Alan's Health Log

As you may have read, on 17th April 2008 I had my appendix removed.

Unfortunately, during the biopsy a lymphoma was detected; further tests showed other instances of cancerous lymph cells in the abdomen, as a result of which I am now on a full course of chemotherapy.

This is my log of progress, appointments, thoughts and feeling as we go through the next few months, so that interested people may be informed.  Skip the messy bits!  I would be happy to receive your comments by email to  Alan Wood

The earliest entry is at the bottom of this page, and the latest news follows this paragraph.

Wednesday, 22nd April
I managed to get a cancelled booking and saw Joan Scriven this afternoon.  I went prepared with a list of what I had eaten since last Thursday, which was very useful.  The aims were to reduce the blood glucose level, reduce the LDL cholesterol, and to reduce my weight by some 10% to start with.  These were to be achieved by cutting out butter, cheese, jams, Ribena, chocolate digestives and cakes.  Those who know me will be able to judge what I think about this!  The other thing is ... more exercise!  Oh, well!  Let's see how we get on.
I was thinking - this log started as an account of the cancer treatment, and, thankfully, I got complete remission in December.  But it has continued with general health matters, and I ask myself 'Is anyone actually still interested?'  Answers on a postcard, please, or email if you prefer.

Saturday, 18th April
I got in to see the doctor this morning, to discuss the blood test.  Blood glucose was actually 7.9, which is a bit too high; for the cholesterol, HDL (the 'good' cholesterol, was 1.4, which was good, but the LDL was rather high at 4.2, which needs something done about it.  The ratio of 'Total Choesterol/HDL', which is apparently significant, was 6.2/1.4 = 4.4, which is satisfactory.  Anyway, I was asked to make an appontment to see the Dietitian.

Thursday, 16th April
I rang the surgery this afternoon about the recent blood test: Glucose level normal, so no Diabetes; Prostate marker normal, so no more cancer; full blood count normal, so that's good; but Cholesterol a bit high at 6.2.  I am to go into the surgery and pick up a diet sheet.  So I must hurry up and finish my Easter Eggs before they are banned!
I have just added two photographs, one under June 2008, showing me in 2007 with hair, and the other in August 2008 showing me without hair!  I notice that I last had my hair cut on 5th June last year - dare I  try and go a whole year before getting it cut again?  It's only six weeks more, but my hair is already looking a bit unkempt!

Thursday, 9th April
I last ate at 21:00 last night so that I would be 12 hours without food by the time of the blood test this morning.  The poor nurse, I did feel sorry for her as she took about five goes to find a vein!  I felt sorry for me, too!

Monday, 6th April
I received a copy of letter from Dr Knowles to Dr Bala, the GP, which said basically that everything was proceeding well, but that the Random Glucose test was elevated, and wanted me to have a Fasting Glucose test before the next hospital appointment set for 22nd May.  This test was arranged for 09:00 on Maundy Thursday, 9th May.

Thursday, 2nd April
I had my follow-up on the water tablet treatment with the G.P. this morning.  He was pleased with the improvement, and said I could reduce then leave off the water tablets, starting them again if I felt that I needed them.
I told Dr Bala about the possible diabetes, but he had heard nothing of this from the hospital - neither had I, so I carry on waiting for news.  Maybe the liver function will have recovered to normal by the time I hear!
My next appointment anywhere is the INR check on 14th April.

Friday, 20th March
Back to Epsom Hospital for the two-monthly check-up; this time I saw Dr Knowles, for the first time.  Basically, she was very pleased with my progress, and the way that the blood levels had recovered.  I saw a graph of blood quality against time, and compared with lower and upper limits of acceptable values, my blood was at about 75% and still rising, so that's good.
The liver function she was showing concern about was also shown on a graph, and compared again with lower and upper limits of acceptability - sorry, I don't know what units these are set against - my reading started out some months ago at about 40% above the upper limit, and was slowly coming down towards normal and was currently about 15%.  Extrapolating the curve indicated that it would probably be acceptable in some four/six months.
The causes of a fatty liver were overweight (surely not!), excess alcohol (impossible!), congestion of the liver (whatever that is!) or diabetes.  So I had a blood test for diabetes, and made my next appointment for two months' time, 22nd May.  Dr Knowles said that she would write to me and the G.P. with the results of the diabetes test.

Monday, 16th March,
Well, that's better - I feel that I am breathing properly again, and not out of breath doing the simplest things!  I must remember to make an appointment.

Friday, 13th March
Well, the water tablet had an effect - I've lost 1.3 kgs since yesterday!

