Monday 30 March 2009

Tick tock

Waiting for the funeral and celebration of my gran's life to be over tomorrow. I bought some lovely tops today to wear - one is bright purple with fawn and beige stripes, and a green and pink floral top with pink sequins on it - nicer than it sounds honest! Gran liked bright colours and would hate everyone to be in unrelieved black.

Poor Cirrus is coughing still - he did improve almost entirely then got worse again - as a result David the vet is coming on Wednesday to do a tracheal wash on him to see if we can figure out once and for all what the heck is going on with him!

Physio is very pleased with my leg this morning - so much stronger - I can do nearly 30 one legged tiptoe manoeuvres in a row now! It still looks pretty ghastly - weak and still discoloured - I'll get some recent pics and blog the whole story soon, for posterity like!!

Anyhow that's all for today, just checking in.

Hugs

Niki xxx

Thursday 26 March 2009

Night and God Bless

Peggy wasn’t a glaring inspiration,
nor a loud explosion of greatness,
She was an everyday hero,
Comfortable and safe.
A hot bath after a cold day in the rain,
Freshly baked bread.
She was a good sport, a special smile,
A guaranteed cuddle.
She was an open fire when the frost draws in,
A hot pudding when the craving sets in.

She was an exemplary Grandmother,
Loving and comfort,
A safe haven from the perils of life.
Gran was coming home for Christmas.

She was a wonderful Mom, much treasured,
much loved.
We all carry her loving everyday, in every way.
Much missed, always loved,
Our memories will never rest.
Always in our hearts.

Night and God Bless.

Funeral on Tuesday - kinda life on hold til that is over. My head has been horrendous, stress does that, and its gutting as I haven't been able to be as supportive and helpful as I would like. This is when I hate the TN most, when it impacts on other peoples lives in a negative way. It hurts.

I miss Gran, but in a way I can pretend she's still around, just not here, I guess Tuesday will put paid to that. I have talked to her as well, so I know full well she's not here physically. She sounded happy and relaxed, though she was definite that the hearses wheels had to be clean - so picture me running round with rags polishing on Tuesday! I hope the weather is good - she was so obsessed with the weather!!

Niki x

Monday 23 March 2009

Good bye Gran

My gran died this morning.

Sad.

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Sunday 22 March 2009

More on my Gran

She's not doing so well today - the Dr's say that it is all stuff that can happen after a gut op, but its depressing and distressing to see. She is vomiting a lot, and as the gut isn't working its basically poo that is coming up. Which is grim for her poor girl. She is so thin and frail and obviously feeling terrible.

I did manage to give her a good dose of Reiki today, which made me feel better, and hopefully her as well.

My face has not been great today - had a busy day yesterday with the horse dentist, so it was hard work for me as there is a lot of interaction, holding noses in place!! Both were very good though. I slept this morning, had some really odd dreams again, I think I need to listen to the nice dreams CD again!!

The travelling to the hospital and then the visit is always tough on my face, but there you go - but I'm back home and pretty sore now, had two lollipops today. I have physio class for my leg tomorrow at 9.00 a.m.

Must go, its Lost now!

Niki xxx

Saturday 21 March 2009

DBS stuff

Here are some extracts of the correspondence.

Extracts from a letter from HCW to Oxford:

“The reasons for this (decision to refuse funding) are listed below:

the panel took into account the clinical and treatment history of the patient, the current clinical evidence for the use of DBS to treat this indication, and HCW’s new technologies policy (*NB/ need to get a copy of this).

From the information you submitted (Oxford), we understand that Oxford is one of only 3 centres in Europe undertaking DBS for pain, and has treated about 64 patients over the last 10 years, 18 of which were for face/head pain. …HCW’s view is that the application of DBS to treat neuropathic facial pain is experimental and as such constitutes research. GMC (what is this?) guidance states that “before starting any research you must ensure that ethical approval has been obtained from a properly constituted and relevant research ethics committee”.

Unfortunately, despite our best endeavours, we have not received confirmation from you that this procedure for this patient is adequately covered by research ethics approval. In the absence of this information, the Panel were unable to approve funding.

If you believe you have any exceptional circumstances or additional information to support this funding request, you may request a copy of the Review Policy which explains the review procedure should you wish to request one.”

Extracts from an e-mail from Edwina Hart, Minister for Health and Social Services:

explains the process of HCW looking at my funding via an Individual Patient Commissioning Panel. She states that she has asked her officials at HCW write directly to me to explain the reasons for turning down the request for funding and outline the process for requesting a review of the original decision. (waiting for letter)

Extracts of a letter from Prof Aziz to HCW:

“you state that DBS for neuropathic pain is experimental. This is not the stance the Body of Neurosurgeons internationally would take. DBS for pain is one of the oldest indications but the numbers remain small as very few patients are referred for this to specialist centres. … the ethics I have are for understanding the physiology and research into the cognitive aspects of DBS for neuropathic pain – the procedure itself is fairly standard.

