Chemotherapy and auto immune diseases

Was just commenting on a post in the Vasculitis UK Facebook group today, and reminded of the devastating daily nausea I had for years from Azathioprine. I started taking this drug in 1998 to control my life threatening neurological auto immune disease cerebral vasculitis. Basically the drug controlled the inflammation in the blood vessels in my brain, and kept me alive. Azathioprine is a very old chemotherapy drug, though not just used for cancer, but also auto immune diseases like mine. It’s quite mild, but it can cause the horrible side effects. I would feel sick within 90 minutes of taking the pills, and it lasted for up to 8 hours a day. Every day, for most of a decade. That’s what I lived with from 1998 onwards. Every single day. For some people the sickness goes away. Not me. I stuck with it because I suspected – rightly as it turned out – that all the cytotoxic drugs (including the main alternative drugs I could be switched to, and ended up trying later anyway) would make me hurl. Eventually, after another drug had been added to the mix in 2006, and I said I just can’t cope with this sickness from both, the medics put me on twice daily anti nausea drugs for life. That transformed my life. I wish I’d been on them sooner. Years later I had high dose chemotherapy infusions in hospital, which made me even sicker. But they only lasted a few months. Azathioprine went on for years. So yup, chemo and auto immune disease can be a stinker. And not just the obvious high dose infusions.

P.S. A point that I should add is that auto immune chemo patients don’t get the same support that cancer chemo patients do. We’re not given the same anti nausea drugs. Also no similar arrangements re free hospital parking for infusion days. But it can be just as tough. And a treatment that can go on for vastly longer.

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Brexit and its consequences for rare diseases

I want to post about a consequence of the Brexit result that many people won’t have thought of: the impact on treatment and support for rare diseases. Since 1994, since the age of 22, I have lived with cerebral vasculitis, a 1 in a million diagnosis, which causes day-to-day symptoms similar to multiple sclerosis, but with the added bonus that it could kill me in a flash. Other forms of vasculitis are less rare, but all are rare. Vasculitis = inflammation in the blood vessels. In my case in my brain. Vasculitis is very under-supported by health services worldwide, causing huge difficulties and delays in diagnosis and treatment, which often leads to death. In the UK cuts to funding have impacted on cross-border referrals for vasculitis patients in Wales, seeking to go to centres of excellence in England, to get diagnosis and/or better treatment and support. And likewise for Scottish patients. Equally many patients in England have a considerable financial outlay, for life, for prescriptions of steroids and chemotherapy drugs that keep them alive. For life. No they don’t get these for free. Charities like Vasculitis UK are working to improve things, but it is a very hard job. Much of their funding and research comes from Europe, both in terms of money, but also working with colleagues elsewhere, to uncover new treatments, and improve support for patients. It is very unclear how this is going to be affected. My friends who are actively involved in Vasculitis UK are very worried. Before any Brexit-er tells me it will be ok, there will be a way, that it isn’t directly EU, or that the UK will replace the funding: no, we don’t know what will happen. And for such a rare diagnosis it is hard enough to get support as it is. The relationship with Europe for vasculitis research and funding is important. And right now the people who are working to save lives are very very scared. This makes me sad 😦 And scared myself.

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Reflecting on AcWriMo 2014

As the month nearly comes to a close I’m winding up my AcWriMo activities. And as always around this time I thought I’d look back on how things went.

At the start of the month I had three goals outlined, all involving academic journal papers in various stages of development.

Two of these goals were fully or better accomplished. One was revising an accepted paper, which I turned around in the first week and emailed to the relevant editor. Another was starting to convert a conference paper from spoken talk with PowerPoint slides to a written version suitable for an academic journal paper. I set out only intending to start this process, the first draft of converting the spoken text to words, with much further development and enhancement required later. But as things turned out I went far beyond this, developing many sections of the paper more fully, and having it much closer to possible submission to a suitable academic journal.

The remaining goal was to finish developing an already mostly written academic paper, ready to send to a colleague to read through and give suggestions before I develop it further prior to submitting to a journal editor. This was the only goal not fully completed, although I managed to overcome a major impasse, working out a new strategy for approaching one of the main case studies in the paper, which I then largely wrote up. There are many sections still to be finished off and polished, and it’s not ready for that read through yet. But it is well advanced, and I should be able to get it ready to email off by Christmas, with hopefully the aim of submitting it to an academic journal paper sometime early in 2015.