Thursday, 12th March
For the past few weeks I have had shortness of breath, and a reluctance to climb stairs at my normal rate.  There has also been the feeling that when I breathed in deeply, I wasn't 'stretching my lungs' in a satisfying way, so I went to the GP.  He listened to my chest, and asked a few questions, and has put me on to water tablets, which apparently help against oedema.  He wants to see me in three weeks' time.
I also mentioned a lot of floaters in my right eye, evident in bright light, so he is writing a letter for me to Kingston Eye Hospital.  I'll try and go tomorrow.

Thursday, 26th February
I attended the Ultra-sound clinic as required, for a very thorough examination of the liver area.  I congratulated the staff on having a device for keeping the jelly warm - this is the stuff that is smeared all over the target area to ensure good transmission of the ultra-sound waves, and previously this has been very cold, and quite a shock to the system!
The scanner had a control console like Concorde - it finished up with about a dozen photographs of my liver; the only comments to me was 'not too much wrong there, but there are some fatty deposits' - the same comment that was noted on the report from the PET Scan.
So now I wait until 20th March for the doctor's analysis of everything.

Thursday, 12th February
Well, I spoke too soon, didn't I?!   I recently received a notice to attend EGH for a 'US Abdomen', which turned out to be short-hand for an Ultra-Sonic scan - and one stipulation was 'nothing to eat or drink for the previous six hours'!.  The original appointment was for 10:45 on Tuesday, 24th February: but Tuesday is a work day, and i didn't want to wait until after 11:00 before getting a cup of tea!  So this appointment was re-scheduled for Thursday, 26th February at 09:30 - much more reasonable!

Friday, 30th January
Well, I've not been called back to the hospital for the kidney function, so it must be OK!

Friday, 23rd January
Seven weeks after my previous visit to the hospital and I went for another check-up - the blood test first, and then to see Dr Zuhar.  And the news was good, with no trace of lumps or bumps, and the blood tests were good.  There was a little doubt about the proper functioning of the liver, and the test result for this had not reached to doctor, but I would get called in if there were anything untoward found.

I still have a little tingling in my finger-tips, but the dryness of the skin has gone - and my hair is growing!  Very useful with the weather as it is.

Tuesday, 6th January 2009.
That's better - the INR has gone up to 2.4, quite acceptable.  Don't change the dosage!

Tuesday, 23rd December
I've  been having trouble with my INR, the ratio indicating the rate at which the blood clots compared with the normal.  My ideal, according to Dr Jones, is between 2 and 3, and since stopping the chemotherapy, it has stayed obstinately below 2.0.  It was 1.6 a week ago, and 1.9 today, despite a small increase in the Warfarin dosage.  So, another small increase in dosage, and let's see what the INR is in the New Year.

Thursday, 12th December
In to hospital again, this time for the echo-cardiagram and then to see the cardiac specialist, Dr Odemuiyia.  As the occasions of AF were so few and far between, and minor and of short duration when they did happen, it was decided that I should come off the Digoxin, but have instructions on what Digoxin to take if the AF came on.  So that's one fewer tablet to take.

Saturday, 6th December
The first day without Omeprazole - no heartburn yet!

Friday, 5th December
Today was the day!  First to give the blood sample, then, an hour or so later, to the doctor; Dr Zuha, this time, Dr Jones being on leave.  And then the news: 'Well, that's all very satisfactory,' she said.  And I was shown the report, of which I took a copy: 'The PET findings are those of a complete remission status."  How about that!  Fantastic!!  I was so pleased that i forgot the other important questions, like is it time to return to the dentist after the lay-off due to the chemo, and should I get the flu-jab.  So then I went around telling everybody the result - a great feeling, and again everybody being so supportive and pleased.  My next appointment was set for 23rd January, 2009, in seven weeks' time.

Friday, 29th November
Off to the Royal Marsden in Sutton for 09:00.  First, a very comfortable, lazy, hour while waiting for the tracer injection to work its way around the body, and then about 45 minutes on the scanner , which was also very comfortable - so much so that I went to sleep, waking up only when the technician said: 'OK - that's it.'  I was due to see Dr. Jones on 5th December, and I was assured that the results would be available then.

Saturday, 22nd November
I heard today that the PET Scan would be on 28th November at 09:00.  Here's hoping!

Saturday, 8th November
The Omeprazole worked!

Friday, 7th November
Went in to hospital to see Dr Jones for the results of the CT Scan done on 28th October.  Dr Jones said that they wanted every node to be below 1 cm., but apparently there were still some nodes around 2cm. diameter, which I found rather disappointing.  It had been decided that I should go for a PET (Positron Emission Tomography) Scan, which is able to discriminate between dead scar tissue and nodes that were still active.  Dr Jones felt fairly confident that the scan would prove negative - I do hope so!  The scan would be carried out at the Royal Marsden Hospital, hopefully within a fortnight, and it was expected that the results would be ready for my next appointment with Dr Jones on 5th December.
I also mentioned the heartburn: Dr Jones said that probably Gaviscon was not strong enough, so she prescribed Omeprazole, which I had  been taking for the past six months! 
I was going to ask some other questions, such as could I have the 'flu jab yet, and whether I could go to the dentist, both having had an embargo on them while I was on chemo., but I was rather thrown by the news from the scan, so I forgot to ask.  Oh, well, next time.

