December 2024

I find myself writing this on the last day of 2024 and no doubt this evening, despite the weather, will be punctuated with the sound of fireworks.

Today I attended my consultant's appointment and yet again I received the excellent news that I have no identifiable paraprotein and that my light chains are normal. Sadly the consultant I saw was working her last day before retirement. She had chaired the Multi Disciplinary Team at which my treatment was first discussed in October 2011.  I shall certainly miss her. The only other piece of information I received was that I shall be subject to a Bone Marrow Biopsy in February but the date has yet to be arranged.  Oh joy!

At the very end of November we travelled to Poole in Dorset where we attended the very splendid wedding of our younger son.  We had the joy of welcoming another daughter in law and her two sons from her previous marriage. The occasion was so very enjoyable and included catching up with so many family members.

Christmas has, of course, now passed by.  This year Margaret and I travel to stay with our elder son, his wife and their son at the weekend before Christmas.  We were joined by our younger son and his new family for a fully turkey feast with all the trimmings.  For Christmas itself Margaret and I celebrated the occasion quietly at home - bliss.

You are never too old to set another goal or to dream a new dream
C.S.Lewis

It only remains for me to wish everyone a very happy and healthy 2025

Keep well

Stephen

November 2024

I trust you will forgive the lack of post for September or October but, apart from a routine visits to the BHOC for blood testing, there was nothing to report.

On the 8th October 2021, three years ago, I was admitted to the ward in the BHOC in preparation to be infused with my CAR-T cells.  Prior to that date I had been given the wonderful news that I was to be recruited onto a clinical trial called Cartitude 4.  The trial sought 400 recruits worldwide.  Half would receive standard treatment whilst the others would receive the CAR-T cells.  All 400 were required to undergo a huge number of screening tests to ensure their eligibility.   Only later did I receive the incredible news that I would be in the second group and thus receive the CAR-T cells.

Having arrived on the ward I was to receive two chemotherapy drugs being cyclophosphamide and fludarabine as "conditioning" and seemingly to reduce the number of myeloma cancer cells.  They would be given over three days after which I then had unexplained temperature spikes.  This meant that the infusion of CAR-T cells was be postponed.  Two days later, and with authority from Janssens in Boston USA, I received the infusion of CAR-T cells on 15th October.  This was undertaken with multiple hospital staff witnessing and, importantly to the strains of "Give me Sunshine" by Morecambe and Wise.

The cells arrived deep frozen in liquid nitrogen in a container which I described as "looking like an undernourished adolescent Dalek".

The cells being so valuable had been packed with their own aluminium cassette.  The bag containing them then had to be warmed up before infusion could take place.

To minimise any damage, the cells were infused by gravity through a canular. 

During the early hours of 25th October, my temperature rose to 38.7 and causing much concern.  Given that I was now neutropenic there was a possibility that I had an infection and samples were rushed to the laboratory.  The staff were very concerned and I was now shaking uncontrollably.  Later that day, despite being given paracetamol, my temperature had risen above 39 degrees.  

The warning "Be careful what you wish for" became significant since when the new cells get to work, the body may release an excess of cytokines producing the very symptoms I was now experiencing.  I had almost hoped for Cytokine Release Syndrome (CRS) which would show that the CAR-T cells were active but the looks of the nurses and doctors clearly indicated their deep concern.   Only once infection was ruled out could I be given the drug Tocilizumab which fortunately brought things under control very quickly.

Remarkably I was allowed home on 29th October.  It had been a very memorable stay in the ward and I remain. even to this day, in debt for the highly professional treatment and care I received.

So why is this month is so very special?  I have just seen my consultant and my myeloma remains undetectable, now three years later. No paraprotein had been found and my light chains were normal. Sadly the treatment I have received has not been made available in the UK. 

I am the living proof of its effectiveness.

When you rise in the morning, give thanks for the light, for your life, for your strength.

Give thanks for your food and for the joy of living. 

If you see no reason to give thanks, the fault lies in yourself.

Tecumseh

Keep well

Stephen

August 2024

Since my last post I have again returned to the BHOC for routine observations and blood tests.  Although my paraprotein results could not be identified, my free light chains results suggested that the CAR-T cells were still hard at work.

The other major event during the month has been a trip to see the British Normandy Memorial at Ver-sur-Mer.  The silhouettes would only be there until the end of the month.  Readers could do no better than to visit the website at  https://www.britishnormandymemorial.org/ .

