Tuesday, 17 December 2019

At least the eyes are ok.

Some good news, at least, in that we went to the Eye Clinic last week to be told the the MRI of my cranium found nothing of note. The swelling at the back of my left eye is resolving, too, and my pressures are well down. It seems quite possible that the enlarged blind spot was associated with sudden peaks of BP associated with occasional fits of vomiting I’ve had when I misjudged my dietary intake.

I’m to be seen in the clinic again in three months time – if the pressures are still down (and I’m still around) it may be possible to reduce the number of eye drops I have to use.

Otherwise, we just plod on. We saw the GP Laura Saunders last week, too, for a good session tweaking my drugs. Maxine the Macmillan nurse is coming tomorrow. I want to discuss pain control with her yet again, the slow release morphine doesn’t quite last the full twelve hours, no matter how much I take, so there may be scope to add in a neuropathic pain killer to the cocktail. The hospital bed has arrived and is installed in the spare bedroom. I’ve started using it already as I’ve been having some trouble with acid reflux (heartburn) in the night which is helped by sleeping with my shoulders propped up a bit.

Sleeping apart from Sheila, together with sleeping much more these days, feels like another slither down the slippery slope but we’re blaming all the morphine for now. Time will tell soon enough but meantime we’re both sleeping rather better.

Sunday, 1 December 2019

Up and down

As always, I’m starting by saying thank you to you all for your love and support, it means a lot to me.

Things are a bit quiet just now with no dramatic investigations – the next big event will be my next Eye Clinic appointment – it’s on Friday 13, but fortunately I’m not superstitious as it’s when we should get the results of the last MRI. In the meantime, I see a district nurse every two weeks and Maxine the Macmillan nurse in the intervening weeks. I see a GP every four weeks, too, so I can keep prescriptions sorted out.

It all means that queries and concerns can be dealt with without having to ring one of the various hotline numbers I’ve got.

Overall, I’m slowly getting worse, as you’d expect. It’s nothing dramatic, but my slow release morphine, Zomorph, has had to be increased a bit and I’ve had a couple of days when I’ve not got up in the morning. I won’t go into reasons, don’t want to get too clinical on here, but each time having a day in bed sorted it. Getting the diet right is the tricky bit at the moment. It’s good to try something different for a change – home made soup with a splash of cream works well, for example – but if I get it wrong my gut takes its revenge, usually several hours later.

Anyway, enough of that gloomy stuff. The other half of the family makes it across from Lincoln every two or three weeks, they were here yesterday for a few hours, and various friends from round the marina drop in for coffee or tea and a chat. What larks, eh?

Monday, 18 November 2019

Chugging on

The main events of the last couple of weeks were an MRI scan of my head including one of the orbit, the area around the eyeball, and a follow-up appointment at the Eye Clinic. The scan was a bit tedious, 45 minutes with my head in the washing machine. MRIs are very noisy, so they play some music down headphones while it’s going on. You’re supposed to get a choice of sounds, so I asked for some 60s pop, but they left the previous CD of very raucous rock on for most of the time. Not that it was much better when they did change over, it was nothing like my memory of the best ever decade for pop. And yes, I was there and yes, I do remember it.

Guess what, the results hadn’t come through by the following week when we attended out patients, but the Registrar did a very thorough review of my retinas and said that although there was certainly some swelling and a bit of a bleed there, it didn’t look sinister and will probably resolve of its own accord. I’m to go back in another four weeks.

It’s always good to be able to end these posts with another example of people’s generosity. As well as a load of transport, I’m very pleased to be able to say a big thank you to Grahame and Chrissy in the Still Waters shop. The most recent supply of food supplements, the Altrashot, the Fortisip Creme and the Complan, was a bit restricted as to flavour, mostly banana with a bit of strawberry. These are all very tasty, but all the banana in particular was becoming monotonous, a touch of a Minion diet. Sheila asked in the shop if they had any ice cream sauces in stock as a way of adding a bit of variety. They didn’t, but instead presented us with the open big bottles of sauce they keep for adding to the ice cream cones. They won’t sell much ice cream now and the open bottles won’t keep to the Spring. 

I could even have had the bubble gum flavour, but Grahame correctly sussed it wouldn’t have been popular...

Monday, 4 November 2019

Downs and ups

It’s been a mixed few days. I was rather poorly weekend before last, I won’t go into detail but by Monday night I decided I needed checking out. So, Tuesday morning I rang the contact number for the community team and after a few phone calls ended up with a visit from a GP Registrar who gave me a thorough checking out. He couldn’t find anything specific but on the basis of my symptoms started me on a five day course of amoxicillin. It’s not something they’d normally do in the absence of a proven infection, but in my case the risk of a trivial infection tipping over into sepsis before it’s declared itself is too high to take the risk.

In effect, I’m being treated as though immuno-compromised like a transplant or chemo patient.

Much more fun was Friday and subsequent days. I’m finding it a struggle to walk any great distance now, even though I’m a lot better after the antibiotics, so we’d talked about hiring a mobility scooter for the duration. Sheila emailed a fellow lodge owner, Dave, as his wife uses one having had a stroke. His response was not to bother hiring or buying, Lynn has a spare which I’m welcome to use for as long as I need it.

He brought it over on Friday afternoon and gave me a course on the care and feeding of mobility scooters. It’s an excellent machine, a type 3 which means it’s set up to be road-legal with a top speed of 8mph, though it can be set to just 4mph for use in pedestrian areas. With it, I can accompany Sheila and Sally right round the marina again. 

It’s just another example of the incredibly supportive community we’re living in here.

