How do I feel?

Once again it has been too long, so thanks for bearing with me. In case you missed it we had our second child in July, and after two weeks of paternity leave it was back to work. My wife is breast feeding, so I’m still mostly able to sleep, although the broken sleep is probably more tiring than a lack of sleep.

Eldest started school in September and has been pretty whacked, so early to bed but still early to rise. So over the last 3 months both my wife and I have got more and more tired. Then you might get a night when the baby is unsettled, and the toddler wakes up a few times too.

I’ve been trying to eat healthily, but can’t survive without energy drinks – although I am now on sugar free ones.

That of course is par for the course for any new parent unless they are blessed with a child who sleeps through. However, with IBD and a Stoma fatigue can be an ongoing issue, as well as dehydration which also leads to tiredness. And that can take many forms.

There is physical, not wanting to get up in the morning tiredness. Or can only manage to sit on the sofa and watch TV or read a book I’ve read before tiredness. The no energy to exercise tiredness – even though I know if might help.

Brain fog, and a lack of being able to prioritise tasks – book a haircut. And as for creative things like blogging and poetry – forget it.

So what’s the solution? I could get up, go to work, come home, and then go to bed shortly after the toddler – but I don’t think my marriage would last long if I didn’t do some of the baby childcare too. Work is non- negotiable, though I have cut down on my evening and weekend work. I could stop the energy drinks, as I know there is a drop off – but not sure I can get by without them yet, or try and do some exercise.

I think it is all probably just parenting fatigue, but it is very draining. My wound has stayed healed, and the occasional discharge I had is less frequent. I don’t have any other IBD symptoms.

I’ve probably not been the best friend recently, so apologies to those I’ve not caught up with. Sometimes I struggle to recognise when I’m just tired and what might be low mood creeping back in.

I’m currently being used as a bed by a baby who won’t sleep in his bed. I shall try him again in a while, as he is now snoring away.

Tomorrow I have a day off and so will be doing some half term activities with a 4 year old, and hopefully some as a family.

So how do I feel? Exhausted.

For anyone else who has been there, how do you tell the difference between IBD fatigue and just being tired?

The power of connections

I am trying to increase my blog output and write a new post every week, aiming to publish on a Sunday evening/ Monday morning. I had a great response to my last post, so thank you to everyone who commented, liked and shared. Good news is that the Purple Wings Calendars are now available from here.

I was going to write in more detail about the Purple Wings Conference and Ball, and I do want to record the Purple Wings poem I wrote, however Rachel Jury AKA Rocking Two Stomas has done a great summary of the event on her blog – so I thought I wouldn’t try to recreate something that has already been done. Rachel gave a great speech at the conference, and it was lovely to see how much her confidence had grown from last year when she was part of the team speaking about the IBD & Ostomy Support Show.

What I did think about coming away from the event is how great and empowering it is to be in a room with so many other people with stomas and IBD. I’ve been asked a few times what would I suggest to someone newly diagnosed, and never really had a clear piece of practical advice – I always told people to ;remember that everyone’s disease is different’. Now I do have practical advice – connect with other people.

This could be done in a variety of ways.

1. Online

There are loads of Facebook groups, blogs and social media accounts of people with IBD and ostomies. There is also a whole raft of similar for chronic illness generally. Because there are so many, there are many different styles and types of content – some groups are very chatty, others are more focused on advice and support. I used to be a bit scathing of the chatty ones until I was in hospital over a hundred miles from home and couldn’t sleep.

Some of the groups are very busy, and posts can be missed, so do persevere. I am a member of many, but not that active at the moment.

You also need to be wary of anyone offering cures or advice that goes beyond ‘this helped me’ – and always consuklt with your medical team, or an emergency medical professional, before stopping nay treatment you are recieving.

I have made some really good connections and friendships that started online.

