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DIARY


Case History

* This page details current 'issues', illness, doctor's visits/appointments, and hospital visits/appointments *

I thought of this idea a while back, and that is to document EVERYTHING hospital related that I am going through, and even trips to the doctors (as long as it's related to my Sickle Cell). I think this will be of help to people, to see that it is possible for a sickler (someone with Sickle Cell) to live a semi-"normal" life.

I don't think I will include anything previous to the dates below, neither will I try to backtrack with hospital visits I have made. This will ensure that the information given is as accurate as possible, as it is written as near the date as possible.

Also, if there is no information included after a certain date, then everything is okay with me.

New ideas for this page have been:

** added canula siting attempts

= February 2003

** change page name = DIARY (not case history)

= September 2002

** current pain scores **

= 29 January 2002

** pain updates

= 28 January 2002

** areas affected

 

** initial page idea

= 11 November 2001

 



Date:
28 April 2003
> Blood transfusion<

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Date:
21 March 2003
> Blood transfusion<

Haemotology ward was busy today as they were short staffed today. I spent most of my time watching the nurse connect the cables to the machine, saline bags, anti-coagulant etc, and she explained whilst she did this.

I received my results from the nurse, and she explained what the results meant.

Attempts to site canula
- First attempt: The nurse got the needle in, and it appeared as if it were in, but stung quite a bit. On attempting to flush the line it was apparent it was not sited correctly, hence my scream of agony with the sharp pain! :o)
- Second attempt: Did not site properly, so aborted.
- Third attempt: Different nurse attempted, and they both saw a different huge vein at the same time. This vein was finally used and canula was sited successfully.

It was 3:45pm by now (arrived 14:40) and they administered Medazolam to sedate me. Last thing I remember at this point is counting backwards from 20. On being woken up, I was meant to have said, "-1, -2" etc, but don't remember a THING.

The Haemotology Unit have a new blood transfusion machine, which I helped them pioneer on it's first introduction to the ward around a year or so ago. There were problems initially, so they had to stop using it and go back to the old machine. I will take a picture of the machine next time and put it on the website.

Felt drowsy after transfusion today, but was fine to wonder to the bus stop and home. Rested all evening, completed this page, and added results.

 



Date:
18 March 2003
> Blood test <

I requested a Glucose level was taken today, just to check for diabetes as a few members of my family have it. Also, I was drinking quite a lot of fluid (one of the symptoms), so just wanted to check everything was fine. Called on 19 March and all was ok.

 

Update to 10 Feb 2003 Well where the femoral line was irritating me calmed down after a while, and it just turned into a normal-type bruise. I didn't feel there was any need in going to hospital for it, as they would have only confirmed what I already knew and just would have said, "it's a bruise and should disappear in X days".


Date:
10 February 2003
> Update after transfusion<

The area where the femoral line was inserted is irritating me, most probably a sign it is healing. I always get this to some extent, but I will phone them tomorrow to ask exactly if everything went ok with the insertion of the line.

Apart from the issues above it's been fine though. As always, trying to recollect the events the day after was a 'challenge'. And today, a little comical event, I looked in my diary and in MY HANDWRITING see an appointment booked for Friday 21st March for my next hospital transfusion appointment, I have very little recollection of this!!!



Date:
07 February 2003
> Blood transfusion<

Went to work before going to hospital today, which was ok as it suits me this way.

Arrived around 1pm for blood transfusion. It took 4 attempts until a vein was found where the canula where the Medazolam is to be administered was found, and it took some pain to get there.

Attempts to site canula
- First attempt: Nurse was mis-informed to administer local anasthetic to the area for trying to site a canula, so I didn't feel the pain involved in this attempt. Left arm.
- Second attempt: Right arm, vein was missed, minor pain.
- Third attempt: Different person this time. Vein was missed, but nurse wasn't a 100% sure of this, so tried to 'flush' the vein with saline. This was painful! Left arm near site of first attempt.
- Fourth attempt: Canula was sited at the top of my right arm above elbow (sort of on/near the bicep)

Just before attempt Dr Bevan, my hospital doctor, came and asked for this website address. Hurrah the flood of students!

