Out of breath

Yesterday, I had a bit of concern about the timing the move home: was I really fit enough; were the rest of the family ready for me in the absence of my parents? The appeal of my better supported and motorised bed won out against the expert (but often very slow medical expertise.)

An ambulance arrived midday, but when they saw the state of me (unable to bend and short of breadth despite wearing an oxygen mask), they decided it was a 4-person job. They had got away with a 2-person delivery because it was an emergency. I had to wait until 2 teams became available simultaneously. I was lucky and this took just over an hour.

After a lot of debate a strategy for getting me from ambulance to home was agreed. So I took a draft of pain killer and the staff slid me from bed to stretcher. I found I physically could not breathe for this transfer, so I had to hold my breath for probably less than 2 secs. In my weakened state, even with oxygen, I found myself gasping for air. Each breath seemed inadequate to replenish my breath. So I felt certain I would asphyxiate, caused by lack of breath capacity and my lungs giving out.

The team were very solicitous, trying out various stretcher positions, while I became increasingly convinced I would die even if returned to my bed. The doctor was called, nurses wandered in and out making posture suggestions, blood pressure was measured. I snatched answers to questions with breadth I thought I could not spare. The only medical action was to give me a slightly bigger oxygen mask.

I signaled the obvious, that I had given up on the move. So I was transferred back, with me expecting the move could be my last. I made it still gasping, but convinced my lung muscles couldn't last. After a while I began to think I might make It and began to stop trying to take the largest breath possible with each breath. So gasped, but more calmly. this is the position my parents found me, having been rung by my wife. I slowly, very very slowly, began to talk between breathes and conditions slowly returned to normal. My breathes remain shallow.


Late last night, I knew I had problems with my catheter. While it had passed some water, it was becoming increasingly painful to drink more. My bladder was under pressure and couldn't relieve it. I kept being assured I would be the next case, but having taken some pain-killer, it was clear that they hoped it would keep me quiet.
Having complained again about the excruciating pain, I finally got attention and a new catheter. Urine flooded out my bladder, easing pressure on my stomach, including my lungs. Suddenly my breathe capacity increased!

With my catheter fixed could probably have made it home with little problem!

Do I go home now? I don't know what the medics would say to this suggestion. Logically, I think I should stay in. It is risky, even if a large part is due to my over-reaction. I hope that my breathe will improve due to anti-water retention tablets and lowered infection. So I am resigning myself to a boring waiting game.

Delay

The pharmists wenthome by 7pm, leaving a vague message about a porter. Without firm information, they wouldn't make arrangements about late night transport. Medicines appeared 9.45pm. So another night listening to fellow patients snore and expectorate. All the patients have got stuck here longer than they expected.

Back home today?

It is likely I will be home again today. First, more anti-biotics, a blood transfusion to receive and prescription to sort out.

Back in Stepping Hill

I am back in hospital.

I could tell you a number stories of why it was thought necessary or the anxious waits while we wondered if I had been forgotten about. To be selective, over the weekend the District Nurses were concerned about the amount of swelling around groin.

Come Monday, my GP was not responding quickly, so the nurse called an emergency GP. In reviewing my case, the GP found several areas of concern, so I was referred to Stepping Hill. From being referred, it was an 8 hour wait for a bed, much of this time we were uncertain whether anyone was dealing with us.

In summary:
Thu, 15th - comfortable, enjoying the hospital type bed;
Fri, 16th - some discomfort from swelling in groin;
Sat, 17th - District Nurse concerned about swelling;
Sun 18th - increasing concerns;
Mon 19th - local practice suggests phone consultation for Tuesday. District Nurse gets on the case and insists on home consultation today. This led to me being admitted on 22:00. Blood tests and X-rays done overnight.
Tue 20th - some changes in medicine. Catheter drained my bladder.

Early days, but staff are talking about me leaving on Friday. A lot of it depends on getting balances right, it will also depends on my attitude to being in: prompt medical attention vs. better bed and home comforts.

Hospital again?

It was decided in discussion, with the nurse, that I may be suffering from water retention. The symptoms are not fully clear, so the District Nurse contacted the emergency GP (my usual GP being on leave).

