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I first noticed something odd with my left testicle at the end of 2006. It had always, at least as long as I can remember, been somewhat smaller than the right testile but now it was getting bigger. No lumps or bumps just bigger.
Over the next couple of months it continued to grow and along with it my concern. I should have gone to my GP in January 2007 and maybe only the testicle would have been affected. However, I did not do so until the end of March. The rest of this page is my journal of what happened from that point on.
30 March 2007
Appointment with a locum. She suggests enlargement is probably a hydrocele but says she'll arrange for an ultrasound scan to confirm this. The locum at the Bramhall Health Centre was filling in whilst my GP was on long term sick leave.
16 April 2007
Call from Stepping Hill hospital saying there had been a cancellation and I could have an appointment tomorrow. I took the opportunity.
17 April 2007
Ultrasound scan done. It is not an hydrocele but a tumour. The doctor/technician said he would contact my GP to get a referral to the Urology department.
18 April 2007
Call from the Urology department to tell me I have an appointment at 10:30am 23 April and they will write to confirm this.
19 April 2007
Letter confirming appointment at the Urology Clinic on 23 April with Registration Form to be completed. Form to be handed in when I arrive.
23 April 2007
Attend Urology Clinic and seen by senior Registrar. He says the testicle should be removed and examined. There is a slot in theatre tomorrow if I can make it, providing they can also get a bed. I say that is fine by me. I need to get a chest X-ray and have some blood taken for checking. Nurse at the clinic takes my blood and I'm sent to X-ray with instructions to bring the picture back to the clinic. Also told to expect a call tomorrow morning about admission for the operation.
There is a long wait at X-ray and when I get back to Urology they tell me that Julie has 'phoned to see if I was still there.
I'm not home long before I get a call from the hospital to say there is a bed for me if I can get there by 16:00. It is a rush but I get there for 15:50. Eventually get properly admitted at 18:00. There was a surge of patients back from surgery apparently. Andrew visits on the way to the Gym and brings in a magazine.
24 April 2007
Early breakfast 06:30 and then nothing, not even water, before the operation. Usual blood pressure and temperature checks through out the day plus an ECG before being marked-up and given one of those daft gowns to wear. Walk to theatre to reception at 16:30. Wired up for ECG machine and have a blood pressure cuff put on my arm by the anesthetist nurse. Then wait for a while before being wheeled on the trolley to the theatre. The anesthetist puts a needle in my arm and his nurse connects up the BP and ECG stuff. Anesthetic administered and I know nothing more until I'm brought round in recovery. The operation was completed successfully. Once I'm awake I'm taken back to the ward. I've missed the evening meal but get a sandwich and fruit. Andrew visits again.
25 April 2007
Ask for some pain killers as the wound is giving me some trouble but can't take them until after breakfast because one of them will irritate an empty stomach. The senior Registrar checks me over and says they'll book me into the clinic in about two weeks to get the result of the biopsy of the tumour and to tell me what happens next. I can go home. A (staff?) nurse changes my dressing, gives me some extra ones in case they are needed, a letter for my GP practice nurse should I get problems with the wound, and some pain killers. I call Julie to say I'll be home shortly and call Matthew to pick me up. Home at about 10:30am.
2 May 2007
Contact AXA PPP about claiming for the two nights in hospital. Am told I need a discharge summary (probably sent to GP) and they will send a consent form for me to sign. If I can't get hold of the Discharge Summary they will contact the hospital direct to get the information they need (confirmation of nights spent in hospital).
3 May 2007
Letter from hospital advising that an appointment is arranged for 10:20am 16 May.
4 May 2007
Rang GP's secretary to ask if they have received a discharge summary. They have but the secretary cannot let me have a copy until she has checked with the doctor next Tuesday. Advised me to ring next Tuesday afternoon.
8 May 2007
Discharge summary form collected from health centre. Some of the dates are wrong and don't make sense (I annotate form to show this). AXA PPP consent form and discharge summary sent to AXA PPP.
15 May 2007
Letter and information pack from the Christie Hospital. I have an appointment at 13:30 22 May 2007 at Dr J P Logue's clinic. There was a registration form enclosed which I completed and returned in the envelope provided.
16 May 2007
Attended the clinic in the Urology department at Stepping Hill. the consultant said the wound had healed up fine and any residual hardness will soften over time. The tumour was a seminoma and any further treatment will be decided by the Christie Hospital. They may take no further action but a single dose of radiation treatment to the abdomen would be more typical. He will forward his results to the Christie.