He concludes with a pithy statement on the track record of Wales’ funding for patients such as myself.

Extracts from e-mail from Professor Aziz’s DBS Pain Specialist nurse Liz Moir (in response to an e-mail from my father)

“With regard to HCW there is nothing further we can do this end to overturn their decision not to fund. We have previously been through the appeal process and failed. The issue of moving to England is obviously a drastic measure, and I have to advise you that even if Nicola moved and registered with a GP in any area, we would still have to apply for funding and there is a chance this would be turned down. DBS for pain is almost always funded in England on an ‘exceptional case’ basis and this involves a panel from the patients local Primary Care Trust meeting and discussing each individuals case. If it is felt that the patient being considered for treatment is not exceptional over and above any other person with the same condition then treatment is not funded. Proving exceptionality is difficult, particularly for those of us who care for patients in chronic pain as we deem all of our patients to be exceptional cases given the chronic nature of their condition.”

She notes that Oxfordshire PCT is not good at funding DBS, and no PCT “routinely” funds for it. They are occasionally successful in their appeals.

Plans:


See Neurologist – to a) get advice on treatments available, and whether they agree with the idea of DBS and b) to be under a physician’s care for med adjustment and care as at the moment I have slipped between the cracks somewhat and have no way of adjusting my meds, as the GP has no authority. This has to be a Welsh consultant as HCW will not take advice readily from another English Doctor.

See Mr Simpson – my Welsh Neurosurgeon – for advice on other surgical treatments available, other stimulators etc. And his advice on who to see above.

See AM Kirsty Williams again

See PM Roger Williams

Talk to Liz Moir – get reassurance over potential effectiveness of DBS, any other ideas, get stats about DBS for pain, and any contacts if possible, case studies.

Any other ideas gratefully received as ever!

Its all rather depressing, and a lot rests on whatever a neurologist says, and of course I can't predict that - though all I know and have tried, certainly strongly indicates that there is nothing else to be done, that wouldn't be very likely to make me worse off (for instance any other ablative procedure) but while I know a lot, I'm not a Dr!! ;) It is all very boring though, and I am very tired at the moment, what I would give for a rest. Hey ho....at least the sun shines!

Niki xxx

Friday 20 March 2009

Clickering

Today we had another lesson - Cirrus was working on standing with me moving to different positions around him and then with me moving away from him - he found me moving at 90 degrees ok, and I could stand by his tail with him maintaining his position. He found me moving off at 45 degrees a bit harder, but got the idea very quickly. We did this on both sides. This is an important part of our training so we concentrated on this - I got a few things wrong on occassion, as did he, but we both did it right more often. I'm getting better at making quick decisions on how to react if he moves or does something not what I want, and he is getting better at figuring out what I really want him to do. I'm very very pleased with him.

He seemed to feel much more like himself today, and coughed only twice despite being in, so fingers crossed its over now. He'll be in tomorrow as well as we have the dentist. My good friend Liz was here as usual and took a few pictures - they are a bit in the shade as I was sticking to the shade so the sun didn't trigger my TN.

Very attentive - me working with him - I've told him to stand here - very early on in the routine.

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Doughnut had a good session as well - he's been a bit over attentive in the field so we are going to work on not doing stuff with him till WE want, not when he offers the behaviour! Today we started teaching him about moving into the lead rope pressure - tiny bit of pressure on the lead rope, and then a treat when he moved his head towards it - this was relatively easy for him. Then we did some backing up - here a combination of the word "back" followed by a small pull backwards on the rope with the hand into his chest and the treat in the hand, all leading to him taking a backwards step to get the treat - I have to be careful to stay in a neutral position until after I've said "back". Once he is starting to back up on the cue word I can start thinking about the quality and quantity of steps.

Then we did an emergency stop with him - he follows the target very nicely now, and we got him walking forward and then suddenly stop and step back slightly - thus the target disappears, and he then stops and turns to find it - reward. This means if he ran off in front due to a scare or something, he would then realise the target/person has disappeared and will know that they are likely to be behind him - and turn to look!

It was very funny this morning when I brought them into the yard - the target I use is a yellow reflective boot for legs - when we walked into the yard there was a round head of a stuffed toy giraffe (dog toy) and he stopped and touched it!! Later he did the same during the session - so is def the [i]colour [/i]he is seeing, not the shape etc.

Here are some pics of Jenni working with Doughnut:

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Thanks Liz for the pics!

I have some news about the DBS, I'm going to copy the letters received here, but probably tomorrow as it is late now, and I'm pretty disappointed about it all. Not looking good. My Gran is still doing ok, hopefully we get a day off visiting her tomorrow (its a 45 min journey to the hospital) as my Uncle is back from ski-ing.

Niki xxx

Wednesday 18 March 2009

Good news of my gran

Went to see my Gran this afternoon - she looks so well, despite the surgery - I guess the three units of blood worked the oracle!

Her tumour was about the size of a football!!! Madness...