The GP reviewed my case and decided that there were a few other items of higher priority that ought to be dealt with first, in priority order:

the high potassium levels - (this occurred only once, but would be particularly big problem if it returned and;
• 2nd item - (I've forgotten what it is); and finally,
• the original worry of blocked pipes.

So the plan is to get me into hospital so a series of tests can be done so I can be treated appropriately.

Pain largely under control

Comfort seems to be coming together. I have a hospital style of bed, which allows me to adjust to comfortale postions or ease me out of ed. The mattress is the ripple type. Which means it is constantly adjusting slightly to prevent pressure sores. It was a bit odd to start with, but now I like it.

Perhaps most fun of all, is that it is possible to place the laptop in a reasonably comfortably position. So emails and and blogging are practical again.

I am not getting out much. I had a trip to the hospital on Monday. On Tuesday we went out for a drive, to see how much fun that would be. It was a scenic drive to a car park the The Romper. To be honest, the fun of the drive, just about compensated for the being shaken around in a car.

I still look forward to visiting Underground Stockport exhibition (perhaps waiting for the final phase of Stockport Story to open as well.

I am in for visitors, though I am well booked-up at them moment. Call me or Lan if you want to come over. I think 3 March is my first available date.

Paul is in Vietnam at the moment. I think I feels a bit guilty to not be here adding suport but Lan and I made it quite clear to him that he should go. Paul phones every day and it gives Lan a great boost to hear the daily updates. Today is Tet (VN New Year) and Paul was interviewd for TV, because he was one of the first people to take a Ha Long Bay ride this Lunar Year. I also enjoy Paul's calls. It makes me think how excellent it would be if I could take a fews hours out of convalescing and install myself at a bar in Saigon, or any number of VN locations.

It is now someweeks since I had chemo. If I had insisted, I could have had chemo last Monday. But I now have more respect for the treatment. I don't want a blast of Chemo if all it means is another 2 weeks in hospital. Of course, no one knows if I would suffer as much the second time around, but we have agreed I need a couple of weeks recuperation before further chemo is sensible.

Back at home

I have been home since February 07. I haven't managed to make or take the time the time to post until now. I appreciate that my silence will have been frustrating for readers, as it has been for me.

I will post some more soon, once I have read your emails, assuming I don't get too weary again.

--------
In the end it was decided for me to go home. There were some risks. The infection (cellulitus) wasn't beaten yet and blood clots remain a risk. On the other hand I am avoiding a whole host of possible hospital infections and the tedium of the hospital.


My hospital 'room' was described by one nurse as a cupboard, but at least it gave me some privacy. I don't know what most of the patients on my ward were there for and to what extent it was there medication which was to blame, but it was a noisy and disturbed wing. The ward door was kept locked to stop patients escaping. This didn't stop them trying every hour or so. Poor chaps were bed blocked. Neither Council nor family could provide them with housing in time, so they were practically imprissoned, with no one to appeal to.

----

On the otherhand hospital could be relatively tranquil and organised compared to home. So I hesitate to invite visitors. Can I suggest you talk to Lan and my parents. If I am fit at the time, then I will join in.

----

I am going to look at the Stockporrt Heritage blog now. To be honest, it is more fun.

Out tonight

I am currentl waiting for my prescription, but once that is done am off home.

Several people have expressed a wish to see me. I welcome seeing them, but give me and my family a chance to get organised. So leave it until after this weekend. (Gitta, Leslie helen, you remain welcome. If I am not strong enough then I will keep out of the way.

Out even later

We haven't had the results of my blood tests yet, but the docotor would like to see some good stable results, today and tomorrow, before releasing me. I am not clear whether it is blood thickness which is most important or signs that my infection is under control. Anyway both have to be satisfactory. If I have two days of good results by tomorrow, I might be out.

I was in a lot of pain ths morning. I think it was because the pain killer came an hour later than usual. t might also be because Dr Leo suggested that I stop using the moisturiser on the wound (as it seems to have softened the skin to such a point that it is leaking). As the wound dries out again, it may be contracting and causing pain. I feel all right now. I shall see if the pain returns.

Steve has lent me a book, You can heal your life. I am cynical, but I will give this book a read.