Click to enlarge

This image shows the Memorial which is in the form of avenues of columns each recording the names of 22,442 British service personnel who died during D-Day and the Battle of Normandy.  In the foreground are just some of the 1,475 silhouettes which represent those who died on D-Day itself.

Click to enlarge

I had the very great privilege to be able to walk amongst the silhouettes and to take this picture looking up to the memorial.

Having visited the Memorial we also took the opportunity to visit the Commonwealth War Graves Cemetery at Bayeux.  This cemetery, the largest CWGC cemetery in France, contains 4,649 graves of servicemen who fell during Operation Overlord. There is also a Memorial to the Missing which commemorates the over 1,800 servicemen who have no known grave.

Margaret and I only planned to be in France for the one day and so travelled over on the night sailing of the Portsmouth-Caen ferry returning on the evening sailing.  Sadly the handling of vehicles at both ports was utterly hopeless with very extended queues.

Everyone can be great, because everyone can serve

Martin Luther King

Keep well

Stephen

July 2024

It's been an eventful month!

Margaret and I went on another cruise.  This time for two weeks visiting the Baltic countries of Sweden, Finland and Denmark. 

Copenhagen's Little Mermaid

Showing just one image from our cruise; The Little Mermaid which is situated in Copenhagen in Denmark.

She is allegedly the most-photographed statue in the world (and I've added to the count!)

On return to the UK both of us felt rather unwell.  I had to provide routine blood samples the day after we got home so I mentioned my condition to the nurse.  She promptly had a doctor check my lungs but they were OK. Never-the-less she had me provide a sputum sample.  A few days later one of the consultants phoned me and during the conversation it became clear that I had an infection which would respond to antibiotic.  After some problems, my GP kindly prescribed the necessary medication which is now doing its job.  

Still feeling unwell I had obtained a COVID test kit.  Be warned, the government has ended the ability for immune compromised people, like me, to order kits on line.  Finding my existing kit had time expired, I had to go to a local pharmacy in order to get one provided.

The result of us both taking our COVID tests was plain to see - both positive.

At least we now knew why we felt so unwell.

I find myself rather critical that in order to test, I must first risk infecting others in order to get a test kit. Crazy.

As things stand, whilst Margaret is still somewhat under the weather, I have almost recovered and will shortly be able to return to normal activities.

I enjoy convalescence.  It is the part that makes illness worthwhile.

George Bernard Shaw

Keep well, keep safe

Stephen

June 2024

Nothing medical to report this month really. I attended my routine (non consultant's appointment) where I was asked to complete some surveys.  These are undertaken from time to time and seek to record my health conditions and quality of life.  With regard to the latter, The system also reported that I was at Day 980 as measured from Day 1 when the CAR-T cells were infused. - WOW.

Of note was a trip Margaret and I had on the Waverley.  This is the last and only sea-going paddle steamer.  We joined the ship at Clevedon Pier and first sailed up the estuary to abeam the Avonmouth Docks.  We then sailed down to round both Steap Holme and Flat Holme.  Both islands are steeped (pun) in history.  I was fortunate enough to capture this image of the setting sun.

Sunset at Steap Holme

I was less than fortunate though in that to get the picture I had spent some time on deck in the chill wind.  Early next morning what had been a mild cold had turned into sinusitis and earache.  Even at my age, there is much to learn.

Life comes with pain

Rod Wave

Keep well
Stephen

May 2024

You will have noticed that I didn't provide a post during April.  To explain, I now attend the BHOC every month but only see a consultant once every second appointment.  At all the appointments I see the Clinical Trials Team to have my observations (weight, blood pressure, oxygenation) checked and to provide both NHS and trial blood samples.  Accordingly my health is carefully monitored.  At the consultant appointments I get the chance to report symptoms in detail and especially to check my myeloma status.  

At this month's consultant appointment I learnt that my paraprotein level which had been at the low count of "2" had returned to zero.  My free light chain count (another measure of cancer activity) was also normal.  Put simply, my myeloma is currently undetectable; the CAR-T cells are still very much active and keeping things under control.  Given that I was first diagnosed in 2011, this truly extraordinary.  As I've said in the summary above, I am extremely fortunate.

