There was good news and bad news. "The good news is that you haven't got cancer," said the doctor. "The bad news is that we think it's TB." I was surprised. I thought I'd been vaccinated, and I thought tuberculosis was very much a disease of the past. But, by then, I was almost past caring. I just wanted to feel better.
I had been referred to the oncologist in December, three months earlier. My mother and sister had both recently developed cancer, so my abdominal pain and weight loss clearly required full investigation. I was given an endoscopy (a bowel examination), but then my condition began to worsen.
After a week of feeling like I'd been shot in the guts, I went to see my GP. She called an ambulance. After tests, it was decided that I didn't have peritonitis, as feared, and I was told to return a week later for the endoscopy results. I returned for my appointment, only to find that I wasn't on the list. After waiting for several hours, the nurse told me I'd have to come back another day. I staggered down to accident and emergency and saw the same triage nurse who'd dealt with me the week before. She looked on the computer, grabbed a file and wrote a quick note.
"Go back and show them this," she said. "They'll see you straight away." I staggered back.
"You back again already?" said the nurse. I showed him the note and the file. His attitude changed. Another nurse fetched notes and print-outs; a doctor was summoned.
The doctor explained that they'd found a granuloma (a type of tumour) in my bowel that indicated abdominal TB. He said that the BCG vaccine is not always 100% effective, that TB is not only a disease of the lungs and that I showed all the other symptoms: weight loss, chronic fatigue, fevers and night sweats. I didn't give it too much thought at the time, as I was so relieved to be diagnosed - all the more so as it wasn't bowel cancer.
I needed to go for more tests, follow-up appointments, more tests, another specialist, yet more tests. Three months went by and I got sicker and sicker, thinner and thinner. I took weeks to recover from each outpatient visit.
In June, I was finally referred to the TB unit for treatment. Four different antibiotics, massive doses of painkillers, anti-emetics, antacids, supplements, horrible side-effects. For a while, I was taking 15 pills at a go - at a time when I could barely swallow.
I see now why it's called consumption. All my fat and muscle wasted away, as if I was being eaten from inside, and I ended up looking like a walking skeleton and feeling like the living dead. Now, four months into treatment and almost a year since I started to get ill, I am beginning to recover.
My case is a little unusual - a rare form of TB in a white middle-class male - but it highlights some serious issues. TB is no longer a thing of the past: international travel and migration, re-circulated air in airliners, the rise of HIV, and the growth in poverty and bad housing have all contributed to a global explosion.
This opportunistic disease is once again the greatest infectious killer in the world. More than 8m people a year contract TB - over a quarter of whom die of it. Britain experienced a 10% increase last year, with almost half the cases in London.
As my father had suffered from TB, I'd been vaccinated at birth. Having worked in some of the poorest countries in the world, I was all too familiar with the disease. But it hadn't occurred to me that I was vulnerable to it.
Now I discover that the BCG vaccine is effective in only three out of four people, and it works for a maximum of 20 years. It is now treatable, but the current six-month regime of antibiotics is a sure recipe for the growth of drug-resistant strains.
The medicines can cause many unpleasant side-effects, but anyone failing to complete the course risks increasing the growth of multi-drug resistance. About 2% of cases in the UK are now failing to respond to any of the four antibiotics being used to fight the illness. The problem is worsening worldwide, particularly in the former Soviet Union, and we could soon face an incurable epidemic.
It would be far better to develop a treatment that took only a few weeks, but drug companies are not tempted to research a replacement for such a cheap therapy: a six-month course costs less than £20, so there is no clear opportunity for profit.
The delay in my diagnosis and treatment resulted in my becoming seriously ill. It is lucky that I wasn't infectious. As it was, I spent two months in almost total isolation following my diagnosis, before being told whether I was infectious or not. With two of my immediate family on immuno-suppressant drugs I could not risk infecting them, and most of my friends felt it advisable to stay away. I spent weeks in my own private universe of pain and exhaustion.
Gini Williams, a lecturer in TB and public health, believes that health professionals need to be better educated on the current threat of TB and the need for early diagnosis and treatment.
"We may have the world's best TB service, but if people aren't referred there it's pointless," she says. "Too many people are misdiagnosed - mostly as asthma."
The fact that TB is now curable with antibiotics has undermined its fearsome reputation: 95% of patients in the UK now recover and are no longer infectious after starting treatment; there is no more need for sanatoria and isolation wards. Yet it remains a terribly debilitating illness and those treated as outpatients still require tremendous care and support. I was virtually bedridden for six months, but only now that I'm recovering have I started getting help with meals-on-wheels and social services.
Interestingly, the same local authority took only a few weeks to sue me for non-payment of council tax when I was unable to keep up with my paperwork.