2. Support Groups

In the UK, the major (and some independent) charities and organisations run support groups. These might be organised via your hospital. They offer an opportunity to come together and meet other people with the same condition and talk to them, or hear from an expert in the field.

Crohn’s & Colitis UK, the ia (ileostomy association) and Colostomy UK all have local networks or groups operating around the country.

I previously coordinated my local Crohn’s & Colitis UK network, and it was great to be able to have discussions with other patients. Some meet in pubs, some in coffee shops, some at hospitals – it will vary depending on the local volunteers, but it is rewarding stuff.

3. Big events

Periodically, a big event, such as a conference or ball will come along. Things like the Crohn’s & Colitis UK AGM, The Purple Wings Ball or the GetYourBellyOut ball. Because these events tend to be longer in duration, you get more of a chance to speak to more people, and hear some inspiring stories of how people deal with there disease or bag.

4. Make a friend

I have some people who I would class as friends who have IBD and/ or a stoma. I work with one of them, which is helpful if you just need a bit of undertsanding, or at least informed sympathy. If you can, it is worth doing – lots of people are happ to talk and share. Remember though they too are chronically ill, so they might not be able to support you all the time.

 

Question for the Crohns Colitis UK #IBDHour Takeover

Q1 Please introduce yourself – what’s your name and where do you come from? Share your dx if you like, or your relationship with IBD.

Q2 Where do you find community and support for your journey with #IBD?

Q3 If you could tell everyone one thing about #IBD, what would it be?

Q4 What’s the most useful piece of advice or information you’ve received since #IBD diagnosis?

Q5 Have you ever taken part in a research study?

Q6 We’ve got a lot to do in the years ahead. What do you think our number 1 priority should be?

 

 

You can leave your hat on…

You might remember that in the summer I went to an event organised by Purple Wings Charity who give grants to people with stomas from IBD to help regain confidence.

One of there annual fundraising events is the pin-up calendar, and I am going to be taking part for 2019! the shoot is in January and I need to raise at leats £50 to take part – I’m hoping to raise at least £100.

You can read more about the charity here and donate via JustGiving – so go on, get me in my pants!

I’m hoping that this will be a motivation to take control of my diet and lose a bit of weight too, so help me help myself!

What happened in Wales

 

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University Hospital of Wales

So today I crossed the Severn Bridge and went to my appointment at University Hospital Wales with the Wound Healing Service led by Professor Keith Harding. After 22 months with my unhealed perineal wound where my pouch, rectum and anus were removed, I – and the team supporting the wound – were keen to get the expert opinion of the man who literally writes the books about wound healing.

I arrived in plenty of time – I’d taken the day off work and know that hospital parking can be interesting. The setting is lovely, with a nice open space and some sculptures at the entrance to the children’s hospital.

The concourse at the main entrance is like a small shopping centre with a bank and a post office, as well as coffee, book and sandwich shops. What was nice is that there was a mix of high street names and independent units. I worked out where my clinic was, and then headed for the restaurant which has won awards for it’s healthy eating options – so I had a flat bread, baked crisps and water, and it was really nice!

I also found a portrait of this chap…

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Nye

So after lunch I went down to the clinic and was first in which is always nice. I saw a lovely nurse called Hannah who started taking a history – which always takes a little while these days, and it was mostly just the wound treatments!

A registrar came through and then they examined the wound, measuring it and noting the dimensions. They then called through the Professor!

Depending upon your point of view, I’ve either been fortunate or unfortunate to have been treated by three professors – Nicholls, Clark and now Harding. There is something very calming about being in the presence of someone who not only knows what they are doing, but also turn teaches others either directly or by writing books and journal articles – the very top of the field.