And so to "Life Normal".  We've recently had a team in to remove a tree which had fallen in the strong winds and to clear excessive growth of intended shrubs but also an unintended infection of briars.  The team came equipped with every piece of professional equipment needed including chain saws, brush cutters etc.  They were also quipped with a chipper/shredded which converted the unwanted into useful mulch.  Once they had gone I covered the two large beds which had emerged with weed suppressant fabric topped off with the mulch left by the team.  My next task now is to choose and install plants which will enhance the re-found openness of our garden.  It seemingly will keep me busy!

Dianthus (Pink). Hopefully just the start!

I need my friends, I need my house, I need my garden

Miranda Richardson

Keep well, keep safe

Stephen

March 2024

This month I'm actually adding this post on time!  It must be spring. Of all the seasons, spring always promises so much and always delivers.  

This year, spring was first signed when a bumble bee appeared on the delicate flowers of our cherry tree

Our garden has been a riot of colour: the blue of Grape Hyacinth, the red of Ribes (flowering currant),and of course the yellow of Primrose and Daffodil.  Perhaps the greatest show was provided by our magnolia tree.  For once all the buds appeared at the same time and lasted for such a long time.

Just one issue though; we now have an awful lot of petals on the grass and just when my mower has decided to sulk.

I'm reminded that I must mention my health.  I can't deny that this winter has been a bit of a struggle with a bout of flu followed by a least one cold.  As the weather improves, so does my health.  I've visited  the BHOC for my routine appointment.  All my blood results are excellent.  The consultant checked my paraprotein and it seems to have been hovering for some time at the very low count of one.  So barely detectable and presumably being kept low by the CAR-T cells.

Everything has beauty but not everyone sees it
Confucius

Keep well, keep safe

Stephen

February 2024

OK, yet again I'm just a little late posting, this time for February.

So far as myeloma is concerned, there is nothing to report.  I attended routine clinic and without any drama.  In respect of my ongoing health issues, I spoke to my GP about my hearing problems and was prescribed some sodium bicarbonate ear drops for the left ear which contained some wax.  After using the drops for a few days I carefully washed the ear out and was rewarded with the offending wax.  He also prescribed some nasal spray to try to clear my eustachian tubes.  It seems to be slowly working.

I also consulted him about a small growth on my forehead which HRH had been nattering me about for some time.  That meeting was on a Tuesday.  

The BRI

By the Saturday I was at the dermatology centre at the Bristol Royal Infirmary.  

The GP's belief that the growth was a Basal Cell Carcinoma (BCC) was confirmed.  I was asked if I had spent much time in the sun. Yes, four years living in Cyprus not wearing a hat or sun screen probably did it. I was to return on the following day to have it photographed.  I did so only to have surgery!  This was just five days after I had seen the GP; amazing.

I've also attended a new (independent) opthalmologist.  The check he undertook was by far the most thorough I've ever had and justified my loss of faith in a certain high street opticians.  

Given my recent surgery for cataracts and now for the BCC rather suggests that I am getting just a little old - or maybe just "vintage".

Aging is not lost youth but a new stage of opportunity and strength
Betty Freidan

Keep well, keep safe, and "KBO"

Stephen

January 2024

OK so not the best start to the year; late posting January's missive.  

January in fact didn't start too well anyway.  I went down with flu at the start of the month.  It lasted only days but then followed with a bad cough.  Even now I still have its remains.  Now I have deafness.  That shouldn't be a problem now that pharmacies can prescribe.  Except that to do so they must be first qualified on the otoscope (look it up) and most seemingly are not yet.  If they did find excessive wax then the NHS no longer offers syringing by GPs.  Seems rather like the failed NHS dental system.  Anyway, never mind, I've got a GP appointment booked before the end of February.

I had my second eye check-up and have now booked an optician's appointment later this month.

Oh, and I've attended two routine consultant's appointments and no I apparently don't need immunoglobulin (there is a national shortage) unless I develop repeated infections (like flu, cough, deafness?)

Just because nobody complains, doesn't mean all parachutes are perfect

Benny Hill

Keep well, keep safe, and "KBO"

Stephen

December 2023

Firstly, you may have noticed an absence of a post for November.  This was simply because I only needed to attend the BHOC to provide blood samples. The only notable event during that month was my attendance in the Remembrance Parade in Bristol on the 12th.  Perhaps inevitably the rain came down each time I removed my bowler hat!

