Wednesday, August 20, 2014

Even more haematology

Haematology outpatients this morning below, with last time's and normal range. Platelets are within the normal range for the first time for ages, other values much the same as four weeks ago, outside the normal range but tolerable. Dr G was pleased there was no drop in WBC or Hb. He acknowledged that deciding the hydroxycaranide dose was pure guesswork so it was left at six times a week.

Blood tests
Aug-14 Jul-23 Normal
WBC 3.75 3.8 4.5 -10
Hb 108 108 130-180
PLT 388 470 150 - 450
Neutrophils 1.7 1.74 2.0 - 7.5

Monday, August 11, 2014

Optician, amd knee

Cataract and macular degeneration in both eyes diagnosed by optician today. Cataract in right eye can be dealt with surgically, she thinks, and is writing to the GP to refer me to King's accordingly. Macular degeneration is incurable and gets worse with time, but maybe I will be able to see until July 2016

GP telephoned this evening to inform me about the scan of my right knee. The cartilage between the bones is nearly worn out, and physiotherapy is needed to strengthen local muscles. Waiting list for physiotherapy at King's is 18 weeks

Oh well, can't be helped, as JW says.

Friday, August 01, 2014

More haematology

Notes from start of hospital stay May 14 to June 4 with pneumomia includimg 16 days in ITU:

Pneumonia etc

May 14, 2014 we both woke early and were up by 06.30, to have a cup of tea before going to King’s at 07.45 for the blood test required before every haematology appointment. Then back home for two more cups of tea and the newspapers before the haematology outpatients appointment at 10.00 which as usual turned into 10.45. The consultant Dr Aldawi said the platelets were OK, but haemoglobin was only just above the level where a transfusion would be needed. He wasn’t concerned about the slightly raised temperature I had the previous evening and at 02.00 that morning, or that I had coughed up bloody phlegm. He listened to my chest and said he couldn’t hear anything. But finally he ordered an x-ray which showed that I had pneumonia in my right lung., and Dr A said he would arrange for me to be given intravenous antibiotics. He left the consulting room for half an hour, and on his return said I would be admitted to the day ward All the cubicles were occupied and there was a further wait but when I was finally admitted it was clear they were not going to let me go. Lindsasy went home, returning at 15.00 with  washbag,  slippers and dressing gown, plus a sandwich, fizzy water and a tangerine.
At 16.00 the saline drip was replaced by 1200 mg Augmentin drip. Dr A said my kidneys weren’t working properly, as indicated by a rise in the creatinin reading from 108 to 180 since the previous blood test, but at the time this didn’t trigger an investigation of the renal arteries.
At 18.00 a nurse told me I would be g oing to Elf & Libra, a new ward for haematology patients, when they had a bed space available. !9.45 SATs were 85 so I was given oxygen. But they remained obstinately at around 90 and the next morning a consultant from Intensive Care fitted me up with a more intensive flowof oxygen which increased the SATs to 96. I had an infusionof anti-nausea medication and also of Meropinem.
Friday May 23 I was prescribed Furosamide to reduce water on the lungs, but still there was no suspicion of the renal arteries.

After that in intensive care my writing deteriorated and I can't read it.

Funny that it didn't occur to anybody that fluid retention was a problem linked to the kidneys. After five days out of hospital I was in a bad way and Lindsay called an ambulance on the Monday morning. After ECGs and scans of liver, heart and kidneys it was found that my renal arteries were both blocked, and the following day I had angioplasties and stenting which dealt with the problem effectively. I lost 10 kg over the next three days as the kindneys started doing their job of getting rid of the fluid.

Blood test July 23 (normal range in brackets):

WBC 3.8 (4.5 – 10.0)
Hb     108 (130-180)
PLT n 470 (150-450)
Neutrophils 1.74 (2.0-7.5)

All values are outside the normal range, but the one the haematologists watch closely is platelets (PLT). I take hydroxycarbamide which reduces the platelets, but also the haemoglobin. The dose is varied after each consultation to balance the two values. While I was in hospital I had a blood transfusion (2 units) which did increase the Hb from its previous reading of 8.5.