So he came in, asked a few questions about how I came to be there (and then asked me to share that with some visitors to the clinic too) and examined the wound. He asked a few more questions, in passing mentioned that ileo-anal pouches do ‘often fail’ (I guess he doesn’t see the people whose are fine) and then gave his prognosis:

  1. An underlying infection. He requested some bloods be taken, and this may show if there is something there. He asked if a biopsy had been taken (it hasn’t) so this might be a future possibility depending on the blood results.
  2. A ‘dumbbell’ shaped cavity, with the coccyx pushing in and not allowing the upper cavity to drain sufficiently – and MRI scan is being requested back in Bristol so they can compare images. Possible solution – shave off some of the coccyx to allow it to drain…

Obviously it is early days, but he also said something to me before he went off to see another patient:

‘We can’t heal everyone we see – we help about 80% of our patients. I won’t promise to heal you, but I do promise that you won’t be forgotten.’

I go back in 4 weeks, so lets hope I can get the MRI before then!

 

More wound news…

Back in September I posted this update about my wound and mental health. I had some really lovely feedback and messages, so thank you to all the well wishers.

Dealing with the mental health first – I saw the GP, and was signposted to South Gloucestershire Talking Therapies also known as IAPT (Improving Access to Psychological Therapies) and had an assessment consultation which assessed me as having moderate depression/ low mood. I’ve been assigned to a course for support and although I have to wait a while for one that fits in with work and everything else, but have support at work and from my family too. Opening up about it has really helped, but I’m going to see it through and get the help.

In the last update I said we were bringing out the big guns and going back to vac therapy as the PICO dressing hadn’t been able to cope with the exudate. So we started the Acti VAC therapy with a little portable unit (see picture).

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Sadly it was not possible to maintain the seal which seems to be due to the position of the wound as much as anything, although it was also still pretty wet – so I ended up having to remove it – in the photo below at work. Vac dressing also includes a free wax, in my case of the buttocks. I also think that being at work and managing a toddler didn’t help.

The Acti VAC pump was pretty easy to manage though – it comes with a little carry bag and doesn’t need to be constantly plugged in, and is nice and quiet. It does take a while to change the dressing, as it has to be framed and then applied, then the seal checked and any gaps filled in.

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Following the failure of this, and been advised to apply something antibacterial, so went back to the Ortem metronizadole ointment which once again did some good stuff. At the same time I wrote to my surgeon requesting that either I be admitted for the vac therapy as an in-patient – or be referred to the Wound Healing Unit in Cardiff, where Professor Keith Harding is the lead consultant. My wife heard about this unit by chance at a conference, and I’m very glad she did!

Patients I speak to online often seem reluctant to ask for a second opinion. Perhaps they fear upsetting their current team or consultant, but this has never been my experience – in fact twice I have had consultant surgeons say they want me to see someone else because either they recognise they can no longer help me, or they just want me to hear other options. My consultant referred me to Cardiff, and because of a cancellation I am going there on Wednesday, which has pleased everyone involved.

In the mean time, the tissue viability nurse has started me on a different negative pressure therapy – SNAP by Acelity (see picture below).

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This silent, spring based unit has a dressing more akin to a stoma bag, so it has been much better at maintaining the seal and seems to be working well – however I am not going to be cancelling my appointment with the Prof just yet…

So, that is my little health pdate – I have some other stuff to update on too, but now it is late and time for bed (after I schedule this post!). Until next time, which will feature nudity (sort of).

#IBDHour September 2017

On our first birthday Jenna Farmer is posing the questions as follow:

Q1 Please introduce yourself (you can share your diagnosis if you wish) and tell us how your summer was!

Q2 There are so many different diets out there, do you follow a strict diet and does it make a difference to your symptoms?

Q3 What are your ‘trigger foods’ that make your IBD worse?

Q4 On the end of the spectrum, what’s your go to food in a flare?

Q5 Do you think there is enough support with discussing diet and IBD-such as access to dieticians?

Q6 What’s your biggest worry about the diet you are on? E.g missing out on a certain food group or nutrient?

Q7 Low residue and low Fodmap diets are becoming popular-but have drawbacks. What are your experiences with them?