22 May 2007
Attended Dr Logue's clinic at the Christie hospital. Was seen by one of his registrars. She asked about medical background, both mine and my family's. Told me that, as far as I should be concerned, the operation to remove the testicle also removed the cancer. Any further treatment is to lower the already low possibility of it returning. She examined me, particularly proding my abdomen. All looked fine. The plan ahead is to have a CT scan to positively locate the lymph nodes close to the aorta. This will be followed by a planning session where they will decide where the radiation will be applied and I will be marked up accordingly. It will also be decided when the radiography treatment will start. There will be eight sessions on consecutive days (exlcuding weekends) each lasting about ten minutes. Possible side effects of the treatment are feeling sick, tender skin, changes to bowel movements (this might be due to anti emetic medicine rather than the radiography) and finally an increased risk of secondary cancer caused by the radiation (this is a much lower risk than that of a recurrence of the seminoma without treatment).
30 May 2007 (approx.)
Letter from Christie Hospital advising me of an appointment at the Radiography Department for a planning scan at 14:10 on 13th June.
13 June 2007
Arrived at Christie Hospital a bit early (bus times). Was registered at once at the Radiography reception and asked to go along to the Pat Seed Suite. Announced myself at the reception desk and was called almost at once. A young chap checked some details and told me what the plan was, including that treatment would start on 22nd June. I would have to drink a dye, over a period of an hour, that would enhance the scan. The drink would have an aniseed flavour that could be enhanced by a cordial orange, lemon or blackcurrant. I chose blackcurrant. I'd need to drink two cups of the stuff at once then another cup each 15 minutes following. Then I'd be called for the scan. He then produced a plastic flask with about 900ml of drink and a plastic cup.
The final cup was drunk spot on the hour and having just downed it I was called for the scan. I had to remove my shoes, jacket, shirt and trouser belt and get onto a hard flat bed with a small plastic covered pad to rest my head on. I also had to push my trousers and pants down just below my hips. There was then some adjustments to ensure I was aligned correctly on the bed. The bed was moved backwards and forwards by electric motors and marks were made on my chest between my nipples, just above my naval, and between my hip bones. Marks were also made on my flanks in line with the one above my naval. The marks were covered by clear circular plasters. Then the actual scan was done.
Once redressed, I was given an appointment card for the planning meeting the following week (20th June). I was also given a set of extra plasters to replace any of the originals that might go awol.
14 June 2007
Letter from Stepping Hill hospital advising me that an appointment had been arranged for the Urology Clinic on 26th September. Not sure what this is for, unless it is just a check on the surgery performed in May. Will check after radiotherapy treatment.
20 June 2007
This should have been the planning meeting. Instead Mr Logue, the consultant, had a chat. The scan had shown up something unexpected near my liver that needs further investigation a more detailed scan and, perhaps, a biopsy via a needle. The first scan also showed that a couple of lymph nodes were enlarged so I'll be treated as having stage 2 seminoma rather than stage 1. This basically means 15 days of radiotherapy treatment rather than just eight. The marks on my body were tattooed to ensure that they will still be there when treatment starts. The hospital will contact me about a second scan.
21 June 2007
A call from the Christie advising me that an appointment for the next CT scan has been made for Tuesday 26 June at 14:30. They will send a letter confirming this.
22 June 2007
Appointment letter from the Christie confirming appoinment at 14:30 on Tuesday 26th June in the Pat Seed Department. Enclosed was a Questionnaire for the CT scan. The procedure will take about 2 hours. I'll have to drink 900ml of Gastrografin (this takes an hour) according to the letter. The questionnaire form suggests I may also have an injection of Omnipaque.
26 June 2007
I had to cancel the CT scan due to sickness, diarrhoea and vomiting in the early hours with the former continuing during the morning. I will be sent a new appointment.
27 June 2007
Letter from the Christie with a new appointment for Friday 13th July at 12:30pm.
28 June 2007
Another letter from the Christie changing the appointment to Wednesday 4th July at 11:20.
4 July 2007
Scan done. I arrived early and the procedure started almost at once. Same iodine drink as before and stuff pumped into a vein during the scan to show up blood vessels. Will now have to await contact from hospital about what happens next.