She was moved from ITU back to her room in the private ward while we were there. She is rather doped up, and being a bit confused at times - but that is only to be expected. She still has the epidural in (which doesn't make her legs numb!) She has an ileostomy rather than a colostomy, but she's relieved that there will be no more rushing to the toilet!

I won't go to see her tomorrow, I was feeling rather ill by the end of today, combo of the stress and the lights in the hospital, but I'm so relieved to have seen her and how well she is doing.

My Dad got a letter from the Welsh Health secretary today, saying she would write to me to explain why they had refused my funding - its pretty uninformative, again re-iterating that there was insufficient information from Oxford for them to make a decision. I'm thinking that getting a consultation with a Neurologist wouldn't be a bad thing to do now, but has to be a Welsh one as it is pointless seeing someone outside of the country as HCW won't take their recommendations seriously if they approve the DBS treatment, or fund any treatment that they suggest given they are outside the country! Heyho. I think the thing to do is write to Brian Simpson again and ask who he recommends.

Niki x

Tuesday 17 March 2009

Good news

My gran pulled through the surgery - now we have to wait and see how she does. She is in ITU, and apparently happy - drugged up to her eyeballs and in no pain as she has an epidural!

So big relief. First hurdle over.

Niki xxx

Kauto the Star

Well what a Gold Cup!! Kauto was awesome! It was a great day and I was delighted with the result - and what a race My Will ran for 5th - no wonder he is now favourite for the Grand National!!

My friend Val came over to watch Thursday and Friday's racing with me which was lovely.

Cirrus was still coughing and refusing to eat his antibiotics and so the vet suggested mixing it with fruit yogurt and squirting it down his throat in a syringe - which I have duly done and the cough did get better-er - so I then got a few more doses to make up for the ones not eaten. He seems to like the Vanilla and Rhubarb yogurt!! It does get all over me though - trouble is I can't fit it all in one syringe-full so have to have a hiatus while I re-fill it, which is when he takes advantage and runs off! He will also refuse to be caught if he sees the syringe and pot so you also have to be sneaky about that. I'm taking someone with me....

As we speak my Gran is in surgery - according to the text messages sent by my Mum and sister who are there with her, the surgeons were reluctant to do the surgery as they felt the risk of her not coming through were too high - but what is the alternative - a guaranteed horrid death?? I was amazed at how happy and perky my Gran was this morning, knowing that the op had arrived and the cancer was going to be taken out - and that says it all to me. I'm thinking of her very hard and waiting on the phone...

It is incredibly frustrating to me that I can't be there waiting with my mum - I'm good at that kind of thing (not to say Caitlin isn't, shes wonderful and very good as well) but my TN makes me more of a liability now for long waits in places with strip lighting. It makes me feel even more useless and disenfranchised.

But at least I could talk my Gran through the whole operation procedure!!

Niki xxx

Thursday 12 March 2009

CHELTENHAM!!!

I wait all year with bated breath for the Cheltenham Festival - so am totally immersed in it at the moment - its been a great year so far, and am eagerly awaiting the Gold Cup tomorrow.

Jump racing is so visceral - you can feel every emotion, the whole gamut, from anticipation to delight, to despair to devestation, in the space of 10 minutes - and you are allowed to feel them, no pretending, no covering up, no being brave, no slippery slope.

It's bad for my TN, the reading the paper as a PDF, the excitement, the talking, the watching the TV with squinted eyes because you've taken so many drugs to try and damp the pain down so you can concentrate 100%. My concentration is shot at the moment and any extraneous noise totally distracts me and ruins the whole thing - so my poor gran has been persuaded to stay awake and then to go to bed after lunch rather than lie on her chair and snore!!! Poor lady, but god she is loud!

I was so excited and scared when Master Minded ran in the Queen Mother - you want the legend to come good - and he did, even though he was obviously not at his extreme best. Ruby rode him beautifully and it was a great race. Its a shame Voy Por didn't take his chance as well as I felt 2 1/2 in the Ryanair today was a bit far for him - but I don't think he'd have beaten the Master! I loved Simon Holts comment last year during commentary "He's making Voy Por Ustedes look ordinary, and he's NOT ordinary!"

Didn't have a lot of luck with the betting today, but more than covered my bets yesterday - I don't bet big, and never more than I can afford to loose, and only at the Festival and Aintree - but it adds a bit of fun to it all, though sentiment will trump any bets I have made in a finish!!

I have a mouth ulcer - right on an occasional trigger point - so very annoying! Its stupid how something so inconsequential can have such an impact!

Cirrus is still coughing and I'm struggling to get him to eat all his antibiotics in the evening - breakfast he yumm's up....sigh. He seems to have gone off the speedibeet as well which is typical of him. Hey ho.

Hugs

Niki xxxx

Sunday 1 March 2009

Great link!

This is a great link for information about TN in all its forms, the treatment options and drugs.

http://www.brainandspine.org.uk/information/publications/brain_and_spine_booklets/face_pain/trigeminal.html

Niki x