All this was achieved against the backlog of struggling for much of the month with my neurological illness, more so than usual. There were several weeks when I could barely manage an hour of writing total. And then there were better weeks when I might manage 2-3 hours total if lucky, again done in 1 hour bursts.

The main strategy I found for keeping going when well enough was to think in terms of which goals I would target in specific weeks. So I had in mind key activities for the first week, and the second week, and so on. This broke down what might still have been quite a daunting task – three quite ambitious goals for the whole month for someone so very ill with so limited time – into more manageable chunks. And if I put in the time, even in isolated one hour chunks here and there, I could make slow but steady progress. Breaking it down into week by week goals also helped to keep the momentum going, and that I had to get on with things, lest time slip by and be lost. But I did have to rest when too ill.

Academic writing month can be a wonderful focused time, but for me the best thing about it is the good habits it can help to develop, which can be applied throughout the year. So the importance of making achievable goals and to-do lists, breaking down larger tasks into manageable chunks, and keeping going, even in small bursts, to make progress in spite of time and other limitations.

So I’m very glad I took part again. I look forward to taking part in 2015!

 

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A year in recap: 2013

Just before the old year ends and a new one begins I thought I’d do a recap on how things have gone for me in the last year, particularly academically.

My honorary research fellowship was renewed again. This is from History in the School of Humanities at the University of Dundee. After I finished my PhD in 2010 I asked if I could get an honorary fellowship, to help me continue to access vital resources like electronic journals, which are typically only available to current staff and students of universities subscribing to them. This is particularly important as more and more university libraries switch from subscribing to print copies to e-journals, which, generally, are restricted in who can use them. I’m a life member of one local university library, and have another one nearby, but neither opens up their e-journals to people who aren’t staff or students. So this was important to allow me to keep up to speed with current research and new developments. And the fellowship has been renewed every year since. It’s also nice that when I give a conference paper or publish a new academic journal paper it provides some kudos to the department which has supported me so well.

Over the year I’ve submitted more journal papers. I learned early in January that another paper had been accepted. It’s derived from part of my PhD thesis, with new additional material, and will be published in Library & Information History in 2014. Another prize-winning paper is due to be published at some point in the Journal of the Edinburgh Bibliographical Society. And I was asked to do my first academic book review, for the Journal of Scottish Historical Studies, and it was published in November 2013. Other papers are with editors, or at various stages of development. And I was pleased to see two of my past academic papers became freely available online, under open access rules.

I took part in four academic conferences this year. The first was a conference for archivists, where I gave a talk about my experiences as a disabled user of archives. This was held locally, in a hotel in Dundee, so was easy for me to get to, but I was very weak from the neurological disease that day, and it was something of a struggle. But I wanted to present this important view, and was glad to make it. I blogged about both my time there, and the topic I was talking about.

In the summer I attended one day of a conference about the Middle Ages in the Modern World. This was at St Andrews, my former university, actually very near to where I was once a science undergraduate and postgraduate student. This was much fun. Again my husband was with me on the day, to help me manage everything in my wheelchair, and I blogged about my time there.

The third conference was that of the Economic and Social History Society of Scotland. Their autumn conference, in September, was held in Inverness, and focused on the topic of Rural Scotland. I gave a talk about my postgraduate Masters dissertation research examining Melrose regality court records (local court records for Melrose and the surrounding area) in the late 17th century. I am currently looking to publish this as an academic paper, and got very good feedback and had a very rewarding time there.

The fourth conference was held in late October to celebrate the work of my PhD supervisor who died a month earlier. It had been planned long before he died, and was a conference of mixed emotions, but ultimately positive.

I also had another flying visit to the Edinburgh International Book Festival in August. Not academic at all, but a wonderful celebration of books and reading, and I was very glad to be able to go again.

In November I took part in Academic Writing Month again. My goals were more modest this time: resubmit a revised journal paper (done), and submit a paper to the SHARP (Society for the History of Authorship, Reading and Publishing) 2014 conference in Antwerp (also done). Whether my paper for SHARP is accepted or not I will be there. I’m also planning on going in 2014 to a book history conference at St Andrews in the summer, and will be flying down to London to attend the Worldcon World sci-fi/fantasy/etc. convention at the Docklands.