Thursday, 6th November
Again, uncomfortable heartburn, making it awkward to eat, and to have any hot drink

Wednesday, 5th November
Had very uncomfortable indigestion/heartburn today - Gaviscon partially helped.  Apart from that, this week has been good.

Tuesday, 4th November
In to hospital for a check on the INR, and went into the HMDC to say Hi! to the nurses there.  As it was three weeks since my eighth chemo, I said I was suffering withdrawal symptoms, and needed to have a quick fix!

Friday, 31st October
I went to see my GP today about various things.  He said he would write to the cardiac doctor and see what he wanted to do; he also agreed that it appeared that I was getting off the Zimovane, which would be a good thing to do.

Thursday, 30th October
Woke at 06:00 on Wednesday, and 07:30 today - am I getting free of the Zimovane effect?  It seems so.  Had a good day today, doing the NewsLetter

Tuesday, 28th October
I woke at 04:15 this morning and then just dozed!  Withdrawal symptoms?  I was in to the hospital this afternoon for a CT Scan.  Only the pelvis and abdomen were scanned this time, as there had been no trace of the lymphoma anywhere else.

Monday, 27th October
I don't think the Zimovane are having the desired effect - they help the sleep eventually, but I'm still tired during the day.  I will try and do without them.

Sunday, 26th October
I had another Zimovane last night, but was still tired for the brass band concert this afternoon.  I had great difficulty in generating enough saliva to play!

Saturday, 25th October
After a Zimovane last night, had an easy day cleaning the tuba ready for tomorrow's concert.  Still felt tired during the day, though.

Friday 24th October
In to the hospital to see Dawn - she says I'm doing too much and should be taking it easy!  Some chance!  Blood tests were as expected,  Dawn noticed my uneven pulse; I had had no attention to the cardiac problem since 27th May, and thought that I should get my GP to write the Dr Odemuiya, the cardiac doctor at the hospital, to see if he wanted to see me again.

Thursday, 23rd October
As previously, I had the pain under the sternum and the lower back, which would again appear to be connected with the stimulation of the bone marrow by the series of seven injections.  Paracetamol eased the pain

Wednesday, 22nd October
Three days work, went OK, with Zimovane on Monday and Tuesday nights.  Tonight is the last Lenograstin injection.

Sunday, 19th October
Another Zimovane last night, which took a long time to take effect - and rather tired during the day.

Friday, 17th October
Not sleeping too well, so have been taking the Zimovane again - once, not until 04:00, then slept until 08:00, then still feeling tired during the day!

Tuesday, 14th October
So, the date I've been looking forward to since last May - the Last Chemo!I took a selection of cakes in for lunch and afternoon tea as a form of celebration.  The canula was put into my right arm, as agreed, and it wasn't too inconvenient.  Everything went OK for the day, and the eighth chemo is over - apart from the tablets for the next three weeks!

Friday, 10th October
Into hospital to see Dr Jones.  Blood tests, etc., all OK so ready for the LAST CHEMO!!! on Tuesday.  I mentioned the painful vein, and we agreed that I should use the right arm on Tuesday - I'll have to be left-handed for that day.  We also applied for a CT Scan appointment.  Next appointment with Dr Jones will be in four weeks' time (Dr Jones N/A on 31/10) so the scan can be held off for a further week, so giving more chance for everything to clear.

Wednesday, 8th October
Another three days of work, with no problems.

Saturday, 4th October
I noticed that the vein in my left arm where the canula goes is a bit painful, especially if I stretch my arm out.  I will mention this to the doctor on Friday.  I am also noticing the cold air around my poor hairless head, and am wearing a hat more!  Very fetching!!

Friday, 3rd October
In to hospital to see Dawn.  The blood test were OK, as expected.  I mentioned about the cold and the two days in bed, and got told off!  I should have telephoned the HMDC, as they would probably have called me in to check the blood count again - I might not have had the white cells to combat the cold!  I apologised, but said that the cold had run its normal course, so no problem.  I must remember next time - if there is one!  Next appointment with Dawn will be on 24/10/08.

Thursday, 2nd October
Just a cough and a sniffle today, so that's OK.

Wednesday, 1st October
After two days in bed, feeling very sorry for myself, I got up today, feeling a bit better.  I've lost 2kgs since Sunday!

