Friday, 22 February 2013

Between a Rock and a Hard Place

'Waiting has never been our choice in the past, nor is it in the present. We are always striving, anticipating the future and preparing for it'  

Flowers amidst the bleakness
I realise that as we go on each day, week and month and years even now, my illness has become 'normal' for me, what was once my normal world of busy wife, mum and teacher has been completely lost now and has somehow slowly slipped away and the reality of being ill and all that goes with it has become normality. Waiting in for drugs, collecting drugs from the pharmacy, visiting the GP, hospital stays, visiting the warfarin clinic, visiting the PH clinic, visiting the transplant clinic, blood tests, walk tests, lung function tests, CT scans, X-rays, echo- cardiograms and ECGs and managing the actual physical symptoms of being ill, which are many, plus all the various medication and intravenous drugs are all the norm for me now, where once upon a time even a visit to the GP would have been unheard of. In fact when we moved to our house seven years ago, I didn't even move GP surgeries for about the first three years! Now it's all normal to me and in the course of our everyday lives, sometimes it feels like I've carved out a career in being ill, which is not how I want to be or be defined, but it is difficult to stop it completely taking over and getting buried underneath the towering heap of it all. It takes a tremendous lot of effort and hard work sometimes to breathe normal life back in amongst it all, but we all keep trying our best and keep striving towards the future and trying to be prepared for my transplant when it comes.

This week has been a difficult one, on Wednesday I went back to Papworth for my three monthly visit to the Pulmonary Hypertension team, this time a full MOT on the day ward. I've done this before and knew what to expect; a deluge of more tests to go through: blood tests, walk test, lung function tests, x- ray, echo-cardiogram, ECG, MRSA tests, Hickman Line and pump checks, plus a thorough checking out by a doctor or consultant. So we prepared ourselves for a very long day.

I don't mind most of the tests now, as I've said, they are all a normal occurrence to me now, but for some reason I absolutely hate and detest the Lung Function Tests. I don't know why really, as they are not painful or anything, but there is just something so humiliating about sitting with a peg on your nose and some technician ordering you to blow this way and that way into a tube, then making you keep repeating it over and over again until they think you have done your best.

'We have to make history and approach the future with steady steps, not wait for the future to come to us'

A whole year ahead of us!
Following all the tests I had a thorough checking over by the consultant. It was at this point, when all seemed to be going well, but then after some discussion about the tests and about my quality of life that she broached the idea of having my intravenous drug increased. She thought my quality of life could be improved by having a higher dose of my intravenous drug and also that by doing this it would be preventative measure against further deterioration while I wait for my future transplant. I also had some signs of deterioration before Christmas and it is two years since it was last increased.  She thinks I need to be able to enjoy a better of quality of life now, not keep putting up with so many restrictions while I wait for the transplant that always just seems to loom in the future and be just outside of my grasp.

Now having the Epopostrenol increased may not usually be too big of a deal for most patients. It involves being admitted into hospital for a few days, the nursing staff will then either increase the flow rate of the pump gradually over a few days or slowly increase the amount of drug in the syringe on the pump, whilst you are wired up to and monitored on a heart tracing machine. All should be sorted within a few days and then you are allowed home if all is well. Some people get some mild side effects: headache, nausea, jaw pain and flushing are the usual ones, but then that normally will subside and you go home and feel much better.

For me it is a different story, unfortunately I have had a worse reaction to Epopostrenol than most patients usually do.  The first encounter, actually, being put on the drug resulted in three weeks of being sick, diarrhoea, searing headache and jaw pain and flushed skin. The sickness and stomach upsets resulted in me being placed on drips because of dehydration and I was unable to eat or drink anything, not even a mouthful of water and became bedridden for days. It then subsided and I had minimum side effects by the time I was allowed home.

Then came the time for the first increase, for this I reasoned well maybe I'm used to the drug it may be easier this time, but this wasn't to be. I came into hospital just supposedly for the weekend and two weeks later after a repeat performance of last time I was allowed home. This time I was still being sick and felt very ill and it took a few months to feel properly back on my feet again, but I have never really been the same again and I still have some side effects two years on and have to have medication for the sickness and stomach upsets and suffer badly from headache and flushed skin. On the other hand the drug saved my life and has improved my Pulmonary Hypertension. Love this drug; hate this drug.

'True joy is that which comes from progress and success.'

