MEDICAL MATTERS

[Stanley]

Ian I made the enquiry for you yesterday as I want to switch from Whitworth's to Well. You have to go to the chemist and fill in an application form with them, they will then make the arrangements with the surgery.
You used to just give your repeat order to the chemist but recently they have changed the system for some reason. Now you have to take the order for the repeat to the surgery and they issue a prescription and send to the chemist of your choice, I allow 5 days for them to do this. When you get your meds the order for the repeat is in with them.

[PanBiker]

I don't know how long I will be kept on these meds only that it says GP to continue and what I have runs out next Thursday. I rang the surgery yesterday for an appointment and they could not give me one. I explained my situation but was told to ring back at 8.30 on Tuesday morning for an emergency slot with anyone who is available. I would have liked to have a 10 minute catch up with Hassan but earliest is 24th September!

More efficient news. I had mail this morning from Dr Zain (Zainalabdin) the stroke medicine consultant I saw first. He has confirmed that my carotid artery doppler scans were clear with no significant carotid artery disease. He also confirms that my ECG showed normal sinus rhythm. Copies have been sent to my GP/Clinician. We have moved on from here of course thanks to his referral for the CT Scan but welcome confirmation anyway.

[Stanley]

[PanBiker]

I don't know how long I will be kept on these meds only that it says GP to continue and what I have runs out next Thursday. I rang the surgery yesterday for an appointment and they could not give me one. I explained my situation but was told to ring back at 8.30 on Tuesday morning for an emergency slot with anyone who is available. I would have liked to have a 10 minute catch up with Hassan but earliest is 24th September!

It took almost half an hour to get through to the surgery this morning, busy no doubt because of the bank holiday. When I asked for an appointment I was told that I didn't need to see a doctor to get a repeat prescription authorised. All they wanted was sight of the hospital discharge and the associated request for continuation. With this as the case, I printed out my BP spreadsheet for whoever had asked for the info and walked round with my notes. It was rammed when I got there so rather than stand for a long period (which could be a problem at the moment) I withdrew to the town square benches for 10 minutes. Our friend Val was on reception when I went back and she entered my request on the system, my doctor not in so actioned to someone else to sign off, theoretically I can pick up the prescription on Thursday which is when my existing medication runs out. I could have done this for the meds on Friday if I had not been given the wrong information at the time. It seems that not everyone sings from the same sheet when talking to users. Could still have done with the 10 mins with Hassan but that's not going to happen.

More efficient news again in the mail, this time from the cardiac consultant confirming that my recent Echocardiography does not show any significant abnormalities. Surgery are due for a copy of that also.

[PanBiker]

Had a bit of lunch then received a call from the Consultant in charge of the AAU. He signed off my discharge, he was ringing to check on my progress. I reported the ongoing "events" to him and the nature of their randomness also the no increase in severity He was happy with that and welcomed the news that I had received my appointment with the Neurosurgery team. He reiterated that I should go straight back to the AAU if there is any change in my symptoms or severity, still an open door there if I need it. He spent about 10 minutes chatting and asked if I had any questions or needed any further information. He said that he was sure that the Neurosurgery team would be able to help me further and wished me well for a speedy recovery. Nice that he has taken the trouble.

[Stanley]

Sounds positive again Ian.

[PanBiker]

Professionalism in care Stanley and good to hear.

[Tizer]

I'm glad they're looking after you well, Ian.

The Children's Society reports today that nearly a quarter of 14-year-old girls in the UK said they had self-harmed. I went to the report (64 pages) and skimmed through it but couldn't find anything about differences in geographical distribution, ethnicity, urban v. rural, wealthy v. poor, level of education...there's a lot missing from the study and it's disappointing.
LINK

[Stanley]

It's a terrible problem and all part of the pressure society is putting on young girls. What strikes me is that many start after reading on line that it has helped others to cope and then they find they are hooked. I'd like to know when it started.

