From Crohn's Disease to a bowel transplant how did I get there?

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Hi Michael,

great to hear about the ongoing issues as i'm similar to you. things just dash straight through and cause me all sorts of issues. i too have small intestine bacterial overgrowth and broccoli, i suspect, is as bad for you as it is for me! its incredibly acidic i find. lay off it if you want, lol, despite what wifey says! I think things might get better once the ilieostomy is gone and that new to you (or second hand bowel, if you like) can do a proper job (no pun intended).

that cycle ride looks good, and great funds raised.

well done, and i hope loads go your way in the near future. its hard hanging on to any wight and energy with this sort of health. you're amazing.
 
Hi Michael, as always it has been a pleasure reading your post :)

Well done on the E-Patient scholarship!! Also a big congrats to you all on the charity bike ride, what an wonderful achievement :dance:

The temp is supposed to go down again over the next few days so hopefully you will catch a break soon with your hydration probs.

AB
xx
 
Hi Michael,

Thanks for the update - I always enjoy reading your posts and you always make me laugh with your sense of humor! It certainly seems like quite the journey you have been on!!

Do they have you on any medications to slow the transit time down - over here in the States there is a med called lomotil available by prescription only:

http://www.webmd.com/drugs/drug-6876-Lomotil.aspx?drugid=6876&drugname=Lomotil

Also, are you taking any psyllum husks like Metamucil?

Congrats on the E Patient Scholarship! You are such a great representative of us all! I will google the Guts in Motion drive - a very worthwhile cause!!

Don't stay away so long next time:)

Promise I won't, incompetance isn't a good excuse!!I had lomotil when I was very young which frustratingly didn't help. However I haven't tried Metamucil so will definitely explore that a little more. Thanks for staying in touch, I feel very lucky that forum's such as this provide me with the opportunity to create such great friendships. Take care x
 
Hi Michael, as always it has been a pleasure reading your post :)

Well done on the E-Patient scholarship!! Also a big congrats to you all on the charity bike ride, what an wonderful achievement :dance:

The temp is supposed to go down again over the next few days so hopefully you will catch a break soon with your hydration probs.

AB
xx

You know, I love the heat that's the irony!! as always your replies make me smile. Hope you are well at the moment xx
 
My continuing journey from Crohns to a new bowel

Monday, 20 August 2012

Bowel transplant phase two
I knew from the age of 12 that anything to do with the bowel or rather my bowel wasn't going to be easy. Then 30 years later my bowel transplant comes along and bang I realised that everything else in the last 30 years WAS actually easy, well easy ish.

My wife, who writes so much better than me (gutted about that!) has filled you in on all the details and any street cred or dignity I may have had has definitely gone out of the window. My stoma and my backside have probably been talked about more in the last week than the start of the new X Factor series which began over here on Saturday. I guess though that is really what this blog is all about. Getting across exactly what my patient journey has been. Whether it is writing about crohns disease or my stoma reversal I just hope my experiences make others feel not so alone with what they go through.

Without doubt these last 10 days have been some of the toughest I have faced going through my bowel transplant journey. Why? I mean it was only a stoma reversal. True and yes they were hard physically for me but the real reason they were the toughest was seeing first hand the impact it had on my wonderful wife. You have all heard me waffle on about how lucky I am to have amazing family support and quite often I guess, not deliberately, I have taken it for granted well never again.(or at least not too often) And if I do and you hear or read about it then you have my permission to book a colonoscopy for me without sedation!!

Twice in the last ten days I thought I was gone. I'm not exaggerating and when one of the doctors tells you that it was lucky your wife was around then you realise things weren't great. My wife who, aside from being amazing, has coped brilliantly throughout all my illnesses but the expression on her face and the ashen look she had after I came round is something I cannot get out of my head. I could see how scared she was and that is something you never want your loved one to have to go through. It made me really understand how hard being a long term patient is on the ones we rely on the most. I know how lucky I am. I have you guys who support me constantly. I have an incredible family network as well as wonderful friends. In that split second everything hit me about how fragile life is and how much pain you put the ones that you care about most through. People have been wonderful and saying how inspirational I am but the truth is it everyone I have just mentioned (yes including you) who are the real stars and my wife and kids who are the most inspirational people I know.

The stoma reversal went well and I think my heamatoma is improving although it flipping well hurts and the next procedure to be done relates to my peg tube. Frustratingly I still need a feeding tube but the part of my peg tube that comes out of my belly is constantly blocking. I often have to bolus in my feed and that doesn't help so my surgeon will replace the front part of the tube with what is called a Mickey tube. This new tube will sit almost flat against my stomach, will still allow me to use it for feeding but won't dangle down the whole time. Hopefully that will be done this week and I should only have to go back to my second home for a day.

I guess I am now at the point where phase two comes in. The major part of my transplant has been done and those 5 words ( in case you forgot them "I can change your life") uttered by my surgeon nearly 18 months ago can actually happen. I'm not sure where this is all going to take me but it is going to be one heck of a ride. I didn't go through all of this to muck up my second chance. My hopes and ambitions may one day come true. Except probably the one where I see QPR lifting a trophy, but you never know. The term e-patient is one used far more commonly in other countries than here and means a number of different things. For me it is all about using my experiences to help others. To stimulate patient to patient interaction and to use social media in healthcare to give patients more of a voice and more of a say in their own journey but who knows where my own journey will take me.

What I do know is that I don't want my loved ones to have to experience again what they have just been through. Now back to the mundane stuff and my lunch time meds.

Catch up again soon, I promise!



Sunday, 12 August 2012Stoma Reversal
Post surgery, I'm presently out of action but my wife's blog gives an update. www.the-transplant-wife.blogspot.com




Tuesday, 7 August 20123.45pm
I would regard myself as a "seasoned patient". I mean I've had Crohn's for 30 years and in relation to its treatment and surgeries I think I know the manual and getting from A-Z. Bowel transplantation well that is a whole new ball game. There are so many things to be conscious of on a daily basis and just when you think things are ticking along fine and you can start to relax something smacks you in the face.

I'm writing this in between ridiculously lengthy trips to the toilet. Sometimes it feels like I should put a bed, shower and kitchen in that room considering the time spent in there. You will recall that just before my torch bearing I had a bad week well those symptoms have returned. I have though learnt a bit more about my transplanted bowel since then. What I didn't realise that when you have a transplanted bowel the nerve endings that the bowel contains do not work straight after the transplant. In fact it takes a while for the nerves in the bowel to say hello to the nerve endings in the stomach and also to say hi to the nerve endings closer to your backside. You would think that in this day and age with mobile apps and blue tooth technology that a nerve to nerve connection would be simple.

I am reliably informed that nerve signals do connect at some stage relatively soon. For now though it means I am in quite a bit of pain. It feels like you need to go to the loo but there is nothing there. These symptoms seem to ramp up over a number of days whilst at the same time stoma output thickens significantly. I put in 3 or 4 litres of fluid at the same time to try and keep everything as hydrated as possible but you do start to feel a bit crap as the day progresses. At the moment I am trying to time my toilet runs against the Olympics schedule on telly. With GB doing pretty well (at least by our standards) I really don't want to be emptying stoma bags when there is the potential of a medal. What would be really good was if I could get in and out within the same time frame as a British Cyclist takes to win another gold. Yes I know that was a little patriotic but hey we don't often celebrate successes here. Oh and by the way Sir Chris Hoy has just won his 6th gold medal!

Tomorrow I am going back in to hospital at Oxford for some minor surgery and a stoma reversal. Of course I am delighted that the reversal is happening, it is absolutely a step forward. It is though being done for specific reasons. Firstly the dehydration issues that I continually drone on about haven't sorted themselves out and neither has the absorption problems. I am eating more now which is great but it is coming straight out in to my bag. For both problems to improve I need to use the length of my new transplanted bowel to help out. It does mean that checking on the bowel gets a bit harder. I guess it will go back to the old camera up the bum but hey us IBDers are used to that.

Ok, I started writing this at 3.35pm and it is now 6.35pm. About half that time has been spent in my "little cupboard" and it is time for me to disappear again so I am going to sign off. Will of course keep you posted over the next few days from life inside the Wytham Ward.

