Contract For An RAI Pushy Doctor

Contract For An RAI Pushy Doctor
written by Jody
used with permission from Jody

1.  You agree to accept 100% responsibility for any adverse side effects I may suffer if I take I-131 at your request with your assurance that this treatment is 100% safe, for the duration of my life, especially if I am kept in any hypO state because of lack of proper treatment from yourself. This will include:

-loss of work because of hypo symptoms that may become so debilitating I can’t function properly or without pain;

-weight gain, you will accept responsible for any and all new wardrobes I will have to buy in the duration of my life should I experience weight gain because of being in a hypo state with lack of proper treatment, proper labs and proper replacement hormone;

-you will be available 24 hours a day, giving me access to your home phone number, your cell phone numbers, your pager number, your e-mail address, and take any phone calls I place into your office, your home, your cell phone or your pager; should I become depressed and need to talk; should I not be able to sleep, and need to talk; should I just need to talk or ask questions.

2.  Should I be continuously cold, because of being left in a hypO state, it will be your responsibility to see that I have whatever I deem necessary to keep warm.

3.  You will accept responsibility for all hair appointments, hair and nail treatments should I suffer from hypO symptoms that will cause my hair to become brittle, break or continue to fall out or affect my natural nails;

4. You will accept responsibility for any and all fertility treatments should I not be able to conceive caused by your treatment keeping me in a hypO state for my individual set point;

5.  You agree to work diligently with me to make sure I do NOT go hypo in any form…this will save time and effort for both of us, and money for you. This will include working diligently to find my set point, where I feel my best.

6.  You will accept responsibility for ALL ophthalmologist visits and any surgeries that may occur as a result of I-131 bringing on or worsening my eye disease.

7.  Should I get the eye disease or my existing eye disease worsens after treatment with I-131 you will accept financial responsibility for all eye drops, eye gels, tape to keep my lids closed over night, steroid treatments, eye radiation and surgeries.

8.  If my eyes become so bad I can no longer drive and must use public transport or be driven, you will assure me that I will get to wherever I need to be day or night.

9.  You will monitor me for the duration of my life using the Free T3 and Free T4 lab tests so we both have a clear picture of what is going on with the actual thyroid hormones. You may run the TSH for YOUR benefit but it is not to be considered in any adjustments of my hormone replacement medications I will have to be on for the rest of my life. The TSH will become your financial responsibility.

10. You will NOT treat me as a lab value but will adjust my hormone replacement meds based on symptoms more so than lab values.

11. You will be open to using Armour Thyroid or a combination of T3 and T4 supplements, a compound prescription using a time released T3 with T4 hormone replacement so that I may remain balanced throughout the day should *I* deem it necessary that T4 replacement is not enough for me.

12. You will keep close watch on ALL thyroid auto antibodies until they disappear. This will include TSI, TPO, Thryoglobulin, TRAb, both blocking and recepting, as well as the standard antibody tests in the standard thyroid anti auto antibodies panel. Should these remain high 3 months after I-131 treatment, you will then prescribe and pay for the anti-thyroid drug that I may be able to take, until these antibodies are no longer registering in my labs. This will assure me that you are willing to also address the autoimmune nature of this disease, rather than just ablating my thyroid and considering this enough.

13. You will accept financial responsibility for all necessary treatment, for the duration of my life, should I ever get any of the cancers associated with the use of I-131, this will include, cancer of the thyroid, breast, ovarian, (or testes) cervix, uterus, pancreas, and parathyroids or any others that may be deemed at a later date to be an outcome of radiation ablation of my thyroid gland.

14. You will accept full responsibility should my pancreas, pituitary, adrenals become incapacitated for the duration of my life.

15. Should there be, at a later date, any other symptoms, reactions, consequences of the use of I-131 on my body released from the Department of Energy’s currently sealed files, from Medical Associations, and from Independent Research that are not listed above, you will accept full responsibility in medical bills, free medical treatment and lost wages for the duration of my life.

16. Should I die because of an adverse reaction to the use of I-131, because of any future complications, because I became hypo and depressed and have taken my own life out of desperation, you will, willingly, without bias, pay numeration to my family, or the person I decree, a sum total of Ten million dollars ($10,000,000.00) within 5 working days of my demise.

17. Should you expire before the end of this contract, you will designate your estate to continue with full financial obligations through the duration of my life.

If you will agree to sign this contract, after reading and initialing each item in front of a notary or your attorney and return this signed agreement to me and my attorney, we will then sit down and discuss I-131 treatment. I will then be able to believe YOU that all is safe with this treatment, that you have no qualms treating me this way, and in the future, because you know that none of the above mentioned consequences is a possibility.  I can trust you to treat me safely, compassionately, with full medical attention.

However, should you not be inclined to sign this contract, I will fully understand, and we will both understand that I-131 treatment will not be discussed between you and I again, unless *I* choose to bring it up.

Doctors
Name _________________________Date__________________________

*Witness ______________________ Date _________________________

Patients
Name________________________ Date_________________________

*Witness ____________________ Date_________________________

* Witnesses to be an attorney or at the very least a Notary Public.

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