[PanBiker]

Went round to the surgery around lunchtime and my prescription was ready. Took it to Well and got it filled, they have dispensed the 40mg capsules which is the full dosage, the ones from the hospital pharmacy were 20mg. I will ask on Monday if I need to continue with these, don't know how long the potential side effects of the steroids I was dosed with are likely to last, I will ask about this as well. I'm hoping to have a lot more information on Monday.

[Stanley]

You do right Ian. Large doses of steroids are a serious matter.
On a separate matter..... I'm not sure where I said it but I asserted that Jack has another fortnight to go before his deeper wounds will be fully healed. I noticed this morning that the dog bite on my hand which was also a deep penetrating wound is now fully healed leaving a small scar. These things take time, the attack occurred on the first of the month. So I think my estimate in respect of Jack is about right.

[Tizer]

Ian, I'm curious to know, what is the 40mg drug supposed to do? (I may have missed an explanation earlier.)

[PanBiker]

They are for gastric complaints such as ulcers and to protect against internal bleeding that the steroid dose could cause.

[Tizer]

With a name like Lanzoprazole perhaps?

[PanBiker]

Omeprazole, sounds like the same family Tiz.

[Stanley]

I think Ian is being remarkably level-headed and pragmatic re his present condition. I wish him well!

[Tizer]

Yes, Ian. Both drugs are proton pump inhibitors. The stomach is kept acid by secretion of protons from the cells lining it. The drugs partially block the secretion to prevent acid corrosion of the stomach and gut wall. I take Lanzoprazole at night because I have chronic inflammation of the gut and need to protect it from acid. Inflamed gut wall is rather like sunburnt skin and you can imagine the pain if you poured vinegar on sunburn! Inflammation is a complicated business controlled by the body's natural prostaglandins. A prostaglandin that suppresses inflammation and pain in one part of the body may promote it in another part. Anti-inflammatory drugs work by manipulating prostaglandin levels. That's why an anti-inflammatory/pain releiving drug, such as aspirin, ibuprofen etc, can cause inflammation in the stomach and has to be prescribed with the proton pump inhibitor.

[PanBiker]

I take mine first thing in the morning before I have my breakfast. As I have mentioned, I don't know how long I will be on these as I understand they are a contra medication for the potential effects of the oral steroids I was given. I would have thought they would be short term unless the continuation is to cover potential further treatment. Fortunately I don't have any of the nastier side effects although they have given me extra flatulence (possibly too much info) and quite a peculiar one, a tendency to itch.

As for being pragmatic about my situation, thanks for the comments, but really there is no other way to deal with this. Whatever the treatment plan, it is certainly out of my control and I trust explicitly that the regime into whose care I have been passed are experts in their field and will do their very best for me. Some trepidation about Monday but I'm no good as I am so bring it on.

[Tripps]

I think Omeprazole is given to anyone who takes other medication fairly routinely now. I've been popping one a day for years now. No side effects at all. Just a tendency to post strange things on distant websites.

I remember querying it once - "so this tablet is for when you are taking a lot of other tablets?"

"Yes".

I left it at that.

[Stanley]

David, often triggered after responding to "If you have any side effects let us know" and before you know where you are you need a charge nurse to manage your pills.
Good man Ian!
Talked to one of my mates yesterday and he has had a migraine for ten days. And yes, he's seen the doctor about it. I often think I am so lucky........

[Tizer]

Tripps, Omeprazole and Lanzoprazole are taken to prevent and treat stomach ulcers, indigestion, heartburn and acid reflux. Perhaps one or more of your other medications can increase stomach acidity or otherwise irritate your gut lining. I don't need to take mine all the time, only when my gut gets inflamed and then I take one capsule before going to bed each night because the problem occurs when my stomach is empty.

[Stanley]

As I say so many times Tiz, I am so lucky! I seem to have a cast iron stomach........ (and perhaps the head also!)

[PanBiker]

Right, game on properly now.

We rocked up at Wharfedale around 50 minutes early and after getting a bit of advice from reception we were directed to a self service touch screen machine where you can enter your details and it then outputs where you need to go. "Through the doors immediately on you left and through to waiting area 3." We sat down intending to seek out a brew as we thought we would have a bit of a wait, not so, nurse was checking my identity and date of birth within a couple of minutes, my arrival already flagged on her screen.