Lan continues to suffer. A GP visited and diagnosed vertigo. I thought this related only to heights, but Google search tells me that there are a number of conditions and infections, related to blockages of the middle ear which lead to dizziness. I haven't tied the description of Lan's consultation to any of the specific googled diagnoses, but I am heartened that GP seems to have a specific diagnosis in mind, not just an unspecified infection.

Ever since I have known Lan, she has occasionally complained of dizziness due to: running; walking up hill; to much excercise or worry. Usually something too minor to worry about. Maybe this is a clue to something longstanding and maybe it will improve Lan's general spirit of well-being.

Dad had his eye-site tested yesterday, back in Good Hope hospital, Sutton Coldield. They have given him an appointment for laser treatment next month. As well as being grateful that his poor eyesite will be improved, we hope that he will once more be able to drive. This will take the pressure off Mum.

Out whenever

The vitamin K has done the trick and got my blood thickened to about the right strength. As Tom observed recently, the 'correct' thickness is a very fine range.

I am not fit enough to leave the hospital, however. The main area of concern is the failure to rein in the infection. I am now on my third anti-biotic after 11 days. The hope remains to get me out soon, but I am hostage to the infection of cellulitus.

I fell a bit like a balloon, with hands and feet puffed up, but am in very little pain or discomfort. I just have to put up with the tedium of hospital life.

Out tomorrow?

I am not out today. My blood is even thinner, despite the fact the haven't given me warfarin for 3 days. So they are going to give me Vitamin K, intraveneously, otherwise I could be waiting a long time before my blood thickens to safe levels.

They are also starting me on a new antibotic, in tablet form. Visually it looks like the inflamation is under control or perhaps declining, but blood tests show an increased level of inflamation markers suggesting the infection is far from beaten. The doctor says he prefers to treat the patient rather than the blood tests, but the indicators are strong.

At home, the occupational therapest has delivered useful items such as a bath stool and an adjustable bed table to make life easier.

I hear Jim has fixed our door lock which was getting unreliable and we continue to get cards and messages from friends. Thanks a lot, it is very comforting to have all this support.

Out today?

Talking to the nurses, it seems likely that I will be released today, though the Doctors won't meet until this afternoon to make the decision. If it doesn't happen, it will probably be due to concern over the thiness of my blood. A few days ago the worry was too many coagulents risking another blood clot. I seem to have responded too well to the medicine so that I might bleed too quickly.

nyway, I should hear the decision this afternoon, then predict delays while they prescribe the controlled drugs to take home with me. I am still taking a largeamount of morphine derived pain killer.

Meanwhile, poor Lan, who has been worrying about me and scrubbing the house to achieve a sterile environment for me to return to as well as being hostess to my parents and brother, has worn herself out and is suffering from a sore throat.

Friday update

The results of the angiogram are that I did have a blood clot near the lungs when I was admitted. It is likely that this was at least one of the causes of my shortness of breath which led to us calling the emergency services.

That led on to the discovery that I had an infection. The infection might also have contributed to my shortness of breath and general level of sickness when admitted. There seems little doubt that the infection was the cause of my pain in the leg and lack of mobility, so it was a timely discovery.

The angiogram also showed up cancerous bit in the blood near the lungs. Mum is insistant that we were previously told that the cancer had been detected round here so it shouln't be veiwed as a further spread.

I am no longer hooked up to tubes, but the plan is that I stay in hospital until Monday. This will give them more time to confirm that the infection is under control & adjust my blood density to make the re-appearance of clots less likely. My next chemo will be delayed by a week, until a week on Monday. This is to give my body a chance to recover.

Angiogram

It's a pulmonary angiogram by the CT Unit which I am having, rather than a CT scan.

[Correction: after a bit of Googling, I have concluded that a pulmonary angiogram is one of a number of tests that can be done on a CT scanner. http://www.muschealth.com/gs/TandP.aspx?PageID=P07966 ]

I think this is to test if I have a blood clot. This was identified as a possible reason for my shortness of breath when I was admitted. If so, it has taken a while to arrange. I have been able to take deep breaths, without discomfort, since Sunday.

Of course, if there is a clot, it is important that it identified as clots can move and cause more serious blockages. T nurse pointed out that the doctors may want to know what effect the wound & cancerous bumps are having on circulation.

