I was pleased they were taking things seriously. So I agreed to go radioactive as part of a diagnostic scan using molecular medicine. Christchurch Hospital receives a canister of the preferred radioactive isotope once a week and it is preprepared into the correct testing doses.

Nuclear medicine uses radioactive material inside the body to see how organs or tissue are functioning (for diagnosis) or to target and destroy damaged or diseased organs or tissue (for treatment).

Unlike x-rays, CT and MRI scans that give structural information, Nuclear Medicine imaging demonstrates the function of an organ or organ system by monitoring the passage, accumulation or excretion of a radiopharmaceutical (a radioactive pharmaceutical).

To perform a Nuclear Medicine scan, the radiopharmaceutical is first administered to the patient, usually intravenously. Depen​​ding on the type of scan, the pictures may be taken immediately and/or after a period of time during which the pharmaceutical localises in the target organ or system.

Thyroid scanning is a well established test for evaluating many thyroid diseases.  The thyroid scan aids in the evaluation of hyperthyroidism by demonstrating findings that differentiate Graves' disease, toxic adenoma, toxic multinodular goitre and thyroiditis. 

  • Following an IV injection of 99mTc-Pertechnetate, there is a waiting time of approx. 30 minutes, Apart from the needle, it doesn't hurt. This radioactive product will concentrate in the thyroid gland. Pertechnetate is excreted in breast milk, so breastfeeding women are advised to express and discard breast milk for 26 hours after injection.

  • The scan takes approx. 10 minutes to complete. I had a 2 minute one, followed by a 4 minute one. I was not allowed to swallow during the scan.

    After a few hours, certainly after a day, I am no longer radioactive. The scan confirms I have drug-induced thyroiditis. With careful medicine correction I hope to eventually get back to normal.

    Don't take those regular blood test checkups lightly. They can reveal problems that can't always be seen. Stay vigilant and be your own advocate.

    https://www.youtube.com/watch?v=3yfdXzZ6Uu0 Hyperthyroidism vs hypothyroidism in detail