miércoles, 17 de abril de 2013

EL PACIENTE INGLÉS. (Primera parte)

Fue uno de esos días de finales de invierno en los que estaba perdida entre sombras. Había terminado la consulta afónica y el cansancio me hacía sentir que era gris, que podía estar allí o no estarlo y que nadie lo notaría… absolutamente nadie.

Me puse a leer algunos correos pendientes antes de apagar el ordenador.
Uno de ellos llamó mi atención. Comenzaba así:

“I was born on November 1934. With high blood pressure I am currently taking Valsartan 800, Amlodopino 5mg and Simvastatina 10 mg every day. I play tennis three times a week, and 18 holes of golf once a week with an ocasional 9 holes of golf or extra tennis.”

Me detuve a mirar quién era el remitente. No me sonaba y supuse que alguno de mis pacientes ingleses le había dado mi dirección a aquel señor. La historia me pareció interesante… estimuló mi curiosidad y los nubarrones en mi cabeza empezaron a disiparse mientras la leía.

“On friday 10 August I was finding it difficult to see so my wife took me to our local doctor´s surgery where I saw a lady doctor, who referred me immediately to the ophthalmic clinic in the nearby town of Hastings. However they were unable to see me that afternoon and instead made me an appointment in the hospital of Eastbourne, which I visited three days. A junior consultant there diagnosed keratinoconjunctivitis and gave me some drops to insert. On my third and final visit there, he called in a senior consultant who diagnosed possible herpes behind the left eye. He advised me not to take steroids which he said might be prescribed for me by my next opthalmologist when I returned to the Hasting´s hospital.

However when I saw my next ophtalmologist in Hastings she recommended steroids. When I reported the advice of my senior consultant not to take them, she merely repeated her recommendation for me to do so. I couldn´t check with my own Doctor as he was away but other Doctor advised me to follow the advice of my current ophtalmologist.

Several weeks later during September I noticed some blistering around the nostrils but this didn´t last more than a day or two and I neglected to take any medical advice. At the start of October – as we were leaving our English house- the blisters became more serious but were still only a minor nuisance and I was unable to take medical advice as we were travelling out to Spain by car.

After arriving here the blister disappeared, but then re-appeared a week or so later as I had a permanet cold. On visiting the Beach pharmacy, the lady there suggested the blister were due to cold sores/herpes and recommended a cold sore cream. This worked for a time but when the blisters kept re-appearing I opted for Compeed to cover them up. However my cold continued and the blisters got worse.

It seemed to be spreading down my front and back as well as my temples. My head hair itched and there were more lumps there than ever before. I visited Dr X who initially prescribed Zovirax and Zovicrem. But this failed to solve the problema. He therefore gave me a blood test – the results of which I have and will bring with me but have no reproduced. (These are attached below.) He gave me a course of Aciclovir in tablet and cream. Unfortunately the blisters continued to come especially on my Leith nostril. We traed in total three courses of Aciclovir tablets and cream. But the problem persisted.

Repeated application of the Acyclovir cream has eventually moved the blisters to my body where despite using it on every blister, the problem remains. We also tried a short course of an antibiotic in the hope that the cold would disappeared and with it the herpes. This appeared to have worked but as soon as the antibiotic course was finished, my cold returned and the herpes problema re-occurred.

The blisters seemed to move down the front of my body until just below my chest, then it switched to my back and has gradually worked upwards towards my head. My belly button also requires cream to keep it free from blisters – as does my left nostril. I keep on applying the Aciclovir cream and my wife pricks and removes the fluid from the blister son my back. After several tubes of Aciclovir cream (6 in all), I am still uncertain whether we are making progress. The herpes now feels as it is in my hair.

I feel more lethargic and much colder than usual, the cold has recently become heavier and when the blisters appear I tend to have a sore throat, but I am unsure how much of this is due to old age and how much to the herpes infection. For the first time in my life my gums are feeling tender and sore.

While it is tiresome and annoying herpes is a problem I can live with but prefer to be without. I understand that it may recur but I would welcome a clear period for a time. Can you help me?

Al final copiaba los resultados de unas serologías para herpes, que eran positivas para el anticuerpo IgG del virus herpes tipo II y el resto negativas.
Con la certeza de que aquello no sonaba para nada a clínica de herpes y con gran curiosidad por conocer a una persona tan meticulosa, le contesté de forma escueta lo más razonable:

“I need to see you.”

El día que apareció en la consulta… (Continuará)

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