Friday, June 12, 2009

Not well...

Well it might be time to face facts... Whatever it is that is ailing me is fairly serious and the most likely scenario now would be Hodgkins Lymphoma.
My cough continues to get worse and I've run a constant low grade fever of around 38C for the last few weeks.

Sure it certainly looked like radiation pneumonitis when considered in the light of the clear CT scan, but once the Doctor admitted that the two look exactly the same under CT and PET the alarm bells started ringing. The scan wasn't clear at all, it had an area that they thought was inflammation but just as easily could be cancer. What a bummer!

At the moment I feel very similar to how I felt when I returned from Germany and developed a severe cough and tightness in my chest with about two weeks.
Today I am at the worst I have been since symptoms first appeared two months ago. Perhaps I've picked up some sort of other bug too, hence the fatigue. Last time I exercised heaps and managed to keep on top of it energy-wise. I'll see if that helps this time too.

I emailed Dr D'Souza this morning to say that the antibiotics did not appear to be having any effect and that I was concerned that time was now of the essence due to the two month delay. I asked that he make my case a priority and if he could schedule a meeting as soon as possible to discuss further tests and my treatment options should it be Hodgkins.
He emailed me back straight away asking that I see him first thing Monday morning.
Certainly fast by any standards.

I know they will want to redo the CT scan to see if the area of involvement has changed or spread to surrounding lymph nodes, a bad thing. However if the area is in exactly the same place as the radiation field covered then it could be inflammation. If it's outside of that field it's most likely HL but could then possibly be treated with further radiation... so many possibilities..

Work-wise I have decided to close the workshop next month. I'm not well enough to be trying to do the physical work involved and I think I'll be better off concentrating on getting well, no matter what the cause is of my illness. If I need to get out of the house then there's always the building of our new house to oversee.

I'll post again next week once I've spoken with the doctors.

Tuesday, June 9, 2009

It's never so simple...

I just got off the phone to Dr D'Souza. Man talk about a Chinese puzzle to sort out!!
He said that the written CT report describes areas of inflammation in the lungs.. fine we knew that.
But he then goes on to say that it could be caused by three things... Hodgkin's, an infection or inflamation (radiation pneumonitis).

OK I have no problem taking that in.. But it gets tricky when trying to work out which.
He said that a PET scan would light-up exactly the same for Hodgkin's as it would for inflammation.. so we would be none the wiser. I suggested throwing steroids at it and seeing if things improved, therefore proving inflammation. He said that Hodgkin's responds to steroids much the same as an inflammation.. so once again we would be none the wiser as to which we were treating.

So we are going to throw some heavy duty antibiotics at it and see if we can't at least get some sort of result that way. If it doesn't work we are still left with two possibilities... one of which could be Hodgkin's.. I don't want to consider that. I'll stay focused on it being an inflammation.
Meantime I'm doubling my dose of inhaled steroids to see what that does as I have had some modest success with the dose I'm on now and my GP said I could double it if I felt I needed to.

Monday, June 8, 2009

Radiation Pneumonitis ?

Not that I'm obsessive or anything, but having spent many dozens of hours scouring the internet for an answer to what ails me, I've found one scenario that fits like a glove. Radiation Pneumonitis.

Symptoms include constant cough and a low grade fever. I've emailed my Haematologist, again, I bet he's sick of hearing from me! He's given a quick reply asking that I phone him tomorrow morning to discuss things.

My formal written CT results show that there are some areas of inflammation in my lungs, so that too fits with my theory. It's a serious condition that if left untreated can cause permanent lung damage, but it's easily treated with steroids, so I would expect to see a rapid improvement after just a few days.

It annoys me somewhat that I first complained of a constant cough over six weeks ago and it's been completely ignored once the clear CT scan came through. If I wasn't the sort of person to push and push for a result it would be three more months until my next scheduled appointment and by then the damage would be done.

Fingers crossed that this is in fact the problem!

Sunday, June 7, 2009

So why the long face ?

At a time when so much seems to be going so well, you'd think I'd be dancing in the street and singing from the mountain tops.. alas I just can't shake this feeling that something is not right.

Maybe I'm expecting too much too soon, maybe it's just this bitterly cold weather we have been having.. That would good if it were so simple, An attitude change could fix it all.
However I have a few thorns in my side and until I can get some answers, I can't relax and enjoy my declared "remission".

I still have a cough. It's nowhere near as bad as it was, and it seems to have been tempered by a steroidal based inhaler. I no longer cough when changing from a cold to a warm environment, but have a bit of a cough when I talk sometimes, and in the morning, like an old smokers cough.
That gives me some indication that perhaps it's the lung damage that showed on the CT scan. If I have a cough for the rest of my life.. then so be it, as long as I'm alive to complain.

The other thing I have is a constant low grade fever. I run at about 37.5C during the day and peak at about 38.4C during the night. This has been going on for about a month as far as I'm aware. At night I either sweat or feel chilled. There seems to be no in between.

A constant low grade fever is a symptom of Hodgkin's disease. However I have a CT scan that shows I'm clear so I'm going to have to take a leap of faith and believe it. The other causes of constant low grade fever are a viral infection or a lung infection. The latter fits in with the cough.. wouldn't that be a nice co-incidence.

If it were Hodgkin's and it had somehow managed to hide from a CT (How it could do that I have no idea) then I'd expect to have all my other B-Symptoms back as well. Back pain, Itchy skin, night sweats and an intolerance to alcohol which in turn produces an extreme back-ache.
None of these I have.

Other symptoms I have are lack of appetite and fatigue. These are symptoms of Hodgkin's but also of a lung infection or a virus. I emailed my Haematologist last week, but have yet to receive a reply. I'd say I'm going to have to push really hard to get someone to look at this one seriously as the clear CT will no doubt be more of a hindrance than a help when it comes to getting extra tests done.

If it's just a bug and it clears up in a few weeks, then fantastic, I'll throw a huge party and everyone is invited... if it's not ... sheesh... I wouldn't even know where to go from here.

Oh! one more bit of good news (so I don't end on a low note) Our building consent approval came through on Friday. I couldn't help but notice that all the paperwork had been date-stamped "approved" on May 27th, it just took them another week to inform us! So that piece of news can technically be added to May's list of good fortune. :)