Archives: Antibiotics

Today has been a pretty impressively brilliant day.

It was another Harefield appointment, my first in six weeks after MC told me that it was a bit pointless coming back until they had clear data on whether my CMV had retreated for good or not.  So he had sent me away with instructions to send in bloods every 2 weeks to keep a check on things and that if I hit the 3 month mark with no adverse effects or without showing anything above a zero on my CMV then he’d take me off the Valganciclovir I’ve been on since May and see if my body will cope without it without submitting to CMV again.

Seeing him today with a month-and-a-half of clear results, he was suitable pleased and happy for me to drop my Valgan and continue with everything else, albeit being very much more aware and careful about the first signs of CMV infection, necessitated by the fact that CMV can very rapidly kick-start rejection of the not-very-good kind, which could do my serious damage.

That said, though, he came out with something I wasn’t expecting to hear at all.  Although I may feel like I’ve had a fair number of blips, he thinks I’m doing incredibly well and – going by his experience of CF patients post-transplant – thinks I now stand a better-than-average chance of 5-year survival.

At the time of my transplant, I was quoted statistics saying that 73% of people make it through the first year, and within that 27% that don’t are included people who may die on the table or suffer serious post-operative complications.  Once you stretch the survival period to 5-years, the odds stand at 50/50, but MC now believes that for me the benchmark can be shifted from 50/50 at 5 years to 50/50 to make 10 years.

Another decade of life is better than I think many of us dared to hope.  I said before my transplant if I’m given just six months of a new life I’d be happy.  Time enough to play with my Godsons, experience the things I’d not been able to do for breathlessness and lack of energy, learn to do things on a whim again.  Having slipped past that stage back in May, albeit in the middle of a CMV/EBV attack, I’ve felt contented with my lot, whatever is thrown at me next.  To know now that there’s a very real possibility of a future worth planning for is too incomparable for words.

I’m aware every day that someone, somewhere has lost someone they loved very dearly.  I just hope I can make enough use of the extra time I’ve been given to show them what a truly wonderful gift they have given not just me, but my family, too.

It’s taken me a while to get around to writing about my admission for two weeks almost a month ago, but that’s because I’ve still not really managed to wrap my head around the whole deal.

The two weeks I spent on the ward in Harefield in the middle of May were the hardest two weeks of “inmate” time I’ve spent for a long time and I’m not entirely sure why. Perhaps it was something to do with being on an open ward, something I’ve only experienced once or twice in my life, despite numerous, often lengthy, hospital admissions. Perhaps it was because I was missing out on the holiday with a big group of friends that K and I had been planning for close on 3 months.

Above everything, though, I think I struggled more than I have for a while because something in my brain told me I was passed all this. My new lungs have had an amazing start. A minor hiccup after 2 weeks not withstanding, they’ve gone from strength to strength and my lung function has been steadily rising, my exercise tolerance going with it. I even completed the famed last mile of Tresco with my brother and started entertaining thoughts of doing the whole thing next year.

So I suppose I had kind of taken my eyes off the post-transplant complications ball and started to enjoy life without a second thought for whatever else was going on, assuming everything was tickety-boo. Which is, I suppose, a lesson in itself. While new lungs mean great new things, you can never take their health for granted and even though I’d been booming for the last three months, it doesn’t take much to send the body reeling.

The chest pains I’d been worried about were initially diagnosed as Gastritis, but when I saw the team at Harefield I had managed to spike a good-looking temperature to go with the pain and nausea, leaving them little choice but to admit me. For the first 24-48 hours the cause of my ailments seemed a mystery to the docs, until they got my CMV count back, at which point they were more contented, knowing that they knew how to deal with it now that it had been properly identified.

There’s something disconcerting about being given drugs intravenously which are so toxic the nurses have to wear gloves and the pregnant women aren’t even allowed to touch the packaging. Knowing they can’t go near while you watch it being pumped into your veins is pretty bizarre and something I’ve never got used to, despite a history of high-caliber potions in my time.

When I was moved to the open ward, which happened to coincide with K’s departure on the holiday with our friends (at my insistence, I must add, and under considerable duress) and I dropped into a pretty deep funk. It’s the lowest I’ve been since the darkest days of the early post-transplant period and there didn’t seem to be a whole lot going for me at the time.

I’m slightly ashamed of myself now for letting it all get on top of me so much, since at the end of the day I was still a good deal healthier than I had been not 6 months ago, but for some reason (or, I suppose, a myriad of reasons) I couldn’t raise my spirits at all.