Oh one last think, our charity ride has now raised over £97,000. If you fancy joining us next year then watch this space. I'm going be there, come and join me...

Catch up soon
 
I wish you all the best with your re-connection....I had my entire colon removed and then had an eliostomy for one year and had my bowel resectioned (j-loop / ileo-anal loop) taken from my small intestine and made into a new bowel. I had it done in one surgery and that was a major mistake - so bloated I thought I was going to lift off my hospital bed - lasted for about 2 weeks and finally I had some plain old yoghourt and that let out the most nastiest smelling fart - but the gas was gone! I have had the j-loop now for 3 years and have had numerous bouts of 'pouchitis' and too many trips to the lou - but through diet ( I am not on any meds - only ferrous gluconate and acetiminaphen for pain ) I help ileviate my trips to the lou - sometimes I go about 30x a day. Dehydration is an ongoing event - so soups, gatorade, juices, water and straight cranberry juice (for the kidneys) (I know it's nasty tasting but it acts like a teflon and does wonders).
Again good luck with your surgery.
 
Thanks for getting in touch. Wow you have been through so much but it sounds like you have come out the other end. Thanks for the dehydration tips as that is still an on going battle for me. To say it has been an interesting journey is an understatement but like you we are here to tell our tails.

Hope that you keep well and please stay in touch. Cheers
 
Michael, thank you for the updates! May I say, I am sooo grateful you made it through! May each day bring you more health.
 
I really appreciate the support from all of you. It definitely helps keep the spirits high. We all endure tough times in one way or another and I just hope that I can be there for you guys when you need it. Take care x
 
Just read your story I'm amazed how positive you keep. How do you do it? 0 - 5 would make anyone weep!

Congratulations on your e-patient scholarship and the fantastic charity ride. This might be a slightly OT question but are you aware of anything like e-patients in the UK? I've looked on the internet and can only find the US scheme.
 
Hi there, thanks for the post. As you know I am based in Herts, UK and I have scoured the UK for e-patients and e-patient groups etc but like you have found nothing. I wasn't sure that I was going to adopt this name as it seems to only resonate in the US and Canada but I guess that I am hoping it comes here.

For me I am about patient to patient interaction and the benefits that it brings. I really believed the opportunity of better informed patients is key and will grow in the near future. maybe we will be the 1st e-patients.

Am delighted to chat more as and when you want too.

Take care
 
My journey from Crohn's Disease, via bowel transplant, to a normal life

Sunday 2 September 2012

How do you define normal life? I'm pretty sure that my idea of normal life will be different from yours. When you are recovering from long term illness and major surgery the phrase that keeps popping up is "don't worry you will soon be back to a normal life."

After having a major setback a couple of weeks ago I have now been able to have some unbroken time at home and return to that phrase "normal life." Now that I've had my stoma reversed going to the toilet has taken on a whole new meaning. Somewhat frustratingly though I still can't always control when I am going to go and stepping in to the shower at 3am is still a relatively regular occurrence. I know that things will settle down sometime soon but it isn't always as quickly as I would like and I can feel the frustration brewing inside me at times. Like everyone I have my good days and my not such good days at the moment, though I think some of my not such good days are as much trying to cope mentally as my frustrations with the physical problems.

Whether it is as a result of my crohn's, my intestinal failure even my bowel transplant if I'm perfectly honest I have days now when I wake up feeling worn out by it all. I just want a normal life but as I said earlier what is normal? I mean the football season has started and my team qpr have lost 2/3 games which I guess is normal for them. I'd like seeing them winning a trophy to be normal but that would be more like a miracle.

I can always rely on my kids to inspire me and shake me out of a strop. Thankfully our eldest Aaron did very well in his GCSE exams. Yes some of you will still remember the old "O" levels and these exams are the equivalent. We all went out on the weekend to celebrate and it was so lovely to be a family again celebrating something for a change. Watching my daughter consume a pizza in record time sounds silly but actually it was fab.



A few days later we had our first proper day out in ages. We decided to go up to a museum to see a tour that never happened. (usual incompetencies) From there we went to Westminster and walked along the river. I was more knackered that you could imagine but it was so important for all of us to have this day out and be a "normal" family again. By mid afternoon I was flagging but loving it. So many things that we just take for granted in life become very important again after you haven't had them for a while. We sat and shared a plate of nachos whilst sitting on a boat anchored near the Houses of Parliament. For me it was an ideal place to drop my anchor and just take stock of how lucky I really am. A few jokes about the new bicycles that are now part of London life and we headed for home.



Throughout all of this dehydration has still continued to bother me. I am putting litres in on most days. Yes I still have the odd spoilt child, I can't be bothered strop. Something isn't quite right and my mouth is constantly very dry. The issue of the haematoma at the site of the stoma has not yet cleared and is flipping painful and then there is the saga of having this Mickey tube fitted. I know that I talked about having it done in the last post but the ability of the NHS to coordinate two doctor's diaries continues to amaze and frustrate me. In fact don't get me started as I can feel a rant coming on. Suffice to say, it hasn't happened yet.

So there you have it, my attempt to get back to normal but I am still not sure what that normal is actually meant to be. I have never wanted to be a person defined by my illness yet I know I am bowel transplant patient and that has to have an impact on my life. Right now I am trying to work out how all the pieces in the jigsaw that is my life fit together. The one thing that I am passionate about is using my experience to help others. For me that will always be part of my normal life.

Till the next time
 
2012Bowel Transplant + QPR + NewsRoom+ Emotional turmoil = ME!

Thursday, 20 September



I spent ten days writing and then re writing this blog post as there has been so much going through this tiny mind of mine and I never knew how to start. Then about half an hour ago I was back in my own den of tranquillity, the toilet, contemplating the meaning of life (actually I was contemplating where the hell the toilet roll was) when finally it happened. No, not that thing. Oh crikey believe me no waiting there. I think I fell asleep on the loo I had been in there so long. What did happen is that the haze that had really engulfed me mentally for the last ten days lifted. From spending days debating the meaning of life with myself, questioning what the future was going to be like and if I really can make a go of it, worrying about how much Justine and the kids had been put through and finally whether QPR could gain enough points to avoid relegation I realised that actually I needed to stop feeling sorry for myself and just get on with it.


Why was I worrying about a bowel transplant when you have Newsroom to watch? Please tell me that you have seen this one? For those of you who read my blogs regularly you will know that my all time favourite tv show was The West Wing and secretly I still want to be Sam Seabourne! Newsroom is by the same creator just based on a nightly news broadcast. I've attached the opening scene link below if you fancy a watch!


And on top of this Aaron, our eldest has just started studying politics for A levels. He may not share my love of the mighty QPR but like him I studied politics and couldn’t wait for the debates to start. Having him come home and tell me his views on first past the post voting system well; it was like that same warm glow all inflammatory bowel disease patients must feel the first time home from hospital when you go in to your own bathroom and see andrex toilet tissue and not the thin hospital tracing paper on the wall. It is amazing how this diverse range of random thoughts can go through my head. Some psychologist will probably tell me how strange I am; mind you I don’t need a professional for that.


There is always a lot going on when you are a patient especially a long term one. With Crohn’s Disease I was part of a relatively large community and got to know the drill. Intestinal failure saw me part of a smaller one and actually the range of potential options were not so wide so it was containable emotionally. A bowel transplant puts you in a very tiny community and for the first time that has found me wrestling with all sorts of confusing thoughts that usually I would have batted away. The overriding question has been whether my life really is going to work out ok? I mean this in three ways. Firstly medically am I one bad episode away from problems or am I doing exactly the right thing and it will all be ok? Secondly Justine and the kids are utterly amazing but what impact is all of this having on them? And finally I talk and talk and talk about the positive impact patient to patient interaction can have on your health and your life but am I spouting rubbish? Can I actually make a difference or am I a delusional patient who’s had too much morphine?


