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Sunday, 15 December 2013

Fromage Du Noel





"Fromage Du Noel
And Jingling Bells
Christmas cheese
And Candy Trees"


A brief return to the blog to wish you a happy Christmas 2013 and to share this link to my cheesy Christmas song. It's in aid of Crohn's and Colitis UK And if you like it you can give money directly to them by following this link to my Just Giving page:

http://www.justgiving.com/Roger-Knott-Fayle

In other news I was recently visited by a bloke who was about to undergo the surgery. He'd been given my phone number by the hospital. We had many good chats and I went to see him in hospital. He has got through the experience despite his fears and misgivings.


Happy Christmas




Friday, 21 June 2013

The Bangkok Connection.


 Bangkok 1988. Where is this?


Sometimes stories (Books and films etc) start before the protagonist has realised.

It's only when they get to the end of their story that the meaning of forgotten moments becomes retrospectively clear, or revealed as random.

In this case the story has not ended; the denouement has not yet been reached.

But perhaps this post can start the process.

The image above is of me in in Bangkok in 1988. I'm holding a map, and Clare and I are on a trip. We are going to get married secretly in Hong Kong.

Clare takes the picture. It looks as if I might be conscious of that.

Many years later I post this picture on this blog : http://theknifeyousee.blogspot.co.uk/2010/06/back-to-start.html

Now here's the odd thing.

This picture has been repeatedly downloaded. Yet why? What does this picture show that I cannot see?

If you happen to choose this picture to down load (and I'm more than happy for you to have it- with compliments). I'm not bothered about ownership or anyhting like that. I just wonder why.

Should you choose to download this picture could you please leave a note saying. . .


Why?. . . . I really would love to know. I'm sure there is a story lurking here.




With kindness and love


R

Wednesday, 16 January 2013

Ulcerative Colitis - Goodbye



 
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Something I have realised: Ulcerative colitis; It’s in the past for me now.

Yet people I haven’t seen for a long time will ask me “… and how’s your . . .” then mouth the word tummy. I understand that people are genuinely concerned and wishing me well. But I moved on a long time ago now. Sometimes I even wonder why they are asking such an odd question. I can even admit to you, dear reader, that I find it slightly irritating, despite the very good intentions behind the questions.

Gone are the days when I spent hours worrying about my diet, or even whether I should eat at all. I no longer worry about where the nearest lavatory is.

OK sometimes I’m a bit self conscious of my physical form, but even that I can lve with. Before the surgical removal of the colon and the creation of a stoma I thought it was something I would never be able to live with. But I can, and it’s alright.

Diagnoses was frightening, living with it was difficult, treatment was radical and full of fear, but even in the depths I found there was something valuable to be learned there.

The causes of Ulcerative Colitis seem to as mysterious as they where in 1997, and the experience, signs and symptoms are still just the same. I’ve been disembowelled, and I have “moved on”. It’s in the past; it’s total and complete.

Have I been defined by it? Maybe a little too much, and it occurs to me that I am complicit in that by, amongst other things, writing this blog.

I was lucky. I didn’t have Cancer and this is not so bad by comparison. I feel that perhaps I have come to the end of my commentary.

So until something that is relevant and worth reporting comes along I wish you health and happiness and, finally, leave a link to another blog that I hope you may find of interest: hypnottik.blogspot.co.uk

Be well.

Roger

Monday, 12 November 2012

"Boom! Boom! (Happy Christmas!)" Christmas single raising money for Crohn's & Colitis



I know! I know! It's too early for this. But it's too late to find a cure for Ulcerative Colitis . . .

SO . . .To amuse you, here's my small composition for Christmas. The Great British Christmas, as it is usually lived. :)

If you like it you can donate a small amount to the research into Ulcerative colitis and Crohn's by visiting my just giving page here
 
http://www.justgiving.com/Roger-Knott-Fayle/eurl.axd/c1bcfad60e3efc43bd513f5d398842ed

You can also share it with others who might find it amusing.

Wednesday, 19 September 2012

J Pouch construction, benefits and problems

Fitch's Sketches


It’s my second meeting with Mr Fitch, the surgeon. We’re waiting in Room 7 with the ominous sub-label “Demonstration”. A tissue covered bed awaits the next person, and the noises of the corridor echo around.

Fitch enters; he’s a tall man with very short hair, glasses and impossibly clean hands. The wrinkles around his right eye are slightly more surprised than the left. I wonder if this is the eye that he uses to look down microscopes. He shoots out a hand at me, and then sideways at Clare. I have my questions spread out before me, a copy for all three of us so we can keep track of the conversation.

My first heading on the list is “What are the implications of doing nothing and continuing as I am?”

Before I even ask the question Fitch is off like a busy man on a bicycle approaching the subject without reference to my sheet. He is talking about the fact that I still need another operation anyway; whatever happens. He’s predicting my questions very well. I wonder how many times he’s had this conversation.

It seems that the tattered ribbon that remains of my gut (rather horribly called the – I hate to even write it – the stump) has been left in case I want to get reconnected. However if I don’t then that too must be removed. So whatever I decide I still face one more sharp encounter. This operation is because the stump itself may have the remnants of colitis and could even later develop into some kind of worse disease. After that has been removed there is no going back. It’s done and I would be a permanent ileostomy. There is a slight risk here of accidentally damaging “the naughty nerves” in which case you are limp and leaky. (Nice)

The next question is about time, do the prospects of successful surgery change with age? Not really it seems. He’s operated on 60 year olds who don’t like the stoma and he’s had 17 year olds who say they’ve had enough and they don’t want more operations.