16 July 2007
Letter from Christie Hospital with details of an appointment at Dr Logue's New & FUP Clinic on 17 July at 15 10.
17 July 2007
Consultation with Mr Logue following the taking of blood samples. The second scan still left uncertainties regarding whatever it is on my right side so a biopsy will be needed. The biopsy will be done under local anesthetic whilst being scanned. There is a scanner available on the morning of the 24 July but Mr Logue would like me to stay in the hospital the night before. The availability of beds needs to be checked and his secretary will ring me tomorrow.
The second scan showed that one group of lymph nodes were unchanged but a second had increased in size a little. The proposed treatment has changed from radiotherapy to chemotherapy. They will need to do some sort of check on my kidneys to see what the likely reaction to the chemicals will be. Once it starts, the chemotherapy will involve being on a drip for three days (two nights in hospital) every three weeks for three sessions in all. I will check if AXA PPP cover this as it might speed things up due to shortage of beds.
Checked with AXA PPP. I would be covered for the chemotherapy as long as the drug is on their list. I'd need to get Mr Logue to fax this information to the AXA PPP Nurse Managers (01892 504677) along with details of the regime. Both the Christie Hospital and Mr Logue are on the AXA PPP lists.
19 July 2007
Letter from the Christie Hospital advising me that I have an appointment in the Radioisotope Department for the kidney test - Glomerular Filtration Rate. This will involve having a blood sample taken followed immediately by an injection of a radioactive trace. There will be two more blood samples taken the first two hours after the injection and the second four hours after the injection. The appointment is at 09:45 on 25th July but I need to be there 15 minutes earlier.
No information received about the biopsy so I 'phoned Mr Logue's secretary. She told me that she had arranged it all but was not aware that I was expecting a call. The bed is booked for 12:30 on Monday 23rd July and the biopsy for 10:30 on Tuesday. The scanning department had originally booked me in for 31st July and there is a possibility that I'll get a letter advising me of that although they have tried to stop the letter going out. I should get a letter about the scan on the 24th July in the next day or so.
20 July 2007
Two letters from the Christie Hospital. One was confirming admission at 12:30 on Monday, 23th July. The second was confirming details about the biopsy appointment on the 24th July at 09:40. The biopsy will be taken with an Ultra Sound scan at 10:00.
23 July 2007
Arrived at Christie hospital to be admitted overnight for the biopsy tomorrow. Blood samples taken then sent to Ward 4 and allocated a bed. Various questions asked about allergies, medications and recent illnesses. There was also a screening for MRSA swabs in mouth, nostril and groin. Then the usual periodic blood pressure, pulse and temperature checks.
I was in a four bed bay with two other men. The guy next to me had breathing difficulties and took oxygen and uses a nebuliser from time to time. The latter had a noisy motor. Later on I also found he snored. I spent my time doing crosswords and reading.
24 July 2007
I'll be returning to the ward after the biopsy. Made my way to the Pat Seed reception in good time and soon whisked off to the X-ray Diagnostic 2 waiting area.
The doctor explained the procedure and did a preliminary Ultra Sound scan. He also explained that the area of interest went from over the bottom of my liver, down over my colon and back towards my kidney. It could be an abscess as a result of an infection perhaps caused by an escaped gall stone or a mild attack of appendicitis. It could also be a tumour. Analysis of the biopsy samples will indicate which. After the procedure I will have to lie on my back for three hours then wait for another hour before going home.
Then local anaesthetic was put in my right side - three or four lots I think until the doctor was satisfied that the area was numb enough. He explained that there would be a sharp click as the biopsy was taken and to try not to jump. He took three samples and, having checked I was still OK, another. After the procedure I was taken back to the ward on a trolley then transferred to the bed using a board as a bridge.
I missed out on a good lunch as there was no way I could eat it on my back. So I has a salad bap instead. After more than three hours my lower back ached something rotten. It was a relief to sit up and walk around. At three o'clock my friend Derek picked me up for the journey home.
Although the area of the biopsy was still a bit sore I found I was able to lie on my right side during the night.
25 July 2007
Given a lift to the Christie by neighbour Sue. Three more needles. First in left arm to take a blood sample and inject the radioactive tracer. The second in my right arm two hours later to take another blood sample. The third a further two hours later for another blood sample.
The doctor will analyse the samples this afternoon. The amount of radio activity in the second and third samples will indicate how well my kidneys are filtering my blood.