As my time on the toilet reminded me actually you just have to deal with the cards you are dealt and the only person who can influence the answers to any of those questions is me. In the bowel transplant team at The Churchill in Oxford I have world leaders so as long as I fulfil my side of the “contract” then I’m in safe hounds. I can’t answer the second question and that still troubles me daily. I just have to believe that as long as I listen to them and do my best by them it will work out ok. As for the final question; I really hope that in some tiny way I can help others. Maybe I will never be able to answer that one. I don’t do it because I want anything back I do it because I believe I have experienced a very long journey that can help others who are at different stages on their own. In some tiny way it can be of benefit to share experiences. After all isn’t the patient supposed to be at the centre of health care globally?


I’m writing this from my hospital bed having been admitted after another relatively minor blip. What felt and still does feel like flu became temperature spikes and blood results indicate a viral problem. That combined with a small hernia at the site of my stoma reversal has put me back in for hopefully just a short stay. Yes physically I do feel rough but I know it will pass.


This post has had more changes to it than any previous one. Not because my beloved QPR are yet to win a game in the Premier League, although that has caused a high degree of turmoil in my life but because this last period has just been a very hard emotional journey on my bowel transplant recovery. I try and be as open as I can about how I am feeling but I just couldn’t seem to adequately articulate what’s being going on in that pea size brain of mine. I guess that if you are still reading at this point it is either because you really have nothing else to do or maybe because you can understand a little of what I have talked about.


Worry, guilt, frustration and discomfort are words I often use when talking about my bowel transplant and now I will add confusion and guest contributor to the globally acclaimed QPR match day programme.



Till next time
 
Michael, you are indeed in the small minority...what 18 people I believe is all that have had bowel transplants in England? You are ground breaking. I bet you dont feel like it with all the ups and downs you've had though.

You are an insiration! And when all this is done and you have your life back, I know you are the kind of person who will give back to so many. Including your loving family. You are so close to being back in the saddle, keep fighting.

Always....look forward, never back. :heart:
 
Words of support and encouragement like yours are what help to keep it all going forward. Can't thank you enough. I know that my struggles pale in to insignificance compared to some so I should be grateful. You keep well too xx
 
Thank you for the continuing update Michael :) I like how... what's the word for it... contemplative you're being. I don't think it's the morphine talking. Well, maybe just a TINY bit :D

I hope your stay in the hospital is a short one!
 
Hi Michael,I read through your posts and it seems that the bacterial issues are a constant that wont go away. Given all the antibiotics you have been on, I imagine that your bacterial flora will continue to be out of whack or in an unnatural state. Perhaps a fecal "transplant" can restore the correct flora. I may be totally off base, but I think its worth suggesting and hearing what the doctors have to say to that.
 
Hi Steve many thanks for your kind comments and looking in to some suggestions. I'm in very detailed discussions with the dietician here about the various options so who knows which direction it will take. I know it is going to take a while for things to settle but we just keep going. How are you keeping? i see you are a new member so welcome x
 
Hi Michael,

Thank you for the update - it is always so nice to read your posts!

I'm so glad the mood lifted, and your spirits have improved. I think its just amazing how much you have been through, and how you have remained so brave and strong, and at the same time, so inspirational to so many people.

I think if you didn't have days when it hits you hard, there would have to be something wrong with you don't you think. You are an incredibly strong person and so concerned for those around you and for your family.

There were times when I used to make myself sick with worry about the future, until I decided one day to just do the best I could, leave no stone unturned, and the rest was out of my hands. At least I could look back one day and know that I could not have done more or tried any harder. There is a certain peace that comes from realizing this.

Someone once told me that I should try not to worry because 90% of it doesn't happen, and the 5% that does, no amount of worrying could change:) Much easier said than done, but so true.

Please let us know what happens and when you get to go home.
 
From hospital bed to San Fransisco in 72 hours!

5 Oct 2012


The thing about recovering from a bowel transplant is the unpredictability; you are fine and then before you know it you are back in a hospital bed. I woke up feeling like I had the flu; you know that achy feeling, joints hurting and a bad headache. I never get headaches or at least I only get them when QPR lose (all the time at the moment), when I forget to sky plus The Newsroom and when the dog doesn’t stop barking at a squirrel climbing a tree that he has absolutely zero chance of ever catching. With a temperature that would spike I was admitted back to my “other” home the Transplant Ward.

It turned out not to be anything particularly troublesome just a viral infection that wiped me out and required another set of antibiotics. With my blood markers off kilter and my creatinine climbing it meant a stay of over a week.

As you could read from my last post I had been going through a bit of a psychological dip and with this hospitalization on top I found it harder to snap out of this particular blip. On top of it all my picc line burst in two places. It became blocked (which really annoyed me) and then in trying to flush the line clear it burst. I knew deep down the moment it happened that they would not be putting another one in. It is a very real potential source for infection. Boy was I gutted though. It meant that I had to take my anti sickness meds in a different way. This time it was by crushing them and injecting them through my peg/j (feeding tube in my belly). To say they do not have the same effect is an understatement of epic proportions. I knew that I would have to be weaned off them at some stage but this felt like I was going cold turkey and I really don’t like cold turkey (it’s too tough and hard to chew). As I write this I am still taking my anti sickness that way although I am being sick now at random times so if you are reading this Lydia (yes another reveal – Lydia is the intestinal transplant coordinator at The Churchill), can I have the line back please!!

I also knew that 28th September was looming and I was due to have a date with San Francisco. Should I stay or should I go? (Great lyrics for a song by the way if you ever want to use them)
Ultimately the decision lay with my transplant team and primarily with my surgeon Anil Vaidya. There I said it!! Yes he is the incredible man I have been talking about without revealing an identity. I’m taking the view that if you know me by know then you know the hospital where I had the transplant so figuring out his name does not really require an IQ of Mensa proportions. On the Tuesday before he told me that I should make the trip. He said that he was entirely confident that if I ran in to trouble he could sort it and after all I was going to one of the finest medical institutions in America. To say I was delighted would be an understatement. Perhaps only the news that The Newsroom has been commissioned for another series or that The West Wing is returning would have brought a bigger smile to my face.

So, just over 48hrs later and with the kids safely deposited with family and friends we flew to San Francisco to attend a conference at Stanford University School of Medicine called Medicine X. I was privileged to have been selected as an e-patient scholar and this was my first ever conference I have attended in my capacity as a patient.


walking in to Stanford

The flight was fine although I loved watching people’s faces as I did my meds and connected up my tube to stay hydrated during the flight. It is the look of intrigue mixed with the “should I be worried about him?” that is so fascinating.

Justine and I arrived as Stanford mid afternoon, which was 10pm UK. Usually that would be anti sickness and meds time but I knew I had to adjust my routine whilst there so I held off as long as I could. Time difference doesn’t just play havoc with your body but you also have to work out very carefully what time you take your pills especially the anti rejection ones. I know I can’t miss a dose yet taking them at the wrong times is also not great. Oh the joys of being a patient.


part of the campus
Walking in to the conference was for me a real defining moment in recovery. In less than a year I had gone from bowel transplant to being at Stanford, mind blowing really. The conference itself was attended by a combination of patients, medical professionals, healthcare providers and pioneers of cutting edge technology that was being used or about to be used in healthcare. It was full on leaving my hotel at 6.30am and often not finishing at the conference until 6.30pm but I loved every minute. I knew it would be knackering and I knew I would feel rough at times but I desperately wanted to be there so I also knew I needed to just get on with it.

It was one of the most inspiring, informative, educational and fun experiences I have been lucky enough to have. My brain is still aching from consuming all the information; mind you it hasn’t been properly used for so long I am surprised it remembered what to do. (a bit like the QPR defence, it hasn’t known what to do all season) I listened to other e- patients tell their stories, share their experiences and explain how they have used social media to build communities, gain greater knowledge and really be an integral part of their own healthcare plan. They explained how by using their own experiences they have become a vital ingredient in the overall healthcare policies of hospitals, medical professionals and healthcare providers. Patients are right slap bang in the centre. On top of this I learned about the impact that social media and the digital developments in healthcare. From mobile apps to new websites to new technologies speakers explained how this was all focused around the patient playing a key part in health.

I met some incredible people who will undoubtedly become friends as well and hopefully by sharing my story I was able to provide a small insight in to what I am trying to do and what it has been like going through a bowel transplant.