Next I’m interested to define what is meant by failure. He says this whole question of success and failure is quite interesting. In one sense failure is a j Pouch that has to be aborted, and you have to return to ileostomy as a result. There are a number of possible reasons failure he explains, grabbing my question paper, turning it over and scribbling on the back. (See above) The two main causes of failure seem to be when the join between the newly created pouch and your backside leak. Obviously this is extremely bad news as your body cavity is now filling up with sludge. An anastomatic leak. The other is where an infection works it’s way from the gut outwards through your flesh to the surface – a fistula. Lovely.

It’s to prevent such nastiness that in the UK there are two operations. The first forms the pouch, which is not used for a few months while it completely heals up before it has to deal with any crap. Once it’s been proved watertight by means of a liquid and an X-Ray, reconnection is made and you are back to being a bum wiper. Often in the US he says it's done as one operation but there is a higher chance of a leak / infection that way.

Interestingly he also talks about how success is hard to quantify as well. The fact that you have a functioning leakproof pouch does not, in his opinion, equal success. “I want people to be happy!” he says "Despite continence you may well be going to the loo up to 8 times a day, and you may be unhappy with the quality of your life."

“The thing about you guys” he says “is that you’ve forgotten where you were. Your quality of life was terrible and frankly you were dying. An ileostomy isn’t natural – it takes some management and your skin can be itch and uncomfortable but . . . compared to where you were. The ileostomy is an amazing operation and it’s been around for a long time.” In fact this kind of surgery has been around since the 1780’s or thereabouts.

To find out more about the history of the stoma you can start here http://www.stomaatje.com/history.html

“The 85-90% success rate has to be taken on board very carefully” he says. "If you are one of the 10% of failures, then that’s 100% failure for you. You know it’s OK most of the time to cross the road anywhere, but if you knew you were going to be hit you’d use the bridge 100% of the time”.

That’s true isn’t it.

Post Op monitoring and care is minimal he says. “Once you’ve got that far and I’ve monitored you for a year that’s it. You’ve been prodded enough by then.”

One other thing that might interest you: If you have lost your colon you are more likely to suffer from iron deficiency, b12 deficiency, and get arthritis. There’s also an increased risk of kidney stones of a type that don’t easily show up.

“You have to really really want to have a J pouch. If you are managing OK with your stoma then I would urge caution”

So there we are.

I’d be very interested to hear your views. Would you or wouldn’t you? If you have I like to know about your experiences.

May we live to be 100







Monday, 27 August 2012

An expert view on reversal surgery

 Should I jump?

I recently wrote to my surgeon to get more information about the pros and cons of reversal surgery. Here's his reply:


Dear R. Sole

In brief

Average frequency 7-8 X / day but able to defer defecation until convenient. Some people (probably less than half) still get up at night.

Overall satisfaction rate after pouch surgery =85%  (definitions are very woolly though)

The quality of life in people who have had a failed pouch procedure is measurably less good than it was before they had the pouch procedure

“Failure” (again definitions are very woolly) rate is approximately 10%
 
Would it be helpful to meet in clinic?

I can answer all these questions

There is extensive medical literature to draw from. However the difficulty with all such statistics is that they hold no predictive power.
 
Best wishes

Man with knife in green pyjamas.

Friday, 27 July 2012

A Quick Guide to the structure of the intestines; or "Do you know your arse from your ileum?"



 I had a conversation the other day with someone who didn’t know the difference between the commonly understood colostomy and the less well known ileostomy. Why should you know unless the red hand of fate intervenes in your life and hits you with something like colitis or Crohn’s?

I’d never heard of it before it came my way.

So here’s a quick run down of the guttering. . . . (Click on the image below to enlarge)
Gut Map - Roger Knott-Fayle



Mouth: Where you put it all in
Esophogus: Pipe down to the stomach
Stomach: Cement mixer and vat that breaks down the food
Pyloric sphincter: Stops food that has not been properly processed by the stomach from moving on. When it’s “done” it’s called “Chyme” and this is allowed through the spincter to be further processed in the . . .

Small intestine

Duodenum which further digests food and extracts nutrients. The duodenum is the first part of the small intestine.

The jejunum – part two of the small intestine – absorbs carbs and proteins.

The Ileum – the last part of the small intestine where fats are absorbed into the blood stream

The small intestine finishes with a valve called the ileocecal valve. This stops anything coming back up from the large intestine.

The large intestine – the colon- is about 5 foot long and starts with the cecum which is a large pouch which receives the gunge that emerges from the small intestine.

The colon has four parts the ascending colon, the transverse colon, the descending colon and the sigmoid colon this 5ft of gut is mainly concerned with absorbing any water back into the body, and acting as a packing and warehousing unit before expulsion at your soonest convenience.

It is this last 5ft where your ulcerative colitis lurks.

So depending on the severity you might face either an ilesotomy, or colostomy.

If, like me, your last 5ft is so completely kaput, the whole 5ft comes out and the hole – or “stoma”(Latin for opening I think)- is formed at the end of your ileum. Ileum stoma  which contracted down becomes ileostomy. This is where everything exits me.

If your last 5ft is not so completely kaput, for example if the colitis is only in the sigmoid section of the colon, you get to keep the rest. In this case the hole is made on the colon; colon stoma shortened to colostomy.

In the case of Chron's I believe, please correct me if I'm wrong, the problem can occur anywhere along the small intestine or the long intestine. In the case of ulcerative colitis it occurs only in the colon.