It's a different story at the moment after my last report on day 7. That evening my platelet count dropped below 10 to 8 which meant it was time for a platelet transfusion. After receiving around 330 ml of platelets my count rose by the next morning to 25 which didn't seem like a big increase. For patients without fever the doctors look for a reduction in platelet levels to below 10 prior to a transfusion, whereas a patient with a fever has a lower limit raised to a count of 20.

Saturday morning was also a great start to the day especially since I was able to eat my breakfast without too much pain. It seemed as though I had found a good combination of drugs that helped me through the pain barrier that had been preventing me to swallow the food properly. I would have a booster of morphine, with a cocaine mouth wash followed by a paracetamol gargle. This combination actually gave me a real high which probably explains the mood of the last diary entry.

I was also given the third and last dose of methotrexate along with the warning to expect my mouth to deteriorate that much further as happened after the two previous sessions with the methotrexate. My weight had also started to creep up, and I began to entertain thoughts that just maybe I'll be able to get through this all without having to resort to the NG feed, and that my mouth wouldn't give in the ulceration. I should have spotted the signs, as it was not possible for me to eat my macaroni cheese for dinner or the omelette for lunch. I was, however, managing to eat the high protein milkshakes and yoghurts and feel full after each meal.

Well, during the night I was simply unable to sleep, initially because of the adrenaline rush of waiting for the Pop Idol results (not!!!), but because I began to develop very thick saliva in the mouth and throat, such that I was unable to either swallow it or spilt it out due to the pain. Eventually after increases in the morphine dosages I was able to spit out the saliva, only for it to lodge at the back of my mouth. This went on the whole night, and I don't think I managed more than forty minutes of constant sleep.

By Sunday morning I was wide awake at 8:30 am and felt totally exhausted. Not to mention the fact that I was unable to talk. Well that wasn't a problem before, just have a booster of diamorphine, followed by a cocaine mouth wash and paracetamol gargle and that would sort me out. Except you can't have paracetamol with a temperature which I had just started to develop. This is because the paracetamol masks any increase in temperature, and in my state it is vital to spot any temperature hikes as they are the first signs of an infections.

Therefore breakfast was no go. Even swallowing water felt like swallowing broken glass. I was hoping that the temperature would subside, but the lunchtime observations showed that it had increased a bit more. No lunch then. Finally I had go give in to NG feeding, Eugene (one of the nurses) feed me through the tube with a syringe. Actually the standard way of feeding using the NG tube is to have a constant drip for twelve hours through the night. As I'm one the diamorphine 24/7 I don't really feel like having more tubes connected for longer periods. Also I'd prefer to have my 'food' at regular intervals during the day when you most need your energy, which means I have to push down 400 ml of EnsurePlus four times a day. I've got to make sure the NG tube is flushed after each session to avoid blockages in the tube. I was semiconscious throughout this mainly due to the lack of sleep.

As my temperature began to fall in the late afternoon and evening, I hoped that I could resume the paracetamol, but I had to have another platelet transfusion which caused a temperature spike. That required Gill my night nurse to some blood samples, one from my hickman like and the other from my arm. This will determine whether I have an infection from inside or possible from the hickman line.

I still managed to sleep better last night but got up early at 7:30 am. My mouth was still very sore again, but I've found a better sleeping position that means I can get up to 100 minutes of constant sleep before having to spit out the saliva. The pain is a tad more tolerable with the help of the diamorphine and cocaine mouth wash. Incase you may have concerns about my affinity to the cocaine mouth wash, it isn't addictive, but helps to numb the mouth which is a big relief as I'm then able to gargle and spit out all the phlegm that I'm unable to swallow. It also allows me to talk for a while since I'm nearly reduced to using sign language to communicate otherwise.