Treatment (Days 1-5)

Today was my fifth day of treatment for leishmaniasis. The treatment is a slow, daily intravenous injection of sodium stibogluconate (Pentosam). Slow and diluted with saline due to its toxicity and the painful sensation that trails up the vein during injection and also due to the risk of thrombosis of the vein.

Thankfully I've not yet suffered any of the many possible side effects except being a little more tired than usual but that could just be because I'm in bed a lot and feeling lazy as everything is done for me.

Saying that, I've been out and about every day since Thursday (day two) even including a pint of Strongbow on Friday which the pharmacist and nurses reluctantly allowed me to have. I'm lucky to be on an Infectious Diseases ward though feel a bit of fraud in being here in that I'm up and about all the time and feeling otherwise as good as normal when the people around me have AIDS, malaria, swine flu and tuberculosis. The reason is that sodium stibogluconate apparently isn't licensed to be given anywhere other than this unit.

Only one of the nurses who has administered the drug has done so before. A few years ago she treated a soldier with the disease and said that he didn't have any side effects for the entire three weeks which is promising.

Had a few doctors and medicine students come visit wanting to see the wounds and have a chat. Keeps me busy and is interesting chatting to some of them too. Other than that have been brushing up on my spanish and reading the papers more than anything. Did pop to the library on Friday and picked up Richard Dawkins' Blind Watchmaker. I forgot (after reading Ancestor's Tale a few years ago) how good a science writer he is, even if people have little respect for God Delusion.



As can be seen, the main wound is slowly healing. The second, newer one, is the same as ever. Since Robert Darbishire stopped dressing them, I've been fairly good doing them and only when I've faltered has the second, smaller, wound become slightly infected. Inadine was used again by the nurses here the other day but today replaced that with the silver (Mepilex Ag) that has been so good since Christmas. Very impressed that neither Glastonbury or Barcelona caused any problems. Slightly worried that customs didn't pick up on the hundreds of pounds worth of silver in my hand luggage (the dressings), nor the scissors to cut it, deodorant, shower gel or toothpaste.

The cannula was initially placed in the back of my left hand which was okay but nowhere near as comfortable as the one placed today further up my arm. There is also much less pain on the injection of the sodium stibogluconate further up the arm. Rather than taking the fifteen minutes it has the previous four days, today only took about five minutes. It's certainly not a serious pain for which I'd like to take any further medication; it's just slightly unpleasant and, the first time, worrying not knowing how I'd react. Anaphylaxis and chest pains during injection are to be looked out for.


One potential side effect of sodium stibogluconate is that it can increase the QT interval measured by an ECG. Have been fascinated learning about the P, Q, R, S and T waves that denote different points in the heart's beating. Takes me back to A-level Biology. Learning about the disease itself over the last few months was stressful initially but later very interesting too. http://www.nhlbi.nih.gov/health/dci/Diseases/hhw/hhw_electrical.html

The guy in charge of the Guardian's response column is the same one that is leading my work experience there next month. He responded to the two letters below along the lines of "you raise some interesting points". It's been a bit long since the interview and he is slightly overrun with content at the moment (but space may become available) so no chance for a direct response, however, I may wish to speak with the paper's Health Editor when I get there. Will do.

Talking of Fogle, his 'On Thin Ice' is on BBC2 tonight at 9.05pm. It is the episode about the disease apparently. I imagine he will be on even thinner ice when I've seen what he has to say.