Having to starve prior to the test presents problems due to my diabetes. I am now managing my insulin, which is an improvement as the nurses are too busy to reliably coordinate the injections with meals. That's fine until they say I can't eat for 10 hours then concede a few hours later that I can have a light lunch.

Scanning

A CT scan is planned for Wednesday. I think the main purpose will be to see the status of the infection. I am in hospital so they can blast the infection. Once that is done, they want to chuck me out as soon as possible, because hospitals are a great place to pick up new infections.

Whereas yesterday I was reconciling myself to being here for another week, it sounds like the hope is I will be out on Thurs or Fri.

Email

Inow have access to email from my hospital bed, whichis good. (I make no promises as to how often I will read or reply.)

Note that I don't have my address book, so I cannot initiate an exchange of emails.

Still Stepping Hill

I am still in Stepping Hill Hospital.

The area of the infection, as implied by the patch of reddened skin round the wound, seems to have stopped increasing. I continue to be fed anti-biotics intavenously, to eradicate the infection. Then chemo can continue. If it can be beaten quickly, then I may still be able to have my second chemo cocktail on Monday, as originally scheduled.

'Patientline' gives me limited Internet access, so I can update the blog. It depends on how weary I am & how restricted my arms are with tubes.

Annoyingly, I can't access Flickr, to view friend's photos, because the content is potentially too adult.

I will see about accessing my email this afternoon, if my parents can find my notes on NTL passwords.

I'll post a comment to the blog when I get onto email.

Courtesy of Patient Line

The blog is out of date,so i will jot some quick notes before returning to something more passive.

SAT: awful nights sleep due to pain.

SUN: a fine day out. My brother drove me and my parents ,to Castleton and Buxton, to enjoy the views. We then got out of the car for a coffee at the Palace Hotel. A remarkably untiring, unstressful and pleasant day out.
An awful nights sleep due to pain.

MON: slept downstairs. V comfortable. Concluded pain set off by climbing stairs.

TUE: repeat the success. Little mobility about the house, but lifestyle quite bearable.

WED: meet Macmillans nurse. Good discussion. Initiate steps for improved & focused pain control.

THU: 00:30 - agony. Eventually find bearable position.
04:30 - still in pain and short of breath. Start thinking that it may not be muscular and start worrying about cardiac possibilities and ask my parents to call an ambulance.


CONCLUSION: I am in Stepping Hill Hospital (my local hospital). We are fighting an infection around my wound area using anti-biotics applied intravenously. This will keep me in hospital until Mon/Tues at least. It may delay my next Chemo, until I am up to strength.
I am on ward B4, in my little room to reduce contact with others to reduce risk of further infections.

If you want to visit, please contact Lan/my parents first. Waiting times are restrictive and there is not enough space for all family to visit.

District Nurse

I had a visit from the District Nurse who has put me on her books and made me aware of the local Beechwood Care centre as well as other services.

Tuesday-Wednesday

The first two days after treatment are said to be the worst, but I actually felt better than usual. I was quite perky. So that was nice.

Kevin dropped by on Tuesday and we had a good chat.

Wednesday morning, the water was cut-off. It turned out the water meter we requested was finally being installed. We requested one a long time ago and after a long delay, they made an appointment to install it in pavement outside. No one turned up on the day. When I complained, they said their records showed the contractors had installed it. So I did nothing more until a while later when the billing department rang to say they couldn't find our water meter. That was some months ago. Anyway we finally have one. That should significantly reduce our water bill.

Later Jim popped round to fix our door bell. There has been a spate of vandalism on door bells on our road. Lan wanted it replacing securely and I am not up to it. So Jim very kindly came to the rescue.

I felt very chipper these two days - the days which are expected to be the worst - then to stop me being cocky I was struck by an accute pain. The unpredictability is annoying.

GP

Saw GP and had a useful chat about pain killers and support services.

Chemo

I got To Christie Hospital for my 09:30am appointment. We saw Dr Lorrigan at 10am. We had a more frank discussion than Wednesday. Basically, I am in a war with this cancer and the final result may not be postive.

So treatment set for 12:30pm. Come 12:30 and the medicine was not ready. Apparently the cocktail of drugs which make up the chemo are prepared off site, in Burnage. My intravenous bag had not been delivered. I was not alone. Most of the people there were due to start their treatment at 9:30am and were still waiting.