Luckily, at Dad’s suggestion, I managed to secure a weekend release while the guys were all away. The ‘rents agreed to drive me in for my doses of anti-biotics twice a day, but I was free to go home for food, rest and over-night sleep, something I’d been getting very little of on the ward, what with the world’s loudest talker on one side and the telly addict on the other.

Eventually, thank goodness, my consultant, the amazing Doc C returned from his paternity leave in the middle of the next week and on his first round of the day told me I was free to head home as they expected my viral load to be low enough to no longer necessitate the use of the IV drugs, enabling a switch to the more home-friendly orals.

I hadn’t been happier than that afternoon when I got back to the flat just after K returned from the holiday and we could just chill out on the sofa and enjoy each other’s company again after nearly a week apart – pretty much the longest we’ve spent away from each other since we got together.

Getting used to the ups and downs of transplant is clearly taking me longer than I thought it would. My mind appears convinced that things can only go well, so any minor hiccup is a bigger deal than it ought to be because it carries with it something of a heavy shock value. I need to keep reminding myself that it was only 6 months ago that I had new lungs fitted and that I still have a way to go to fully recover, however good I may feel right now.

So I’m trying to take things a little more slowly, although how long that will last we’ll have to wait and see. The main thing for me at the moment is doing what I can to avoid what Doc C affectionately calls the “Superman complex”, whereby people (mostly men) post-transplant start to see themselves as indestructible and slacken off their meds and treatments. It’s hardly the way to say thank you for the greatest gift of all, so I’m determined to stay away from it and keep myself at my best.

Hi, this is K, Oli’s parents have gone away to Luxembourg for a week so to coincide nicely with that Oli has landed himself back in hospital.  He did the same thing in January when they went to Rome.  If I were them, I’d be a little concerned about booking any more holidays!

Oli has gone in today because his stomach/chest pains haven’t really gone away, they kept him there because he decided to spike a temperature as well, I think I’ve said before that if Oli is going to do something he’ll do it well.  It shouldn’t be a long stay for him, the main aim is to get him re-hydrated (he hasn’t eaten or drunk anything for a few days due to pain), get his temperature down and they’re giving him some anti-biotics as a purely precautionary measure.  Blood cultures should come back in the next day or two and they’ll tell if he’s growing anything but the general opinion is that sleep and fluids should make Oli a happy boy again.

In other littler news, a few of you might like to know that I got accepted to City University yesterday to start a Speech Therapy degree in September, I am ridiculously ecstatic and thought you might like some happy news to temper the hospital news.

I’ll fill in with updates once results have come back from blood tests, etc.

Was back at Harefield today for my first clinic flying solo. Up to now I’ve been along with Mum or Dad and maybe K in tow, too, but now I’m more mobile and – more to the point – can drive myself comfortably for an hour or more (just), I can finally let Ma and Pa go about their usual daily business. In other words, they have to stop skiving off work to run me to the hossie.

What was even better about today (barring all the medical stuff, which I’ll come to in a bit) was that after our experiment with popping into Town last week, I took myself off on the train after the morning tests and got to have lunch with a really old school mate, who’s working for a record label near Archway. It was brilliant to see him and catch up – both of us feeling really happy about our lot in life at the moment, which not only makes a change (for me, anyway) but makes for a refreshingly up-beat and happy little luncheon.

Back at the big H, I saw the main man himself for the first time in a few weeks, which apparently worried him, because you only normally get passed to him if there’s something wrong.

As it happens, there’s not – he’s even given me such a clean(ish) bill of health I don’t have to go back for four weeks(!), barring unseen complications on my part. It’s amazing to think that just 3 months post-transplant, I’m already in a place where my docs are happy for me to stay away for such a prolonged period of time.

The down-side to it is that my lung-function doesn’t appear to be following the usually predicted improvement curve that he would be expecting to see at this stage. Whether this is left-overs from the Organising Pneumonia or signs of something potentially more sinister, he’s not sure.

The big issue with the O.P. is that it can take a long time to resolve (hence the 6 weeks of high-dose oral steroids I’m on at the moment), which means it’s pretty hard to detect if there’s anything else happening. The good news is that the biopsy from my bronch a couple of weeks ago is definitely negative for any signs of rejection and there is also very little or no sign of infection, which are the two main dangers right now.