Now the consultant is aware of all this, but thinks there may be a chance my body may cope better this time, as I am now well established on the drug, but she cannot promise anything and she did give me a wry smile when she mentioned coming in hospital just for the weekend, indicating well yes it may be weeks!  
Spring has sprung!

So for me it is quite a big deal to put myself through this again, but my biggest worry is what state I will be left in afterwards. It will almost definitely keep my Pulmonary Hypertension at bay and maybe improve my exercise capacity, but it may come at a price of worsening side effects that drag my quality of life back down. We also discussed the transplant with her, and again found ourselves considering similar odds for surviving PH and surviving transplant. As Rob says, for both situations, 'we are stuck between a rock and a hard place'. Impossible decisions. Decisions we wish we hadn't got to make. Sleepless nights. Tears.

Well the transplant decision is made, sometimes I wish I'd just had my transplant right away and then all this would be taken off me, but then again I would be facing new problems, but at least the deed would have been done; however, the transplant decision is made, questioned sometimes and that's healthy I suppose, but the same answer is always forthcoming, transplant is my way forward and the only way I can see to make some proper progress in my future.

I have also made the other decision, a no brainer really in the cold light of day, Pulmonary Hypertension is life threatening, sickness and upset stomachs are not, so with some trepidation, well a lot of trepidation, I am going back in hospital for the increase and I will just have to get on with it afterwards whatever happens. I have asked if I may wait until after Sarah's twenty first, as I don't want to ruin things for the surprise plans we have made. So it looks like the middle of March will be the time.

Sometimes it's along and winding path before you get there! 
So I've got a few weeks respite to pick myself up, brush myself down and go for it. As a friend of ours once said when facing secondary cancer, 'time to get my walking boots out and get ready to climb the next mountain'. And she did, and I will! The consultant told me to stay positive, well for me being realistic is my positive in this matter. Expect what I have experienced before, after all that is all that I have got to measure things from and who knows I may be pleasantly surprised after all. Believing that all will go swimmingly is asking for a fall at the first hurdle if it it doesn't, but I do believe that we will all manage this as a family whatever happens, just as we have always done.

Decisions where the outcome is life changing or even life ending seem to be happening too often for us and Rob is wishing for the time when decisions we have to make are just simple ones again. Decision, decisions and more decisions about illness and life are a thing many sick people have to face and I know I am not on my own this week. One PH friend is facing a decision about life threatening treatment and another is facing the impossible decision about transplant. It would be so good to see into the future sometimes and not have to weigh things up on sterile medical data, which we often end up doing. So here's hoping anyone facing a tough decision this week, can come to a conclusion they feel brave enough to cope with, even if they are unsure in any way.

'People naturally like comfort and relaxation, but it is more satisfying to work hard and enjoy your achievements'

The most amazing news this week and news that gives me some strength and hope amongst all of this is that 147,000 people have signed up to be organ donors. How fantastic is that? Somewhere lives are going to be saved and again, I can't thank ITV enough for raising awareness of organ donation and the plight people like myself find themselves in. The bravery of the donors and the generosity of their families during such a testing and tragic time has also been discussed and the difficult times families have had to face losing a loved one while waiting for a transplant. People are discussing organ donation and that is a wonderful thing. It has been uplifting to play a little part in all of that and I'm sure there will be lots more opportunities along the way to continue the campaign. It was a busy week or so, nerve wracking and fun both at the same time and it's good to see such high rewards after such a big concerted effort by a lot of people.

Rob says that since I said, 'I would like to do something about raising awareness of organ donation and Pulmonary Hypertension, but I'm not sure what', back in autumn, we have managed to do quite well really, talking in the House of Commons, being on the local radio, being in the local papers and being on the regional and national news. We are really thankful for the opportunities that came our way to do this and I'm hoping it will not end there and we will seek out more opportunities to keep up the campaign in the future.

I have put the link to the ITV website below, which is full of transplant stories, so you can see it if you happened to miss anything (you probably needed to be out of the country for that), but really I just like scanning the page because both me and Stacie are on it, doing our little bits and it's a lovely souvenir of the week for us both!

The little proverbs are Arabic proverbs, three years ago during February half term, we were lucky enough to visit Dubai and every day a little proverb card was placed in our bedroom. I just came across the cards recently as I had saved them and thought them apt!   

Just a reminder if you want to sign up to the organ donor register click on:

You can help us get the Government looking at organ donation by signing the epetition: 


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