We soon picked up that someone with a 2 pm appointment had not turned up or cancelled but they had received no contact telephone number so could not chase the circumstance. Good news for me, within another 5 minutes I was called in to the consultation room by Mr Anderson, he introduced his nurse Andrea an invited us to sit down. He confirmed who Sally was in relation to me.

He asked me to relate my story so far, occurrences and symptoms experienced and any current medication. He then asked if I had seen the images of the scan and how much I knew of the diagnosis to date. I told him what I knew so far as related to me by the AAU and my discharge notes. He said it would be easier to discuss if he got the scan images up. When he showed me the scans I was quite surprised to see where the tumour is situated, it was described as being on the right so I imagined it at the side of my skull but its actually at the top, ranged left but impacting the right side. It completely covers and is hiding the bits of my brain that it is impacting. He pointed out that the brain is symmetrical in design so could show me the area that controls my leg and another that controls the arm on the good side so to speak. It was clear after seeing the positioning why I am getting the seizures at the right

As he was zooming through my head it was clear just how big "Darth" is, he dragged the measuring tool over it and said that it's basically the size of Satsuma! He quickly followed this with that it is not cancerous but a benign growth and owing to the size, one I have probably had for over 20 years! He explained that you can carry these around without any onset of symptoms. Because they are very slow growing your body compensates by cocooning the growth in fluid and as the brain is actually quite flexible (blancmange like) it can compensate, but only up to a point. When there is no more room and things start to get squeezed, that's where we are at now. He said some people can present already in coma.

I asked about options and he said that there is no Chemotherapy option for this type of tumour. No Radiotherapy option either as that is only useful on much smaller tumours often picked up on scans after road traffic accidents or head trauma where you may end up in a scanner. The only options are surgical removal or to leave it alone. The latter option may be considered if I was 20 or 30 years older as to do nothing would eventually move into the life threatening stage but may be managed at first onset with medication, not an option as far as I am concerned.

So, the surgical option. Typically a six hour procedure followed by around seven days in high dependency, could be less, If you are walking around after four you can go home. Surgery and recovery will be at Leeds General Infirmary (LGI). He said that the larger tumours are the easiest to work with. He would aim for 100% removal but that would depend if it was interfering with any critical blood vessels in which case they may leave part behind. That may eventually regrow but over a period that would take me well into old age. There is a risk that I could be left with reduced function in the right side which could recover over time or may be helped with physio.

He added that that he has removed over 30 of these this year with only one patient (female) that has required extended remedial therapy. Mr Anderson is probably in his mid 40's, he instils confidence in his delivery of the facts, straight forward but willing to answer any questions at any time.

We moved on to scheduling.

Due to the size of Darth he has marked me as urgent. Realistically with his existing schedule it will be 4 - 6 weeks. Same terms as the AAU, I need to advise if my symptoms worsen. In the interim he will advise my doctor to prescribe me a common anti-seizure medication usually used for epilepsy if my symptoms continue the same. I can stop taking the Omeprazole for the time being but to hang on to them. He has prescribed me further high dose steroids which I need to take two days before my scheduled surgery along with a restart on the Omeprazole. The steroids will help to suppress potential swelling when they open me up.

I will need to go back to Wharfedale for pre surgery assessment, I will get a letter for this. After that it will be waiting for the slot for surgery. My consultation lasted about 35 minutes. I shook his hand on the way out and asked him not to get run over as I was now totally dependent on him to put me right.

I feel a lot better now seeing the nature of the beast and knowing that there is a resolution. It also looks like I have found my Obe Wan.


We came back out to the outer waiting area where we could get a brew, I had a Bakewell Pie as well.

[plaques]

PanBiker, What a relief, nobody wants these sort of things but your write up strikes a confident note. Both myself and Mrs P feel more relaxed about it, better the devil you know ... Best wishes from both of us.

[Marilyn]

I do hope you get along ok with the anti-seizure medication.
( I'm thinking of the Carbemazepine that I couldn't tolerate in any way, shape or form).
Sounds like you will have some good things to celebrate this Christmas!