I was reeling from shock, being sick and really struggling with the Epoprostenol, there was also the selfish thought in the back of my head, if this can happen to someone in the same position as me, then it may well happen to me, especially as I am twenty years older. My main concern, however, was thinking of my friend's family and the loss they had suffered this weekend. Things felt very low at this point and very bleak. I didn't think they could get any worse and had to believe I would adjust to the drug increase sooner, rather than later, I had to summon up the strength to stay positive.
By mid morning, things declined again. The consultant came to see me and explained that they would slow the increase down and give me a day off to try and recover from the sickness and eat something. That suited me in the circumstances of the day. She also explained they were going to give me a second specialised medication to help, Sildenafil, once they had increased the Epoprostenol to the target dose. No going home for me on Tuesday then, in for another long stay! My mind was quickly registering as I was being told all this, that I was lucky at least they were still able to do something and I was here trying my best to get through it, determined I would. I was being given a second chance, unlike my friend, and must stay positive.
The consultant then went on to give me another 'bolt of the blue', she was referring me to the transplant team to assess if I was ready for a lung transplant, as the PH team felt it was time to explore this avenue before things deteriorated. I was reeling in shock again and wondering how much more I was going to be able to take. But positive thoughts, better to get another door open if that was what was needed and another option in what was now becoming a journey to keep alive.
Lung transplantation is really a last resort option when drugs begin to fail to do their job, it is a route that may offer a better quality of life, but not a route to be taken lightly as after transplantation there are no more alternatives, it is final and comes with many risks. For some patients there is a chance of better quality of life and a chance to live longer than the prognosis offered by drug treatment, and this is the main aim. Contrary to popular belief, patients do not go riding off into the sunset completely cured, but for a tiny minority this may happen and longevity of life is restored. For the average patient one set of problems is usually swapped for another, but a better quality of life is achieved.
So I have lost a friend, I am struggling with drugs, my PH is not stable, there is more drug increases and drug adjustments to be made imminently and now the very daunting prospect of having a lung transplant looming much more closely than I ever anticipated. This is the point where one small step at a time needs to be put in action.
First and foremost, I have to get these drugs increased for my own safety and deal with the side effects.
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