Sunday, 28th September
During the afternoon I got that feeling in the back of my thoat which meant that I was getting a cold - the first during the treatment.

Friday, 26th September
Had trouble sleeping last night, so took a Zimovane, which did the trick.

Tuesday, 23rd September
After a day at work yesterday, today was a rest day, with the tube up my arm! All went OK, as expected.

Friday, 19th September
Nothing much to report this week, probably because it was the third week and I was again over the immediate effects of all the chemo.  I was at work on the Monday, Tuesday and Wednesday, all OK.  Blood tests today were satisfactory, so I'm all set for chemo #7 on 23rd September.

Friday, 12th September
Yesterday was not a very good day, very tired and more cramps.  Dawn today said, "Take it easy!", but the blood tests were OK

Wednesday, 10th September
Two more successful days at work.  Today, though, I did start experiencing more hand and thigh cramps, and slight pain in my chest and lower back, just as before.  I wonder what causes this?  The last of the seven Granocyte injections was today.

Monday, 8th September
It seems as if this inability to sleep is a regular occurrence for days 5 and 6 after the treatment, as I needed  a Zimovane both nights.  They are very helpful, and I had a good day at work today.

Thursday, 4th September
Two days not doing a lot, just reading and watching TV, and a bit of computer work.  I hope this lassitude is purely brought on by physical feelings, and is not a change in mental attitude.  I can see all these things that need doing, but it's so much easier to ignore them - I hope this attitude disappears after the treatment finishes!  We'll see.
Started the Granocyte injections today.  Because it appeared that the series of five injections that I had previously were not totally effective, I have  course of seven injections this time.

Tuesday, 2nd September
Another day sitting in the treatment chair.  It took 50 minutes before we found a suitable vein in my arm.  I wondered whether I would have to offer a leg!  Once started, everything went OK, and home at about 17:30.  The INR blood test showed a value of 1.8, so my Warfarin dose was adjusted slightly, to 6mg for that day, then back to normal.

Monday, 1st September
Another day at work!  I contacted Tracy at the HMDC and confirmed that I was OK for Tuesday.  I was concerned about the effect of the anti-biotic on the Warfarin, and asked whether Dr Zuhar had taken this  into account - I was assured that she had.  The INR will be checked tomorrow, anyway.

Friday, 29th August
A good week, with three days at work.  Still rather loose bowels, but not inconveniently so!  Dr Jones on holiday, so spoke with Dr Zuhar.  Despite there being no bowel infection found, she decided to put me on anti-biotics, just in case.  The blood test showed that Neuts were up to 1.9, so that was OK.  I was to contact the HMDC on Monday that I was still well, and OK for Tuesday's chemo.

Friday, 22nd August
This is the best I have felt for a week!  Into hospital to see Dawn, and bring her up to date.  She was happy with the blood tests done on Wednesday and Thursday showing the improvement in the Neuts level, so that was good.  Not being a cardiac specialist, she could not comment on the heart symptoms, so left me to discuss it with Dr Jones at the next scheduled appointment next Friday.

Thursday, 21st August - in CAU
Well, further checks were done today.  None showed any problem, and the Neuts had risen to 0.6, so that was comforting, going the right way.  The cardiac doctor was happy for me to leave, with no fault found (NFF), and the Haematology doctor agreed, so long as I attended my regular Friday clinic at 12:00 tomorrow.  I was discharged at around 17:30, and had a quiet evening.

Wednesday, 20th August
I had that thumping heart feeling in the middle of my sternum, as on 10th July, during the afternoon, and more diarrhoea.  During the evening, as it had not passed, I took a couple of paracetamol and went in to A&E.  There I had the normal checks, ECG and blood tests.  It appeared that one blood cell count (Neutrophils) were worryingly low, at 0.3, so I was admitted to the Clinical Assessment Unit (CAU), in a room on my own to protect me from infection.  The thumping heart symptom went during the late evening, maybe due to the paracetamol

A bald me on 19th August 2008 - no hair, no eyebrows, no eye lashes, but still smiling!

Tuesday, 19th August
Yippee - a good night's sleep - still feeling a bit stale, though.  Again, I didn't go to work.

Monday, 18th August
I was hoping to go into work today, but another bad night's sleep prevented that.  Still feeling very tired and out of sorts.  I rang Dawn, the Macmillan nurse, who advised me to get something from the GP to help me sleep, which I did.

Sunday, 17th August
I had a very bad night's sleep last night, and today I found it very hard to concentrate on essential things.  And in the afternoon, I had diarrhoea!

Saturday, 16th August
I was much the same as yesterday, but I managed to get essentials done.  Apart from that, what a good job the Olympics are on TV.

