Week 30-31 – A little dentistry

First, a little (very dark) humour:


Ok, on to a little more interferon experience...

I went into a clinic for a couple of hours to have a wisdom tooth removed. Although it had not developed into a serious abscess, it had been worrying me for a couple of weeks, and my dentist said it was time-bomb waiting to go off. I could have waited a while longer, but if it had developed further it would have been more serious. So we went ahead with the next available slot.

As I have described previously, one problem with interferon treatment is that some of the blood counts get depressed. The white blood cells are produced in the bone marrow and this process is interfered with. The effect is to reduce the body’s ability to respond to infections. Also, the platelet count drops, and this affects the ability of the blood to clot, and may make bruising more likely. The red blood cells are also affected – I think this is why one feels weak and light-headed / dizzy at times.

The bottom line of all the above is that surgery is best avoided while on interferon. There is an increased risk of bleeding, and one has to be careful that infections are not introduced.

It is interesting that each doctor has a different view – presumably informed by their specific experience. For example, I was told that it was possible to provide platelets in a transfusion. However, the dentist and his anaesthetist did not like the idea of introducing any blood products while my white cell count was depressed.
Also, I was told that surgery was inadvisable with a platelet count below 100. But these guys were quite happy with my count of 84.

So we went ahead, and I was in and out of the clinic before lunch.

Although I felt quite good after the surgery, the next week was not so good. I suppose it would have been OK if I did not have to continue with the interferon injections. And the antibiotics they gave me may have also contributed. I felt pretty lousy after each injection, and took longer than before to get back to ‘normal’ again each time. I took a whole day off and read two detective stories on Thursday last week!

Today I am almost back to normal, whatever that might be.

I also realized today that I have been neglecting my regular exercise. For the last couple of weeks I have been working hard on a consulting job, and it is so easy to carry on at my desk rather than get up and walk the dogs. I have to change this – My priority should be my health, and everything else should take second place.

Week 29 - Celebration and a minor challenge

I see that my numbering for blogs got a little out of sync, so this post brings the numbering back into line. That's the danger of writing in the middle of the night, especially after an interferon injection...

First, the Really Good News: This morning I went off to the local clinic for chest xrays and ultrasound scans. As I have been feeling particularly good lately, and there have been no new side effects, etc, I have been quite positive and optimistic. But of course, there is always the possibility that some mets start growing.

Well, anyway, both the xrays and the scans came up completely negative! I had a good chat with the radiologist who did the scans, and he showed me everything he was looking at. He picked up a small cyst in my liver, but I know about that - It's been there for years and doesn't seem to have any significance.

So, Really Good News.... Jocelyn and I plan to celebrate with a small glass of champagne this evening, and possibly with a larger bottle tomorrow evening! Definitely a good excuse to celebrate.

As to why we are not doing a PET/CT scan again: That is another longer story, which I may write about next week. The simple answer is that PET/CT scans are still very expensive in South Africa, and the medical aid funds are still sorting out their policies.

And then another minor challenge has crept in to the picture. I started having a slight toothache about a week back. I hoped it would not be too serious, and I put off seeing my dentist - All health issues seem very important to me, and whatever I may say, I worry about them! I suspected that the root was infected, and that it would probably have to come out. As this tooth is a wisdom tooth, and it's opposite number was removed a long time back, it is not performing any useful function.

The problem is that surgery is not recommended while one is under interferon treatment, because of the depressed blood counts. Generally the anaesthetist will not want to go ahead if the platelet count is too low. My onc is out of the country, making the decision more difficult!

So, after chatting to my GP, we agreed to do another full blood count and then decide what to do. It is quite practical to do a platelet transfusion to boost the count temporarily. So I have put all of this in motion and we will see how it works out.

But the bottom line is that I have been doing quite well, and feeling quite good. I have been walking regularly with the dogs, and even made the gym a couple of times. So it seems this will not be a real challenge. The only problem is scheduling surgery to fit in with the interferon schedule, and the work time I will lose - I am working on a small consulting job which has a very tight deadline.

Until next time

For Kim-from-Iowa

I started reading your blog a few weeks back, and have only just started to get to know you. When your latest update appeared on Holly’s blog a few days back I wanted to write to you. You are constantly in my mind, and I seem to think of you a few times each day. I don’t know if that qualifies as prayer, but I sure hope so.

I battled trying to decide to write to you. You don’t know me from a bar of soap, and I am only now learning about you. But having decided to write, here goes…

Kim, what can I say? You have been so positive over the last years. The position you are in now has not been for want of trying – You really worked hard at doing the right things, learning about this mel guy, and doing everything to keep him at bay.

I am pleased that you have so many friends and family to support you. I wish them strength to provide support all the way.

We know not where we are going, or when. We know only that we have to move on in the circle of life. My wish is that your future is filled with hope, as you have lived your life.

Alfred, Lord Tennyson wrote these words in The Passing of Arthur.
Right at the end, Arthur says:

“But now farewell. I am going a long way
With these thou seëst--if indeed I go--
(For all my mind is clouded with a doubt)
To the island-valley of Avilion;
Where falls not hail, or rain, or any snow,
Nor ever wind blows loudly; but it lies
Deep-meadow'd, happy, fair with orchard-lawns
And bowery hollows crown'd with summer sea,
Where I will heal me of my grievous wound."

So said he, and the barge with oar and sail
Moved from the brink, like some full-breasted swan
That, fluting a wild carol ere her death,
Ruffles her pure cold plume, and takes the flood
With swarthy webs. Long stood Sir Bedivere
Revolving many memories, till the hull
Look'd one black dot against the verge of dawn,
And on the mere the wailing died away.

I wish you all love and peace on your journey.

Peter

Postscript:
On October 9, 2006 Kim-from-Iowa passed on, in the company of Mary and Charlie. The number of postings on http://www.mpip.org/ has almost reached 100.

I never did speak to Kim. But I am richer for having known her story, and hope that I can be as positive and brave as she has been.

RIP

Week 26 - Half way there!

I have not posted for the last couple of weeks for a couple of reasons. For one, I got a small consulting job with a very tight deadline, and I had to dedicate myself to the work. It's not yet finished, and for the next couple of weeks I will have to concentrate all my effort on this job. One thinks that one has all the time in the world, but working at home has some disadvantages... I need to do shopping, deal with the pool, look after my vege garden, walk the dogs.... Not to mention three days a week when I don't feel quite up to scratch due to the interferon!

Also, I took off five days to visit my parents. My Dad is 91, still fit and well, but getting older and slower. This trip involved my first 2 hour flight since starting interferon, so it was a bit of an experiment. How would the airline handle my medication kit? I am not prepared to put it in my checked luggage, as the stuff is damn expensive. So I called the airline and they said I should get a letter from my doctor. I got a letter from the oncologist, and then discovered at the airport that they were not even interested in it, and I sailed through the checkpoints without any hassle. So much for increased security!

And this Sunday we are holding a Spring Party for all our friends. We last did this about 20 years back, and it seemed a good time to do it again. Our garden now has a lot of shade, and the weather has warmed up. The pool is still rather cold, as it is shaded by a large tree, our very first Christmas tree! It was a mistake to plant it in the garden, and now that it is there I am not allowed to take it out! The party will be on Sunday morning, with champagne and orange juice, bacon, eggs, sausages, wheaties, yoghurt, fruit salad..... I'm really looking forward to this one.

And the interferon just goes on. Its getting rather boring, but I suppose that's exactly what one hopes for. Later this month I need to go for an xray and some scans, and see the oncologist again.

So, ciao until next week.