- 87/8
- Original treatment for endometrial cancer consisting of some
chemotherapy and about 40 sessions of radiotherapy to the pelvis, both
front and back
- 95
- Codeine Phosphate to help "rapid transit"
- ~99
- Dexromoramide, a powerful opioid analgesic for pain relief during
blockage attacks
- 01
- Referral to a gastroenterologist with a special interest in damage
from radiotherapy. Tried antibiotics as bugs in gut can be factor.
- Feb 02 - Started trial of Pentoxifylline (PTX) +
alpha-tocopherol (vit-E)
- July 02 - Hospitalised with series of pain and vomiting (blockage)
attacks. Treated conservatively with IV hydration, morphine and gastric
nasal tube.
- Feb 03 - Reported improvement to gastroenterologist since PTX + vit-E.
Blood
tests during above visit revealed deficiency of vitamin B12,
common in bowel injuries. Regular intramuscular injections
have
normalised levels effectively. These will continue for life
- Aug 03 - Fewer attacks since February visit! Gastroenterologist could not
feel reduction in fibrosis. Recommended PTX + vit-E continues
- Feb 04 - Continue with PTX + vit-E
- Sept 04 - General improvement sustained. Long term
effects of Vit-E at high doses unknown. Stop vit-E, continue
PTX
- Feb 05 - No overall change so stopping vit-E had no effect. The
PTX + vit-E appears to have reduced the impact of attacks
- Oct 05 - Dexromoramide had become
unavailable. Subligual Temgesic tried to no effect
- Dec 05 - A skin lesion, thought to
be Bowens disease, has been developing on Jan's back just outside the
irradiated area. Her oncologist thought now best to have it removed and
examined so referred to plastic surgeons
- 23
Dec 05 - 8 Jan 06 - series of attacks ending in hospital
admission for re hydration
- Jan 06 - Gastroenterologist - apart from above, in the last year
there has been fairly frequent minor attacks of pain. Continue with PTX
and the
essential codeine phosphate
- April 06 - Skin lesion removed without need of difficult operation. Was
actually a basal cell carcinoma
- Dec 06 - Gastroenterologist visit - reported overall deterioration. More
attacks, more with vomiting.
Continue PTX
- June 07 - Gastroenterologist visit - reported reasonable but not good since last visit. Dr noted Jan
had been
relatively free from attacks following antibiotics for a severe asthma
attack. Thought worthwhile trying antibiotics for 5 days every month
as prophylactic. These upset her so abandoned. He also suggested Fentanyl in lollipop lozenge form (Actiq). Not effective.
- Oct 07 - Original Oncologist Jan sees every year. Found iron low and
recommended supplements. Saw GP who thought likely to do with limited
dietary intake and absorption due to
damage. Ferrous Sulphate prescribed
- Dec 07 - Gastroenterologist visit - reported 22 attacks in just over
year. He
was informed about iron levels. He was initially concerned about bowel
cancer
- Jan 08 - Saw Oncologist due to back pain. X-rays and CT scan all OK.
Ferritin levels only rose slightly into normal range. GP prescribed Tramadol for pain before seeing Oncologist.
- June 08 - Attended the first meeting
for patients with Pelvic Radiation Disease at the Royal
Marsden Hospital in London.
- July 08 - Saw Gastroenterologist. 12 attacks in 7 months. No anaemia even
though Ferritin levels still low.
- Aug 08 - Saw dietician who put Jan on some
multivitamin tablets. These upset her so abandoned.
- Sept 08 - Saw Oncologist again. Back pain and right leg weakness
investigated but OK on X-ray and MRI, neither explained. Referred to
rheumatologist.
- Jan 09 -
Pain/vomiting attack late Dec 08, repeated three times throughout
Jan 09. Well enough between to see Gastroentrologist and
Dietitian. Told of report from Dr Delanian who used Clodronate with PTX and Vit-E. Dietitian prescribed juice style vitamin drinks called Ensure Plus Juce.
- Feb/March/April 09
- Saw rheumatologist who saw earlier MRI. Leg weakness confirmed on
examination and nerve conduction tests. Physiotherapy helping with
improving strength.
- Oct 09
- 12 pain (blockage) attacks. Saw Gastro & Dietitian. Continue with
PTX and vitamin drinks. As pain very severe during attacks advice from
pain team recommended Effantora (buccal Fentalyl).
- Nov 09 - Saw Oncologist and was assured all was generally well, current problems notwithstanding.
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