Friday, 15th August
Not a lot of energy today, so took it easy

Tuesday, 12th August
Chemo #5, and  all went well.  After the Piriton I dropped off for my regular snooze! The pump regulating the input of the drugs must have ben set up higher today, as my reactions to them are known now, as I was out of the clinic by about 15:30, together with my drugs and appointments booked for the next three weeks.  Incidentally, all these trips to the hospital are made on the mo-ped - very convenient, it's so easy to park, and I hate to think what it would otherwise have cost me in parking fees! 

Monday, 11th August.
I was intending to go into work today, but this was scuppered by the blood tests.  The results, when they came, showed that all was in order for the next chemo tomorrow.  Today, I'm halfway through the course - Yippee!

Friday, 8th August
Hospital again, first of all to have the blood tests taken, then up to the Macmillan Clinic.  One reading was a bit low, so I was asked to go for a further check on Monday to ensure that I was OK to take the chemo on Tuesday.  An examination showed no lumps or bumps. The scan showed two lymphomas in the abdomen, but both much reduced;  this result meant that I would be taking the full course of eight chemo sessions, the last one being scheduled for 14th October.  It does seem a long time to go.  I wonder how long after the last chemo do things start going  back to normal?

Thursday, 7th August,
Into hospital again, this time for a CT Scan, halfway through ther courset of treatment.  I hope the results are ready for the clinic appointment tomorrow.

Wednesday, 6th August
I have been to work the past three days.  No problems, and it was nice to be back,

Friday, 1st August
Into hospital again for the Nadir blood count. tests  All were OK and as expected.  I mentioned again the loss of sensation in my finger tips - this is known as peripheral neuropathy, and again, is a common side effect.  Then into hospital in the afternoon for the Echo test.  As before, this checks that there has been no effect on the heart muscle by the chemotherapy.  And again, there were no changes, so that's good.

Thursday, 31st August
We had a lovely few days in Southampton, highlights being a ferry trip to Hythe, a guided walk round some of the old walls of the medieval town, a trip on the car ferry to the Isle of White where we went to Osborne House, and several museums.  Today, when the weather was not so good we went for a drive round the New Forest.  And as hoped, I was back to normal on the Monday - just as well with the amount of walking we did.

Sunday, 27th July
Still tired the past few days, but not as bad as after Session #3.  Val and I are due to go off for a few days in Southampton.  I don't actually feel much like getting on with packing, etc., yet.  I hope I'll be back to normal by tomorrow.

Tuesday, 22nd July
4th Chemo day!  I was in in good time, only to find that the HMDC was closed until 10:00 for staff training.   I went to the Warfarin clinic - the INR was 2.9, so keep taking the tablets.  Then back to the Discharge Lounge to wait, with a cup of coffee, for the HMDC opposite to open.  The chemo started eventually and continued uneventfully until about 16:30.  The steroids and/or the Piriton made me quite drowsy, and I must have slept for an hour or so around midday, but being woken every half-hour for blood pressure readings.  I must pay tribute to the nurses in the HMDC - Tracy, Anita and Becky.  Kind and cheerful and chatty - ideal people for that work.  I quite look forward to going in!  We booked the future appontments, but still no appointment for the CT Scan yet.  I collected my big bag of medication for the next three weeks, this time without one drug (anti-gout!) which has been stopped, and came home.  Now for five/seven days of disturbed sleep patterns and low energy levels!  I'll keep you informed.

Monday, 21st July
In at work, again.  The work is piling up for me!

Friday, 18th July
In to hospital again, for a blood test and to see Dr Jones.  All blood test readings were OK, so no harm done by delaying the injections (7th July). A quick examination, and no more lumps or bumps found, so all OK for the 4th chemo on 22nd July.  Coming up to halfway through the treatment, it was necessary to book for an Echo Heart check, and a CT Scan, before I saw Dr Jones again, booked for 8th August.  The Echo test was booked for 1st August at 13:30.

Wednesday, 16th July
Feeling in good shape, I was in at work yesterday and today - quite enjoyable!

Monday, 14th July
I have been noticing cramping in my hands recently.  Apparently this is another side-effect, but doesn't last long.  It really is an effort to force my hand open and into a normal shape.  Somebody at work said put them  in hot water and massage them - a bit tricky when I'm at brass band rehearsal playing the tuba!