Anyway, my chemo bag appeared 4pm, by which time most everyone else had also go theirs. First was a talk about precautions for Chemo. E.g.:

• no salads (can't be sure is it is fully clean - cooked foods only);
• full cream milk not skimmed, to counter the tendency to lose weight;
• keep a digital thermometer to hand and check temperature at slightest sign of fever then immediately contact hospital if in excess of 37.5C.

We also discussed support mechanisms, so they have refered me to the Distric Nurse. They said they are best for medical and pain relief advice, whereas MacMillan is more geared to benefits advice, which is important to some but not my main concern.

Then I went on the drip. I could feel it stinging as it went in, so they slowed the drip to reduce the pain. That meant a 2 hour session rather the the hoped for half an hour. (Most chemo drips are painless as they go in, but some people react to this particular one.) That was fun. There was a dozen of us patients, plus hangers on. I was the youngest and we were all facing our personal battles.

We finished the day at Christie with a free NHS meal, for all four of us.

Visit from Jim

Jim dropped round after a long day in the Heritage Centre, which was very good of him. He brought me up to date on Heritage and Stockport news. This included an attempted break-in at the Heritage Centre. Fortunately for the Trust, the intruders gave up when the saw the size of the drop from the roof to the Centre's floor. However, they have damaged the fabric of the church and the church will have to make a claim on insurance.

Discussion with GP

Friday afternoon, I got frightened by one of my bumps. I was worried it was infected and might lead to problems in addition to the cancer itself. My dicoveries always seem to occur on a Friday evening, to give me maximum time to worry before surgery is open again.

But as it was afternoon I was in time for an emergency appointment that afternoon. In fact, it was nothing to worry about, or nothing new. It is one of the melanoma tumours becoming visible beneath the skin.

However, it was a useful meeting in terms getting support from my local GP. We discussed regular consultations and providing practical support. Also the need for Lan to have consultations to discuss her stress.

Visit by Graham

Graham was a very welcome visitor. There was a lot to bring him up to date on. I had spent the morning adding some items to the blog, decided I'd had enough of that, when Graham arrived to my surprise. Lan had made the arrangements in secret.

Visitors are welcome. It's a fairly full house what with me, Lan and my parents. Give us a ring first.

For gamers, Graham and I talked about a a Games day here, probably a Sunday. I'll see how the chemo affects me before setting a definite date, but I guess 21st or 28th Jan are likely to be the best dates for me.

Sorry for the embarrassing photo Graham. Lan did take a lot, but this is the least worst in terms of someone pulling a funny face.

Hospital visit

It's a fortnight since my last appointment with Dr Lorrigan, during which time I have been watching the bumps and get bigger and spread.

It was the usual procedure, a half hour wait in the waiting room then Lan and I were shown to a room and we were left there for half an hour before the Dr and his assistance finally came. Next door there was a lot of activity with 10 staff coming and going. My parents thought all this attention was for us.

When the Dr finally did come, Lan was so upset by what she might hear, Lan left and my mum came in. (It was only later did I learn that mum thought I had. been briefed for the last half hour and the information was being repeated for her benefit only.)

Dr Lorrigan now says I cannot go on the trial after all. Having been treated for a previous cancer (radiology for testicular cancer in 1998) automatically excludes me.

So my treatment starts on Monday. This is the BOG standard treatment or gold standard treatment as Dr Lorrigan called it. I had read-up on this for
the trial, except that it is not the same after all. The trial used a more friendly, oral version of temosolide.


[I will complete this posting after a bit more thought.]

Not much help line

I was right. I only got a response from the Christie line on Tuesday and the secretary couldn't offer much, except to cancel my appointment if I wanted. Which I definitely did not want.

Christmas Day video

Lan took this video on Christmas Day. No one likes the sound of their voice, so I have promised to produce a version without dialogue, meanwhile here is my first edit.


[Click on the picture to activate, then click the 'play' symbol. Or click on the 'google video' button if you want to see links to similar videos by me or others.]

More pain

Friday night, I was in great pain, which hadn't gone by Saturday morning. Typical that these episodes happen at the start of a Bank Holiday weekend.