Canula was sited and then had to wait a little, then the Medazolam was administered. Next thing I remember the line from the vein in my groin being taken out and pressure being applied to the area in order for it to clot and stop bleeding. Next the canula in my arm was taken out and then I remember being woken around 4:45pm.

My leg was numb. I had never experienced this after a transfusion, so this was new to me. I nearly collapsed when I tried to stand on it. Maybe I was laying awkwardly on it, or the blood didn't circulate into the leg properly, but it still affected me so had to be very careful. Got dressed next. The nurse was having some problems printing from the computer, so I helped her out there. Went and washed hands etc, booked appointment, then wandered down the corridors and went to the bus stop and came home.

I do not recall any of what I say under the affects of Medazolam, and there's always this strange feeling I get like I may have said something and couldn't quite remember it. One of the main things I remember about the whole hosptial affair is when the nurse administered the Medazolam and waking up 3 hours later!!!

Life is mad...



Date:
04 February 2003
> Blood test<

Went for my blood test first thing in the morning at the hospital, cause I had some training nearby, which is to do with my current employment..



Date:
01 February 2003
> Impending visits to the hospital this week<

The countdown to going hospital happens now. I'm sure there's a mental thing which happens when I know an impending hospital visit is due. Anyway, I have a blood test due on 04 February and transfusion due on 07 February. I'll keep you posted.



Date:
20 December 2002
> Blood transfusion<

Written on 01 February 2003 - from what I recall everything went fine with this blood transfusion. I do recall being tired beyond comprehension! :)




Date:
08 November 2002
> Blood transfusion<

Everything went ok today. Got there 15 minutes late, which was ok as they weren't ready for my transfusion yet.

Canula was inserted after the second attempt, and Medazolam given. Next thing I remember was being woken up and the tube taken out...

They used a different kind of needle/tube today (and from memory I think the last time too). This new needle gives less resistance when it's taken out. This causes around 75% less pain, so you just get the sensation of the tube withdrawal, not the pain usually associated with it. Why couldn't they use it in the first place???

As always with Medazolam I recollect little fragments of thoughts which I believe happened while I was under the influence. Today's recollection was just of pain. I do not know exactly all what happens, and I do notice the nurse's reluctance to tell me everything that happened! See specimen A: Taj - :o)

Saturday...

Slept like a "baby" last night :o) - I was well worn out after yesterday.

Spent most of today just resting, sorting out stuff on the computer... My weekend feels so short after Medazolam :o)




Date:
05 November 2002
> Blood Test<

Just a blood test today, which was straight forward. Bought a digital camera recently and took it with me. See pictures page for the result of this :)



Date:
09 October 2002
> Doctor's Appointment at Hospital<

Had a doctor's appointment today which went well. These 6-monthly sessions are to see how my treatment is going and to ensure I am happy with the service provided. If there are any issues which I feel need to be raised I can also raise them at these appointments.

Feritin (hope that's the right spelling) is present in the blood and based on the amount your iron level can be calculated from it (that's what I think anyway). If this builds up too much they will have to think about giving me a drug to bring it down. The level of Feritin would have to be around 2000 to start using the drug, but as I understand it my level is way below this.

In general the doctor feels my treatment is going well and that there are no issues which need our attention.




Date:
27 September 2002
> Blood transfusion<

Went to work before going for my transfusion today, and also phoned before making my way to ensure they weren't busy with another patient before I went.

Arrived around 14:00, and canula was sited and transfusion given. This was a straight-forward procedure, hardly any pain when I awoke (I think I remember them saying something about a new form of femoral line tube). If all transfusions went this way I would be very happy! :) Altogether a good experience.




Date:
25 September 2002
> Blood Test<

Went to the hospital before going to work today. I find it works out better this way than to start work then go to hospital.

Everything went ok, and they are prepared for my transfusion on Friday.



Date:
23 August 2002
> Blood transfusion<

Arrived at the hospital at 13:00, as appointed, but as they were understaffed (damn NHS) I had to come back in an hour. Seeing as I had a heavy bag I thought I might as well go home and drop it off while I had the strength, and then come back to the hospital.