More likely than not, the plateau in my lung function is a by-product of the O.P. and as that clears up over the next few weeks, my lung function should start to creep back up towards the predicted curve that they would hope and expect to see. Going to the gym and getting more exercise, putting weight on and generally getting stronger should all help that. Since it’s a bit of a waiting game to see how it progresses, that’s why they are happy for me to head off until the steroid course finishes and they can have a proper look to see if everything’s resolved.

For the time being, he’s kept me on some oral antibiotics and added in a second immunosuppressant to try to discourage rejection should there be any lurking or even thinking about having a bit of a lurk. It does make me mildly more susceptible to colds and infections and things, but not to such a degree that it should mess with too many of my plans. The main thing is I can still go to the movies…

All in all – beyond the slight concerns over the plateau – it’s been a good day hossie-wise. In terms of independence and self-confidence, it’s been even better. For the first time since my transplant, I really feel like I’m fending for myself and reaching a level of true independence and it feels amazing. I’ve not known this kind of freedom for a really long time and boy is it good to have it back.

Back in the olden days of years ago, I distinctly remember plaguing my parents with moans about being made to walk far too far and the whole lark giving me sore feet.  Today, after over an hour wandering the shopping centre in Uxbridge (more on which later), I turned to Mum with an enormous smile on my face to declare, “My feet hurt.”

I’ve not done enough walking to make my feet hurt for pretty much as long as I remember.  There must be a time, three or four years ago, when I’ve been on shopping sprees with K in the days of our simple friendship, which ended with me having sore feet, but it really must be that long ago.

In the four-hour wait between tests and seeing the doc at clinic today, Mum and I decided to head off and explore Uxbridge, which is only a few miles down the road from Harefield. We found our way – surprisingly easily – to the main shopping centre and spent a good two hours browsing around and taking things in.  Unfortunately for my bank account, “taking things in” also included “putting things in bags” and since most shops are reluctant to let you bag things up without paying, my wallet came away a fair bit lighter.  That said, my wardrobe is now a fair bit fatter.  Or will be when I make room amongst K’s stuff for my new additions.

Clinic went really well, with my lung function up, weight up, X-ray clearing up nicely, all other obs stable and doing well.  My CRP was up ever-so-slightly, but we think that may be due to the semi-cold I have been suffering this week; it never fully developed but I’ve had the snuffles on and off since Monday.  The doc gave me 2 weeks of oral Zithro to ward off any nasties that may be lurking, but I think it’s unlikely that anything’s going to come of it – it’s more a protection measure than anything else.

The last few days have been such a joy – doing all sorts of things that I haven’t done for ages and just starting to feel normal again.  Today we finally managed to catch up on Christmas with K’s brother, which has been delayed and delayed after my stays in hospital and a combination of them and us not being well enough for us to meet up (bearing in mind I still have to do my best to avoid anyone with colds or bugs).

It was great to see not only them, but their new house too – a 3-storey affair which I’ve now got the lungs and the legs to enjoy a proper tour of.  Not only that, but discovered my fitness levels are also now up to the Nintendo Wii.  Dangerously addictive, that machine.

I think the most amazing thing about the last few days is being able to do things without thinking.  There’s no moment’s pause between the impulse, need or desire to do things and actually getting up to do them.  For so long I’ve been used to working out all the ramifications of what I’m about to do and how much it’ll tire me out, how much O2 I’ll need to take with me, what I need to save my energy for later in the day and everything else.  Now, if I want to do it all I have to think about is whether I have time to. (And possibly whether I can afford to….).

I honestly can’t believe how much my life has totally turned around and the fact that this is only the beginning fills me with the kind of excitement I haven’t known since I was a child.  It feels like the whole world is opening up to me and all I’ve got to do is reach out and grab it.

So here I am with my butt parked in the very same room I was sat in almost precisely 8 weeks ago waiting to be told my life was about to change forever.

Thanks to the wonders of the now famous (or is that infamous) Norovirus, F-East ward of HAREFIELD beckons again. I don’t remember my last visit here being quite so deeply involved with vomit and isolation, but there’s a weird sense of calm and good omens that comes with being back where my journey began two months ago.

As it happens I don’t think I’ll be here much longer – I was admitted yesterday mainly so that they could give me IV fluids through a drip to replace all the stuff my stomach was resolutely rejecting and sending back out from whence it came, and also to give me my immunosuppression IV as well since there was no chance of me absorbing the oral pills.