Another major interest of mine is genealogy. I run a Cavers one-name study, researching all families with this surname, particularly before 1900. Developments on this in 2013 included me starting a new Y-DNA study to use DNA to look for connections between different Cavers lines. I also gave a talk about my Cavers one-name study at a Guild of One-Name Studies regional meeting at Perth. A version of this is online, with PowerPoint slides and my audio delivery.

I also run two one-place studies, where I research two parishes in the past. Both of these have a particular focus, for practical reasons, before 1820. The two parishes are Coldingham in Berwickshire, and Melrose in Roxburghshire, both Scottish Borders parishes with family connections for me. I continue to transcribe and develop online resources for these studies, and in 2013 this included adding a person index of about 9000 names for Melrose court participants between 1657 and 1676. Likewise for Coldingham I put online a list of 19th century prisoners from the parish.

I’m a roleplayer, and play Call of Cthulhu online at Play@YSDC. This works well for my neurological disease, meaning I can play as and when I’m able to. It also means I get to play with people around the world. In 2013 I started a new game in our ongoing campaign of Doctor Who / Call of Cthulhu crossover games. And I also started a game set on the Bass Rock, hopefully the first of many games (if our characters survive!) set in Scotland. Sadly I also dropped out of a game for the very first time – it was proving too unreliable in terms of keeping going, with long periods of inactivity by the keeper which I couldn’t keep up with – but I hope that won’t happen again for a long time.

Continuing the roleplaying theme I’ve been writing more of a series of crossover history/roleplaying articles, which I plan to compile into a book, probably in digital format. This is slow-going, but I hope to make more progress in 2014. Likewise I have been continuing to develop my very long-standing interactive fiction (text adventure) work in progress – a whodunnit set in Hermitage Castle in the Scottish Borders, about 500 years ago. Again another thing to work on in 2014.

My neurological disease continues to be a problem, but is being a bit better behaved at the moment, and may have gone into remission or need less daily chemotherapy and steroids to control it. I’m still left with the legacy of brain damage from the past, and wide-ranging disability that this causes. But I hope for a bit of a break from too toxic a cocktail of daily drugs. And maybe I will be able to get more done in 2014 than I have for a number of years. It may be just a temporary respite, but I want to make the most of it.

Anyway I’m looking forward to 2014 in an optimistic manner. Hopefully it will be as productive and rewarding as 2013 was.

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Challenging yourself in academia

One thing I learned in my PhD is that it’s important to push yourself to try difficult things. It’s possible to get through an undergraduate degree by always playing it safe. Even a postgraduate Masters can be mostly completed in your comfort zone. But when you get to PhD level, it’s only by trying difficult things, and tackling them head on, that you get the best results.

I’ve been trying to apply that since completing my PhD in 2010. For example today I submitted a proposal for a colloquium on library history research to be held in London in early 2015. It would be much easier for me not to go. I have a severely disabling neurological disease, and travelling all the way there, even giving a talk locally, would be very difficult. But I know that I can contribute a lot to the meeting, and so I sent in a proposal. And if I managed to attend the meeting and present my paper I’d get a huge sense of personal achievement.

Likewise the other day I put in a proposal for a conference to be held at Inverness in a few months time. Ok Inverness is not as far away from me as London, but it would still be quite a trauchle (good Scots word – think ‘struggle’) for me to get there. But again I think I can contribute a lot to the conference, it would be nice to get the research from my Masters dissertation ‘out there’, and it may help to see it eventually in print form in an academic journal.

This is also why I’ve been pushing to get my research published in journal articles. Again this is a difficult thing for me to tackle. My progressive neurological disease causes significant cognitive problems, such as considerable difficulty reading, concentrating, general confusion and dementia-like memory problems. So preparing journal papers, and dealing with revise and resubmit for example isn’t easy. But I do it because it’s challenging and rewarding, and seeing my research in print is ever so satisfying. I currently have two papers accepted by journals and awaiting publication, another one being considered by an editor, and another one where I was offered revise and resubmit, and will be doing that. For the same reason I aim at ambitious journals. I have time, hopefully, and would rather wait and work to see my paper published somewhere really good, than go for an easier, safer, less satisfying result.

Of course doing all this requires confidence. But generally that’s something that grows during the PhD process, and culminates in the successful passing of a viva. And then as you get first one paper accepted and published, and then another (I’ve had five single author history journal papers accepted so far) the confidence grows even further. So it’s an ongoing process.

So try the hard things folks. Don’t play it safe. And see where it takes you. Even if, like me, you are outside conventional academia, and ploughing your own path.

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