Saturday, 26 October 2019

Plodding on

I’ve not blogged for a bit as I’ve not got much more to say, except, as ever, to express my appreciation of all the messages of support, love and good wishes from you all. Main developments have been establishing contact with the district nurses and the community palliative care team, formerly the Macmillan nurses but now funded by the NHS around here at least. I’ve seen Dr Cowley twice now, first off to sort my prescriptions and then two weeks later as a follow up. She’s started me on Mirtazapine, a tricyclic antidepressant which has both improved my sleep and lifted my mood a bit.  She also wrote me up for some injectables, the “just in case” meds that live in a box by my bed together with the necessary paraphernalia for giving them. This means that if I have a sudden bad do of pain or nausea, an attending nurse or paramedic can give me the needed drugs without delay.

It’s all made us feel more supported – the nurses each visit fortnightly, so I see one or other each week, an opportunity to check out any problems and to get that all important psychological support. I’ve got a whole set of phone numbers I can call in the event of having a problem, day or night, any day of the week.

The other development health wise is with my eyes. I had a routine Eye Clinic appointment the other day. As far as my pressures go, all was well and I would normally have been discharged from that clinic to the care of my optician, but unfortunately, the fields test showed that the blind spot in my left eye had got larger. If this had been both eyes and I was also having severe headaches, one would suspect raised intracranial pressure, which would be alarming. As it is, it’s a bit of a medical mystery (here we go again!) which needs explaining if possible. Pancreatic cancer doesn’t normally spread to the brain, so this is not likely to be a secondary. I’ve had the usual routine bloods, which only showed that I’m still a bit anaemic, and I’m booked for an MRI scan of my head to look for causes. This isn’t until the 7th of November. Oh well, I’ve been missing all those trips to the Royal Derby.

Sunday, 6 October 2019

Not very good news, again

Things take a turn for the worse, I fear. I meant to write up the blog about this earlier but just haven’t got round to it now.

After having a CT scan two weeks ago to find out why I’m having trouble keeping solid food down, I was seen in clinic last Wednesday. It’s not good news, I’m afraid. The scan showed no obstruction of the duodenum, but there are several hotspots in my liver and the tumour is compressing one of the arteries that feed the colon, the superior mesenteric artery. This means I’m in stage 4, palliative care only, too risky to attempt surgery or even chemo. I might have several more months or things could go downhill quite quickly.

I’ve been referred to the community palliative care team and have been left with an open appointment to see the oncologist. I’m not in any extra pain yet so the blood supply to my guts must still be getting through, but obviously the danger is of ischaemia (lack of blood supply) causing tissue death in there with serious consequences that I’m slowly getting my head round.

As always, we’ve had loads of support from the Mercian community with visits, transport and all sorts of offers of help. For example, it’s boat shuffle month in the marina for the residential boats, but we’ve not had to do a thing, our fellow moorers moved Sanity Again with shafts and ropes to her new berth. I just had to take the credit off the old electric meter and put it on the new one, an advantage of the new smart card meters now installed on our pontoon.

I’ve got a GP appointment on Tuesday to sort out some tangles with my repeat prescriptions and to discuss the Respect form I completed in the clinic. This is a new scheme being rolled out across NHS districts for folk in my situation to record their preferences about the balance of quality vs extension of life and to take the Do Not Resuscitate decision (no point of it in my case, when the end comes, it comes).

After a few days of feeling panicky and depressed, I’m coming to terms with it all. I’m still watching Strictly so my first milestone goal is to survive long enough to see who wins.

Wednesday, 11 September 2019

Another little problem

I saw the oncologist yesterday, which was good timing as things have recently started to get a bit more difficult. I won’t bore or disgust you all with an account of the search for a laxative I can tolerate, suffice it to say that good old senna has proved to be best. I’m taking rather more Zomorph to keep the pain under control and opiates tend to slow your gut down, hence the need for a counteractant.

Unfortunately, on Sunday evening I found out the hard way that solid food isn’t going down well anymore. I’m currently living on a variety of fancy liquid nutrient products, like Complan but in small quantities. Dr Morangie, one of the GPs, had already written me up for some, fortunately, and I had a chat with a dietitian at the clinic yesterday to explore more of these. They’re all quite tasty and so far seem to be staying down.

Dr Shankland, the oncologist, is referring me for another CT scan to see what’s going on in there. The concern is that this is gastric output obstruction or GOO for short. The lump may have started compressing the duodenum, the bit of intestine immediately below the stomach, so that food can’t escape from the stomach in the normal way. The result is very like the problem some babies have, pyloric stenosis, which results in projectile vomiting. The short term answer is to do what I’m doing, survive on liquids, not too much at a time, so that it can find its way through slowly.

The long term answer is, guess what, another endoscopy, this time to place a stent in the duodenum to keep it open. I’ll see Dr Shankland again as soon as I’ve had the scan to discuss that and maybe actually start some treatment. I’ve not been able to put on any weight, what with one thing and another, so the chemo choices may be more limited.

I have to say that all this is finally getting through my mental defences. Being restricted in what I can eat and feeling precarious about my internal processes means that the phony war is over. What I think of as the beast in my belly is being more than just a bit of a nuisance, making me use Creon with my food and take morphine to keep on top of the pain. It’s showing its teeth now, becoming life threatening in a very real way. If it gets to the point where I can’t keep fluids down I’ll start to dehydrate and will need admission for IV feeding.

Still, there are positives. We’re going to get to the Braidbar Owners’ Weekend this weekend, staying in an Airbnb house in Poynton with Elanor and Sally. It’ll be good to get away from Mercia for a change of scene for a few days, though of course we continue to be hugely grateful to all the Mercians who give us so much support.