I’ve a bit of an infection rearing its head in my chest, but that’s much to be expected when I get knocked back at the mo, and should be easily sorted by a short course of antibiotics which shouldn’t keep me in here.

K has written a nice pleading note to the docs in Scrabble tiles (we couldn’t find any paper) so I’m sure doc C is going to be convince by her superior medical knowledge and eject me straight from his rounds in the morning.

Watch this space, I guess…

I had a true yo-yo day today.

Clinic visits at Harefield run something like this:

Morning (around 9.30) – Arrive, register, sit and wait for 5-30 mins (depending on busyness), go in and have bloods done, get weighed and have obs checks (blood pressure, pulse, oxygen sats etc).

Get given cards to take to lung function (or RFTs as it’s known in-house) and X-ray and/or any other tests they may require up to and including ultrasound, ECG, CT scan etc.

Finish off those tests and report back to reception, where you are given a rough time to return in the afternoon, sometime after 2pm.

This morning, I had completed all required checks and balances (to great satisfaction – RTF going up, X-ray looking good) by 10.15am, and returned to be told that Doc C would get round to seeing me around 3.30pm, but to be back by 3 in case he ran early.

For those of you not too quick at maths, that’s well over 4 hours.  I looked at Dad and he looked at me.  Jokingly, I offered up, “Go home for lunch?”

On more serious consideration, however, we realised that if Doc C were running late when we came back, we’d not be back in MK in time to get to the GP surgery to pick up my prescription I needed and collect it from the pharmacy near my ‘rents house (the great little place that sorts all my druggy needs).  On further thought, it occured to us that the 45min-1hour drive it would take to get back home, plus hour-and-a-bit to do what we needed to do, including lunch, plus the drive back still left us with a good half hour to spare.  So home it was.

The clinic appointment itself went swimmingly.  Doc C is really pleased with my progress – all my infective markers are right down, my liver function is almost back to normal, the other bits and pieces in my blood which were low are coming back up.  My lung function is steadily increasing, as should be expected as I start to get out and about and to exercise more and he’s now seen fit to take me off two of my anti-biotic tablets, which brings me down to a total of 10 Tx-related drugs, plus 2 CF-related drugs.  Cracking.

This evening I’m feeling pretty tired, but not too bad.  I’m looking forward to two days at home tomorrow and Wednesday, then another clinic visit Thursday.

Keep well.

24 hours later and I’m all tucked up home again.  My tac levels are all over the place and the docs can’t really work out why, but on the basis that pre-Christmas they let me go if I came back every day for bloods to keep an eye on them, they couldn’t see any more reason to keep me in if they were only going to be doing the same thing there and have me taking up precious bedspace and resources for the rest of the time.

I’m not about to start arguing with their logic.

I guess, after the last two blog-hijackers entries, I can hardly say I’ve had a rubbish Christmas or that I spolied it for everyone, since that’s already been disproved.  What I can say is that it’s no fun spending Christmas day feeling like you’re about to hurl, nor is it a bundle of laughs spending Boxing Day actually hurling and in hospital.

That said, it was wonderful to be at home and have the chance to celebrate, as much as I could, with my nearest and dearest, even if it did feel somewhat tainted by sickness.  I was incredibly lucky with the tremendous gifts I recieved from family and friends and I shall enjoy getting out and spending the bundle of vouchers I received as soon as my docs let me out in puclic places.

There’s not a great deal for me to add – being in hospital, particularly for one night when you’re mostly concentrating on not throwing up – doesn’t give you a great deal of war stories to relate.  The team of docs and nurses were fab as usual – the nurses particularly making me feel right at home again.  The one advantage of spending a month on the same ward is that you do get to know the staff particularly well, and it feels like something of a bittersweet homecoming when you’re entrusted to their care again.

So, Merry Christmas again, and apologies to all those of you I didn’t reply to on the day with emails and text messages, but I was rather preoccupied with either celebrating as best I could or sleeping the sickness off.

Here’s to a better and more stable New Year’s celebration and to an ever strong me off into 2008.

Hi guys, Kati again – I also wanted to write tonight, just to give my side of the journey, too.  As Oli’s Dad has already said, Oli is back on E ward tonight and looking pretty rough. 

So far since his hospital discharge, Oli and alternating family members have been taking him back to Harefield each morning in order for bloods to be taken to let the docs know what his Tac (the immunosuppressant) levels are.  On Christmas Eve the doc phoned and and said that Oli’s level was 5.something and gave the instruction to effectively double the dose.  As I understand it, the Tac level they are aiming for is around 10, so doubling it makes some kind of sense, I guess.

