Sunday, November 30, 2014

Return Of An Unwanted Consequence

This post was started just under two months ago, upon our return from a holiday in the Cook Islands.  At the time, it was going to be a reasonably small post dealing with the effects of the climate in the Cooks on my post-treatment system.  However, every time I sat down to complete it, something else sprang up health-wise and that took priority.

This then, is a completely clean-sheet post in which I'll bring you all up-to-date.

Towards the end of August, my throat started playing up again.  It became really raspy and I was having difficulty swallowing.  A visit to Tatiana saw some words uttered that had last been heard in Sept 2010 - Oral Thrush.  The condition is a direct result of the lack of saliva allowing the bacteria to grow, but nature had kept it at bay for 4 years, so why now?  Tatiana has no answer for that and "bad luck" springs to mind.

Anyhow, I'm given some Nilstat to take for a week and told to come back if it is still a problem.  In fairness, it did start to settle down quite well, so I just continued the Nilstat for an extra week for safety.

By then it was about time to board the big bird and spend a week in what is now my favourite Pacific Island destination  (If somebody wants to shout me a trip to Hawaii, I'm prepared to reconsider that viewpoint).

The trip to Rarotonga and Aitutaki was the first off-shore excursion since the end of my treatment, so to some degree it was stepping into the unknown.  Sure, I'd been told I needed to be more careful regarding sunburn around my neck as the radiotherapy had an impact on the tolerance levels, but apart from that I'd been given no special list of dos and don'ts.  The 2012 Christmas Day heatwave hadn't presented much in the way of issues, so I was pretty relaxed about it all.

And, to be honest, apart from the need for a slightly increased water intake, the holiday went without a hitch.  It seems that the heat even benefited my ankle as I had absolutely no issues with it, despite doing a fair bit of walking. 

So, relaxing on the flight back home, it seemed my body was quite happy to visit the islands again whenever the desire took me.  You know there is a "but" coming now don't you. 

But, everything was not as it seemed.  We stayed overnight in Auckland on the Thursday night, prior to catching a red-eye flight to Wellington the following morning.  Without word of a lie, within 4 hours of landing in Auckland, my throat was flaring up.

Come the Saturday, it was so bad I went to the after hours Doctor for an 11:45am appointment.  I got home again after 10pm that night, eventually spending all afternoon and evening at the Hospital.  At this point, I should probably mention I developed a rash on day 4 in the Cooks that was very reminiscent of my previous sun tan lotion allergy (although the brand of lotion I'm using now has been trouble free for a good 7-8 years), and the antihistamine wasn't doing much to relieve it. So, I presented with the sore throat and rash.

To be fair, the symptoms made the Hospital ponder somewhat and after some blood tests they came to the conclusion the oral thrush had come back with a vengeance and the rash could be viral, related to the thrush. Goodie.

I came away with more Nilstat and some analgesia to help ease the sore throat and was referred to the Acute clinic for follow-up the following week.  That follow-up ended up being the week after (Oct 13th), and by the time they saw me, things had settled right down.  Throat was more than 95% OK, no visible signs of the thrush and the rash had fully gone.

Come Friday Oct 17th, I was back at the Doctor's as the throat had flared up again!  This was really starting to get annoying. I saw the duty Doctor and he prescribed some antibiotics and more Nilstat along with instructions to see my regular GP the following week if things don't settle down.

Friday 24th, I'm back seeing Tatiana, and low and behold (as women will know) antibiotics actually induce thrush.  Tatiana wants a two week course of Nilstat (apparently one week isn't really enough) and if that doesn't work she would look at some pretty potent oral medication.

No prize for guessing where I was on the 13th of November.  I walked out with a prescription for more Nilstat (including repeats) and Fluconazole tablets.  The fluconazole is apparently an anti-fungal and prescribed to people who have had radiotherapy - and I'm wondering why wait so long to offer this solution to me then.

Instructions were to take the tablets for one week in conjunction with Nilstat.  Apparently there isn't an exact science to this, so I was told to mix and match to find something that worked.  Oh, and I can't take more than a week at a time - there needs to be a week gap between course of the tablets.

At the end of week one, things were going pretty damn well, in fact almost back to normal.  However, that was short lived as the sore throat returned within 3 days of stopping the pills.  That meant I had to wait until yesterday before I could start the 2nd course, and although today is only day 2, there has already been improvement.

All this isn't helped by the current travel I'm doing out of town as that requires a fair bit of talking ,which aggravates the throat even more.

The relief from the Nilstat has also become a lot shorter in that it only offers 1-2 hours relief now whereas it used to provide 4-5 hours. On top of that, the effort required to swallow as painlessly as possible takes a fair bit of energy and I'm knackered at the end of each day.  This weekend has been really low key as I just don't have the energy to do much.

Needless to say, it seems there'll be another visit to Tatiana in the coming days and maybe even a sit down with Mr Morrissey before long to see what he can offer.

In the meantime, this coming week should be pretty good and it will be the following one that will be a downer.  "Life is a roller-coaster" as the song says,

At this late stage of my journey, at least in my mind, I'm not meant to be having these sorts of issues.  Something has changed and until I know what it is, I'm suffering an automatic escalation on the "dread level" scale.  PMA is doing well to keep it to a minimum as I'm currently convincing myself it is only a short term anomaly, but the longer it goes on, the harder it gets not to worry about it being something a tad more sinister.

No comments:

Post a Comment