After the conference we had a couple of days before catching the flight home so rested up and did a typical tourist tour around downtown San Francisco. The best bit was waking up to sunshine each day. It’s amazing how much better you feel with the sun on your back; yes I was careful, loads of sun block, cap at all times although much to the astonishment of my wife I did actually venture downstairs in shorts. I hate showing my legs, not I might add because I hadn’t waxed!!

So with presents bought for the kids it was back to London and yes rain. I’m looking out the window right now and it is pelting. Even the dog is depressed.

If there is one thing that I wanted to convey to it is this. No matter how tough things are as a patient try and live your life as well. None of us know what is around the corner. I would never have gone had my surgeon said no but he didn’t he said yes and I went. Believe me if I can then you can, may be not today and maybe not tomorrow but one day.
Till next time
 
My bowel transplant journey continues....

Sunday, 25 November 2012Patient/doctor relationship, is it the ultimate trust you can have in someone?
I talk a great deal about what it is like for me being a patient and specifically a bowel transplant and inflammatory bowel disease patient. Actually being a patient though isn't just about me the patient it is about finding a doctor then building a relationship like the one that I have with my transplant team and specially with the guy who is at the top of the tree my transplant surgeon Anil Vaidya. You see when you go through chronic long term illness you build up a relationship with your doctor that is quite different to most people who go to hospital. Then when you go through transplant and require long term care that relationship goes up on to an even higher level that you can imagine. It is not like a routine bit of surgery where you can often feel like just a number on a list here you really build a one to one connection and that is as scary as it is fantastic.

The last week has been a pretty uncomfortable one pain wise and it has only been in the last 48hrs that I have actually been able to stand up relatively straight. Being challenged in the height department (no, before you ask I don't suffer with short man syndrome) means that my wife is forever reminding me to stand up straight, I mean it doesn't exactly do my credibility much good when my 12 year old daughter is almost taller than her dad. Managing to stand up bizarrely also coincided with actually going through a couple of days without having an accident. Quite how the two are connected I doubt any medical genius could work it out, mean what has walking around like the hunch back of notre damn got to go with random stool action I have no idea but the timing was the same so that will do for me. It also coincided with a visit to my surgeon for a further check up.

I stood there with my top pulled up under my chin and my surgeon telling how great the scar was looking and how symmetrical my belly now looked. These conversations weren't quite what I had in mind as my life has gone on but now, hey a symmetrical stomach and a wound one of the world's leading surgeons is happy with is nothing to be sneezed at. On the car journey up I also heard that my football team had sacked our manager so all in all it was a good morning. We then got on to the topic of the future and what next. Anil has always been very good and basically telling me that I should go and do anything I want to do, to go and achieve my dreams and live my life and when things go wrong he will sort them out. In reality he has sorted things out and with that comes a confidence like nothing else you can experience. But as I said early it is also really scary. You see the question that entered my head then is what happens when he isn't around? What happens if one day he leaves, he pursues a career elsewhere and he is not there to take my call or give me the pep talk I need? He has been my surgeon, yes my personal surgeon, but he isn't is he and the transplant team are not my personal team. Marion isn't my personal dietician. No they belong to the NHS and the Oxford Transplant Unit and that is very scary.

I hadn't ever thought that they wouldn't be there for me, how dare they want to have a career elsewhere, how dare they potentially go on to greater things. Of course I don't mean that but you catch my drift. You see this whole journey is like no other and it is only when you go through a medical journey that takes you right to the edge that you really appreciate and understand how close and attached you become to those that care for you. They become your second family, the one you literally have trusted with your life, they know you like no one else, even your mum and dad can do. Going right back to that walk to theatre, holding hands with my wife Anil would have been the only other person who could truly have known how scared we were and how that walk could have been the last time we held hands.

So is it is a good thing to have such a trust and confidence in someone who may not be there one day? How do you deal with the whole doctor/patient relationship especially given what you go through together?

For me I guess my whole reason for turning to social media and for building on line relationships is where I find my answer. The world is actually so small and connecting with people is so much easier today than ever before. With technology in healthcare growing daily actually my team can be anywhere in the world and I can still connect with them. I recently watched a video of a brain operation that was tweeted live http://youtu.be/dxJvbi6tW88 and if this is the future then should I be worried?

Connecting is one thing but could I ever imagine actually being treated by another surgeon. Right now the answer is of course no way. I don't have to even worry about that right now so I guess what I should do is exactly what he would want me to do and try and live my life to the fullest it can possibly be. Now that bit is a challenge I will take on no matter what. Do I still feel fragile most days, absolutely I do. Do I still have pains, worries and concerns, absolutely I do. Will they stop me, of course not; I just now have to tell my brain that it is ok to give things ago and if and when it goes wrong then I have the best team in the world to look out for me - wherever they may be.

Till next time
xx


Monday, 19 November 2012When Mr Armani was joined by Mr Gucci in Bowel Transplant Land



There is an old adage that a week is a long time in politics; well there should be an adage that a day is a long time healthcare especially when you are a patient. I started the week by going back in to hospital for what was supposed to be a minor and routine hernia operation. The only slight complication was that it was at the site of the stoma reversal and that made closing the site potentially more difficult.


Everything had started as a niggle; I constantly felt in discomfort and it sounded like a blocked drain every time I ate. Food would go down and as it hit the hernia site huge gurgling would start and then it was as if the drain would unblock and the contents would flood out. Gurgling became louder and louder and pain got worse and no amount of self plunging seemed to clear things. (I’m not sure that the medical term “self plunging” actually exists in the British Medical Journal but you get my drift). Sitting in the waiting room before going to theatre my surgeon and I chatted about if things went well then maybe I would go home that day. I must remind him not to choose my lottery numbers in future.


I woke up several hours later back on Wytham Ward in real agony, connected to a pain relief pump and with a drain attached to the wound. My initial pride at having the hernia described as “a corker” was soon replaced with the realisation that I couldn’t actually move properly and that the surgery had taken much longer than planned. In addition I had always prided myself on my Armani style zip that went vertically down my stomach. In truth it was just a series of scars all in the same place that have been repeatedly cut out and replaced by the next season’s style of scar. This time though Mr Armani was joined by Mr Gucci a 6 inch horizontal scar across my stomach. The wound had also required a double mesh to be used to try and keep things in place and then the skin was actually glued back in place in the hope that it will stay fixed. So not only do I have Armani and Gucci fashion accessories but I now have an arts and craft store permanently on tap to place with. If anyone is connected to Hobbeycraft then for a small fee I will advertise their wares on my body. Think of it as the new telemedicine advertising.



At home I feel that I have been walking around like quasi modo as it is proving a real challenge to stand up straight. I also picked up an infection at the site of the wound and am on antibiotics. I’m not sure whether it is the new meds, the effects of another anaesthetic or simply my bowel going “for goodness sake when will you leave me alone” but the time spent on the toilet has been huge. It can also be at any time of the day or night and I have found myself either asleep on the loo a 2am, in the shower at 3am and contemplating the meaning of life on many different occasions over a 24hr period. I am thing of putting an office in there and a camp bed then I probably won’t need to leave. Also it has crossed my mind at times to actually throw my food straight down the toilet bowl as it would save a whole lot of aggravation waiting for it to go through my own plumbing works and back out again. Surely cutting out the middle man makes sense. And following my new innovative sponsorship strategy I am a one man focus group for any toilet paper company looking to launch a new luxury brand. Andrex 3 ply are my favourites by the way J


I don’t want to paint a total picture of frustration over the last week especially as has been one monumental breakthrough. Yes folks a fridge that is now in the waiting area on the ward and can be used and accessed by patients 24/7. Up until now the only fridge I have been allowed access to as an inpatient is the one in the kitchen (let’s be clear it is not a kitchen in the sense that you and I know – it is a place where a microwave, fridge and dishwasher exists) which is constantly locked and relies on the complete kindness of nurses to get you access to it on an ad hoc basis. If the nurses are busy which invariably they are then it means getting your own food can be really challenging. This fridge is ground breaking.


