AOPA Pilot Magazine - May 2011 - 34

FLYWELL

BY DR. JONATHAN SACKIER

Letters from Japan

ll of us were shocked and saddened to see the awful loss of life and widespread destruction from Japan’s earthquake, tsunami, and the

of thyroid cancer treatment, often followed by the administration of, wait for it…radioactive iodine! This is given at a high dose to kill any remaining cells. The patient must take oral thyroid supplements thereafter. With the exception of anaplastic tumors, the outlook is pretty good. After the 1986 Chernobyl accident, the incidence of thyroid cancer climbed, estimated to affect an additional 3,000 people, most of whom had been youngsters in Russia, Ukraine, or Belarus when the ensuing nuclear reactor issues. Email corresponincident occurred. The United Nations stated in dence from pilots en route when disaster struck 2002 that another 10,000 people remained at risk Jonathan M. Sackier is a described critical decision-making when destinaof developing the illness. However, Poland, next U.K.-trained door to the affected area, saw no such increase. tion airports were closed and no alternative seemed surgeon living in possible, illustrating the wide-ranging effects such Why? Simply put, the Polish government distributed Charlottesville, natural disasters may have. Although there is no curpotassium iodide to its citizens. Widely available Virginia. rent impact on the United States, such catastrophes in the United States, this substance, when taken a might occur elsewhere, so I think it timely to address few hours before radiation exposure, satisfies the one medical impact of radiation—thyroid cancer. thyroid’s craving for iodine, effectively “filling it up” so that the Radiation harms biological tissues (like us) by “ionizing” nasty glow-in-the-dark iodine cannot get in. or damaging cells at the most basic level. Snakes are either In the event of a nuclear accident in the United States, the venomous or harmless and some wax lyrical on how to tell authorities would purportedly distribute the drug if radioacthe difference. My philosophy is, keep the heck away from all tive iodine had been released (www.fda.gov/Drugs/Emergency snakes! I feel the same about radiation. Preparedness/BioterrorismandDrugPreparedness/ucm072265. When a nuclear reactor has problems of the kind seen in htm). However, there are some who recommend having a Japan, radioactive materials such as iodine and cesium may leak supply on hand, especially if one lives in close proximity to a and enter the atmosphere, water supply, and food chain. The nuclear power plant (www.nrc.gov/info-finder/reactor/). thyroid, a butterfly-shaped organ located in the front of the neck Dirty bombs have entered our lexicon—conventional explowrapped around the windpipe, is very sensitive to radiation. It sives packed with medical or other radioactive isotopes—and produces hormones that regulate how fast we metabolize and thankfully none have been detonated, but in the event of an use energy—think “human throttle.” To function properly, explosion iodine may not be released and local health officials iodine is taken up by the thyroid after consuming items rich would hopefully provide advice. I do not want to be a scarein the substance such as shellfish, iodized salt, or kelp. Radio- monger, but as pilots we talk about staying ahead of our aircraft, active iodine released in a nuclear accident is problematic as so in the wake of the Japanese tragedy this is a good time for the thyroid cannot differentiate between “good” and “nasty” emergency planning for the home, just like we plan in flight. I encourage everyone to develop an emergency plan—how iodine; the bad stuff is absorbed into the gland, where it might cause cancer—a risk more pronounced in babies and children, to contact family members and loved ones remembering that lessening after 40 years of age. when disaster strikes, phones, text, and email may not be availThis may present with a lump, but most thyroid nodules are able, so consider an agreed upon location to gather. Think about benign. Other symptoms include neck, jaw, or ear pain; hoarse supplies for home, hangar, airplane, and car. There are plenty voice; or enlarged lymph nodes. A full medical history and exam of good resources in libraries and on the Internet. are necessary, as thyroid cancer may be associated with other I want to stress that I am not endorsing the purchase of malignancies. As this condition tends to be more common in potassium iodide; that is a matter between you, your doctor, women, a male with a nodule or a younger (less than 20 years and family. If you do, make sure you purchase from a reliable old) or older (over 70 years old) patient favors a malignant pro- source. One facet of Japan’s apocalyptic events that deserves cess. There are four types: papillary, follicular, medullary, and mention is how calmly and gracefully this proud nation has the most aggressive, anaplastic (the type Chief Justice Rehnquist borne its suffering. Most pilots know what to do in the unlikely succumbed to). Tests include measuring blood thyroid hor- event of an engine failure or cockpit fire. Learn how to deal with mone levels, an ultrasound to ascertain if the lump is solid or events that may be even more widely catastrophic and do what fluid-filled, a special scan to determine whether the nodule we as pilots are trained to do. Take charge. is composed of active (“hot”) or inactive tissue (“cold”), and a biopsy taken with a very fine needle. Surgery is the bedrock Email the author at jonathan.sackier@aopa.org. 34 • MAY 2011

AOPA PILOT •

http://www.fda.gov/Drugs/EmergencyPreparedness/BioterrorismandDrugPreparedness/ucm072265.htm http://www.fda.gov/Drugs/EmergencyPreparedness/BioterrorismandDrugPreparedness/ucm072265.htm http://www.fda.gov/Drugs/EmergencyPreparedness/BioterrorismandDrugPreparedness/ucm072265.htm http://www.nrc.gov/info-finder/reactor/

AOPA Pilot Magazine - May 2011

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