Hales help Please if you have the book

[Bama_5]

I had to have a nuclear stress test today. I had several different opinions from professionals regarding how long it is necessary to avoid bf. I am not bf a newborn or round the clock babe. He is 2 1/2 and nurses twice a day (occasionally 3 times).

Anyway, these are the drugs used and I need to know what Hales has to say. If you don't have the book but frequent IHMMB, please ask someone there to pop in here and answer (I'm not registered there or I'd do it myself).

TC (99m) Sestamibi x2 (the 99m is written as exponent on my note and the x 2 means it was administered twice - once at 9:30 and then again at 10:30 a.m.

Lexiscan

I was told it is half life in 6 hours if that is noteworthy.

I was told it is water soluable and flushing my system with water would increase the rate of clearing my system. I am drinking water like a camel (over a gallon in the last 5 hours) :)

Thanks - sorry if too chatty but tried to give you any info you might need. Yes, I know this is the internet and not a doctor and any information should be taken with a grain of salt but, I don't have access to Hales so I wanted to know what He has to say to help me balance the varied opinions.

I talked to my doctor before the testing, got different info from radiologist and tried to call my doc to discuss the differences. He is out of town and I had to talk to his young associate (who I liked on the phone but still wanted to check out Hales to confirm one or the other (the young doc and my doc or the radiologist).

Thanks again!

Bama

[Amy_G_]

let me look,
my dr hales doesn't list the TC-99m Sestamibi
but can probably find info on it online at dr hales site

the 6 hour half life means in 6 hours half of the dose is out of your system, and in 6 more hours, another half of that half is gone(so 1/4 remains)

did you get an amount? the chart I have says that above certain MBq or mCi then instructions on length of time for cessation of breastfeeding is required to be given.

[Bama_5]

no, unfortunately the amount isn't listed on my note the radiologist gave me and it is too late to call.

I did find Dr. Hales site and it does address the Sestamib (http://neonatal.ttuhsc.edu/discus/messages/54/17424.html?1198160956)i (didn't give the chart but since i don't have the exact dosage, not sure the chart will help before tomorrow and based on other replies in that thread, I think I'll be fine by then (the 24 hour mark - much better than the 3-5 days the radiologist starting quoting before I said his info was not agreeing with my doc's info and I would make phone calls to figure out why or why not).

I didn't find anything about Lexiscan on Dr. Hales site. Again, I did not get the dosage as I thought he listed everything on the note he handed me after asking for the information.

thanks for being quick to reply and for any information you did/can give me - you are a blessing!

Bama


ETA: Salt form used is listed as normal saline. I didn't mention that earlier because I knew normal saline would be fine but in case it matters on the chart you mentioned, thought I should add that note. Now, I've told you all I know :)

[Amy_G_]

The chart looks something like this:
http://www.radiopharmacy.com/breastfeeding.pdf

I will assume (perhaps falsely) that since the tc99msestamibi doesn't have anything in the recommendations for interruption of breastfeeding column for an amount that you'd need to stop breastfeeding at, that the dose is not that important in determining it's safety. Does that make sense?

with a half life of 6 hours, at 24 hours from the 10:30 dose, 1/16th of that dose remains, plus < 1/16th of the 9am dose, which is less than 1/8th total.

with radioactive agents, I've read that if you pump and store the milk, any radioactivity in the milk will continue to break down at the rate of 1/2 every 6 hours, so the milk would be even more radioactive clear in another day or so to feed. Does that make sense?

Lexiscan has a half life of 2 hours I think, so it's pretty much gone out of your system by now, even though it says don't breastfeed while taking it in the Physician's info for the drug, most likely because it's got such a short half life, nobody has done much research on it and safety in breastfeeding. In 12 hours, 1/64th remains and it is a usual .4 mg dose in IV.

[Amy_G_]

as long as the sodium was regular saline and not radioactive sodium which you have to stop breastfeeding for 16 days..... :(
but I don't think that is used for a stress test.

[Nipple_nectar]

No advice just a warm hello:) Nice to see you Bama! I see your nursling is still nursing, similar to mine. Are you as ready as I, to be done?

[Bama_5]

Amy, thanks for all your help! The info you gave me confirmed the conclusions to which I had arrived as well as gave me new information. I'm glad it wasn't radioactive saline - 16 days would have been not doable in my book (although if situation had been life and death, I'm sure we would have managed). Your replies were reassuring to me and I appreciate your time and quick response.


Mrs. R - wave right back at cha! Yes, it's true - I've not been around much (not even lurking except on occasion - too much IRL activity). To answer your question, I was glad when he got down to 2 times a day (with rare midday short snack). As it is, morning and bedtime (with him sleeping all night - woohoo), is ok by me for a little while longer. He is my last nursling so this weaning will be different. With the others, I was always expecting a new babe soon. With this one, it will be the end of bf, for me. I guess I'm just saying that closing any chapter (even if ready) is sometimes a little sad. So, I may welcome it but not rush it, if you now what I mean.

Bama

[Amy_G_]

Bama, glad I could help! Take care of yourself. Hope the results of your test were ok?