This week has seen my usual blood test challenges and attempts at re-siting cannulars. Putting one in a tiny vein in my index finger was interesting to say the least and I have been working on the basis that they last around 24hrs before tissuing. I tend though to take all these things in quite a blasé fashion. In a way taking bloods or sticking in needles to difficult patients is just as hard for the doctor as it is the patient. Some run a mile and some see it as a real personal challenge, I just want to know if one of them would be brave enough to let me have a go at jabbing them. Come on, man up!!



So there you have my week in a nutshell. I made a serious of very short videos whilst in hospital. Here is the first one if you fancy a viewing and the rest will be up on my You Tube Channel. http://youtu.be/IZG9u0EBCSo Yes I know that I am not President Bartlett or even the legendary news anchor from The NewsRoom but you can’t blame a man for trying. I mean this is reality tv on a shoestring budget. I have to write the script, act the part, be director, producer and editor all rolled in to one. What more do you want from a humble bowel transplant patient.
Till next time
 
Wow this is quite a journey you are having.

I just want you to know that you have our support.

Good luck HUGS
 
Wow you have been through a lot but is nice to read that you still keep your sense of humour, I especially liked "Also it has crossed my mind at times to actually throw my food straight down the toilet bowl as it would save a whole lot of aggravation waiting for it to go through my own plumbing works and back out again" I have thought this a few times and have said to my family when I have had flares.
I will have to look at your other posts you had a very interesting story do thank you for posting :)
 
Thanks Kayleigh. It has been a journey but hey you have to keep smiling don't you. Think we have all had those "plumbing moments" when it seems just easier not to bother but then when it works it is such a good feeling.
Hope you enjoy the read and if you ever have anything more to say or ask then I would love to hear from you.
Take care
Michael
 
Michael, as usual I enjoy your updates. But I was hoping you were planning a ski trip this time, instead of enjoying the luxurious accomadation in hospital!

Having the parastomal hernia from hell myself (operated on once already, FAIL) I can relate to that OP at least. I too can do the shuffle at an alarming forward pitch after OP, and the others. Yes indeed.

I do think it is the antibiotics that are causing you the inglorious pleasure of the loo. Soon it will pass. Or at least I certainly hope so for your sake!
:kiss:
 
so lovely to hear from you Misty and thanks for the advice - really do appreciate it. Hope that you are keeping well at the moment. xx
Just hoping your advice proves to be right, there is a limit to how long a man can spend in the loo!!!!

Take care
M
 
Erm, I've managed to spend up to 24 hours there at one point in my life. I just got a pillow and blanket and slept in between. Thankfully it passed. After the stoma anyway!

You must be tired...as hard as it is, keep looking forward tomorrow has got to be better!
 
Thank you Michael for your interesting story.
It is amazing what the human body can take and it sounds as if you have had more than your fair share of the slings and arrows of outrageous fortune.
Sure puts my own situation into a minimalist position.
Think I will never complain again.
Hope your situation improves greatly for you.
Humbly
Trysha
 
Retraining your brain to flip out of patient mode is so hard

I have only really heard of the term “flip flopping” in connection with UK politics; in other words when a political party keeps changing its mind on policy. However at the moment I think it best describes the challenge that lies ahead in getting to grips with my bowel transplant.
It is not like my new bowel is flip flopping but it is what my brain and my mind set has to do. You see the trouble with long term illness is that you can forever be a patient and forget what it’s like to just be you. I have really only not been a patient for 11 years of my life and now, here I am having gone through one of the rarest transplants, being told to get on with my life and try and adjust to not just being a patient but being Michael. And that is flipping hard.
For most people the moment you are out of hospital you are fine and there is nothing wrong with you. They don’t see the accidents at 3am and they are not there when from literally nothing I start being sick and it doesn’t stop which is exactly what happened last night whilst watching I’m A Celebrity Get Me Out of Here. So for me there are parts of every day when I feel a patient yet I need to train myself to get out there, do all the things I want to do, put being a patient in a box and get on with life. How do you do this? How do you flip flop from patient to non patient and back again? For me when I have the good spells and feel great it gets much harder to revert back to patient mode when I get sick. I find myself getting frustrated, even angry yet that is totally irrational as I am transplant patient and that doesn’t leave you.
Often the easiest things to say are the hardest things to do and lead to silly reactions from me. I fight very hard not to be treated as someone who is ill; yet quite naturally the first thing people want to know is are you ok. I would probably be very upset if they didn’t so why get angry. So as you can see training the brain to flick a switch one way or another constantly is not so easy. I mean take one of my favourite programmes right now Homeland.

How does Brody cope with playing both the terrorist and potential Vice President? Is Carey in love with him or has she trained her brain to be able to simply tease him in to doing all she wants? Hey I know it is only tv but it would be so cool if I could have a script writer come in and just write my week out for me. I could go from one scene to the next, ill patient one minute, recovering patient the next then on to normal dad and hubby before ending the episode back in hospital. We could then all sit down and have a cup of tea in between takes. That would be so much easier that having to do this in real life.
So as farfetched as it may sound I am on a mission to change the world that I live in. To try and make an impact on the lives of patients undergoing similar experiences to me but at the heart of that my brain then flip flops in to patient mode, I get unwell and think what the hell is going on. Hey I would love to emigrate and live in a warmer climate and have a better quality of life. One side of my brain is like, for goodness sake get on with it you lazy lump; the other side is like – yeah right who do you think you are?
And there you have a typical patient dilemma in 600 words. Can a long term patient ever truly stop being a patient in some shape or form? All I know is that if you keep going on about how ill you are then you will probably stay ill and that is a mindset you can do something about. I mean take my 95 year old Grandma. She is one truly amazing lady but every day she will moan about an ache or pain somewhere yet we know that if you talk to her about something else she will forget about it. Then she gets diagnosed out of the blue with breast cancer and brushes it off with the bravery so many wish they could have. What is it inside your head that says ok I am going to moan about a bit of trapped wind (mind you that can be painful) yet when I get a really bad illness I am going to be a strong as anything about it?
Whoever said that being a patient isn’t easy was a genius (yes it was me ) but being a patient then flipping to being well and then flopping back again, well that is a whole new ball game.
Till next time
 
Hi, Michael!

I'm sorry you're having such a rough time. :( I'm wondering, how long have you been diagnosed?

I don't have as much of an issue with the "patient mindset" as you do - but I can absolutely see where it would be a problem. In normal life, you're in control of everything you do. However, so much of our lives are dictated by our health and what our doctors say. It can be very difficult trying to maintain control of your own life while still keeping up with your health.

As far as your Grandma goes, I think a lot of us have adapted to act the same way. My stomach hurts, and I'll complain nonstop about that. But I don't complain about having Crohn's. When I was diagnosed, I wasn't upset - I thought, "Okay, well, where's the treatment?" For me, I'd been having stomach problems for so long that it was normal. It was just part of my life. The diagnosis only meant that we could finally do something about it.

I hope your transplant goes well and you can get to feeling better soon!
 
The flip flopping can be very very difficult indeed. I've been in and out of patient mode so many times that it's gotten very boring. Like many here, I found a mindset more on the positive side that made getting through the ins and outs of health much easier to deal with. The unfortunate part of that is when I am feeling at my lowest with pain, diarrhea, stomach issues and just bummed out, many peope around me (including doctors) don't realize just how miserable I am and fail to recognize that I need help.
 
A transplant patient or just a patient? What defines you?