So I called Christie on the number that I had been assured I could get support. I got the answer machine of the doctor's secretary telling me she was away from her desk at the moment and she would get back to soon. I think she will be away from her desk till at least Tuesday.

So I called Emergency GP support. The GP who returned my call was very helpful. I still have a range of pain killers from before the op. So she was able to advise me what to take (Oxynorm). So pain is largely back under control. So I think I can make it through to Wednesday when I get to learn when my chemo starts.

Mum and Dad have responded by coming back to give me support, which is very good of them. Not only that, Mum has postponed her hip operation. I think she should get the treatment as soon as possible, but this very good of her.

Yuletide update

On Christmas Eve I over did it a bit, accompanying mum on some last minute shopping. I was in quite some pain by the evening. My leg muscles and stomache muscless seemed to be pulling against each other. By Christmas day, my muscles were relaxed enoough for me to enjoy the day.

The five of us: Mum, Dad, Paul, Lan and myself; had a good time following the Hoad traditional Christmas, taking it in turns to open presents, then a lot of TV watching - not that there was a lot to watch.

Paul gave us a slideshow of his recent holiday in Guetemala. Almost a 1000 photos, all very well taken. In return, we introduced him to Vietnamese kick horse or horse chess. I don't think he was impressed, particularly when mum kicked his horse. Mum always used to be a cooperative player of family games, but kick horse brings out the competitor in her.

Paul had to return home for some urgent work on Boxing Day and the parents left a couple of days later.

Excerpt from ThanhNien News

At 8pm Vietnam time, CNN, BBC, AP and others carried news of the tsunami off the southern Taiwanese coast. It later killed one and injured three in the Chinese territory.

Vietnam, which as yet has no equipment to predict tsunamis, immediately stirred into action.

Vietnam's National Hydrometeorology Center and the Steering Committee on Flood and Storm Prevention instructed provinces stretching from Quang Binh to southernmost Ca Mau in the central and southern region to move residents at coastal areas deeper inland, and call vessels ashore.

Around 2 hours after the first warning, the Japanese said the tsunami was unlikely to pose a threat and one hour later at 11pm, Vietnam reported the danger over.

But in that short span of time, the Vietnamese government managed to put one half of the nation on full alert, with thousands ready to be evacuated any time.

Mass preparation

Deputy first Prime Minister Nguyen Sinh Hung immediately arrived at the central weather bureau to hear updates on the seaquake.

At 10.30pm, central Quang Binh province mobilized all soldiers ready to evacuate over 10,000 locals.

In former imperial Hue city, over 15,000 started their evacuation.

In Da Nang, plans to move 20,000 residents to safety were in place.

Deputy PM Hung said after the incident, “This was an important drill for real calamities”. He instructed provinces to return to normalcy but to be on guard against possible aftershocks.

He also instructed weather agencies to keep a close watch on international forecasts and warnings.

The country has 24 stations to monitor earthquakes but none to predict tsunamis.

This Thursday, the Vietnamese Institute of Geophysics will hold a conference to discuss earthquakes and tsunamis.

The Japan Meteorological Agency reported the seaquake as occurring at 19:34pm Vietnam time (1234 GMT).

According to China Seismological Bureau, two quakes - the first measuring 7.2 on the Richter scale and the second measuring 6.7 - hit the East Sea.

The epicenter was located at 21.9 degrees north latitude and 120.6 degrees east longitude, about 350 kilometers from the Chinese mainland and 15 kilometers from Taiwan.

Panic in Vung Tau

Today's earthquake in Taiwan (7.2 on the Richter scale) caused a tsunami warning to be issued to parts of the Philippines. The threatened tsunami never appeared.

Meanwhile, somehow or other, the message got through to Vung Tau, Vietnam, that a tsunami was on its way within the hour.

According to Lan's family, the result was chaos. People on the Front Beach ran to the Back Beach and people on the Back Beach ran to the Front Beach. Lan's eldest son walked up the adjacent hill to the lighthouse. While the younger son took a lift with his girl friend 25km in land.

As far as I am aware, the evening passed without any calamity.

If you look at a map you will see there is no direct line from Taiwan to Vung Tau, though a hypothetical tidal wave might have swept round the curve of Vietnam, having hit cities such as Danang first.

Stress of inept letting agents

Making plans for a successful let
Originally uploaded by Dep Lan.

