Medical visits and Welsh whisky

At the drive-through blood test

It has been an unusual week. On Tuesday, I went for the pre-immunotherapy blood tests. These were taken in the park-and-ride carpark in Cambridge. They have erected a large marquee in one corner, where cars were queuing to enter, being directed to one of five lanes. There, I had to wind down the window and hang my arm out while the phlebotomist wheeled up a trolley with all her gear to do the necessary. It all seemed very odd, yet strangely efficient; they had all the paper work and sample bottles ready, the test was done quickly, and the result was available on the Addenbrookes website later that evening.

On Wednesday, I saw the oncologist who examined my rash and listened to my moans about how itchy it was. In fairness to myself, the pruritus had become almost unbearable, being constant and waking me several times at night, unless I dosed myself up with strong painkillers and antihistamines while smothering my whole body with various creams and lotions, including some with strong steroids and antibiotics in them. The urge to scratch is almost irresistible, despite Ann's constant warnings, but it is she who finds the blood in the bed each morning and has to change the sheets and pillowcases more often. The doctor looked me all over and agreed it was bad, so called in his consultant. She too made me strip down and looked all over. Her decision was to postpone the next immunotherapy for two weeks, as this was probably contributing to the rash, and commence an immediate dose of strong oral steroids. The way I explain immuno is simple: the immunotherapy triggers the immune system, firing it up like pouring petrol on a smouldering fire. The gush of flames in the form of active T-cells attack the cancer cells, trying to incinerate them like they should any foreign body (that's how they fight infections). The trouble comes when the fire is so intense it starts to burn other organs in the body. It is non-selective, so every organ is vulnerable: kidneys, liver, adrenal gland, thyroid gland, heart, pancreas - all my be attacked leading to their failure. That is why they do the blood tests every month, to check for liver function, renal function, diabetes etc. The skin in my case is a sensitive organ, and the T-cells are attacking it, making it flare up in an itchy rash. At least that means the immuno is doing its job and has fired up the T-cells. Now the steroids are the equivalent of a fireman coming along with a powerful hose to squirt and quell the flames again! But already the rash is fading and the itching is easing, so the firefighting is working too. But now everything is pushed back two weeks, and the whole rigmarole of Covid test, blood test, and consultation will have to be repeated. Hay ho.

Then last night, Ann had a phone call from WSH asking if she was free to come in for her cataract operation next day at 8a.m. She had been delaying it for some time because of needing to drive in case I fell ill suddenly, but they had had a cancellation, and as I no longer needed to isolate or be driven, she agreed to go ahead, so this morning I drove her to the hospital. Three hours later, I drove back to pick her up. She is very brave; she has had both eyes done now, but hopefully it will give some improvement to her vision, for though blind in her right eye she still has some peripheral vision in it, which hopefully will sharpen a bit now. The eye is sore now, and weeping, so I have dressed it with a sterile eye patch.

On a happier note, I suddenly received a bottle of Welsh whisky, Penderyn, this week. I have been adding a tumbler of whisky to my various hypnotic concoctions for sleep, so it was welcome, but it had no note explaining who was the donor. Ann put it on Facebook, and it turns out to have been Edwin as a little cheer-me-up. I am not familiar with Welsh whisky, but it seems that, historically, they have been using stills there since the 5th C. so there is a long history behind it. The Welsh-born prime minister, Lloyd George, introduced legislation in parliament specifically to support it becoming a high-quality legal product and move away from the poteen cottage industry. So thank you Eds, most generous, and I look forward to sampling it - though it may have to wait till I'm off my steroids.