Well this is the first time since August that I have been able to write a blog post with my football team QPR finally having won a match and secured 3pts. Fulham fans, this one is for you  http://youtu.be/YE2XSm5-xRk
Yes the QPR revolution is off and running and into phase 2 of the season. My own bowel transplant journey is also probably now about to go to the next phase and whilst that is hugely exciting it has thrown up more questions than answers. In essence it mirrors the lives of many patients so just because I have had a transplant why should that make any difference?
Last week saw me have a full review of all my blood results and a detailed discussion with my dietician Marion about next steps. (as it is Christmas please say hello to her on Linked In she needs more connections so I’m on a recruitment drive) http://www.linkedin.com/profile/view?id=82754883&locale=en_US&trk=tyah whilst the transplanted bowel is generally doing ok the principle remains that if it goes wrong it will somehow get fixed as long as I remain totally focused on keeping everyone updated on any new symptoms. With other levels it isn’t so easy. My lack of absorption has meant that I am deficient in a few areas such as iron, magnesium and vitamin D but infusions should sort them out. What do most people do before Christmas, they shop – me, I get my infusion. Mind you it is holiday season so I am expecting a buy one get one free offer from the NHS. The other issue remains hydration and ensuring that there is no damage to the kidneys. The issue there becomes a lot harder to sort out as it is the anti rejection meds that can, in some patients, really cause havoc with the kidneys. I pretty much know the levels I need to be at and to stay in the safety zone I will need to stay on fluids about 5/7 days of the week with them going through my Mic Key button in my stomach. It isn’t a disaster I know. I mean real disaster would be QPR relegated but what it does do is bring home the fact that a bowel transplant is not your ticket to easy street. You replace one set of problems with another and it is how you cope with these new issues that I think determines what the future holds.
So why is this guy mentioning all of this I can hear you say. Well it is simple. It means that you have to either continue or become and engaged patient, an empowered patient, an educated patient. All of that seems to fall under the term E-patient and when you mention the word e-patient most people thing; what is he droning on about?

Actually I would argue we are all e-patients as let’s be honest when we are a patient we are usually engaged in what is happening to us and we become educated either ourselves but finding things out or simply but listening to what our doctors tell us. So as I enter my own personal phase 2 I would like to think that I have become an i-patient. What the hell is he on about now?
I-patients are in my view, interactive patients. Patients who interact with all aspects of their healthcare. From the doctors and medics to the hospitals, the pharma companies and above all directly with other patients using and sharing their experiences for the greater good of everyone. These days the world is as small as ever and social media makes it even smaller. There is nothing a patient cannot find out if they choose too and to use the well spoken phrase “no decisions about a patient without a patient” put patients right at the centre of healthcare for perhaps the first time ever. So to take advantage of that position a patient has to be interactive. To use their data, to get another opinion, to share a thought or a story patients, in my opinion, have to be proactive and not reactive so from now on perhaps i-patient is the new e-patient.
With that interactivity in mind I want to end by mentioning one thing. I have the huge privilege of being the patient advisor and speaker at the up and coming Doctors 2.0 & You in Paris, France. http://www.doctors20.com/ . You can join me too. Calling all i-patients, if you want to come to this conference check out our video on the crowdfunding site http://www.medstartr.com/projects/113-doctors-2-0-you-funding-epatient-travel-scholarships and if you fancy having a coffee with me in the beautiful Parisian sun then apply or contact me for more info.
Till the next time
 
Thanks for the update Michael, as always it has been great reading. I hope you are able to have a nice Christmas and I will be keeping fingers crossed for QPR for you :)
 
So nice to hear from you Michael. Thank yoh for sharing your journey with us. We are all learning so much from you. I wish you and your family a special merry Xmas. Good luck with your trip to France!!
 
Was 2012 the year of the patient?

This is now my second Christmas since my bowel transplant. Last year I had been out of hospital for a day post my transplant surgery and this year I am thankfully in a much better place. The odd cracks are starting to appear but I’m banking on them not being anywhere as bad as the transplant itself. One of my current challenges is where to inject my anti sickness meds. I take them intra muscularly and a the moment I don’t have that much feeling left in my left leg and better still when I sometimes inject in that leg I can see the liquid spurting out of another hole in the leg that hasn’t yet healed. It is probably something that Darren Brown or David Blane would be proud of but actually it blooming hurts and what a waste of good, beautifully matured neat cyclazine.
Perhaps the bigger challenge is staying hydrated and that is proving a little more difficult with each passing week. It is a difficulty perhaps only matched by my football team who after one victory have reverted to type and lost again. Actually our defence is a bit like my legs right now, full of holes and always leaking. It is a complicated process combining anti rejection meds with preventing kidney issues but hey life is all about challenges so I have no doubt we will sort this one out. I think, I hope, actually I really hope.
So I am guessing that if I was to give myself an end of term report as a patient it would probably be a decent grade for effort and completing my homework and the usual teacher phrase of “could do better but still pretty good” when referring to the body itself. I have never been a straight A student so hey it isn’t bad.
That is me as a patient looking after my own health but what if there was an overall grade for patients in 2012. I think the teacher would have to state that there has been a dramatic improvement since last year; the level of classroom engagement has increased enormously and now the challenge is to keep that up and move on to the next level where patients really do ensure changes happen. I am absolutely convinced that 2012 has seen patients really put their heads above the parapet and really increase their voice in the world of health care but I guess to take it to the next level it has to be all about change and impact. I think that it is inevitable that those, like me, with long term conditions tend to engage more than those who may be unwell for a short period of time but return to good health in a matter of days. However the key thing in my opinion is that it is the sum of all of us that makes patients such a potent and powerful voice. In all walks of life there are those that are happy to be a little more vocal or push a little bit further but with those patients may be considered i-patients and more interactive we are actually nothing unless we all work together.
I guess in my own little world I see things in healthcare as no different to government or any national or international organisation. You can have Presidents or Prime Ministers or Ambassadors but they are really figureheads for us all. Patient leaders are the same and quite often it can be all too easy to get caught up in lovely conversations with people that you think of as your peers talking in wonderful circles about how patients will change everything and what this one or that one has done wrong. Talking at that level is fantastic, it is intellectually stimulating, it is thought provoking but it is often not the real world. I have been to a few health conferences now and even spoken at a few and the buzz word(s) is always “patients” or “patient engagement” but often that is marketing speak.
How many really know what it is like to be in a waiting room when there is not enough room for patients to even sit. How many have talked to patients who have to stay in a treatment room because there are no beds on the ward or have to get admitted as an inpatient for a few hours in order to get an urgent test done? Better still how many have experienced what it is actually liked coping as a patient, being served food that is inedible for the 10th day in a row? These are real patients who need to be embraced and taken with on the journey for real change to happen within healthcare.
So to answer my own question I think that 2012 has seen massive advances by patients. The self management via social media has been huge, patient communities are growing, how we now engage with our doctors is changing so rapidly it is amazing. As engaged or interactive patients we now have a duty to share our experiences with the wider patient communities and then 2013 can be the year that patients affected change. I am going to try next year and use the hashtag #patientpower as I truly believe that it is what can change the way healthcare is delivered forever.
As for right now, well I have a few Christmas wishes I want to pass on. To my transplant team at Oxford, who I am sure will read this, thank you from the bottom of my heart for continuing to change my life. To all patients but especially my bowel disease friends I hope that 2013 bringing you happiness and the health you deserve. And finally to Harry Redknapp and the team at QPR – we have a manager we could never have dreamed of having a few seasons ago so get your act together and sort yourselves out otherwise I will be sending you all for a colonoscopy without sedation!!!
So the kids are nearly finished catching up on an episode of Merlin and then it is off to make another batch of chocolate brownies for my daughter’s party on Thursday. My son kindly misread the instructions on my first batch and let’s just says that 1 teaspoon of salt ended up being a few tablespoons – enough said!!
Thanks for reading my blog, following me on social media and engaging with me, your support and friendship makes it all worthwhile.
Till next time
 
Michael thank you so much for the update. So good to hear from you, and so grateful to you for sharing your story with so many people all over the world.
I am following your thread with great interest, and am learning a lot from you.

You have been through so much over the past year, sometimes we have to remind ourselves of how far you have come compared to a year ago!

Those intra muscular shots are not pleasant. Can you alternate between both arms and legs, thereby only inject the same limb every 4 days? I wish there was another way for you to take these meds.

Hopefully 2013 will be a year when our voices as patients are heard, and changes are made to the healthcare system.
 
Michael, well said, yes we patients are starting to find our voices now and it is past time!

As always, I wish you continuing improvement and may 2013 be YOUR year!
 
The end of the year doesn't mean the end to being a patient!

