Sunday 26th April 2009

Hi All,

Not a good week this week really. I've been playing around with drug doses and combinations (apparently two of the anti-emetics I was on are not recommended together, so I tried cutting each one out) and things were definitely worse for most of the week - lot's of uncomfortable nausea leading to lots of time in bed and simply not being able to eat enough food. I've lost quite a bit of weight which means that I am now just below my ideal weight for the first time since I was about 20! Trouble is, I'm losing it from my muscles, not my wasteline!

However, there seems to be some possible light ahead. The Palliative care team recommended a new drug regime which I've been on for two days now. Early indications are positive - I'm still suffering from nausea, but it seems less, particularly in the morning, and I do have the option of upping the dose of this new drug, so we'll see if things develop well.

The new regime means dropping all four of the anti-emetics I was on, and swapping my Lansoperazole ant-acid for the similar Omeprazole (which I was on right at the start of all this). This switch allows me to have two a day, one in the morning and one at night.

The main change is that I now have a once-a-day, nightly tablet called Haloperidol to manage the nausea.

Haloperidol is a multi-purpose drug, and is a bit scary because it's main use is in the treatment of Schizophrenia! Here's a few things that Wikipedia has to say about it:

Haloperidol is an older antipsychotic used in the treatment of schizophrenia and, more acutely, in the treatment of acute psychotic states and delirium

Haloperidol possesses a strong activity against delusions and hallucinations

The peripheral antidopaminergic effects of haloperidol account for its strong antiemetic activity. There, it acts at the chemoreceptor trigger zone (CTZ). Haloperidol is useful to treat severe forms of nausea/emesis such as those resulting from chemotherapy.

But most worryingly ...

The peripheral effects lead also to a relaxation of the gastric sphincter muscle and an increased release of the hormone prolactin, with the possible emergence of breast enlargement and secretion of milk (lactation) in both sexes.

So, the chance of growing Moobs - nice! Hopefully, the dose I am on is extremely low compared with that used to treat psychosis, so I may be able to avoid such side-effects!

I've got to stick on this dose for 5 days before we decide whether to up it slightly. I am finding that it doesn't last for the full 24 hours so far - it may get better once its had a chance to build up in the system, but I am definitely encouraged by the better mornings. I am really hoping for some good news here, because based on last week, I just couldn't see myself getting back to any semblance of normality, and that was really starting to get me down. However, I am glad to hear that there are still a few avenues left open even beyond this one, so here's hoping.

Thanks for all the comments about the band by the way - you can see/hear more at www.greatband.co.uk if you want. No more gigs for a while, but to be honest I'm glad. I need more time before I can get back to doing gigs regularly, so a quiet spell has come at the right moment!

Time to go and try and get some dinner down me, even though every possible food type reminds me of poison at the moment :(

Cheers

Col.