7 August 2007
No contact from the Christie yet. So I called Dr Logue's secretary and left a message on the voice mail asking if the results of the biopsy had come through.
My call seems to have prompted some action. I had a call from the Christie advising me of an appointment with Dr Welch at 14:30 on Friday. A confirmation letter will be sent. I'll need to report to the main out patients' reception. It seems Dr Logue may be away.
Later DR Logue's secretary rang to check I had been given details of the appointment and to offer to ask one of the registrars to call me about the biopsy. I told her I would like her to do that.
8 August 2007
Early call from one of the registrars (didn't get his name). The official report on the biopsy is not yet available but it seems that a cyst is most likely out come. I asked if that meant that radiotherapy would now be an option. He said yes, but because the affected lymph nodes are in line with my kidney it would be tricky targeting the x-rays to avoid them. So on the whole chemotherapy is the preferred option. Both are effective in eliminating the last traces of the seminoma.
10 August 2007
Letter from the Christie confirming this afternoon's appointment.
I was seen by a doctor who confirmed that the biopsy showed no problems. I have been referred to Dr Welch by Dr Logue because the latter now specialises in the radiotherapy side whilst the former specialises in the chemotherapy. She also gave a slightly different slant on the reason for the change to chemotherapy from radiotherapy. Apparently if there are signs that the seminoma has spread from the testes chemotherapy is the preferred treatment.
The chemotherapy regime they will use to treat me is called BEP 3 Days. The treatment consists of the following:
This is repeated every three weeks for three weeks. For the three day BEP sessions I will be an in patient. The extra Bleomycin treatments are done as an out patient.
Before the treatment starts I will have a lung test, probably at Wythenshawe Hospital and a hearing test, probably at Withington Hospital. These are to set a bench mark and both will be tested after the treatment to see if either have been affected by the treatment a possibility. The BEP treatment will start on 29th August.
The doctor gave me a leaflet on the BEP 3 Days regime which describes it and the possible (some probable) side effects. These include reduced immune response (lowered white blood cells); anaemia (lowered red blood cells); proneness to bleeding (lowered platelets) these three all due to bone marrow suppression; hair loss; and nausea.
I think I'll make sure I have some before and after photo's to document the hair loss (and regain, hopefully).
16 August 2007
Letter from the Christie hospital confirming admission details for 29th August at 09:00, A bed has been booked on Ward 11A.
18 August 2007
Letter from Withington Hospital Audiology Department advising of an appointment at 13:30, Tuesday 28th August for the hearing test requested by the Christie Hospital.
20 August 2007
Letter from the North West Lung Centre, Wythenshawe Hospital advising of an appointment 1t 12:00, Wednesday 5th September for the Lung Function test requested by the Christie Hospital. This is a week after my chemotherapy starts, does this lessen it's validity?
This is fun! I checked with the chemotherapy suite at the Christie, they tried to connect me to Dr Welch's secretary but could not do so and gave me her number. I rang the secretary, she wasn't in but her stand in suggested I contact the NW Lung Centre direct, and if any problems to ring her back. I rang appointments at the NW Lung Centre. The lass who answered was deputising for the usual lass and could not find the paper work from the Christie although she confirmed that the 5th September appointment is in the diary. Without the paper work from the Christie a new appointment can't be made not that there are any slots available anyway. The lass will check with the usual girl tomorrow and get a new copy of the form from the Christie if necessary. I gave her my mobile number so that I can be contacted tomorrow.
21 August 2007
I called the NW Lung Centre this afternoon and spoke to the usual bookings lass. There are currently no available appointments before 29th August but she has me on the top of her list for any cancellations. I then called Mr Welch's secretary to bring her up to date. She said that, though not ideal, having the lung function test after chemotherapy begins is OK.
22 August 2007
Call from the NW Lung Centre to say that they have a couple of cancellations this afternoon and would I like to take one of them up. I selected the one at 14:00. The tests all involved breathing through a mouth piece into a tube whilst wearing a nose-clip. The tests were repeated to get consistent results. Mostly seemed to be filling and emptying the lungs, blowing hard, holding breath and breathing against obstructions. The results will be sent to Dr Welch at the Christie Hospital.
23 August 2007
A letter and application form about the Expert Patients Programme Living with a health condition. This is a free course run over six sessions on consecutive weeks. I'm not sure whether to take this up and will e-mail the organiser for more information.