Recent blood tests over two consecutive months had indicated a very low (2) but meaningful rise in my paraprotein level.  They would seem to have suggested a potential relapse.  This was perhaps confirmed when I was informed that I was to see the haematology lead.  In the event the news was very different.  My November blood test indicated an inability, again, to detect paraprotein.  We could only guess that the previous indications had reinvigorated the CAR-T cells which had done their job and fought the cancer cells.  Only time will tell but I take the news as a significant Christmas present. 

The consultant did check my immunoglobulin level and decided that I should be put back on to IvIg treatment just like I needed during the last two years. No doubt I will shortly be allocated a treatment appointment

One extra bit of news - I've now had my second cataract surgery.  Early indications are that everything went very well.  Remarkably I could even see through the new lens as HRH drove me home after the operation.

No news is good news

Ludovic Halevy

I wish everyone a very Happy Christmas

Stephen

October 2023

As the summary above indicates, I was infused with my CAR-T cells in October 2021 and thus two years ago:

During that time, my myeloma became undetectable, I have not needed any any anti-cancer treatment, and my quality of life has improved immeasurably.  I have seen many more dawns and sunsets than I had the right to expect.  Together with Margaret, I've had a holiday in Cyprus and another where we finally cruised to Norway.  I have even returned to my duties as a Volunteer Listener with Samaritans.  I have every reason to celebrate this anniversary.

Just 10 days ago I had my first cataract surgery where my natural eye lens, which had become cloudy with age, was replaced with a plastic one.  The operation went very smoothly and within 4 days my sight was almost back to normal.  I had feared about driving, especially at night, but I found that the reduced glare had actually improved the experience.  Yet again I feel so very fortunate.

Returning to the subject of myeloma, this week I had my routine clinic appointment at the BHOC.  The last time I saw a consultant was actually in July.  In August and September it was decided that I only needed to see my clinical trials nurse.  This week, the consultant gave me the news that my last two blood tests had both shown a paraprotein count of 2.  I was told not to be too concerned yet as both readings were very small and, importantly, the same.  Significantly my free light chain results currently remain normal.  It was always to be expected that the CAR-T cells would eventually deteriorate and it remains to be seen what these two readings really mean.  Of note, I was also told that all my general blood results were very good.  Having two years without any chemo has clearly made them better.

To summarise - I will just have to wait and see and in the meantime ENJOY.

When you arise in the morning,

think what a precious privilege it is to be alive

to breath, to enjoy, to love

Marcus Aurelius

Keep well, keep safe

Stephen

September 2023

As usual, this week I attended the BHOC for routine blood tests etc. with nothing to report.

Last week I attended an eye clinic following from a recommendation by a certain high street opticians that I be referred for consideration for cataract surgery.  For some time I have become increasingly aware of glare especially when driving.  

The recommendation indicated that I was "borderline" for need for surgery.  The eye specialist I saw last week said that my need for surgery was "absolute" and that I had (until then) an undiagnosed condition called Fuch's Dystrophy (missed despite repeated visits to that high street opticians).  The condition is a deterioration of the cornea which may delay recovery from the cataract surgery and eventually result in need for corneal transplant  Oh well ! Now I just have to wait for a date for surgery.

One last story to tell. Last month I showed an excellent crop of grapes developing on our vine.  I have always used the principle that when grapes start to drop, they are ready to harvest.

Well, this month that time had arrived and we enjoyed a very healthy crop.  These were duly crushed and fermented.  Unlike previous years, though, the juice has proved to be very acidic.  Despite referring to my Boy's Own book of Oenology (look it up), this year I must accept defeat.  2023 clearly is not a vintage year!

A smile is happiness you'll find right under your nose
Phyllis Diller

This month definitely "KBO"

Stephen

August 2023

Just for once I have little to report except, of course, that I attended my monthly appointment and again my paraprotein was undetectable.

We're all experiencing something of a rather strange summer but nature seems to know what to do:-

Grapes almost ready !

As in previous years, our grapes have developed and will shortly be ready to harvest.  Again I will crush them (though not with my feet) and ferment them before adding spirit to make something like port wine.  Best practice requires that I make two bottles: one for this Christmas and one to keep.

I love everything that's old; old friends, old times, old manners, old books, old wine

Oliver Goldsmith

Keep well and KBO

Stephen

July 2023

Again I attended my consultant's appointment and my paraprotein remains undetectable and my light chains (another measure of any cancer activity) remain normal.  

