Once more into the breach part 2, I told them I was ill

I've now had my second Haematology appointment at Plymouth. We had better co-ordination between Barnstaple and Plymouth this time so that this the Doctor had my blood tests results before the appointment. Apparently Barnstaple is paired with Exeter in Devon (but not Plymouth) and has a robust on-line reporting system through "My-Care", but this appears to be a different system again from the NHS App. I understand Plymouth are adopting My-Care in 2026 as well, so perhaps then we'll have all the results in one place.

An AI waiting room

At the time I wrote the last blog I don't think I'd seen my test results. It appears the only value that was outside limits was my platelet count. Haemoglobin level was as good as it's been since I finished treatment last year, but the low platelet count, coupled with the mild night sweats and swellings in my neck and armpits are the main signs that the lymphoma is returning. We aren't helped by the fact that the platelet reading from Barnstaple is lower than when the measurement is taken at Plymouth but both readings are lower than the acceptable lower limit and are gradually trending downwards.

A word about night sweats for those who are interested and need to calibrate their condition. When I talk to the Doctor about night sweats she always asks me if I'm having to immediately change the bed clothes. My sweats are not at that level, I'm more at the mildly moist stage as opposed to soaking the sheets. As always everything is relative.

If you look up low platelets (thrombocytopenia) on Google it tells you what can cause it (beside lymphoma or leukaemia) so I've had some virology tests to rule out these other causes. I've noticed heavy Alcohol use is also on the list so perhaps it won't hurt to try out dry January and February to see if it helps (once I've finished off my latest four bottles of Ghost Ship!)

Other beers are available!
©Harveywetdog

As my nodes are continuing to swell the Doctor has decided it's time for treatment to start. She's basically considering three options:

1. Venetoclax (tablet) and Rituximab (intravenous)
2. Acalabrutinib (tablet) 
3. Zanubrutinib (tablet)

The first option is very much like the treatment I had initially, albeit with Obinutuzumab rather than Rituximab, but the Doctor was slightly concerned that the treatment should have given me a longer remission period so is less keen on this option this time. The benefit of option 1 is that it is a set course of treatment.

Options 2 and 3 you appear to commit to take indefinitely. They have the benefit that you can take the tablets at home without the need for visits to the haematology unit but they do come with some risks to the heart so I need to have that checked out before we can decide on a specific course of action.

An AI patient

Diagnostic cardiac services are provided by a private company in the South West and I'm booked in for a check up early in January. There was a slot in the week before Christmas but I chickened out as it would have meant a 7:30 start (and because it was the week before Christmas!)

In the meantime I'll keep enjoying the trips out around Dartmoor with the video camera and hopefully one day it will stop raining!

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Harveywetdog/Author - David Robinson CEng FIET 

David spent approaching 50 years in Her Majesty's Electricity Supply Industry before retiring

He was part of the highly successful design team on the Sizewell B Nuclear Power Station Project before spending 25 years producing safety cases to keep our aging AGR fleet generating for the good of the nation

He is responsible for the Harveywetdog YouTube Channel which he maintains as an outlet for his creative talents

David has experienced blood cancer treatment twice but refuses to be a victim

All views are of course his own but might be influenced by the medication he's had to take