Friday, 11th July
I stayed at the hospital until it was time to visit the Macmillan Centre for the routine 10-day check.  Blood tests were already done, so no need to do them again!  I explained what had happened the previous night, and was told that I had done just the right thing by going into A&E.  I would have hated to have wasted their time.  The blood tests were as expected

Thursday, 10th July
In the early evening I started a heavy pounding pulse and a bit of pain in my chest.  After three hours of this I asked Val to take me in to A&E and Epsom.  Due to telephoning in advance, they were all ready for me and was soon wired up for ECG.  They did blood tests and I had a chest x-ray, but no fault was found (NFF).  A doctor checked for a possible aneurysm, but there was no evidence of this, thankfully.  I had a paracetamol and cocodamol, and eventually, about midnight, the pain and pulse subsided to normal. I was kept in overnight in the A&E observation ward, then more blood tests and blood pressure, but all was normal.  We have no idea as to what caused this.

Monday, 7th July
I have just realised that I should have started taking the new injections from last Thursday.  I rang the HmDC and got Dr Jones, who said that I should start taking them tonight.  They work better the sooner they are started, but today will have to do.  Embarrassing!

Sunday, 6th July
The steroids were finished yesterday, so I hope that I don't feel so tired over the next few days.  A friend said that in her experience, the chemo appears to be rather cumulative, so this tiredness for the first few days may be progressive, and get more noticeable - and I have only had three of the eight sessions so far!

Thursday, 3rd July
I'm still feeling tired, and have put on a few pounds due to the amount of liquid taken on board on Tuesday.  It does seem to take time to disperse.

Tuesday, 1st July
Chemo #3 due today.  First they repeated the blood tests, and no problem apart from the INR, which was rather high at 4.5 instead of between 2 and 3.  The doctor reduced the Warfarin doseage, and recommended that the INR should be checked in a week's time.
The chemo all went OK, starting at about 11:00 and finishing at 16:30.  I was issued with my bag of drugs for the next three weeks, including a new injection to quick-start the bone marrow, called Granocyte 34, or lenograstim.

Friday, 27th June
Into hospital for blood tests and a chat to ensure that all was OK for the next course of chemo, due on Tuesday, 1st July.  They were all OK, so seeya Tuesday.

Wednesday, 25th June
I was back into hospital today for a repeat visit, at six weeks from 7th May, to the Registrar of the surgeon who removed the appendix.  She was pleased with the healing of the scar, and said that the ridge currently in the healing abdominal muscle would gradually fade.  Certainly, at the inboard end of the incision, it is reducing, but the upper part, where it took longer to seal up, is taking longer.  The registrar said give it six months, so that's three months to go.  I also mentioned the area of skin without any feeling, where the nerves had been cut:  I was told that these would heal up again, too, so this is all looking good.

Friday, 20th June
I was in at the hospital before 09:00 this morning for a blood test, and then went up to the Macmillan Butterfly Centre for a check-up.  The blood test was very satisfactory, and also showed that the five days of injections had been effective in getting the bone marrow to produce more white cells already.  I am apparently still in good form as, apart from the hair loss and the change in my taste buds, I have none of the classic symptoms, i.e., nausea and sickness, constipation, and tingling in fingers and toes.  My next appointment will be on Friday, 27th June, for another blood test and check-up to ensure that I'm OK for Chemo Session #3 on Tuesday, 1st July. 
But before that, next Tuesday, I have to go for a check on the INR of my blood, to ensure that the level of Warfarin is OK; and then on the Wednesday, I have a check-up on my appendicectomy scar with the surgeon or his registrar; it appears all healed to me, but sometimes wearing trousers with a tight waist band is a bit uncomfortable.  I never realised that the abdominal muscle would heal with such a ridge in it - but I have never felt anybody else's scar, only my own!  Perhaps it will smooth out with time.  I'll let you know.

With all these hospital visits, I am very pleased to have the mo-ped, which means that I am not dependant on buses, and I can park it for no cost - particularly useful on Chemo-Days, when I am in hospital for eight hours or more!

Wednesday, 18th June
I don't think that I have mentioned another of the side-effects that I've noticed - and that is the effect on my sense of taste!  I hardly notice my baldness - apart from when I look in the mirror, which isn't often (!), or put on my crash helmet and find it less snug than it used to be - but the change to my taste buds is always noticeable - at every meal!  Coffee and tea taste strange, and rather metallic, and even toast needs a thick layer of butter and marmalade to make even a slight impression.  I really look forward to the return to normality of my sense of taste.

Monday, 16th June
The palpitations were still there today, so I rang the Haematology Day Centre, who called me in for a check-up.  They did a blood test and an ECG; then they reported that all was fine, or, in engineering terms, NFF (No Fault Found), and they sent me home.  But I knew things weren't right!  However, during the evening, while at brass band rehearsal, everything suddenly sorted itself out, and I felt good again!  Obviously, playing the tuba has amazing therapeutic powers!
I also asked concerning Saliveze, but I was advised to do without it if I could - so I have. 