So much is going on in my life and most of it positive.  

First the not entirely good news.  We were due to go on holiday and I discovered a lump in my neck under which I could feel my pulse.  I Googled the situation and became convinced that I might have an aneurism.  I decided to not tell HRH - why spoil her holiday - I would sort it later.  The day after our holiday I tried to get a GP's appointment but one could not be arranged within a reasonable timescale.  I therefore went to our local A&E.  From entering to leaving took a full eight hours during which I had been triaged, seen by a doctor, cannulated, CT scanned, and again seen by the doctor.  The diagnosis was that there was absolutely nothing of concern.

I also waited until after our holiday to get my eyes tested.  Two years ago the  optometrist had reported some cataract development.  Since then the affect has become more pronounced with a marked increase in glare.  This month's eye test resulted in a letter to my GP proposing a referral for cataract assessment and presumably surgery.  Today I was able to book a specialist appointment in September - excellent.

Now the fantastic news.  HRH and I had a holiday involving a cruise to the Norwegian fjords.  Just one of the highlight was my first view of a glacier.

Briksdal Glacier - Click to enlarge

The image above is of the Briksdal glacier which we reached from the village of Olden.  The whole holiday with the sights of Norway scenery and the experience of the cruise was truly awesome (a word I use sparingly)

The best and most beautiful things in the world cannot be seen or even touched - 

they must be felt with the heart

Helen Keller

Keep well and KBO

Stephen

June 2023

A surprisingly busy month.  

First I had yet another birthday - they seem to come round so very often.  For this one I wasn't described a old but instead as "Retro".  Whilst my wife's card to me identified me as being an Honorary Member of the Old Boys Moaning and Groaning Society; a membership that I cannot deny.

This month's consultant's clinic again provided the good news that my paraprotein remains undetectable.  Given such good news I am now returning to a former volunteer role - which requires that I fully re-train.

Growing old is mandatory, but growing up is optional

Anon

Keep safe, keep well 

Stephen

May 2023

As normal I visited the BHOC for my monthly clinic and again my paraprotein remans undetectable and my light chains are normal.  The consultant reviewed by immunoglobulin and is currently content to "wait and see".

The main change was that the trials nurse, DP, has moved on to a new role and I wish him well,  He has been replaced by HW who has already settled into the role.

Since my last post, my improved health and energy, together with improved weather, have enabled several projects.  One of our two garden huts had become clothed with ivy which required two days work to remove.  The other hut, which I had originally constructed, was given two coats of "paint".  The first hut we call "Jabba" and the second "Nissan" - I'll leave you to work out why.  During the Coronation I flew a Union Flag.  I've now installed a proper flag pole and will be able to mark each flag day - the next being the King's official birthday (Trooping the Colour).  I've also cleaned out the greenhouse and planted tomatoes and sown climbing bean seeds.  I can only hope that this year, the slugs don't get them.

It's weird, being the same age as old people

Anon

Keep safe, keep well 

Stephen

April 2023 #2

I recently attended the BHOC for the last of Imunoglobulin infusion in this series.  Happily I again did not react and all went according to plan.  I am indebted to the nurses who took such care with my treatment.

Yesterday I returned to the BHOC and saw my consultant and yet again I was advised that paraprotein could not be detected and my light chains were normal.  In my last post, I mentioned my project to repair the loggia roof.  Since then I've been onto the roof of our dormer and made good where lead flashing had slipped causing one of the wall-hung tiles to drop.  My continued good health allows me to undertake such projects.

You will recall that in March I learned that the NICE appraisal for CAR-T cell treatment would not take place as scheduled and thus its introduction as an option in England could not proceed.  I've now learned that the treatment had been launched in the USA and accordingly the T cell processing facilities were now at capacity and that they could not take on further countries.  A massive shame.  I can only hope that further capacity will become available.

Two falcon chicks being fed - Click to enlarge

Every year I celebrate the arrival of spring.  Sometimes it's the appearance of flowers on the magnolia, sometimes the nodding of daffodils.  This year it has been the hatching of two of the Peregrin Falcons on the roof of Salisbury Cathedral.  This morning the BBC announced that a chick had been seen for the first time on the CCTV.  When I checked I saw that two of the four eggs had hatched and that the parent (mother?) was feeding them.  (To watch this simply Google "Salisbury falcons).  Presumably the other eggs will hatch over the next few days and we will watch the charming little chicks develop into the raptors they really are.  With luck we will see them fledge.

