Ayana (not her real name) is a 38 year old Christian Orthodox woman, who was diagnosed with HIV 9 years ago. She has been prescribed Highly Active Antiretroviral Therapy (HAART) for her HIV disease which she gets free from the local health centre. Three years ago she was diagnosed with vulval cancer and subsequently received 11 cycles of chemotherapy (after having first tried Holy water). She is now waiting for radiotherapy to control her pain, vulval swelling, bleeding and discharge. She is unable to sit comfortably despite taking tramadol 50mg twice daily for pain. Nurse Filagot talked with her about increasing the tramadol but as the ceiling dose is 50mg 4 times daily (QDS) Nurse Filagot was worried about what she will be able to prescribe when the pain gets worse (as oral Morphine is unavailable). Ayana also complained of neuropathic pain down her right leg, so Filagot decided to arrange for amitriptyline 12.5mg at night to be prescribed. Amitriptyline will hopefully help with her sleep too.
Ayana’s mobility is much reduced due to the vulval swelling and pain rendering her housebound and dependent on her family. In addition, she has a poor appetite and local skin irritation when passing urine. She lives with her parents and does not have any children. She receives food support from Hospice Ethiopia as she had stopped working as a cleaner due to the progression of the disease.
Hospice Ethiopia UK 