27 August 2007
A reply to my e-mail to the Expert Patients Programme coordinator. The next courses start 11th September at 10:30 and 12th September at 12:30. The second one is definitely out because it clashes with my treatment. I'm inclined to skip the first one too because of the potential extra burden on Julie. I'll review matters in October.
28 August 2007
Visited Withington Hospital for the hearing tests. My right ear is much worse than the left for lower frequencies up to 1000Htz, slightly better between 1500Htz and 2000Htz and somewhat better between 3000Htz and 8000Htz, then about the same again for 12000htz. The measure of response of my eardrums indicate that they are both flabby with the right one a lot worse than the left.
29 August 2007
Arrive at Christie Hospital at about 08:50 and sent for blood test. This was done at about 09:10. At about 10:30 taken up to the ward. Treatment cannot start until I have been through the consent formalities which have to be administered by a Registrar level doctor. There won't be one available until 12:30 and I'll need to go down to her clinic in the Radiography Department. I consequently miss a good looking and lunch and have to settle for a rather nice beef sandwich.
The cannular for the drip is fitted at 14::30. Blood pressure and temperature measured at 14:45. Ward round doctor sees me at 14:50. Anti-sickness medicine and steroid administered via the cannular. 15:10 and first infusion of Etoposide begins. 16:00 briefing from Chemotherapy nurse very informative. 16:15 first infusion finished. This is followed by an infusion of salts for a couple of hours, then more Etoposide, more salts, Cisplatin and more salts. The drip is removed at about 00:50 next morning.
While I'm having the treatment a track of my liquid input the infusions, and drinks and output urine is measured. This means I need to pee into a bottle.
The main points of the briefing from the Chemotherapy nurse were the paramount need to avoid any infections and the rapid reporting if any is suspected because the chemotherapy will greatly reduce my bodies ability to fight them. It is worth having a bag ready with essentials just in case as in the event of an infection emergency admission is likely. Should there be no beds at the Christie Hospital I'll have to go to Stepping Hill A&E. I was given a special emergency card to advise the A&E doctors of my condition and steps to be taken.
30 August 2007
The second day's chemotherapy does not usually start until 24 hours after the start of the previous session but as I started late mine will be brought forward a bit today and tomorrow but even so I will not be out until Saturday morning rather than Friday night.
09:45 Consultant round for a chat.
11:25 Weight and blood pressure checked. Weight 82.4Kg. BP 151/69 (was 147/72 last evening). The high systolic probably due to retained fluid. The extra couple of Kg could be too, I suppose.
12:45 Plumbing connected up and a half hour flush followed by Bleomycin, salts, Cisplatin and more salts.
15:00 formal attendance checks (should have happened yesterday)
16:25 Next couple of outpatient appointments booked for 10:15 on 7th and 14th September Blood will be checked and Bleomycin infused.
23:50 Infusions complete and plumbing removed.
31 August 2007
09:45 BP 119/72.
09:55 Weight 84.7Kg
14:00 Problem with cannular. I caught it on my dressing gown sleeve last night and it is no longer in the vein. Nurse puts another on in my other hand but it doesn't work. Calls another nurse to have a go. She tried another vein in my left (the first) hand but it is by a valve so cannot be used. Eventually fixes the cannular to the equivalent vein in the right hand.
14:45 Plumbed up and ready to go. Flush , Etoposide then 16 hours of salts.
1 September 2007
07:30 Plumbing and cannular removed. BP 124/79
10:30 BP 156/84. Weight 89.4Kg
11:40 Checked by duty doctor and told I can go as planned.
12:00 Leave and wait for lift from Andy outside. I take with me two days of anti-sickness pills of the sort I've had morning and evening during the stay and another packet of different anti-sickness pills to be used if needed. I also took a discharge notice for my GP.
17:48 Check BP at home 139/84.
2 September 2007
07:30 BP 124/75, Weight 85Kg.
About 13:10 Visit from District Nurse to introduce herself and check some things out. It is normal procedure for the hospital to advise of patients undergoing chemotherapy in their area.
7 September 2007
Outpatient's appointment at the Christie Hospital. Andy took me in and I arrived early. Blood removed for testing at 10:00, then back to general waiting area. After a some while taken to the doctor's consulting waiting area where I was weighed 80.4Kg. Eventually saw Dr Welch at about 12:00. Blood count fine all looking OK. Given notes and sent to Chemotherapy Suite. I was told there would be a bit of a wait and was offered a pager so that I could wander off and be recalled. I decided to stay. Cannular fitted at 14:00 and first infusion soon afterwards. After the Bleomycin there was a ten minute flush with salts (I suppose) then all finished.