Sunday, 15th June
I was a bit tired again today - only two  hours sleep last night! - and also a lot of palpitations during the afternoon and evening.  I have been told about a mouth spray called Saliveze which is good for promoting saliva flow - I will ask at the hospital whether it is suitable for me.

Saturday, 14th June
A bit better today, just as well as I was playing in the brass band at Ashtead Village Day.  I was definitely losing concentration by the end of the day, but the worst part about it was that the steroids really dried my saliva up, so I could hardly play short quick notes; once I was playing a long note, I could hold it, but quavers were a real problem.  I kept having sips of water, but they just didn't last.  Never mind, I was informed that my presence was more beneficial to the band than my absence!

Friday, 13th June
I've been a bit tired these past couple of days.  Still, not too bad, all things considered.

Wednesday, 11th June
Having completed the first (of eight) three-week cycles,  I am pleased to say that I am still in good shape, with not too many side effects, these being mainly a few broken nights' sleep due to the steroids, and the hair loss.  Just lucky, I guess!  Or all the people praying for me.  Thanks, guys!

Tuesday, 10th June,  
Into hospital again - INR check carried out, and found to be 3.6, so another change in my Warfarin dosage.  Then the second dose of chemo, which took all day.  I left hospital around 17:30 with another bag of medicines to take over the next three weeks!  Additionally this time, in order to kick-start the bone-marrow into action quicker, I've got injections for five days.

Monday, 9th June
Into hospital for a further blood test.  The reluctant blood count had recovered well in the three days, allowing Chemo #2 to proceed on 10th June.  GP had not issued a sick note nor the prescription - this was urged, in the nicest possible way!

Friday, 6th June
Into hospital to see how the blood count had recovered.  One was still too low to allow chemo on Tuesday, so a further blood test was arranged for the Monday, 9th June..

Thursday, 5th June
While washing my hair, I noticed lots of it coming out, so that has now started!  I asked Val to cut it very short, so she went all over with a #3.  So now I have to keep my "solar panel" covered, as one friend commented!

 Me with hair, before chemo - actually taken in 2007   
Compare this with the photo in August 2008!

Friday, 30th May
Due at 12:00 for 'Nadir' blood test, when the blood cell count is reckoned to be at its lowest.  All necessary readings were satisfactorily low, so all was as expected.

Thursday, 29th May
Occasional short-term palpitations again a.m., but stopped on their own.

Wednesday, 28th May
No problems, thankfully!

Tuesday, 27th May
02:00 - Difficulty in getting to sleep due to palpitations.  
04:00  - Woke up at 04:00 with a pulse rate of 150 and feeling breathless.  Valerie took me into A&E, where they did an ECG, and wired me up to a monitor.  Pulse rate very variable.  They gave me Digoxin to steady the heart rate, and admitted me to the Clinical Assessment Unit (CAU).  I had missed breakfast, so had to make do with a toasted sandwich.  I had a nice piece of fish for lunch, though.  My pulse eventually settled down, and I was discharged at 18:00 with yet another tablet, Digoxin, to take daily.

Monday, 26th May
Despite eating normally, I felt as if my blood-sugar was low, so had a few little extra snacks, which helped the situation.  I have to be in at the hospital for 09:15 tomorrow for the INR blood check, so up early for a change!

Sunday, 25th May,
Still no real ill-effects, but last night was still rather broken.

Friday, 23rd May
Last night was a bit disturbed and broken, with most peculiar dream, on-going between bouts of wakefulness.  I was told that this was caused by the steroids.  I will finish taking the steroids for this three weeks on Saturday, so I hope Sunday night will be better!

Wednesday, 21st May
Sorted out the tablets for the next few days.   But no ill effects or reaction  today.

Tuesday, 20th May
In to the Haematology Day Unit for the first session of chemotherapy.  Early injections went OK, though the piriton made me very tired.   The ritoximab was started very slowly, to see how I could tolerate it.  This went well, and was increased in stages with no ill effects on blood pressure.  The other medications were added, with no problems and I eventually was collected by Val soon after 5 p.m., carrying a load of different medicines for the next three weeks.

I had taken books, a radio and a cd player into the hospital, just in case I was to find time hanging on my hands - as it was, I listened to the radio on headphones and read a few pages of book, but most of the time I was drowsing, under the influence of the piriton, being woken up to have my blood pressure taken!

Monday, 19th May: A further consultation with doctor and nurses.  I was offered the chance to participate in a trial comparing the normal UK 21-day cycle with a new 14-day cycle used in Germany.  I agreed, but the computerised randomisation put me on the 21-day cycle as a control.  Maybe this is easier, not so aggressive.

