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Dr. Jose David Gamez, M.D.
Endocronologist (Pediatric)
Dr. Jose David Gamez M.D. is a top Endocronologist (Pediatric) in Edinburg, . With a passion for the field and an unwavering commitment to their specialty, Dr. Jose David Gamez M.D. is an expert in changing the lives of their patients for the better. Through their designated cause and expertise in the field, Dr. Jose David Gamez M.D. is a prime example of a true leader in healthcare. As a leader and expert in their field, Dr. Jose David Gamez M.D. is passionate about enhancing patient quality of life. They embody the values of communication, safety, and trust when dealing directly with patients. In Edinburg, TX, Dr. Jose David Gamez M.D. is a true asset to their field and dedicated to the profession of medicine.
Dr. Jose David Gamez, M.D.
- Edinburg, TX
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Is it safe for diabetics to have surgery under general anesthesia?
Usually, before surgery, you should have an appointment or conversation with the anesthesiologist to evaluate all the potential risks of having anesthesia.
What type of sugar should diabetics avoid?
All of them.
What kind of sedation is used for thyroid surgery?
It is performed with general anesthesia.
What should I do if my glucose is high?
Get in contact with your doctor or endocrinologist.
Can thyroid surgery be done with local anesthesia?
No, it's usually performed with general anesthesia.
Why haven't my muscles developed during puberty?
Ask your parents to take you to a pediatric endocrinologist.
Is acupuncture safe for diabetic patients?
I have no knowledge about benefits of acupuncture.
Do you need radiation treatment for thyroid cancer?
It depends on your case. Every case is different. You must discuss this with your doctor.
How does general anesthesia affect diabetics?
It depends on the control of your diabetes.
Does a thyroid CT scan use contrast?
Yes, it does.
Should I visit a hospital for low blood sugar?
Depends on your symptoms and how low is the blood sugar. Usually you should contact your primary care doctor first.
Can CT scan dye affect thyroid?
Usually no.
What sedation is used for thyroid surgery?
Usually general anesthesia.
Can my daughter outgrow hypothyroidism?
Most likely not, however, I had patients that do better over time.
What happens to the thyroid after radioactive iodine?
The thyroid tissue purposely gets damaged, then you will develop hypothyroidism.
Is radiation treatment effective for thyroid cancer?
It depends on the type of thyroid cancer, you should discuss it with your endocrinologist.
Does thyroidectomy require local anesthesia?
No, it is done under general anesthesia usually.
Is local anesthesia safe for diabetic patients?
It depends on the control of your diabetes.
What precautions do I take after radioactive iodine treatment?
Posttreatment precautions — Patients who receive radioiodine have the potential to expose their home and household contacts to very low levels of radiation via saliva, urine, or READ MORE
Posttreatment precautions — Patients who receive radioiodine have the potential to expose their home and household contacts to very low levels of radiation via saliva, urine, or radiation emitting from their body. To ensure the safety of family members, caregivers, and other individuals, several precautions are recommended. We agree with ATA guidelines as described below [13].
Safety for the general public and household members — Treated patients should be given patient-specific advice on the necessary precautions to reduce radiation exposure (table 6). The treated patient should remain ≥1.8 m (6 feet) away from family members, caregivers, and the general public as much as possible for approximately 24 hours after treatment. Adult caregivers may be closer than 1 m (3 feet) for brief intervals. In general, the treated patient should be instructed to avoid public transportation and extended time in public places and should not stay overnight in a hotel or motel within 24 hours of 131-I treatment.
To protect household members from radiation exposure, the treated patient should avoid the following during the restricted period:
●Sleeping in the same bed with another adult, pregnant woman, infant, or child
●Sexual contact
●Kissing
●Sharing cups, utensils, towels, razors, toothbrushes
The duration of the restricted period depends upon the dose received, amount of thyroid tissue, and rate of clearance. As an example, treated patients should avoid sleeping in the same bed with an adult for four days and for up to three weeks with a pregnant partner, infant, or child after treatment with 200 mCi (7400 MBq). The restricted period is calculated individually for each treated patient (table 7).
There are few long-term data to assess the protective benefits of these precautions. In a study of 30 patients with thyroid cancer who received 75 to 150 mCi (2.775 to 5.550 GBq) of 131-I as outpatients, exposure of family members was minimal when precautions were followed [142]. Patients were instructed to sleep alone, drink fluids liberally, and avoid prolonged close personal contact with family members for two days after treatment. Surveillance of family members and pets demonstrated that doses to household members were well below the limit (5 mSv) mandated by NRC regulations.
