Blood Test

Today I have been over to the GPs surgery for a blood test and I have to say that it went very well.

The doctor was very good and got into the vein first time and got the blood out and the vacutainers full. I was also quick to be seen, I barely had time to sit down.

This blood test is roughly at the 6 week point between my last appointment at UCLH where they are now seeing me every 3 months when I have my Zoledronic Acid treatment for my bones and the next one at the start of January.

Fingers crossed that the results will come back and show no major increase to my PSA and also nothing else to worry about.

Overall I feel fit and well and am getting around a lot better although I still use a walking stick when I go out walking.

I have tried to reduce the amount of morphine I take for the pain in my back, I now take 10mg in the morning and 5mg at night.  The are slow release tablets and cover me all day.  I did try stopping the nighttime dose but found it a little painful in bed and it interrupted my sleep so I have started to take them again.

I also take 10mg of Amitriptyline at night and wonder if I could get away with not taking this any longer. I think I will discuss it with my Oncologist in January in case there are side effects coming off it.

The Acupuncture that I had has been going well but I think it was more effective when I was having 3 sessions a week rather than one a month. So I am thinking of stopping them.

As I say I am feeling a lot better and what I really need to do is continue to build up my strength and endurance by walking more. I still need to be very careful with my back and in particular with bending and lifting as the vertebrae above and below T12, the one which partially collapsed and I had cement put in are both very vulnerable to collapse as well although I hope the Zoledronic Acid is helping to strengthen them 🤞.

X-Ray showing my damaged vertebrae.

So I am hoping the results for the blood test come back soon and show good news.

Oncology Outpatients and Zoledronic Acid

Back up to London today for my Oncology Outpatients appointment and for my Zoledronic Acid infusion.

Given I was on the 09.07 train from Stortford it was fairly quiet although the tube was busier.

The streets were quiet with arrows to mark the way!

I made it to the hospital in good time. On arrival I was asked to wear one of their masks which was different from when I was here on Monday.

I checked in and made my way to the first floor reception.

My name was soon called and I was pleased to see that my appointment would be with Dr Mark Linch, the main man, I hadn’t seen him for months 😀.

He asked how I was and I told him I was feeling well apart from my back although I also said I was feeling much better.

He looked up my PSA and told me it was down slightly to 85 from 90 and a high of 1,585 a year ago.

Overall he was pleased at how the Lutetium Treatment had gone. The PET Scan showed that tumours had reduced in size and activity which was great news.

He also said that he felt that the Immunotherapy treatment I had 18 months ago may have helped to prime my immune system to help out with the Lutetium. He also said that the immune system can develop memory and may continue to attack cancer cells now that they have been shown what to do.

I have been wondering about the effects of immunotherapy and how long it stays in the body and active. Is it a permanent change or does it fade over time? I don’t think they know yet?

So now I am to go onto what is called Active Surveillance and keep an eye on my PSA. I am go have a blood test in around 6 weeks and if it is stable I will have an Outpatients Appointment in January 2021. If there is a rise then I should let them know and I will have an appointment sooner.

I also raised the point that I seemed to bruise easily and that my skin seemed very fragile, he thought this may be down to the Dexamethasone and so reduce my dose down to 0.5mg from 1.00mg.

So once the appointment was over I headed upstairs for my Zoledronic Acid infusion. While there wasn’t a lot of people around I did wait a while before being called into the Treatment Room.

I was then fitted with a cannula, again it was a struggle to get it in and while the piercing of the skin is not too bad the wiggling around and trying to get it in the vein makes me wince.

My blood pressure was quiet good today the top image is before the infusion.

Again it took two attempts to get it in, both in my hand. They started with the bigger pink needle but then used the smaller blue needle the second time.

Finally fitted

Once the cannula was set up I then had another wait for the infusion and it was about 12.10 before the infusion was started. Its 15 minutes for the infusion and another 10 minutes for the flush.

The infusion was no trouble at all and soon the cannula was being removed without the same amount of fuss as going in!

It’s all about this little bag of liquid!

And then I was free to go and hopefully I will not be back at UCLH until next year 🤞😁.

I am really pleased with the news I had today and just need to think about what else I can do to help myself.

My back is getting better and I feel stronger so longer and more frequent walks. I need to be very mindful of my back as it is still very fragile so exercise that will not be a threat to that is a must.

I think I will also look at my diet again both in terms of health and cancer prevention but also with a view to losing weight.

So back on the train feeling happy and looking forward to the future.

Covid 19 Swab and Blood Test

Well I am off to London today, to UCLH for a Covid 19 test. It’s actually a bit of a pain as I need to go all the way to London just for a test before coming up on Wednesday for an Outpatients Appointment and Zoledronic Acid treatment.

It has been a while since I have been on a train so it will be a useful recce for Wednesday.

The train arriving at Bishops Stortford

I am also hoping to get a blood test today as they couldn’t get blood out last time. I have spent the morning drinking water and have had at least 2 pints on top of tea and coffee. I hope the extra fluids will make it a little easier to draw blood?

The train was quiet and so it was easy to maintain social distancing, the tube however is a little different and is slowly filling up. As you can expect there are still those who feel they don’t need to wear a mask or wear it correctly!

Soon I was walking down Tottenham Court Road, they were arrows on the ground to help with distancing but clearly they were invisible to some!

I arrived at the Macmillan Cancer Centre and was pleased to find out that the Covid Testing was being done where they do the blood tests 😀.

I checked in and took a ticket, I was number 8 and the counter was on 7, I had hardly say down when I was called in. It was to be a blood test first.

