Saturday, 28 September 2013

More fun with my PICC line

Ahead of last weeks chemotherapy I had to have a new PICC line inserted into my arm. Normally a PICC line is held in place with a dressing could a 'stat lock', but the skin on my arms has become sensitive to sticky dressings of any sort and I get an itchy, blistery reaction to them now. The previous PICC line, the one that seems to have caused my recent infection, had been stitched directly into my arm to hold it in place. The problem with stitching the PICC line in however is that it makes it difficult to clean the skin around the area properly, something that might increase the risk of another infection. This time around I decided that I would revert to using a 'stat lock' but that I'd have a layer of 'liquid skin' applied to my arm first so that the adhesive of the dressing wouldn't be in direct contact with my arm. I went ahead and had the PICC line fitted in this way a week and a half ago, unfortunately by Wednesday night this week it was clear that my skin was still unhappy with the adhesive and yesterday I had to go back to the hospital and have the PICC line stitched in place. Not an ideal situation but it'll have to do for now!
My most recent treatment cycle is going well and the side effects have been quite manageable, a little extra fatigue being the most persistent of them but that has decreased somewhat in the last couple of days. 
This is a great time of year for fungi, I like this shot that I got last week:

Thursday, 19 September 2013

Stephen Hawking & assisted dying

Stephen Hawking, the well-known theoretical physicist who has suffered from motor neurone disease for much of his life, has been in the news this week after speaking out in favour of assisted dying. Assisted dying is where a terminally ill person is helped to end their life by another person, usually a doctor or sometimes a relative. Hawking is quoted by the Daily Telegraph as saying:
"Those who have a terminal illness and are in great pain should have the right to choose to end their own life and those that help them should be free from prosecution".
Assisted dying is illegal in the UK though over recent years there has been increasing debate as to whether the law should be changed, this increased interest has been the result of some high profile cases in which those who wish to utilise assisted dying have sought legal guarantees that people that help them to die would not be prosecuted.
I am strongly in favour of a change in the law to permit assisted dying. There are undoubtedly many terminally ill people who would benefit greatly from the reassurance that would be provided by knowing that they could take control of the timing and manner of their own death and that anyone who assisted them would not be prosecuted. I have thought a lot about this since my diagnosis in 2011, to me the process of dying is more frightening than the idea of death itself.
The main argument against assisted dying seems to be the very valid concerns that vulnerable people could be coerced into consenting to have their lives ended or that some people might even use assisted dying as a cover for murder. These concerns could, I believe, be addressed through the implementation of a comprehensive system of safeguards. These could include restricting the right to assisted dying to a subset of terminally ill people chosen using criteria that provide the highest level of confidence that the wishes they express are really their own. Any law would also have to guarantee the right of medical professionals to decline to be involved in assisted dying if it is not aligned with their personal beliefs or ethics.
Another argument that is put forward by some is one based on religious grounds. I respect the right of others to hold religious beliefs and to use these to shape the way they live. However a change to the law would not force anyone to utilise assisted dying, a person with religious beliefs would be under no pressure to opt to end their life this way if they were to find themselves suffering from a terminal illness. They would, therefore, be completely free to follow their beliefs. As an atheist, I object strongly to other people trying to impose their religious beliefs on me, I respect their right to choose but ask them to respect my right too.
Another argument I have seen advanced against assisted dying is that palliative care has now advanced to the point where nobody needs to endure a painful and distressing end. I spoke to a nurse from our local hospice about this. She works day in and day out with people who are dying. She told me that even with the very best of care she could not say that people always had deaths free from pain and suffering. There could, she said, be no guarantees.
Assisted dying is legal in a number of countries around the world. According to the campaign group 'Dignity in Dying', the evidence from these countries shows that assisted dying laws with appropriate safeguards effectively address the concerns noted above.
If you are interested in supporting the 'Dignity in Dying' campaign for a change in the UK law you can find their website here.

Friday, 13 September 2013

Autumn Hare

I had a routine oncology appointment yesterday and finally got the radiologist's report from the CT scan that I had back on 16th August. I'd already been told verbally that it showed that the tumours are stable but I always like to get a copy of the report just to be sure there are no surprises lurking there. This time around the report confirms what I was told: the radiologists view is that the tumours have not changed in size or appearance since my previous scan back in May. This is really good news.
I will now have another three cycles of chemotherapy prior to my next scan, that should take me through into December. I will have my next treatment on Wednesday next week after having another PICC line inserted on Tuesday morning.
By way of celebrating the scan result Katie and I decided to go out to dinner at one of my favourite restaurants - Hudson's Bar and Grill in Bath. It specialises in steak, not the most healthy food for the body but certainly good for the spirits! By way of a double indulgence we also called in at the Salamander for a pint of 'Autumn Hare'. This is the seasonal autumn beer of Bath Ales, I think it's their nicest brew and I always look forward to it becoming available at this time of year. I only drink one or two beers a month so I'm very fussy about finding a pint that I really like!
With hospital stays and unfavourable weather I haven't been out with my camera these last few weeks. Here's a photo I like that I took a few years back showing the Empire Hotel and Pulteney Bridge in Bath at night. The bridge was designed by Robert Adam and completed in 1774.

Thursday, 5 September 2013

Home again

I'm now back home again after being released from hospital late this afternoon. I didn't see a doctor until around 5pm today so I had no idea until then that they were going to let me out. Since I was admitted on Tuesday night the nurses have been busy sticking needles in me as you can see from the fine assortment of dressings I'm modelling in the photo below:

They weren't doing this for fun of course and the various tests I had enabled the doctors to confirm that the latest infection was a reoccurrence of the one from last week, it is likely that my PICC line harboured some of the bacteria allowing the infection to flare up again once I came of the antibiotics. I've now had my PICC line removed to make sure I don't have the same problem this coming week. I'm on antibiotic pills for the next six days and the hospital have also told me that I need to call them immediately if I develop another temperature.
Whilst I was in hospital I finally received the result of the CT scan that I had back on the 16th August. I haven't seen the radiologist's report yet but I've been told that the scan shows that my cancer is stable - a positive result. The plan now will be for me to have another three cycles of Trabectedin. I was scheduled to have chemo this week but the doctors don't want to go ahead until they are quite sure there is no infection left, they are now scheduling my next treatment for the week after next.
Trabectedin can't be administered through a regular cannula so I'll have to have another PICC line inserted prior to my next treatment. I'm hoping the nurse who does this manages to find some better music this time around, she has very suspect taste if my last three PICC line procedures are anything to go by!
During my time in hospital I've had plenty of opportunity to catch up on my reading. I’ve just finished ‘The Norman Conquest’ by Marc Morris, a well written and informative book about a period in history about which I knew little. Well worth a read for anyone who wants to know whether King Harold really got an arrow in the eye at Hastings or the truth behind the story of King Cnut and his attempt to turn back the incoming tide.

Tuesday, 3 September 2013

Deja Vu

Katie here again. Unfortunately Paul is back in hospital with an infection. He felt unwell this afternoon and came home from work and took his temperature which was high. So, back off to the Bristol Royal Infirmary. They intend to remove his PICC line which can be a source of infection and then see whether his temperature drops. His neutrophil count has improved from last week which means his immune system is in better shape to deal with the infection. He may need intravenous antibiotics again but not certain at this point. Will post again when I have more news.