Personal hygiene — 131-I is renally excreted, and excretion is maximal during the first 48 hours after treatment. Patients should stay well hydrated (3 to 4 L of fluid daily) and void frequently. To avoid personal or caregiver contamination, patients should be meticulous in their personal hygiene, wiping any surfaces that may become contaminated with urine, stool, vomitus, blood, or perspiration for 48 hours after treatment (table 6). For 48 hours after therapy, men should sit when urinating. Exercise equipment should be wiped with flushable or disposable wipes. Exercise and bed clothes can be laundered in a washing machine. Dishes and utensils can be washed by hand or in a dishwasher. Flushable waste can be flushed down the toilet. Non-flushable waste (ie, incontinence pads) should be disposed of in a plastic trash bag devoted to radiation waste. Caregivers should wear disposable plastic gloves during clean-up. Radiation waste bags can be returned to the nuclear medicine facility one to two weeks after treatment or stored in the household (6 feet away from people or animals) for 80 days. After 80 days, radiation-related trash can be disposed of with regular household trash.
International travel — Low levels of 131-I activity (0.0003 mCi [0.01 MBq]) can be picked up by radiation detection systems at airports or international borders. Treated patients may trigger alarms for as long as 95 days posttherapy. Thus, patients who are traveling within three to four months of receiving 131-I require documentation specifying the date of treatment, type and dose of radionuclide, the treating facility, and contact information for the treating clinician.
Future pregnancy — In female thyroid cancer patients, pregnancy should generally be delayed for at least six months after radioiodine therapy to ensure that additional diagnostic imaging or additional radiation treatment is not required. In men, it seems reasonable to delay attempts to produce pregnancy for a period of three to four months to allow recovery of the transient oligospermia that may follow radioiodine therapy. However, in some men, full fertility may not be restored until one year or more after treatment, especially in men receiving high cumulative doses of radioiodine (>350 mCi)
Safety for the general public and household members — Treated patients should be given patient-specific advice on the necessary precautions to reduce radiation exposure (table 6). The treated patient should remain ≥1.8 m (6 feet) away from family members, caregivers, and the general public as much as possible for approximately 24 hours after treatment. Adult caregivers may be closer than 1 m (3 feet) for brief intervals. In general, the treated patient should be instructed to avoid public transportation and extended time in public places and should not stay overnight in a hotel or motel within 24 hours of 131-I treatment.
To protect household members from radiation exposure, the treated patient should avoid the following during the restricted period:
●Sleeping in the same bed with another adult, pregnant woman, infant, or child
●Sexual contact
●Kissing
●Sharing cups, utensils, towels, razors, toothbrushes
The duration of the restricted period depends upon the dose received, amount of thyroid tissue, and rate of clearance. As an example, treated patients should avoid sleeping in the same bed with an adult for four days and for up to three weeks with a pregnant partner, infant, or child after treatment with 200 mCi (7400 MBq). The restricted period is calculated individually for each treated patient (table 7).
There are few long-term data to assess the protective benefits of these precautions. In a study of 30 patients with thyroid cancer who received 75 to 150 mCi (2.775 to 5.550 GBq) of 131-I as outpatients, exposure of family members was minimal when precautions were followed [142]. Patients were instructed to sleep alone, drink fluids liberally, and avoid prolonged close personal contact with family members for two days after treatment. Surveillance of family members and pets demonstrated that doses to household members were well below the limit (5 mSv) mandated by NRC regulations.
Personal hygiene — 131-I is renally excreted, and excretion is maximal during the first 48 hours after treatment. Patients should stay well hydrated (3 to 4 L of fluid daily) and void frequently. To avoid personal or caregiver contamination, patients should be meticulous in their personal hygiene, wiping any surfaces that may become contaminated with urine, stool, vomitus, blood, or perspiration for 48 hours after treatment (table 6). For 48 hours after therapy, men should sit when urinating. Exercise equipment should be wiped with flushable or disposable wipes. Exercise and bed clothes can be laundered in a washing machine. Dishes and utensils can be washed by hand or in a dishwasher. Flushable waste can be flushed down the toilet. Non-flushable waste (ie, incontinence pads) should be disposed of in a plastic trash bag devoted to radiation waste. Caregivers should wear disposable plastic gloves during clean-up. Radiation waste bags can be returned to the nuclear medicine facility one to two weeks after treatment or stored in the household (6 feet away from people or animals) for 80 days. After 80 days, radiation-related trash can be disposed of with regular household trash.
International travel — Low levels of 131-I activity (0.0003 mCi [0.01 MBq]) can be picked up by radiation detection systems at airports or international borders. Treated patients may trigger alarms for as long as 95 days posttherapy. Thus, patients who are traveling within three to four months of receiving 131-I require documentation specifying the date of treatment, type and dose of radionuclide, the treating facility, and contact information for the treating clinician.
Future pregnancy — In female thyroid cancer patients, pregnancy should generally be delayed for at least six months after radioiodine therapy to ensure that additional diagnostic imaging or additional radiation treatment is not required. In men, it seems reasonable to delay attempts to produce pregnancy for a period of three to four months to allow recovery of the transient oligospermia that may follow radioiodine therapy. However, in some men, full fertility may not be restored until one year or more after treatment, especially in men receiving high cumulative doses of radioiodine (>350 mCi)