Friday, 16th May: In to see the Haematology doctor.  She was impressed that the CT scan results were already with her, whereas the bone marrow and echo test results were not available.  She confirmed that the scan showed that further lymph nodes were affected, and that I should therefore be on a full 8-cycle course of chemo, each cycle lasting three weeks.  The cancer was known as Non-Hodgkins Lymphoma.  Of course, this was a bit of a shock, but the way everything was explained minimised the effect.

Thursday, 15th May:  the last test was the CT Scan, both ordinary photographs from front and side, then sections 5mm apart - imagine a sliced loaf!  I mentioned that I had a review with the doctor at 09:00 the next morning, and it would be very helpful if the scan could be analysed by then. 

Tuesday, 13th May: the next test was an echocardiogram, to ensure that the heart muscles and main blood vessels were in order

Monday, 12th May: the first of the tests was taking samples of bone marrow.  I had heard that this would be painful, but I described it as momentarily uncomfortable.  I was also warned about further bleeding, and was given a dressing for this, and more pain, for which I was to take paracetamol - neither of these happened, fortunately

Wednesday, 7th May: saw the Registrar of the surgeon who had taken  out my appendix.  She was not concerned about the oozing from the wound; I was to be patient, and it would heal OK

Tuesday, 6th May: To the haematologist, who described in very clear terms what the situation was, and that I would need a series of tests to ascertain whether and how far the cancer had spread.  I also met Dawn, a Macmillan nurse who specialised in lymphomas.  Both of these ladies were excellent, with 'bedside manner', explanations, etc., all I could want.  It was recommended that I would have at least a 3-session cycle of chemotherapy just to be sure, even if nothing showed up in the results of the tests

Friday, 2nd May: In to the GP again, to see how the infection was - apparently there was no infection, so that was good.  While the practice nurse was changing the dressing, she squeezed the wound area, and more serous fluid shot out!  It was a good job she had an apron on - she realised then what I had been saying about the discharge!  The nurse also described briefly why I was going in to the Haematologist, as there had been a lymphoma found on the appendix.  At the time I didn't realise that a lymphoma was actually a cancerous growth on the lymph system - some later reading on internet gave me more information.

Thursday, 1st May: I had a telephone call from my GP re some trouble with the lymph cells, and he had asked for an urgent appointment with the Haematologist at Epsom.  This was arranged for Tuesday, 6th May

Tuesday, 29th April: The GP thought that the wound looked infected, so put me on more anti-biotics for five days, and I was provided with dry dressings to soak up any more fluid.  This was not considered very serious!

Monday, 28th April: The district nurse came round to remove the clips.  This was accomplished with very little pain.  I thought that the design of the clips, and how they could be removed without tearing the flesh was very clever - I was most impressed.  During Monday evening, I was sitting at my computer and reached down to pick something up from the floor, and suddenly I realised that a large area of t-shirt and joggers was soaking wet.  There had been a discharge of serous fluid from some pocket under the skin somewhere.  NHS Direct said to go the the GP in the morning.

Wednesday, 23rd April:  I weighed myself this morning.  I was 5kg more than when I went in!  I suppose it was the inactivity, and the amount of fluid that had been dripped into me.

Tuesday, 22nd April:  When I tried to do up the waistband on my trousers, I found that it wouldn't meet by a good 4" - my stomach was really distended.  It was a good job that I had a long T-shirt to cover the gap - and my embarrassment!  I brought with me various medications, anti-biotics, etc., to last a few days.  It was nice to be home again.  I hear that 5 days is a long time for most appendicectomies - mine was not normal, though. 

Monday, 21st April: I was told that I would be able to go home on Tuesday

Saturday, 19th April: Started moving around the ward - very slowly

Friday, 18th April: The start of a long recovery!  Tried a little soup in the evening, but this was rapidly ejected, with interest - now I know what they mean by 'coffee grounds'!

Thursday, 17th April: I went to theatre about 09:30 and came to at about 13:15.  I found out later that I was on the table for two hours; one of the doctors said that the appendix was the largest he had seen - about 6" long by 1.5" diameter.  The incision was about 6" long, too - no keyhole surgery here!  Put on a drip and anti-biotics.

Wednesday, 16th April: The pain was still there in the morning, so I took myself early off to the GP.  He hummed and hah'ed a bit, then decided to refer me to St Helier's Hospital.  There I was eventually admitted, and underwent various tests, and x-rays.  I was told that they would be removing my appendix in the morning.  I had had nothing to eat since Tuesday lunch, but wasn't really hungry.

Tuesday, 15th April: While at work, I experienced a general pain in the lower abdomen.  By bedtime this had located itself in the bottom right of the abdomen, a classic sign of appendicitis.  On a scale of 1-10, the pain was about 2-3, and I could prod it without too much problem