14 September 2007
Outpatient's appointment at the Christie Hospital. As last week, Andy took me and I was early. Blood taken at about 10:00 again. Already Dr Welch's clinic was running 60 minutes late. In another 40 minutes it was 90 minutes late. I eventually saw one of the registrars at about 13:00. All was fine until I told him my temperature had been high for periods over the last three days. He took this very seriously, chided me for not calling the hot line and said he wanted to admit me. After discussion with Dr Welch (and possibly because of lack of beds?) it was decided to go ahead with today's chemotherapy but to also put me on a course of injections to boost my white blood cell count and a course of antibiotic tablets. The first injection to be done by the nurse in the chemotherapy suite that attends to me. My blood pressure and temperature (37.6C) was taken by a nurse who also handed me the perscription for the injections and tablets along with my notes. She also told me that it was arranged for the district nurse to carry out the rest of my injections at home.
Then along to the chemotherapy suite where I was told that I needed to go to the pharmacy to get the perscription filled myself. They will give me a ticket and tell me how long it would take, usually at least 40 minutes, but not to worry because I'd still be back before they'd be ready for me. The pharmacy said to allow an hour. So I went off for a coffee. When I returned to the pharmacy the medicines were ready. I had a short wait in the chemotherapy suite then they were ready for me. The nurse that attended to me asked if I had been told that a side affect of the white blood cell boosting medicine was pain in the bones. If I had I'd forgotten. The chemotherapy infusion was finished and plumbing removed at about 17:00. Andy picked me up on his way home from work.
15 September 2007
The medicines appear to be working. I'm feeling a lot better and my temperature is down to 35.7C. Unfortunately the bone pain has started in my lower back. I can use paracetemol if it gets bad. A district nurse came round at about 11:00 to give me my next injection. It will be a similar time tomorrow. Took a couple of paracetemol caplets at about 15:00 and once they kicked in the pain was much reduced. The down side to the antibiotics is that I must avoid milk for four hours before taking them and two hours after doing so. So, as I'm taking them at 0700 and 19:00, no breakfast cereals or porridge and black tea.
19 September 2007
Back to the Christie for second round of chemotherapy. Second in line for blood to be extracted at about 09:30. Taken up to the ward at 10:50 same ward same bed as last time. The volunteer who took me up left my notes with me rather than at the ward desk, though she did announce my arrival. Because they didn't have the notes the ward administrators were not aware that I was there so didn't get taken to the bed until after lunch, 12:40.
A nurse did the check-in stuff at 13:30 and also took BP (115/71), temperature (35.8C), pulse and weight (79.5Kg). The cannular for the infusions was fitted at 13:55. At 14:15 Dr Welch and others came round. Blood count not yet checked. The doctor said that I'd probably be given another course of the white blood cell stimulating injections at the end of the treatment as a precaution.
Infusion starts at 14:50. The delay due to a shortage of pump/regulators. One hour of Etoposide, followed by two lots of two hours of Cisplatin and four hours of salts. 01:08 plumbing removed.
20 September 2007
10:00 Doctor round, confirms that I will be given the white cell boosters. 10:10 BP 143/83, temperature 36.2C, weight 81.2Kg. 14:15 Infusions start Bleomycin half hour, Etoposide one hour, Cisplatin two lots of two hours followed by four hours of salts. 01:25 unplumbed.
21 September 2007
12:05 BP 134/81, temperature 36C, weight 84.4Kg. 15:15 infusion starts Etoposide one hour followed by four lots of four hours of salts.
22 September 2007
08:35 unplumbed at last (during breakfast). 08:45 cannular removed. 09:20 get first of the white blood cell boosting injections. The district nurse will do the next four at home. 10:07 BP 140/79, temperature 35.5C. Time to leave.
28 September 2007
Outpatients. Blood collected by 08:55. Doctor seen at about 10:30. Platelet count low, but OK to go ahead with the Bleomycin. Collect a pager from the chemotherapy suite as there is a bit of a queue. Recalled to the suite at about 12:30. First attempt at fitting cannular fails some leakage. Second attempt OK. Finish at 14:00. Smoothest that outpatients has gone so far.