As the clock chimes midnight it is out with the old and in with the new except as a patient that one chime doesn’t actually make a difference does it? Or am I wrong? The turn of the year gives you a chance to set new goals, make new plans and start up new things but the one thing that doesn’t change is being a patient. Does that mean your mindset has to stay the same though – I think not!
My Christmas was a bit like santa’s relationship with chimneys – lots of ups and downs. I picked up what I assume was a virus and ended up back in hospital for a few days. With me a virus seems to always lead to dehydration and with my kidney function going off quicker than a turkey left out of the fridge I soon found myself on antibiotics, a drip and with an abscess on my leg from all my injecting that has now turned in to a lovely great big hole. All of this and I just wanted to be out ahead of celebrations that had been planned.
Frustratingly I missed two major deadlines, my daughter’s 13th birthday and my 21st anniversary but I did get out in time to share New Years Eve with my wife. I also managed to be around for my daughter’s bat mitzvah & disco – although not eating for 2 days to ensure I could make it through the disco was an interesting challenge. I then managed to appropriately embarrass her with my speech, which I thought sounded cool, it contained a twitter hashtag, references to facebook and everything else teenagers use these days. Perhaps it was the fact that I have more twitter followers that upset my little lady.
I hadn’t really appreciated the effect that my back and forth to hospital was having on the kids until this holiday. I stupidly assumed that they took it all in their stride and that it was almost part of life yet this time it really hit them hard. I saw the odd posts that they put up, heard the reactions on the phone and then saw the look in their eyes and it really made me realise the massive affect this all has on them. I think that some of this was due to the fact that I hadn’t been an inpatient for a few weeks so they got used to having me at home and some of it was the fact that I went for routine bloods and ended up staying in so it was unprepared. Finally there was the time of the year so it was no wonder the kids and my wife got very down over the whole thing.
So you see the journey of being a patient or the trials and tribulations of being the loved one of a patient doesn’t alter based on the change of a number. In essence those elements are out of your control, what can change though is what you wish for and what you are going to do to try and make those wishes come true.
For 2013 what will I be doing to make my wishes come true? My biggest wish is for stability in our lives and for my wife and kids to have a year free of the upheaval that has been there for so long. What can I do to make these things happen? In simple terms I can make sure that I do everything possible to give them the normality they deserve when the times are good and just hope that when we have a few blips they remember many more good things than bad. To deliver on my wish though involves so many things some in my control and some not. I guess that herein lies so many lessons for so many of us. These are my thoughts for what they are worth. I can’t guarantee that I can follow everyone though so I would welcome your thoughts.



1. Focus on what you can control and don’t stress about what you can’t.
2. Live every day to the maximum. In other words control what is right in front of you and don’t worry as much about the future because no one knows what the future brings.
3. Listen to your gut instinct (if you excuse the pun). I think that I have learnt the hard way that often by following what you really think as opposed to over analysing things you can actually make better decisions.
4. Remember who really counts in your life. Focus on those that really mean something to you. My biggest issue is always saying yes and I’m not sure how to change that so by remembering who really count in my life I am hoping that I can prioritise the “yes’” a lot better.
5. This is my personal mission. Use your experiences to help others. I cannot start 2013 without ever forgetting what the team at The Churchill in Oxford have done for me. I rely on them for so much and therefore want to ensure that what I have been through can be harnessed and in some small way help other patients. And with that comes my mission to be proper I-Patient – and interactive patient.
Wishing every one of you a very happy and healthy 2013 and a peaceful one. May all your dreams come true.
M
 
Oh Michael. You and your family have been through so much.

Sometimes we do indeed forget the most important things, the moment we are in, 'the present' and the core things, our loved ones. But I dont think you do.

I think you are feeling guilty for being ill. And it's understandable that you feel guilty when you see the looks in their eyes. But I think they must have a deep fear of losing you at the heart of it. To be living 100% in the 'present' in the moment with your loved ones is the best 'New Years' resolution one can have.

The fact that you are alive, is a most wonderous gift to your family, and I believe they know it very well. I'm grateful that you are here among us on the forum too. Thank you!

If our paths ever cross, it would be an honour to meet you. I'll make a caserole, we can have a nosh! ;)
 
I always really appreciate your kind and thoughtful words. It would be a huge honour to meet you in person one day. We have to make it happen. How are you keeping at the moment? Hugs for a happy and healthier 2013.
 
I am keeping well for now, and grateful for it! I am not far from you, just up the M1. New job now in Hemel Hempstead and so far so good this year!
 
Interactive bowel transplant patient bags a truly interactive medical team

Sunday, 27 January 2013


I feel a very lucky patient. Yes I underwent a rare bowel transplant but I don’t believe that any patient including me can cope with chronic illness or major life threatening surgery without having a team around you. I have written a great deal about the importance of my family and friends but one vital part of what could be affectionately called “Team Bowel Transplant” is the medical team. All my desire to be a good patient, a compliant patient and a patient who thinks positively about the future is underpinned by the health care professionals that I surround myself with. In an age where information is literally at our finger tips and where patients are such an integral part of health care you still cannot do this alone and the relationship that you build with the team looking after you is critical.


My own bowel transplant team is, as I have mentioned before headed up by the lead surgeon Anil Vaidya. It is his relationship with me and the way he treats me and his other patients that actually defines the type of patient I have become. I bang on that all patients are e-patients because fundamentally we are. Like all of you I am empowered, engaged and equipped it is just whether we choose to act on these things. An i-patient though (interactive patient) has to have someone to interact with for it to be completely true. We can all interact with other patients, with new digital health technology, medical apps etc but to be a truly interactive patient you have to have an interactive medical team. In Anil and his team I am incredibly lucky to have that person.


Let me give you an example of what I mean. I am still trying to sort out the abscesses on my legs and one is being re dressed every few days and actually currently hurts more that I thought it would. At the last re dressing the nurse thought that it wasn’t looking great and I needed to go back and see Anil. So I took a photo on my mobile and texted it over to him. He responded with a question, I then emailed with back with a further picture attached and a few minutes later he asked me to come in to see him the next day. I came in and he already had treatment options worked out. All of this took about 10 minutes of interactive communication and he knew exactly what to do.


How often does that happen in healthcare at the moment? Certainly more than it did 5 years ago but I suspect an awful lot less than it should. As far as the abscess goes it was a 50/50 call whether to cut it open, incise it and take out what is called a shelf under the skin to help it drain better. He decided to leave it a little longer and use a form of seaweed to clear it out. Meanwhile I have to say that it flipping hurts.
So what makes Anil stand out as such a forward thinker and an interactive surgeon? For a start you have to have a person that truly cares and always thinks about things from the perspective of the patient. I recently asked him about his views on treating a patient who he felt had perhaps contributed to their own ill health and therefore some might ask why they should have the treatment. His answer summed up his approach. “Most physicians and the general public do not view it from the person’s perspective. One needs to walk in their shoes for a whole day before passing judgement…”


His single minded determination to breakdown new medical barriers is a second reason his interactivity. Anil trained at the world renowned transplant centre in Miami, USA. After finishing off in Miami, he wanted to be closer to his parents and thus looked for jobs in the UK. The Oxford Transplant Centre was just about starting the pancreas program in 2004 and he was able to help right from the beginning. His ultimate goal was always intestinal and multivisceral transplantation and with the help of Prof Friend, Oxford got designated as a centre in 2008. He recently did the first abdominal wall transplant in the UK, and his programme is the only centre active in the world offering this service.


Finally there is his desire to embrace technologies that allow patients, medical professionals and students to truly engage. I am currently discussing with him potentially tweeting from the OR. His response “About live tweeting a kidney transplant. I’m sure it is possible and exciting!”


The reason for focusing on all of this today is that whilst I am incredibly passionate about patient engagement no patient can do this alone. Total patient interactivity and engagement relies on partnership. I am not convinced that many HCPs are ready for this. In Anil Vaidya you have one of the best examples of true patient/medical partnership.