Every spring is the only spring, a perpetual astonishment
Ellis Peters

Keep safe, keep well 

Stephen

April 2023 #1

It seems almost routine to report that, at my recent consultant's appointment, I was given the continuing good news that my paraprotein level was zero.  In addition my light chain result was very good.  Both indications show that my myeloma continues to be controlled by the CAR-T cells.  Yesterday I again attended the BHOC for immunoglobulin  treatment and without any problems.  The next medical challenge is to get my spring Covid booster vaccination - I wait for details.

Click to enlarge

In my last post I reported that I'd re-decorated a bedroom.  Projects continue.  At the south side of our home we have a covered walkway (a loggia) under which we eat al fresco meals, gain access to a garden hut (called Jabba), dry laundry and grow a grape vine (from which I make Port wine).  

I recently noted that some wood rot had set in on the roof structure.  On examination I discovered it was far more advanced than expected and required the replacement of a beam extending over four meters.  The job which required significant planning is now complete.  Probably next on the list is some damage to the side of our dormer.  A wall-hung tile has slipped dislodging the associated lead flashing.  "Man's work is never done."

Getting older is no problem. You just have to live long enough
Groucho Marx

Keep safe, keep well 

Stephen

March 2023

As normal, I attended my consultant's appointment and was again told that my previous blood tests had not identified any paraprotein. I was advised that I would be subject to a further bone marrow biopsy in the near future.  This will be my 15th such procedure!

The other day I attended the BHOC for my monthly immunoglobulin infusion which went without any difficulties.

Since my last post, my consultant asked if I would consider being nominated as a "Patient Expert" in an appraisal by NICE (National Institute for Health and Care Excellence) of what I have come to know as CAR-T cell treatment.

This I willingly agreed to and I was duly contacted by Myeloma UK who would nominate me.  After a series of Zoom meetings with both Myeloma UK and NICE everything was set for the appraisal meeting. I had been asked to prepare a number of documents, the most significant being my Patient Expert Statement which had to be written in accordance with a template.  Sadly I was contacted by NICE just 4 days before the scheduled meeting to say it was cancelled; the company (Janssens) having withdrawn.  This was deeply disappointing not because of the effort I'd made in preparation but more because I wanted to explain, as a patient, just how significant the treatment is.  It is now 15 months since I was infused with my CAR-T cells.  Since then my quality of life has improved immeasurably. Having previously relapsed three times I was running out of treatment options.  CAR-T cell treatment has undoubtedly lengthened my life.

One extra piece of news.  Over the last ten days, I have been re-decorating a bedroom.  Our home was built in 1958 and the room had not been fitted with coving.  A previous owner had installed some but it was very small and of poor quality.  Its replacement took five days.  The walls needed emulsion paint and I chose a one coat solution which went on in one day, without a mess and to an excellent finish. Then came application of eggshell paint on skirtings, door and wardrobes.  This took longer than expected as the wardrobe doors are very fiddly louvres.  The work is finished now and although very hard work, it at least demonstrated my continuing physical abilities.  More projects to follow!

Every project has challenges, and every project has its rewards

Stephen Schwartz

Keep safe, keep well 

Stephen

February 2023

The other day I attended my monthly consultant's appointment at which my health is checked and blood samples taken.  Yet again the blood samples taken in January did not identify any paraprotein and other results were satisfactory.  The CAR-T cells continue to fight the myeloma.

Yesterday I attended for my monthly infusion of immunoglobulin.  This can be quite a long process requiring that I am fitted with a cannula.  To avoid any reaction, I am then given pre-medications requiring a wait of 30 minutes for them to take affect.  The immunoglobulin is then administered, initially at a slow rate. After each 1/2 hour the rate is gradually increased.  Throughout the process, my observations are taken to check for any adverse affects.  Overall the process takes about 4 1/2 hours.

Bristol Haematology & Oncology Centre
(Google Earth Image - click to enlarge)

In the BHOC immunoglobulin is given in one of the outpatient departments.  This unit provides a variety of treatments and I am always humbled to see so many patients who are seriously unwell and needing extensive treatments such as platelet and whole blood infusions.  These can last for many more hours than my treatment.  The care and efficiency of the nursing staff is just world-class. 

Keep safe, keep well 

Stephen