Everyone warned me that letting agents cost a lot and do very little, which is why I was wary of buying to rent, but Lan was keen to own a place to rent.

We use a letting agent and management service because Lan's English still has it's limitations and I don't have the time to chase up rents and frankly I don't want to.

However, I really could do without the hassle of having to keep chasing the agent. Nothing much is going to happen over the festive period. I was going to vent my spleen by publishing an excerpt from a draft letter, but the agent, (Reeds Rains) may consider it defamatory as may the tenant. Reeds Rains have annoyed me enough to throw caution to the winds, but as I don't know to what extent the tenant is contributing to the problem, I had better be more circumspect.

Wednesday 20th, scanning and other things

Morning: Dressings Clinic & Surgeons Clinic
A couple of visits to the hospital today. The first was a standing appointment at the dressings clinic. Dr Lorrigan's assistant said it was a good idea to attend, as they been monitoring the wound and may have some insight on the changes.

The dressings nurse referred me to the surgeon, who was also holding a clinic. I overheard Mr Murphy send back the message, that there was no point in him seeing me.

So Mr Murphy came to see me and gave me his best bedside manner. He confirmed it look like cancer. He said it was unusual for it to reappear so soon after surgery and grow so aggressively. He did explain that surgery can trigger the growth of cancerous cells. He confirmed that surgery was inappropriate (I had wondered if as a surgeon he would have a different point of view). So the 'systemic' approach is required, i.e. use chemotherapy to attack it everywhere in the body.

Mr Murphy also assured me he had spoken to Dr Lorrigan to try to move my next appointment forward, but Dr Lorrigan isn't holding a clinic between Xmas and New Year.

So that was 1.5 hours in the hospital for a few minutes with the surgeon.


Afternoon: CT Scan
Back home, my good friend Tor dropped by, who I hadn't seen for some years. That was great.

Then it was back to the Christie that afternoon. As before, I had to spend an hour drinking dye. This time I was given a choice of flavours: orange, blackcurrant or something else. I commented on this new sophistication. The nurse said that they had changed the dye, because their had been too many complaints about the cheaper one.

I spent quite some time being scanned. They concentrated on my brain and neck. I don't think they scanned my wound or bumps at all. I am not sure as I was told to keep my eyes most of the time, to avoid the laser light used to target the scan. It was at this point that the implications sank home.

Then it was back home. My parents had arrived. It is nice to have them here to give us both some moral support.

Heritage Meal

On Tuesday night we went out with the Stockport Heritage Trust for a Christmas meal. It had been a long day, but I felt the need to be sociable.

For more photos, click here.

Tues 19th: further treatment required

I saw the physician today, Dr Lorrigan, and his assistant.

The assistant started by talking about radiology and using the drug, interferon, to reduce the chance of reoccurrence.

They then inspected the wound and decided that some bumps on the skin which have appeared in the last week are probably caused by the skin cancer. The physician's opinion is that further surgery is inappropriate and that treatment by chemotherpay is urgently required.

A CT scan is being arranged and it takes a week to get the radiographer's report.

I have an appointment with Dr Lorrigan for 3 January, by which time he should have the CT scan report. By then, he should also have discussed me with the surgeon and other specialists to see if they recommend alternative treatment.

There is a clinical trial of a new drug which may be superior to the existing treatment. Assuming I agree to this treatment, I have 50% chance of getting the new drug. From what I gather both of them would be done as an outpatient. The standard treatment is Temozol and is described on the Christie's website at chemotherapy cards. There is no description of the experimental treatment, but the test is reported at Medical News Today.

Both treatments can have side-effects and my resistance to infection is likely to drop. The documentation I have refers to continuing the treatment "until you stop receiving benefit from the treatment". But the TMZ.htm link above, refers to 4 week cycles repeated upto 6 times. So I assume it is expected to have done its work within 24 weeks. I hope that it is not normal to require such a long treatment.

I am going in to the Dressings Clinic tomorrow morning. They can compare the bumps with what they saw last week and they may have their own opinion.

I had been feeling better and cutting back on painkillers, but my skin has got more irritable over the last few days. I put it down to healing, but I am having a rethink.

The Martian Chronicles

I have read and released The Martian Chronicles. See book crossing journal here.