Arrived back about 14:25, and they STILL weren't ready (inside I was frustrated), but I didn't lose my temper (I never really do anyway). They had to wheel in another bed, then moved the other person (who was unconscious from the Medazolam) and put the bed which I was to be on where they were (next to the blood machine).

Awoke at around 17:45pm, everything had gone OK with the transfusion (according to the Haematologist).

As I still had concerns with regards to my liver being tender, I had asked the doctor to be present today. I informed the staff there that I had arranged this, and the 'bleeped' the doctor to come to the ward. My liver wasn't hurting like it was the other day, so when the doctor felt it, there were no complications. Doctors always give you this look like, "are you sure you're telling the truth?", which I got the feeling of today (which I hate so much!) but we'll leave it at that. My liver was slightly enlarged, but the doctor looked at some results from 1999, and my liver was a little enlarged from back then (i.e. no real problems then). My results were still not present from the ultrasound I had had recently.

A canula was sited and Medazolam was given around 15:15. I tried to resist the drug (i.e. not fall asleep), but the next thing I knew I was awoken around 18:00 (so I failed!!! :o). Today I had some recollection of pain (maybe when I wasn't fully unconscious), but the nurse didn't relay any of this information to me.

Altogether this was a successful transfusion, although the day didn't start out as if it would be this way. Nothing to follow up really, the next appointment has been booked for roughly 5 weeks away, so hopefully no problems in between then.



Date:
21 August 2002
> Blood Test<

I came to the hospital before work today, didn't want to start work, then leave, then go back to work again. Got there about 9:00am or so. I let the nurse know I had an ultrasound as my liver wasn't feeling 100%, and she said if I was worried then we could arrange for a doctor to be present on 23 August when I was due for my transfusion.

The blood test went without problem.



Date:
6 August 2002
> Hospital - Ultrasound<

Went to the hospital today for an ultrasound due to some tenderness in the liver area. The result was that my liver was a little enlarged, but that everything was OK. The enlargement of the liver was/is put down to Sickle Cell, and therefore nothing to worry about (if it doesn't hurt any more etc).



Date:
2? July2002
> Doctors - worried about liver<

Went to the doctor's surgery as I am concerned about my liver (as it hurts when I press the area). He confirmed it was a little large, but that it was nothing to worry about. He told me to book an appointment at the hospital (see above).



Date:
7 June 2002
> Blood transfusion<

I cannot remember the specifics to this blood transfusion, but if there were any problems I would remember them (if you know what I mean). Nothing to report here...



Date:
17 April 2002
> Blood test, for transfusion due on Friday<

Just a standard blood test procedure, to which the vein was found promptly. Have hospital appointment on Wednesday for blood transfusion. Lately have noticed that I haven't been feeling 100%, which usually happens around this time. Started taking notice of my s% etc lately, results for this weren't at the hospital (someone didn't fill out the form for this result!).



Date:
01 March 2002
> Blood transfusion<

Arrived at the hospital at 09:30am, as appointed.

Medazolam given at around 10:00am

Awoke at around 12:45pm, everything had gone OK with the transfusion (according to the Haematologist).

Whenever I have Medazolam, I do notice a side effect of it, which is that throughout the remainder of the day I'm fine, but I have trouble recollecting my thoughts from earlier. If I'm reminded of something that happened, I am more likely to 'remember' it.

 



Date:
26 February 2002
> Blood test, for transfusion due on Friday<

Going for a blood test today, which is for my blood transfusion which I am booked in for on Friday. Hopefully this will all go OK (meaning they'll find the vein in one jab, not two or three!).



Date: 02 February 2002
> Stayed in, treating pain with analgaesics <

Stayed in for most of the day today, just treating pain still with analgesics, but it's getting better now, so much better in fact that I am going to go to work on Monday. Went out later to do a little socialising, but came in after about 1 hour cause I don't want to push my luck!

This is the last update of the current pain at the moment, as there's no point continuing if there's no real pain to document.