It didn’t make sense to Oli’s system, from late Christmas Eve Oli began to feel particularly tired and nauseous.  We weren’t too worried, he’d been doing a lot more activity in the previous few days and we were all thinking he’d maybe overdone things. 

Christmas morning started slowly for us which is particularly unusual for me, I am an eternal child and still wake up around 5 eagerly looking to see if Father Christmas has been.  This year, however, I had it on good authority that Father Christmas was not going to visit me but would make up for it next.  Oli woke me on Christmas morning with a cup of tea and a cuddle, that’s worth any Christmas stocking to me – although I did get a stocking as a matter of fact.  It contained a loofah, Father Christmas had apparently had short notice and all the best stocking fillers had gone so he only had a loofah and a few bits ‘n’ pieces left over.  Like I said, he’ll make it up to me next year!

As Christmas Day wore on it became pretty obvious that Oli was struggling.  He felt so tired and so sick and so sad that he couldn’t enjoy the Christmas he’d wished for.  Of course to us, it was just amazing that he was with us, nothing could spoil our day.  By this point I was convinced his body was struggling with the Tac levels, his temperature was fine, his spirometry (lung function) was fine, there were no numbers that were ‘out’.

This morning Oli woke up and was sick before he left for hospital, he was sick on the way to hospital and he was sick at hospital – it was fairly obvious they were going to keep him in.  Later this afternoon his blood results came in.  His Tac level was 39!  No wonder he felt so awful. 

The doc who saw him is fantastic.  She said exactly what I was thinking – other than the effects of the increased Tac, his body was fine.  Of course he was tired and feeling rough – anyone who’s had a morning being ill knows that you’re not at your sparkling best the following afternoon.  They put him on a saline drip to rehydrate him and IVd an anti-sickness drug straight into him as he couldn’t take anything orally.

I’m fairly convinced this won’t be a long stay, it may extend to over the weekend but we are happy that as soon as the Tac is under control Oli will be bouncing back out of those hospital doors and home in a jiffy.

Unfortunately, Oli is also a complete dingbat.  His phone is out of battery at the minute and he’s left the charger at the flat, this would be easily resolved except that his keys are with him in hospital and my keys are in Dazz’s pocket while he hurls himself down the Alps. D’oh.  This means that temporarily he can’t read your comments but I promise that will be rectified by tomorrow, honest injun.

This is 3 dodgy Christmases in a row now, although at least this is now the first of many Christmases that we can spend together, yay!

Hope you’ve all had a wonderful few days x

Hello – yet another new author.  I’m the dad bit of Oli’s “‘rents”.

Oli will shortly be posting another bolg to say how rubbish Christmas was and how he spoiled it for everyone.  I just wanted to get in first.

By way of news, Oli is not writing because he’s back in Harefield for tonight/a little while.  Nothing drastic, just problems getting the dosage of immunosuppressants right.  At the moment they’re way too high, which is leaving Oli desperately nauseous.

So he’s going to tell you that Christmas Day was ruined by him feeling sick all day, and Boxing Day wrecked by his going to Harefield in the morning, being very sick on the way and never coming home.

 Of course, Oli is right: (Oli is always right).  Christmas Day was completely disrupted by Oli constantlyjust popping upstairs for a rest or a nap.  Probably only Emily or the other transplant survivor readers will pick up on the significance of ‘just popping upstairs’.  It wasa shame he needed to, but it brings tears to the eyes to think that he can ‘just pop up’ the 10 steps which 6 weeks ago were an almost insurmountable mountain.

And yes, how rubbish was Christmas!?!  It would have been so much more fun to have been lugging oxygen cylinders round the house, to have waited an hour or more in the morning while Oli did his nebs, and his physio, and generally gathered sufficient strength to come and join us, to have an Oli who could only just make it from the living room to the table for lunch.  Without the transplant, we could have had hours of fun thinking about the fact that this would certainly have been our last ever family Christmas.

 We’ve just been given every Christmas, birthday, Easter and New Year gift we could ever wish for for a lifetime, and although we’re sad that Oli wasn’t quite well enough to enjoy it to the full, nothing, but nothing could have stopped it being the greatest Christmas we’ve ever had.

I’ll leave it to Oli to explain just how bad it was.