Medical Information From Zentralklinik

After consultation with Dr. Baum, the patient will receive a preliminary written report covering their 68-Ga PET/CT scan, the administration of the PRRT and other medical tests performed. Also reviewed is the current staging and a follow-up appointment time for restaging, as appropriate. The patient also receives a CD with the 68-Ga scan images, some printed images from the scan and a letter for airport security.

If the patient is a US citizen returning to the US then it is advisable that the security letter be carried where it can be readily available upon going through security at an American airport. More on this under Traveling Advice.

How A Patient May Feel After Treatment

Every patient responds differently to the PRRT. Some feel few if any effects and others feel fatigued and nauseated, so it is advised that you carry some anti-nausea medication with you just in case. For all patients it is advised that you continue to drink 2 to 3 liters a day for several days following discharge and while traveling. This is done to help the kidneys flush any radiation from the body.

The best thing a patient can do is to plan ahead and have some medications on hand to help reduce the effects of these symptoms if they should arise. Patients should consider having their doctor at home prescribe a anti-nausea medication, such as Zofran, and some form of pain reliever – as a precaution. The selection of the medication really depends on what is best for the patient. Remember to fill the prescription prior to going to Bad Berka as you will find it helpful to have these medications on hand for your return trip home. You can get these medications in Germany, but you will be charged. If you order them at home your insurance/co-pay may cover the medication costs.

 

Flying Business Class

If your budget/wallet can afford it, you may want to consider flying business class on your trip to Germany. It is important to be as well rested as possible and in as good a physical condition as possible before undergoing PRRT. Seating space and comfort may vary by airline. Being more comfortable is a better option on the return trip home should you be feeling ill and/or fatigued. Having a seat that reclines or even turns into a bed can be very beneficial on long trips.

 

Returning to the United States

Letter on Radiation Treatment: Each patient will be provided with a letter explaining what radioisotopes were used in the course of carrying out diagnostics and the PRRT. This letter normally contains information on isotope type and dosage. If a patient triggers radiation alarms in a US airport when passing through US Customs, the patient should be prepared to show officials this document.

 

Radiation & Airport Security: Patients returning to the US will trigger US Customs radiation monitors upon their return from treatment. The radiation monitoring is part of the US Customs and Border Patrol (CBP) program to safe guard US points of entry.

Typically when a patient arrives at a US airport they come in proximity to a Customs and Border Protection officer who is wearing a radiation detector on their belt. Once an officer is alerted to a patient with radiation, he/she is escorted to a holding/office area where a Customs and Border Protection officer can question the patient and review any documents pertaining to their treatment with radioactive materials. The patient is usually scanned with a radiation detection instrument to determine the nature of the radiation. While US Customs does recognize LU-177 and Y-90 as medical isotopes, not all their field equipment has been updated to recognize all the medical isotopes that the Customs' Teleforensics unit recognizes.  This can result in prolonged questioning by the CBP officers until it can be determined that the patient is actually safe to be released. Also note that Customs will most likely scan and search any carry-on luggage you may have with you. Plan accordingly. Some patients have only been held for 30 minutes and some for 3 hours or longer. If you experience an unusually long processing time you may wish to ask the agent to check with the LSS - Teleforensic Unit for help in clearing you.

Working with the Society of Nuclear Medicine and Molecular Imaging we have reached out to CBP to work with them on this issue.  We have been asked to quantify the issue so that appropriate training can take place.  We have created the following survey to better understand the issues of those returning to the US after PRRT treatment.  Please feel free to click on this link in order to tell us your experience upon returning home. These data will assist others who will be returning home in the future.  The information can be submitted anonymously.