Seizure history
Treatment history
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Treatment history
23 Nov 2008
Hazel dies.
22 Nov 2008
Hazel's condition worsens from the previous entry. She is unresponsive and withdrawn. Knowing that the condition is progressing, no action is taken.
22 Nov 2008
Hazel's condition worsens from the previous entry. She is unresponsive and withdrawn. Knowing that the condition is progressing, no action is taken.
19 Nov 2008
Hazel deteriorates after a period of relative stability. She runs a temperature caused by an unknown complaint. She begins to show some possible epileptic activity. Her anti-convulsants are increased 50%, her steroids are reduced and paracetamol is administered. By now, antibiotics to treat the infection are resisted on the request of the family.
10 Oct 2008
The hospice doctor tried to raise the dose of steroid from the current fixed level of 12mg per day to a higher rate of 16mg per day. This is justified because steroid increase can lead to significant improvements in patients because of the reducing effect that they can have on the areas around the tumour.
Despite hoping for a noticeable improvement over a two day period, Hazel does not respond as well as expected, and the dexamethasone is returned to its previous lower rate. The hospice doctor explains that he also feels that there is little else that can be done now to halt, slow or reverse the recent declines.
Oncology experts are considered to rethink other options available to us at this time, but all are considered to be too invasive given Hazel's current unwell state.
06 Oct 2008
Following a scan and a neurology appointment, it emerges that the tumour has progresed since the last scan earlier in the year. This has coincided with a marked and rapid deterioration in Hazel's health over the previous two weeks that cannot be explained by external factors (such as a cold, medication changes or hormonal factors). Both the neurologist and the neuropsychiatrist expect this latest turn to signal the beginning of the end.
24 Sep 2008
MRI scan at Milton Keynes Hospital.
18 Sep 2008
Neurology appointment at Milton Keynes Hospital. She is accompanied only by staff from Mallard House.
30 Jul 2008
Hazel reaches 2mg of steroids after a period of reduction in a state of good health. However, a serious and sudden downturn in health leads to a decision to increase the steroids to 16mg (in 2x8mg doses) for two periods, and following that, maintain them at a high level once again. Whilst no further scans are planned, the GP and consultant anticipate that the downturn in health is due to neurological activity in the absence of any obvious alternative cause.
24 Jul 2008
In light of declining health once again, Hazel has a review meeting at the home with staff, parents, husband and other specialists. No alternative to continuing care at the home is offered, and Hazel's continued fragile state suggests that the funding will continue to be provided for Hazel's unpredictable and complex care needs.
02 Jun 2008
Letter received (dated 22 May) following the MRI scans indicated no further tumour activity on previous scans. However, no further advice re: long term care, and no planned appointments. Steroids to be reduced with immediate effect over the next two months.
21 May 2008
Optician visits Hazel at the home. Bizarrely, she is left with two pairs of glasses, neither of which improve her eyesight.
12 May 2008
MRI scan at Milton Keynes hospital.
20 Apr 2008
Hazel develops pleursy, and develops a wheezy cough for a while. She deteriorates a little, but recovers over a period of days. She begins to need to loo a lot, a condition put down to an abnormality in the pituitary gland.
19 Apr 2008
Informed that Hazel had contracted a pleuritic infection of her chest which was causing chest pains. Initial treatment with paracetemol appeared to be effective in reducing the pain.
01 Apr 2008
Appointment with the neurological team at Milton Keynes General.
20 Feb 2008
Given recent improvement and stability, the care team suggest that neurological investigations are undertaken to provide some prognosis and understanding.
15 Feb 2008
Syringe drivers withdrawn. Hazel is taking the same medication orally with no problems.
31 Jan 2008
Syringe drivers are fitted to Hazel to ensure a constant feed of medication, given her reluctance and inability to take drugs orally. A change to the anti-convulsant and an increase in steroids are coincident with the change in administration of drugs. Nursing staff indicate that this results in a strong relaxant overall.
21 Jan 2008
Doctors estimate that Hazel's deteriorating condition would suggest that she has only 7-10 days life left. Stronger drugs, including morphine and higher doses of Lorazapem, are discussed and prescribed for use if needed.
31 Dec 2007
Hazel's condition suddenly deteriorated for no apparent reason, though a heavy cold could not be shaken. Antibiotics to deal with the cold were introduced.
19 Oct 2007
Appointment with Dr. Blesing's clinic. Hazel was discharged from this clinic because no further intervention can be made.
11 Oct 2007
Hazel diagnosed Lorazepam to ease night time agitation, and Dexamethasone to induce a sense of well being. Hazel rallies and brightens, but after a week remains agitated and anxious, perhaps through being more aware.
20 Sep 2007
Hazel formally moves to palliative care. The house GP advises that Hazel probably has 'weeks rather than days'. Treatment is now constant, because the situation with Hazel's health changes on a daily, if not hourly basis. Hazel's condition fluctuates dramatically, but she remains weak and in need of full attention throughout the day and night.