05 October 2007
Outpatients. Blood collected by 08:55. Doctor seen at about 10:30. Platelet count improved, but red count on low side. OK to go ahead with the Bleomycin. Wait in the chemotherapy suite as the queue is not large but medicine not yet delivered. First attempt at fitting cannular fails no blood flow back through extension tube and resistance to input.. Second attempt OK. Finish at before 14:00. as good as last week. Second cycle of chemotherapy complete.
10 October 2007
Arrived at the Christie Hospital just before nine and was first in line for blood taking. Up to Ward 12 this time at about 10:00. As before there was a hold up. This time the script for my chemotherapy had a start date of 12 October so nothing was ready for me. A doctor altered the script and the infusions started at 15:00. The sequence of infusions the same as previous cycles. Unplumbed at 01:50.
11 October 2007
Dr Welch came round. Confirmed that I'll be given GCSF (white blood cell booster) injections again this time. He also told me that the next scan will be at the end of November earlier than I had expected. Lung function and hearing tests to follow (if scan OK I presume). Towards end of infusion the cannular was looking a bit dodgy some evidence of leakage of blood but no blistering so it was removed.
12 October 2007
It needed three attempts to get a new cannular in satisfactorily. This delayed the infusion a bit and it was not until after breakfast the next morning that it was finished and plumbing removed.
13 October 2007
First of the GCSF injections administered before going home. For some reason the request for the district nurse to administer the rest of the injections had not yet been sent out so the nurse said she'd get it faxed that morning.
14 October 2007
The district nurse usually comes between 10:00 and 12:00. As she had not arrived by 12:45 I 'phoned and left a message on the answering machine. I got a call back at about 13:00 and the nurse said she'd be round in about an hour. She was as good as her word. She gave me the injection then double checked the paper work the authorisation card from the Christie did not match the request form (I had been given a copy) the former having a start date of the 12 October rather than the 13 October. The care given and the staff at the Christie are excellent but the attention to detail on their administration seems at times to be quite poor.
19 October 2007
Arrived early and had given blood sample by 09:00. The doctor saw me at about 11:00. Checked in at the chemotherapy suite at 11:15. The chemotherapy process did not start until about 15:30. The delay was apparently due to the number of patients that had not been processed yesterday and had returned today they had priority. The senior nurse told me that they generally process 30% more patients each day than they are set up to deal with. Finished at about 16:15.
23 October 2007
Temperature high (37.6C) for more than an hour so called the chemotherapy helpline at Christie Hospital. I was asked to go in for a blood test. Just before leaving temperature was down to 37C. Admitted to Ward 2 where a bed was waiting. Temperature confirmed at 37C and blood was taken for testing. The junior doctor seemed keen to let me go home, but the Registrar did not want to risk me not being able to have my last chemotherapy on Friday because my white blood count was low. So I was transferred to Ward 4, with GCSF injections and antibiotics prescribed. During the night I passed out in the bathroom. When I came to I went back to bed.
24 October 2007
I told the nurse in the morning about my fainting episode. It was enough to persuade the doctor to keep me in for another night for observation. Temperature in the normal range. Another GCSF injection.
25 October 2007
Doctor tells me I can go home. Just after I have packed up she returns to say that she has just noticed that my red blood count is very low and I should have a couple of units given to me. I give another sample so that it can be checked against what they propose to give me. Apparently it is a bit more complicated than just getting the right blood type. The blood did not become available until the evening. Transfusion started at about 20:00. Each unit takes 3.5 hours. Eventually unplumbed at 04:00 next morning. I ask for the cannular to be left in for the chemotherapy later in the day.
26 October 2007
Down to Outpatients for chemotherapy. Blood sample taken by 09:10. See doctor at about 11:00. Chemotherapy process starts at about 15:20. It takes longer than expected because the flow stopped a couple of times seemed to be sensitive as to the position of my arm. All finished at 16:20. Should be nothing more until a CT scan in early December.
3 November 2007
I'd had a cold for a few days and in the evening my temperature went up to 37.6C then 37.8C. I called the help line at the Christie Hospital and they asked me to go in for a blood test. Went through the normal admission procedure then was asked if I had any objection to having a cannular inserted by a nurse who had not done one before. I agreed to this despite being doubtful that it would be used for its proper purpose. The nurse did well and got it in first time. Then used it to obtain a blood sample for analysis.