Osei

** current pain score ** - jaw = 15%, chest = 10%, rib pain = 20%



Date:
01 February 2002
> Stayed in, treating pain with analgaesics <

Woke up at 10:47am - realising that I could go to the doctor's if I was quick. So, quickly left to get the doctor's opinion on the pain which I have in my stomach / lower rib area. Arrived there at 11:30am (morning closing time) and was quickly seen by the doctor.

Conclusion: a quick diagnosis by the doctor was that the bones in the rib actually make a lot of the blood so the pain I am feeling in this area is from the lower rib which makes the blood just aching from making the blood so quickly (and to do with the sickle cell etc.), so there was nothing to worry about.

So, it's 12:08am and I'm writing this. I'm not sure if I can trust the doctor on what he's said. I know he's a doctor, and with many years of experience couldn't doubt his information, but from what I feel in my rib area it doesn't feel as though it's a small issue. With this pain, I will remain aware of it and hopefully it will not cause problems in the future.

At the moment, my CPSs are:

** current pain score ** - jaw = 35%, chest = 25%, rib pain = 30%



Date: 31 January 2002
> Stayed in, treating pain with analgaesics <

Woke up at 10:47am - realising that I could go to the doctor's if I was quick. So, quickly left to get the doctor's opinion on the pain which I have in my stomach / lower rib area. Arrived there at 11:30am (morning closing time) and was quickly seen by the doctor.

Conclusion: a quick diagnosis by the doctor was that the bones in the rib actually make a lot of the blood so the pain I am feeling in this area is from the lower rib which makes the blood just aching from making the blood so quickly (and to do with the sickle cell etc.), so there was nothing to worry about.

So, it's 12:08am and I'm writing this. I'm not sure if I can trust the doctor on what he's said. I know he's a doctor, and with many years of experience couldn't doubt his information, but from what I feel in my rib area it doesn't feel as though it's a small issue. With this pain, I will remain aware of it and hopefully it will not cause problems in the future.

At the moment, my CPSs are:

** current pain score ** - jaw = 35%, chest = 25%, rib pain = 50%



Date: 30 January 2002
> Stayed in, treating pain with analgaesics <

The pain was better today than it ever was. I think it's on it's way out so I should be able to go to work next week. I am able to eat better today (which is a good thing cause I enjoy my food) but I haven't been able to eat properly for the duration of feeling unwell.

** current pain score ** - jaw = 50%, chest = 35%, suspected hernia / rib / stomach pain = 50%



Date: 29 January 2002
> Stayed in, treating pain with analgaesics <

Woke up at around 4 in the morning, took pain killers (as the pain was quite severe). Woke up at about 13:00, as my aunt had previously rang my phone and had come round but had had no answer at the door (cause I was asleep). When she arrived back I heard the door and let her in. Said she was worried.

Stayed in looking after myself. As I am not feeling any pain at the moment I have thoughts of going into work.

Update: Pain is coming back - definitely not going into work tomorrow as there would be no point being in pain whilst working.

Pain Update: Pain is bad in my jaw, cannot chew my food properly. Chest pain is still the same

** current pain score ** - jaw = 65%, chest = 35%, suspected hernia / rib / stomach pain = 50%



Date: 28 January 2002
> Didn't go into work today - went to the hospital as pain still present <

Well, woke up in the morning, and notified work that I wouldn't be attending today. Pain is still bad, as it was in the beginning and hasn't eased up at all.

Phoned the hospital and told them of the situation, that I had been feeling the same all weekend. They advised that I come in and have an x-ray and a general checkup.

Arrived at around 2:45pm. Had my sats taken (98%) and blood pressure. They aren't sure of why I am still having pain, considering I had a blood transfusion on Friday. I was given an x-ray form and sent down to the x-ray department to have a chest x-ray done. Results came back OK (but the Haemotologist said she thought my stomach area (which is hurting) was a suspected hernia).