07 Sep 2007
House GP required to attend to a nasty fall Hazel suffers in her room, one of several falls round this time that leads to one-to-one care.
26 Aug 2007
A week of sickness and nausea combined with frequent vomitting, particularly during this day, contribute to the penicillin being stopped.
21 Aug 2007
Hazel leaves the Great Western Hospital in Swindon after a 12 week stay. Transferred to the Brunel Unit at Mallard House, Milton Keynes, for rehabilitation in a neurological facility.
17 Aug 2007
Course of penicillin started
17 Aug 2007
Transfer from IV drugs to oral in preparation for the move from hospital next week
16 Aug 2007
Professor Wade from the Oxford Centre for Enablement visited Hazel on the ward.
13 Aug 2007
Informed by the House Officer that the infection was bacterial meningitis.
09 Aug 2007
Dr. Wimalaratna, informal discussion. Phenytoin used to stabilise Hazel after seizures. Lumbar puncture performed to determine type of brain infection.
08 Aug 2007
Seizure activity commenced in the early evening. Lorazepam and Phenytoin introduced to attempt to calm the seizure activity. CT scan performed. Seizure activity was maintained in status epilepticus for over six hours.
06 Aug 2007
Dr. Wimalaratna, informal discussion
01 Aug 2007
CT scan performed.
27 Jul 2007
WIth Hazel now having been on the ward for eight weeks, a second long term care meeting was held (following June 20 2007) this time including the neurologists. Two options were discussed - referral to the Oxford Enablement Centre, or palliative care in a residential establishment. Professor Wade, of the Oxford Centre, would be contacted immediately.
23 Jul 2007
Dr. Wimalaratna, informal discussion.
20 Jul 2007
Dr. Fillipovic, informal discussion.
09 Jul 2007
John Holloway visited Hazel and delivered a report on July 13th (though this was not seen until 2nd August. Frenchay was discounted as an option.
06 Jul 2007
Dr. Fillipovic, informal discussion.
25 Jun 2007
CT scan performed. Hazel remains in the GWH.
20 Jun 2007
With Hazel remaining in the GWH, a long term care meeting was held with the main caring organisations, but with Swindon neurology absent. PCT sought a referral to the Brain Injury Unit at the Frenchay Hospital in Bristol. John Holloway from Frenchay visited Hazel on July 9th.
15 Jun 2007
EEG performed.
12 Jun 2007
Hazel had a significant psychotic event whilst on the ward. Mental Health team called. Hazel sectioned for two days.
08 Jun 2007
Dr Blesing, planned routine appointment
06 Jun 2007
CT scan performed. Hazel remains in the GWH.
06 Jun 2007
Dr. Hart, planned routine appointment in Oxford. Hazel didn't attend.
31 May 2007
Increased confusion and balance difficulties combined with a cold and reported back and head pains, and ambulance was called. Hazel admitted to the Great Western Hospital, Swindon, after prolonged deterioration from mid-April to present.
18 May 2007
MRI scan performed.
09 May 2007
Dr. Hart, emergency appointment in Oxford following facial ticks and tiredness the previous day.
26 Apr 2007
Dr. Detert, planned routine appointment.
24 Apr 2007
First appointment at the Swindon Memory Clinic, having self-referred.
23 Apr 2007
Dr. Wimalaratna, planned routine appointment.
21 Apr 2007
GP and neuropsychiatrist see Hazel. Antibiotics administered for the chest infection and blood and urine samples taken to enable a more accurate diagnosis. Hazel still suffering chest pains and rather subdued.
16 Apr 2007
Hazel starts at Clapham Hobbs Day Centre in Swindon.
05 Apr 2007
Dr Detert, planned routine appointment
19 Mar 2007
Hazel sick with a virus, pronounced shivering and a chill. GP made a house visit.
15 Mar 2007
Dr. Detert, planned routine appointment.
08 Mar 2007
Dr. Detert, planned routine appointment
02 Mar 2007
Dr. Blesing, planned routine appointment
06 Feb 2007
Agency care commenced.
05 Feb 2007
Dr. Hart, planned routine appointment in Oxford.
11 Jan 2007
Following a grand-mal seizure at 9.45pm, Hazel was admitted to Milton Keynes General Hospital, where she remained until January 15th. She was observed. Social care now required.
14 Dec 2006
Dr. Detert, planned routine appointment
06 Dec 2006
First contact with Social Services and the Brain Injury Co-ordinator.
01 Dec 2006
Dr. Blesing, planned routine appointment
02 Nov 2006
Dr. Hart and Dr. Detert, planned routine appointments in Oxford
12 Oct 2006
Dr.Detert, planned routine appointment
29 Sep 2006
Dr Blesing, planned routine appointment
21 Sep 2006
Further appointment with Dr. Detert. He confirmed that the memory was unlikely to improve further.
12 Sep 2006
Appointment at the Eye Hospital in Oxford confirmed that the eyesight is unlikely to return any further.