The duty doctor came round to ask the usual questions to see if there was likely to be an infection. She also checked out my lungs and heart with her stethoscope and said they were OK. I learnt a couple of things from the doctor. First, that I was right in my estimation that there was no point calling in because I had a cold nothing they can do with them. Second, that it would have been OK to take some paracetemol to reduce my temperature. My blood counts were fine and I was allowed to go home.
12 November 2007
Letter from the Christie Hospital giving details of an appointment for a CT scan on 6th December 2007 at 09:40. Rang Dr Welch's secretary to book an appointment with Dr Welch. The secretary will send a letter with the details in due course.
21 November 2007
Dr Brough's Urology Clinic at Stepping Hill. Appointment time was for 08:00. I was first in at 08:05. The doctor wanted to know if I had had any problems after the operation to remove the testicle. I said not and updated him with the treatment I had had at the Christie Hospital. He said he'd leave me in the hands of the Christie and that was that. All over in less than three minutes.
6 December 2007
CT scan in the Pat Seed department at the Christie Hospital. Appointment was for 09:40 but I arrived just before 09:00. Almost immediately I was checked in and given the gunk to drink over the next hour. The scan was with contrast so I had to have a cannular fitted so that the dye could be inserted. All progressed well and I was free to go at about 10:45. I need to chase up Dr Welch's secretary about the appointment to see him.
10 December 2007
Rang Dr Welch's secretary to check about an appointment with him. One is booked for Friday, 14 December at 13:40.
14 December 2007
Good news. The three lymph nodes that had enlarged slightly are all back to normal size. This doesn't guarantee that I am cured - there might still be some microscopic cancerous particles lying around but there's no way of telling except to wait and see how things progress. The normal plan of action now would be to return every three months for a chest x-ray, blood test and physical examination for the first year, the same every four months for the second year and the same every six months for the next three years. However, the doctor has asked me to return next month to have my blood checked as I'm still a bit anaemic - red blood count of 9.5 when it should be 12. This reduction of oxygen carrying capacity might be the reason for my apparent lack of fitness. The doctor will also arrange for my pretreatment tests to be repeated - lung function, hearing and kidney function - during the next two or three months.
28 December 2007
GFR kidney function test at the Christie Hospital. Same test as on 25 July.
11 January 2008
Outpatients appointment at the Christie Hospital. Red blood count up to 10.5. GFR result about the same as before treatment began. Hearing test is scheduled for 14th January at Withington Hospital. The doctor said he'd chase up Wythenshawe Hospital about the lung function test. Next appointment at the Christie will be 11th April.
16 January 2008
Hearing test at Withington Hospital. The test showed that I have lost some ability to hear high frequency sounds compared to the test back in August. It is not clear whether I will regain this ability but I doubt it.
23 January 2008
Lung function test at Wythenshawe Hospital. I told the nurse/technician that I had been anaemic and she said she had better check my haemoglobin as it could affect the results. The count was 11.5 up from the 10.5 on the 11th January. I will not get the results of the test until my next appointment at the Christie Hospital in April.
11 April 2008
Outpatient's appointment at Christie Hospital first of regular check-ups. Blood collected for testing and X-ray completed within half an hour of arriving. Called to consulting room at appointment time (a first). A registrar gave me a physical examination and told me that the lung function test was fine. X-ray also showed no problems. She will write to my GP with results of the blood tests. Next appointment 11th July.
11 July 2008
Regular check-up at Christie Hospital. The nurse had trouble taking blood from my right arm but the left arm was co-operative. The doctor was happy with the physical examination. I will be called in for a CT scan before my next appointment, 10 October, as it will be about a year since the end of the chemotherapy treatment. If the CT scan is not scheduled at least a week before the appointment, I am to rearrange the appointment to allow at least a week between it and the scan.
6 October 2008
CT scan with contrast at the Christie Hospital. All went smoothly.
21 November 2008
Check-up at the Christie Hospital – blood test, no X-Ray, physical examination. Dr Welch said that the CT scan was clear and that the period between check-ups will now be four months. Next check-up at end of March 2009.
27 March 2009
Check-up at the Christie Hospital. Usual stuff - physical examination, blood test and X-ray. No problems next check-up in four months.
31 July 2009
Check-up at the Christie Hospital. Usual stuff - physical examination, blood test and X-ray. No problems next check-up in four months.