The primary struggle in this case being with the output from the ileostomy, but that also caused a complete lack of output on the blog too, so this has been a bit of a double-whammy in output terms.
My problems started in earnest on Friday, with me noticing that my ileostomy output was higher than normal. Initially I simply assumed that this was down to a little normal variation, maybe having eaten something that provoked me a little, etc etc. But by Friday evening it was starting to become clear that there was more to it than that; the obvious conclusion was that this was a side-effect from the chemotherapy medicines.
In the end the output rose to the point that I got no sleep at all on Friday night. Saturday continued in the same form, with my output continuing to climb, and by lunchtime I had decided to restart taking my codeine tablets again. Sadly, it seemed that these need time to build up in your system and take effect, so the output continued to climb through Saturday and Saturday night, with me again getting no sleep at all. By this time I must have been getting pretty dehydrated too, though in the general melee and through my exhaustion, I don’t actually remember particularly feeling so. Yesterday (Sunday) continued in the same vein, with me taking all my tablets (now feeling well and truly under the effects of the codeine) and struggling to drink enough to stay hydrated.
Things finally came to a head yesterday evening around 8pm when I started to feel genuinely ill on top of everything else – realistically this was probably the first signs of real dehydration setting in. At this point you’re supposed to call the doctors, and get them to help, which in general results in a referral to the local Accident & Emergency hospital department. They would then take me in overnight and put me on IV lines to rehydrate me, at which point I’d have to go through the whole “prove you can manage your ileostomy well enough to be released” game again.
So in the end (because I’m like that) I decided to push my luck a little, and give myself until this morning before calling in the doctors. And in the end (because sometimes I’m lucky) I managed to get away with it. I got no sleep again last night, but I did see my output slowly falling away during the course of the night as the medicines finally took control, allowing me to start to catch up with fluids again. By this morning I was merely feeling exhausted from several nights without sleep, with some small remnants of the dehydration left over. And the ileostomy output is back to (roughly) where it ought to be again – thank goodness.
So the lesson here seems to be fairly clear. When I’m on my “resting” week and not taking the chemotherapy medicines, I don’t appear to need the codeine to control my ileostomy. However, when I am taking the chemotherapy medicines I clearly do need the codeine. And sadly, to go from “no codeine” to “enough codeine” (or the reverse) takes at least 3 days and nights. The conclusion is fairly inescapable; I am going to have to continue to take my codeine all the way through my treatment and put up with the affects on my concentration, because I suspect by dropping my codeine I’d managed to get myself within a few hours of a hospital admission, and that’s not something I want to go through again.