The doctor said that the x-ray was fine. No indications of any kind of infection like pneumonia could be seen from the x-ray To tell you the truth, I don't think they knew exactly anything that I was having. No abnormalities could be felt for the pains I am feeling around my rib/stomach area. There are no swellings around my jaw or anything, but it hurts like hell! For the past 3 mornings I have trouble to eat toast - just to show you the extent it hurts.

All other functions are as normal. Hospital prescribed me with:

Ibuprofen 400mg (1 to be taken 3 times daily)
Co-proxamol (2 to be taken at 4 hour intervals, no more than 8 in 24 hours)
Amoxycillin (antibiotics - to get rid of any general infections I may have)
Mouthwash (for some small tongue ulcers)
Bonjela Teething Gel (related to the tongue ulcers??? - )



Date: 26-27 January 2002
> Stayed in, treating pain with analgaesics <

The pain hasn't gotten any better, but is under control with analgaesics, which is OK I suppose. Contemplating whether to go into hospital or not, but this will only involve morphine and being 'doped up', which isn't a nice feeling. Hopefully I will get better over the course of the next few days. Not going into work tomorrow, will phone in the morning to let them know...

Pain Update: No more back pain, but jaw is worse and pain still in chest.



Date: 25 January 2002
> Went to the hospital for blood transfusion (1:00pm) <

Well, woke up as normal today, still in pain. Went to do things before the hospital, then started making my way at 12:15. Arrived at the hospital at 12:45 and had to wait as there was someone who had to have an emergency transfusion, which I was not happy about.

Had a line sited and the drugs which I was to be given drawn up into syringes. When they were finally ready (roughly 45 minutes later), I was then guided towards ANOTHER chair! Now, I'm not a fussy person, but you can not give a transfusion in a chair (reclining or not)! They could see I was not happy about this, and went and wheeled a bed from another cubicle.

My S% was 59%, which is high for me, and is the reason for me having my aches and pains.. When they brought the bed in I was administered my sedation, Medazolam, and then woke up around 4 hours later, to be told I had an x-ray (which I knew nothing about because I was sedated), and that everything went OK with the transfusion.

I still wasn't happy with the treatment I had received today, and so hence me writing all this on my website (which previously wasn't updated for 2 months). Hopefully all these problems will be OK for next time. Still feeling the effects of the sedation to a certain extent right now. I will wake up in the morning not remembering all the things I have done today. such is life...



Date: 24 January 2002
> Took the day off work <

Didn't go into work today. Woke up this morning and having a considerable amount of pain. Going to phone the hospital if things get any worse to let them know I will be coming in.

Pain Update: Still hurting, but not going to go into hospital. Will attend appointed blood transfusion tomorrow as planned.



Date:
23 January 2002
> Having pains today - also hospital for blood test (1:00pm)<

 

Last night (22nd) I went to bed early, feeling tired and lethargic. Woke up in the morning feeling pretty much the same way, however, when I went to work I started to have aches and pains, reminiscent of a crisis. I took the day easy, not doing anything too strenuous, and went to the hospital for my appointed blood test.

The nurses at the hospital gave me coproxamol which helped the pain a little. Went back to work to finish the day and then went home and rested. The pain lasted all day, and didn't 'let up', which gave me reason to believe I would be having a crisis.

Jaw hurting a little, like when I am going to have a crisis. Took more analgaesics, pain subsided.

Areas affected: Back (all over), chest (mostly left side) and jaw (left)



Date: 07 December 2001
> Went to the hospital for blood transfusion (1:00pm) <

 

Had to wait 30 minutes, as the person before arrived 1h 30mins late for their appointment. When transfused I normally have a bed, as it is much easier to site the femoral line in the groin. However, as the person before me was late I had to have a reclining chair. Wasn't very happy about this situation!



Date: 05 December 2001
> Went to the hospital for blood test <

Two days before I have a blood transfusion I have a blood test to cross-match the blood I will be transfused with. I went on my lunch break from work (taking up all my allocated time).



Date: 27 November 2001
> Hospital just phoned, appointment postponed <

 

The hospital just phoned to say my appointment has been moved back to next week Friday (7 December 2001)... Also, my throat is better now.


