Thursday, 25 August 2011

I woke up today with this feeling; better things are coming my way

When people go into medicine they often start out with an idealised view that they're doing it because they want to help people. Somewhere in their training a lot of that is beaten out of them simply through seeing such horrific things, often on an daily, if not hourly, basis. They start to view patients as bags of symptoms because it's quite simply the best way for their mental health to cope with the enormity of it all.

As they proceed up the pecking order something odd happens and by the time they reach consultant level they start treating you first as a human being. That's my experience at least.

What comes with that experience though is a firmness in your belief that you are in the right and this is why sometimes consultants can come across as arrogant. Getting people who are so forthright in their opinions to agree on a course of action therefore isn't always easy. I now have consultants for

  • Haematology/Oncology
  • Respiratory
  • Renal
  • Oral/Maxillofacial
  • Lung Transplant

My primary carers are the haematology team at the Beatson Oncology Centre, but ultimately heading towards transplant the consultants with the largest sway are the transplant team. Getting these two to agree on what measures to take going forward has been a slow process and it is only with the recent addition of the renal team that has really allowed an actual concrete plan to be formulated. The renal consultant has put forward a convincing case that I should be able to tolerate the post transplant drug regime and that has led to a decision.

So we now have a plan and that is to take me off Cyclosporin, the immunosuppressant drug that has been doing most of the damage to my kidneys, for a few months to give the kidneys a bit of a rest. After this we will then try a month of being on the full dose that would be given post transplant to see if my kidneys really can cope with what they would have to if transplant were to happen.

What this means for me is that I will now be pushing back my return trip to Newcastle by several months but I don't mind that at all. I am perfectly comfortable and having waited this long for progression I'm just happy that I know what we're going to do.

The other really sensible thing the renal consultant did was to go through my entire repeat prescription list (all 22 items) and look for alternatives that are kinder to the kidneys. There's been a few changes already on that front - doctors at any level tend to prescribe what they're most familiar with rather than the best drug for a particular patient. I understand this completely - few drugs have lots of information on what their long term use could lead to after all and doctors tend to prescribe the most common drug first and only when it causes a problem do they change it. I don't expect doctors to be clairvoyants.

In other news one of the great loves of my life (and now one of my closest friends) is back in the country after a year away living in her native America. I can't tell you how relieved I am that I am in relatively good health and nothing bad happened to me while she was away, especially as one of her best friends died while she was over there. I've been worried the whole time she was away that the worst might happen with me too. I can't wait to see her again to hug the life out of her.




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