" how does it feel? how does it feel....like a complete unknown, like a rolling stone, to be on your own, with no direction home, like a rolling stone." Like a rolling stone, by bob dylan

first off, i would like to say that i realize that i have used part of the lyrics of this song, like a rolling stone, by bob dylan before. it is just so appropriate when i write about salivary stones! i did some more research about salivary stones and frankly, there still  is not a lot of research on this subject. or the studies are small, and the results inconclusive. yes, it is known that larger doses of the I-131 given after thyroid cancer surgery are more likely to result in  salivary stones production. one theory is that scarring caused by the radiation, and resulting inflammation,  causes the salivary glands to narrow. some people think that the I-131 also causes reduced saliva production, which causes the saliva to also thicken. so you have thickened saliva and narrow saliva glands. yuck.

i have had both a kidney stone and i still struggle with salivary gland stones- a little over 7 years after my I-131 treatment. i can tell you from experience that both types of stones, while quite different, feel about the same on the pain scale. i should mention that along with salivary stones, I-131 has been associated with mouth dryness, taste alterations, infection, facial nerve involvement, cavities, yeast infections, and abnormal growth of tissue( both benign and cancerous).

salivary stones and salivary gland pain/swelling can occur right after treatment with the I-131. it can come on suddenly and then return months, even years later. my physician recommended that i use sour candies and drink plenty of water ( i did both) after my treatment dose of the I-131. do not confuse a treatment dose of I-131 with a diagnostic one! a diagnostic dose, which has not firmly been linked to salivary issues, is in the single digit milicuries range. a treatment dose starts at about 100 milicuries, and can go as high as 200-250 milicuries. there is a definite link, as i said in the first paragraph, in the occurrence of salivary stones and how much I-131 a patient receives. doses over 200milicuries are generally not recommended. i received 155 milicuries. one source i read said that most of the people who had trouble with salivary gland issues received from 100 to 150 milicuries. it has also been suggested that lowering the dose of the I-131 to the smallest possible effective dose is recommended. now, anyway. i understand that it is a double edge sword, so to speak. i, like many others, had an aggressive type of thyroid cancer and even a brilliant surgeon can not be expected to get all of the thyroid cancer cells. the I-131 is necessary, in my opinion- although there are those patients that refuse treatment- to prevent recurrence of thyroid cancer.

i recommend that patients having salivary stone issues see an ENT ( AKA, an otolaryngologist) for a definitive diagnosis. there are some surgical procedures that can be done, but in my opinion, if you opt for this, make sure that the ENT has done a plethora of these before you have this procedure done. there are nerves and other important stuff in this area, so you do not want to do more damage. what can you do now, at home, to cope with salivary stones/ inflammation/ swelling? here are some things that are recommended: warm compresses, gentle massage, sour lemonade( my favorite- make sure to use plenty of lemon juice and pulp), drink lots and lots of water, and for the pain, the ENT that i saw recommended ibuprofen. of course, some people can not take ibuprofen, due to stomach issues, interactions with other medications,etc, so be sure to check with your doctor or pharmacist ( smiley face here) before taking this medication.

hopefully, more information will be available on the treatment, and hopefully even the prevention of salivary gland pain and salivary stones. thyroid cancer is the fastest growing cancer in the US now. (getting  a thyroid cancer diagnosis has TRIPLED over the last three decades according to the american cancer society ). surely, more people are going to have salivary gland issues, so more research hopefully will be conducted into this side effect from the I-131 treatment.