Date: 25 November 2001
> Throat 90% recovered, blocked nose in morning <

 

I think my throat is going to get better now, so I won't update with anything about this anymore. I have a hospital appointment booked for Friday 30 November 2001. Update will appear after this...



Date: 21 November 2001
> Throat a lot better, not taking any chances though <

 

Woke up being able to talk okay this morning. Still taking medication as prescribed, and drinking plenty of fluids. Hopefully I will be a lot better tomorrow.



Date:
20 November 2001 - 11:15am
> Woke up, throat a lot worse <

 

I woke up this morning, and I couldn't speak (mother was happy not to hear my voice *laugh*). Anyway, so I am taking the medicines prescribed by my GP, so hopefully this will help. Staying inside all day, to make sure it doesn't get any worse.



Date:
19 November 2001 - 11:15am
> Went to GP (General Practitioner) for checkup <

 

I have just come back from my GP. I told him I had a sort-of cold, and he shone a torch to the back of my throat, and diagnosed me with having a throat infection. I was given:

  • Co-proxamol
  • Penicillin V
  • Folic Acid

    He advised me that if I felt the infection was still present (i.e. throat still 'tickling') then I was to come back next week Monday (26 November 2001).


Date: 14 November 2001
> 'Outpatient' Doctor's Appointment <

This type of appointment is for a nonspecific reason, but to see if I am well, and to do any checkups, if necessary.

Arrived at 13:25, for my 13:30 outpatients appointment, to be told that the doctor I normally see wouldn't be in today. I was told that another doctor would be standing in for him today. I had a blood test, and went back to the waiting room to see how long the 'stand-in' doctor would be. I was told he was doing a bone marrow (transplant? maybe) and that he was on the Haemotology Day Care Unit, which is situated upstairs to the clinic I was attending.

Went upstairs to have a word with the good doctor, but to be told he would be 30-60 minutes. Didn't have time to wait for him, considering I was on time for my appointment, and came back home.

** Went to the Haemotology Day Care Unit to take a picture of the machine used to give me a blood transfusion... Pictures will be situated here.



Date:
11 November 2001 - onwards...
> Caught a cold

I have caught a cold, but not a typical one. This one has not so much affected my noise, but a cough, which is persistent and 'tickles' the throat. I have detailed this here because colds, and the like, can lead onto Crisis' and/or pains (caught from the lowering of the immune system by the cold). Will detail when the cold has subsided... See 19 November




Date:
21 June 2001 - 25 June 2001 {--written 19.11.2001--}
> My first Crisis in 2 years, 7 months... :o( <

I am on a 6 week blood transfusion regime at the moment, and have been for the last 2-3 years. I went to Jamaica for a 6 week vacation, and was relatively well for the duration of the holiday. I got back on Friday 15th June 2001, and did the normal things until I was due in for my blood transfusion on the 21st June (a Thursday - which would have been 7 weeks), which had been appointed before I went to Jamaica.

Thursday > On the morning of 21st June, approximately 03:30am, I started to feel pains in my arm and legs, reminiscent to that of my Sickle Cell pains, which I had avoided for the past 2 years, 7 months. Called the ambulance soon after realising I was going into a crisis. In the ambulance, on route to the hospital, I was given Entinox to help with the pain and calm me down. By about 04:30am I was in the Casualty (A&E) department. An intravenous drip was sited in my arm, so fluids could be given. My temperature was taken, which was 38.9, so a fan was used to cool me down.

Later, in the day (still Thursday at this point), I was given the blood transfusion which I had been booked for. This helped dramatically, helping to 'dilute' the amount of 'sickled' red blood cells which I had in my body.

Friday > The next day I spent resting, still on the drip, but refused most pain killers, like morphine, due to it's horrible side effects. Today I was in a better state, with a lot less pain.

Saturday > I was up and about, still with pain, but mobility was okay.

Sunday > Feeling much better, and sick of hospital at this point I was ready to go home. Had to wait until the next day for the doctors to do their 'rounds'

Monday > Told the doctors how the pain was (much better), and the fact that I was wanting to go home. I was discharged, with medication to continue with whilst I was at home.