There were two plebotomists in the booth, one to take the blood and another to record my details.

Once more they struggled to get blood out despite all the extra fluids I had drunk. But she was very good and it was painless although watching her wiggle the needle around made me wince.

Second attempt was in my left hand where she struck blood and soon it was flowing, albeit slowly.

Blood taken I was moved into another booth for the Covid Swab, I was pleased someone was going to do the swabbing, it’s better than doing it yourself.

And then I was done, I must have only been in the hospital for 10 minutes or so. I bet it won’t be so slick on Wednesday!

And then it was time for my journey home. Around 2 hours of travel time for 10 minutes in the hospital!

Just need to wait for the results and the all clear which I should get tomorrow 🤞.

Oncology Outpatients 3 June

Today I had my oncology outpatients appointment via a telephone call with the same doctor that I spoke to last month. The appointment was quick and efficient and to me it seems like a good way to do these more routine type of appointments and is something I hope they continue to do going forward.

The doctor was pleased with my PSA result as was I, 88 is a good number to be at and a good leap down from last month’s figure of 144.

We also discussed whether I was Borderline anaemic and he felt that there was nothing to worry about and that no treatment was needed as it was very borderline. I accept what he says but I will modify my diet to include more iron rich foods, I may also start to take iron supplements to give me that extra boost.

We then then went on to discuss whether I should have Zoledronic acid ( this is to strenthen my bones) at the start of July and he said I should go ahead with that appointment so that will be a trip to UCLH for that treatment. I will need to consider how I get there.

So with the appointment coming to an end and I was given the all clear to go ahead with the Lutetium treatment on Friday. I did ask a cheeky question as to whether the treatment was available on the NHS yet but the answer came back that it wasn’t yet available. So going forward I will need to continue with the London Clinic.

So being given the go ahead I am looking forward to my day trip to London and seeing a little more than just the view from the house and the garden, and of course it will be a little adventure 😁👍.

Lutetium No 4

Second time in 4 days that I am heading up to London, this time it is for my 4th Lutetium treatment.

The Zoledronic Acid treatment I had on Tuesday went OK but I have been suffering with some side effects. The main thing is I have been feeling very tired and have also been having chills. There is increased pain in my lower back although it could be my kidneys as they are recognised as side effects.

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We arrived just after eight and was shown to room three; I feel like this is my room as I am in here every-time I come up.

The nurses were soon in to fit a cannula and take my observations which were all fine.

And then around midday my doctor arrived and we had a quick catch up.

She wanted to hear how I had been and what else had been going on since I last saw her in December.

That done she explained that they were going to differ the process for giving me the Lutetium, mainly because they had a new lead lined box that helped protect the staff from the effects of radiation.

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The box had been developed at Guys hospital and they were looking to bring it to the London Clinic and I was the guinea pig.  As well as my radio oncologist, there was a physicist and his boss in attendance with a Geiger-counter to check radiation levels and to see how much protection the box gave them.

Inside the green box was syringe pump which could be set so that the lutetium was injected into the drip at a set rate.

Here is a view from above.

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You can see a groove in the perspex and in the right side of the box, this is where the tubing would make it’s way outside of the box.

And the picture below shows a tray which holds a syringe with the flushing solution connected to a three way junction.  The purple coloured cylinder is what fits over the syringe while it is in transit in a lead box, it looked fairly heavy so I guess it is lead as well.

tray

So overall the process of administering the Lutetium was a little slower as they went through the steps of using the new box but it seemed effective and the physicist with the Geiger-counter kept making happy noises and nodding his head with a smile.

Well they should be well protected in the future.

As for me I was getting the full effect of the radiation and would be in a kind of isolation for the next few days.

I was given a radionuclide isotope Lutetium – 177 with an activity of 7400 MBq and my exposure rate was 18 microSieverts per hour at 1 metre.  The isotope has an effective half life of 3 days.

In terms of isolation I was to avoid close contact greater than 30 minutes, which means we keep our distance and sit at either end of the sofa.  It also means we sleep in separate beds for 4 days.

And then it was back to waiting, throughout this process Barbara is not allowed in the room and so she went off shopping to console herself.  I then had a few hours to wait while the Lutetium worked it’s way around my body.

Come 4 pm I was given the all clear and we headed home.  I was feeling fine and was hoping that the Lutetium was doing it’s stuff.

Back on Monday for the Gamma Radiation Scan.

Zoledronic Acid

So something new today, same old journey but to a new floor in the Macmillan Cancer Centre at UCLH.

I find myself on the 4th floor which is for Supportive Care and Apheresis. I am here for the Supportive Care part and not Apheresis which is about removing a certain constituent from the blood.

I am here for my first infusion of Zoledronic Acid which is delivered intravenously. The Zoledronic Acid is supposed to strengthen my bones and will hopefully help prevent further fractures although I will still need to take great care with what I am doing.So it is all new for me today and I will have to see what happens…….

We arrived a few minutes late for my appointment, checked in and then waited 45 minutes before I was called into the treatment room.

Much the same as other intravenous treatments I have had, my blood pressure was taken and was 158 over 88, slightly high I think probably down to nerves with it being a new experience.

I was soon hooked up to a cannula and the drip. I was to have 100ml of Zoledronic Acid followed by a flush. 15 minutes for the acid and 10 for the flush.I barely had time to read my magazine and it was all over, cannula removed, plaster stuck in place and there I was booking my next appointment for 4 weeks time.I did think treatment was every 12 weeks and will check with the Oncology team when I see them in a couple of weeks.