04 Sep 2006
EEG performed.
31 Aug 2006
Update with the GP. Appointment at the Low Vision Clinic, Swindon.
17 Aug 2006
Dr. Hart, planned routine appointment in Oxford.
09 Aug 2006
Admitted to Oxford Radcliffe Infirmary with continuing symptoms. Observed for couple of days and discharged 11th August.
07 Aug 2006
Dr. Wimalaratna, planned routine appointment. Hazel was told by him for the second time that the memory loss was down to Hazel's own anxiety.
06 Aug 2006
Visited the Clover Centre (out of hours centre at the Great Western Hospital, Swindon) because of prolonged hallucinations and disorientation over a number of days. Advised that there was nothing neurologically wrong with Hazel and sent home.
03 Aug 2006
Queried the Keppra with the GP.
28 Jul 2006
The idea of referring Hazel to the Oxford Centre for Enablement first raised by us with Jan Stubbings, Chief Executive of the Swindon PCT.
14 Jul 2006
CT scan performed
12 Jul 2006
Suffered a seizure and admitted to Great Western Hospital. Discharged on 17th July. Hallucinations and problems diagnosed as a reaction to the introduction of Keppra as an anti-convulsant.
07 Jul 2006
Dr. Blesing, planned routine appointment
06 Jul 2006
MRI scan performed. Reviewed in Swindon the following day.
03 Jul 2006
First appointment with Dr. Detert in Oxford Neuropsychology. This was a referral from Dr. Blesing.
23 Jun 2006
Dr. Blesing and Dr. Hart discussed medication following absences the previous day
10 Mar 2006
Dr. Blesing, planned routine appointment
13 Jan 2006
Dr. Blesing, planned routine appointment
06 Dec 2005
Appointment with Dr. Baker at the Oxford Memory Clinic. Reported in February 2006.
25 Nov 2005
Dr. Blesing, planned routine appointment
23 Nov 2005
Visual Fields test, Oxford Eye Hospital and appointment with Dr. Elston
02 Aug 2005
CT scan performed.
26 Jul 2005
Dr. Elston, planned appointment
20 Jul 2005
Visual Fields test, Oxford Eye Hospital
08 Jul 2005
Hazel suffered three grand-mal seizures in a three hour period and suffered significant memory loss and confusion and was admitted to the Great Western Hospital in Swindon immediately. She was observed here during the final week of radiotherapy and, having missed the Monday session on July 11th, completed radiotherapy on 18th July.
05 Jun 2005
Radiotherapy commenced at the Churchill Hospital, Oxford. Sessions would be Monday to Friday for six weeks.
26 May 2005
Mr. Stacey, planned appointment in Oxford to sign off the surgery element of the treatment.
11 May 2005
Visual Fields test, Oxford Eye Hospital
05 May 2005
Appointment in Oxford in preparation for the radiotherapy. The mask was made. Hazel was extremely upset about the prospect of hair loss.
14 Apr 2005
EVD converted to an internal vetriculo-pertoneal shunt. This was discussed with the surgeon as an 'insurance' in case a blockage at the base of the skull was preventing fluid from entering the neurological system and maintaing the impaired vision.
14 Apr 2005
Seen by the Oxford Eye Hospital
06 Apr 2005
Surgery to refit the EVD.
31 Mar 2005
Surgery to debulk the astrocytoma and fit an external ventricular drain (EVD).
20 Mar 2005
Following further complaints of headaches, nausea and lethargy, Hazel was again admitted to the Oxford Radcliffe Infirmary. No scans undertaken. Discharged on 22nd March.
04 Mar 2005
Hazel had to leave work due to illness. She was suffering headaches and nausea. She was admitted to Oxford Radcliffe Infirmary for observation, but discharged on the 8th March. CT scan performed on the 5th March.
11 Jan 2005
Surgery required. Discussed with the neurosurgeon at Oxford. Agreed to surgery.
29 Oct 2004
MRI scan performed. Results, reported on 16th November 2004, reported further growth.
01 Apr 2004
MRI scan performed. Reviewed on 7th June 2004, and informed that there had been some growth.
26 Jan 2004
First meeting about the prospect of radiotherapy, with Dr. Blesing, Churchill Hospital, Oxford.
08 Oct 2003
The decision to biopsy was taken in July 2003, after growth in the tumour indicated that it was not a cyst. The biopsy took place on 8th October 2003 without complication. Hazel returned to work after only a couple of days. The tumour was diagnosed as a low grade astrocytoma.
21 May 2003
MRI scan performed. Reported in July 2003 an increase in size and a need to biopsy to further identify the mass.
27 Jul 2000
First MRI scan. An EEG was performed around the same time. Lesion identified in the right side pineal gland. Considered at this time to be a pineal cyst.
10 Apr 2000
First neurological appointment with Dr. Wimalaratna in Swindon, following seizure in January 2000.
01 Jan 1970
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