The current bowel update is one that is generally positive. I feel that I am in tinkering mode at the moment. I am having my vitamin D and various other levels checked in detail to see if there are any other deficiencies. I have been put on a digestive enzyme to see whether my absorption will improve. This will be checked again in a week and then we will go from there. I am also having a follow up with the doctor who deals with the botox in my stomach. The sickness hasn’t gone and although it has improved I am still sick up to 4 times a week for no real reason. Perhaps I needed to ask for a tummy tuck at the same time as another injection.
In the background to all of this is the fact that I still have my picc line but need to wean myself off the anti sickness meds. Anil has set me specific dates and targets that I have to work to as the picc is a high infection risk but whilst the sickness is there it isn’t easy. Oh well just another challenge to sort out.


Sadly I have end my blog post with some bad news. My beloved QPR have been dumped out of the cup by a team two divisions lower than us.

QPR 2 MK DONS 4

An all time low. Or maybe tactical master plan by our genius manager to rest all our key players for one final push for survival in the Premier League.


Till next time
 
brilliant post- great to hear of a consultant who actually consults, although I suspect NHS
chiefs won't be too pleased to hear they have an approachable and interactive member of staff. very very good luck with everything go blaze a trail lol
 
Sounds like you have a great team behind you, congratulations and thank you for sharing. Perhaps your story will encourage others to seek equally proficient doctors if they're unhappy but don't believe theres much better out there (i've seen a lot of this attitude).

In short i'm glad your doctor has more of a clue what he's doing than 'Arry, you've many more puzzling decisions to look forward to!
 
Thank you Brooke. Yes he definitely goes completely against the grain and ruffles plenty of feathers. It won't stop him or me though - it is what all patients should expect, right?


Absolutely make sure yo write him up in the doctor directory and start supporting a decent footie team gig lol:soledance:
 
What an amaing story and fabulous team you have!!

It is a shame that more consultants aren't like him.

Thanks for sharing, sorry about QPR!! :applause:
 
Michael, you are absolutely right that patients and thier medical teams SHOULD be interactive. Sadly not the case so much of the time!
 
A fabulous doctor is worth their weight in gold.... let alone an entire team. I am very happy for you and wish you all the best with your transplant.
 
What an amaing story and fabulous team you have!!

It is a shame that more consultants aren't like him.

Thanks for sharing, sorry about QPR!! :applause:

Hey I am so used to QPR losing its become the norm :ybiggrin:

Am very luck with my consultant they have to be truly open minded to this interactivity and sadly not many are
 
Sounds like you have a great team behind you, congratulations and thank you for sharing. Perhaps your story will encourage others to seek equally proficient doctors if they're unhappy but don't believe theres much better out there (i've seen a lot of this attitude).

In short i'm glad your doctor has more of a clue what he's doing than 'Arry, you've many more puzzling decisions to look forward to!

Put it this way, I'm glad that Arry was operating on me :ybiggrin:
 
Put it this way, I'm glad that Arry was operating on me :ybiggrin:

I wouldn't trust 'Arry to play a game of Operation without half inching the pieces, let alone let the fellow anywhere near my body. Nice to see some fellow footy enthusiasts (and London based at that) on here!
 
What have Space Mountain and bowel transplant got in common?

This last week seems to have typified my journey through bowel transplant. When I was told that having a bowel transplant was swapping one set of problems for another I knew what I was being told but never really appreciated what that actually meant. I went in to the surgery knowing the risks and complications but at that time I hadn’t eaten for 3 years and had intestinal failureso for me there was no choice.

Then I started to recover, get over infections and a few blips and things settle in to a more positive pattern but the stark reality is that there is something that happens every single day that means your mind is on a continual rollercoaster. I guess that is why so many IBD patients call it an invisible illness. My last blood markers were good and my surgeon is happy with me. That should be enough shouldn’t it? You have your bowel transplant and your transplant surgeon gives you a thumbs up but that “high” doesn’t last that long. Nausea has been a big problem that I haven’t been able to rectify. To me only being sick 3 or 4 times a week is good but actually when it happens at 2am/3am/4am then your brain gets scrambled and your mood changes from the “high” to a “low.” If you then thrown in occasional accidents then the “low” can emotionally be very “low” and that can be hard to explain.

I went back to see a great gastro doctor, who I call Dr Botox this week, to see what the next thinks the next steps should be. Another botox injectionis on the cards for March and in the meantime I am going to have another gastric emptying study. Dr Botox believes that there is an underlying dysmotilityproblem and that actually may not ever be solved and therefore it may be about managing the symptoms better. And boom the rollercoaster in my brain starts up again. It would be cool if it was Disney’s Space Mountain sadly it’s more like Michael’s Mumbo Jumbo.

Away from my bowel transplant life is definitely been gathering pace at a good rate. I have been incredibly lucky to have struck up friendships with the founders of the Centre For Patient Leadershipand I am now a co facilitator. I will be involved with 5 programmes over the coming few weeks so all of a sudden my brain has had to go out of 1stgear and straight in to 5th gear but that’s a fun ride to go on. I’m going to be doing an interview with David and Mark, the founders’ soon so watch this space.

Next week I have the privilege of being the opening speaker at the Scottish Health Council on its E-participation in the NHS conference. I have re written my presentation 3 times so far. I’m not sure why as usually I can write a presentation relatively easily. This one though has definitely challenged the old grey matter as it is purely to NHS managers and I want to get the tone write. Then there is the debate on what to wear. I’m going for the smart casual look or as my daughter would say “at least you made an effort” look. I figured suited and booted just isn’t me – unless of course anyone from Hugo Boss is reading this and is looking for a middle aged bloke with no six pack and hair going grey then I’m definitely your man.

I appreciate that this bowel transplant post has been a little disjointed and a bit all over the place. My friend and writer & Crohnie Wendy Lee – you should read her blog will definitely laugh at some of my English but I write as I feel and my head feels a little all over the place. This think that has helped me snap back in to place a little is this video. Please have a watch. The video has been done by my son Nathan without me knowing that he was doing it. What it made me realise yet again, that coping with a bowel transplant and everything that goes with it doesn’t just affect me but it affects those closest to you as well. All they crave is a bit of normality and I owe them that. Oh and if you fancy seeing more of his videos then check out his YouTube channel or follow him @nathansgotfish

Till next time.
 
It's always good to hear from you Michael and whilst the tum still can't be have for you it is good to hear about all the other projects you are involved with :) Please do continue to keep us updated on how things are doing.
 
hi

i am so very fancinated by your story.

Do you knwo what the criteria is for having the transplant?
 
Continued health to you! This is such an amazing story. It's people like you who will make this MUCH easier for others in the future. I'd like to shake your hand one day. You are a brave man and I respect that so much.
 
Heya Michael, I just saw you on the beeb too! :ybiggrin: Lookin good!!

Glad you are campaigning for better quality food. The rubbish they give most of us to eat in there is atrocious!
 
Ditto to the beeb.
Well done you especially as you got Arry from us - although I now live 'Up North', I am a Spurs fan and originate from Enfield.
It was my local hospital that the BBC were at this morning although I don't remember the food being that great. ⚽
 
My Daughter from the age of 12 now 37 has had 17 operations for Crohns had a bag fitted at one time had two.

However now is very disabled as a result of brain damage when in Hospital.

I would like to know more of about bowl transplants no one has mentioned this to us.

Regards

Rob
 
Hi Michael, I have just seen you on the BBC news!!! I cannot believe they were passing that pile of sludge off as food :ywow: I now have a phobia of eating mash in hospital as the last time I had it it tasted like it had been cooked in an ash tray.

The food is so appalling it is time they listened to us patients for a change. Finally hospital caterers agree that we need standards so lets see. Not giving up the fight yet :lol:
 
My Daughter from the age of 12 now 37 has had 17 operations for Crohns had a bag fitted at one time had two.

However now is very disabled as a result of brain damage when in Hospital.

I would like to know more of about bowl transplants no one has mentioned this to us.

Regards

Rob

wow Rob it really sounds like she has been through it all. I would be delighted to help you in any way. Where about are you living? The key componant for a transplant is intestinal failure and on intavenous feeding. is she at that stage now? Take care :ylol2:
 
Rob, I'm so sorry to hear what your daughter has been through, and you along with her.

Michael of course is the expert. Bowel transplants are very, very rare. I think Michael is one of 5 only here in the UK. (Michael, there may be more now, but I'm not sure?)
 

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