Tag Archives: Great Ormond Street Hospital

Here’s to 2015

That’s another year done, more adventures experienced and new lessons learned.  We’re starting 2015 with a positive outlook – the switch to NG-tube and elemental feeding has already started to see some health improvements for M and we finally have a plan for moving forward that will be looking for the root cause for some of his health problems.  Both children are happy and settled at school and G is looking ahead to moving into secondary school in September. We’ve met and made friends with several of the lovely FABED families and have been able to help raise funds and awareness for this charity and the condition it supports.  I’m not sure what 2015 holds for us all, but, if nothing else, I’ve learned to hold tightly to my hat as it’s certain to be a bumpy ride!

Wishing you all a happy, ssuccessful and peaceful 2015.  May your wishes and dreams be fulfilled. 

 

 

The First Hurdle

Our GOSH admission had three key stages, the first of which was to dis-impact M’s bowel and prepare him for a repeat pellet study.  We knew that when the original transit study was done at our local hospital 18 months ago, he was chronically impacted and there was some debate over whether the results, that suggested his transit was relatively normal, were accurate or not. My honest opinion was that he was not struggling with a slow transit colon, but the gastro team at GOSH wanted to be certain and were more than happy to admit him for this test due to the issues we’ve experienced with our unsympathetic local hospital over the last 12 months. My instinct was that nearly 9 years of unrelenting diarrhoea meant that there had to be another root cause for his problems that was still waiting to be discovered and it would just take some persistent looking to find it.

Courtesy of ebsta.com

Courtesy of ebsta.com

Unfortunately, the first hurdle – after the resolution of the whole missing bed saga – proved to be far tougher than any of us had anticipated.  After his amazing courage in facing all the health and medical challenges of the past year, and despite knowing that he needed to have a NG-tube, M showed just how stubborn he can be and steadfastly refused to co-operate with the nurses who were trying to pass the tube.  Wednesday evening saw 5 different nurses, 4 attempts, a flurry of unsuccessful negotiations and 1 small boy, who pulled the last 2 attempts out himself because, according to him, the nurses weren’t listening when he asked them to stop and then told them to go.  Having kept the other occupants of the 4-bed bay awake until past midnight with his cries and screams, we all finally admitted defeat and decided to leave it to the next day’s nursing team to remedy the situation.

Thursday morning arrived far too quickly, with a disturbed night’s sleep for M and an uncomfortable one for me.  We talked about the tube and the need to have it in place as soon as possible so that we could start on the first round of treatment, the dreaded Klean prep – a highly effective laxative that would start the process of clearing his system.  M knew and accepted all the reasons for the tube, but at the heart of the matter was the fact I had a small, scared 8 year old, who had endured a great deal since his scopes last October and was evidently close to saturation point.

Courtesy of The Royal Ballet/ROH Johan Persson

Courtesy of The Royal Ballet/ROH Johan Persson

Even the lure of tickets to go to see “Alice in Wonderland” performed by the Royal Ballet at the Royal Opera House, Covent Garden that very afternoon looked unlikely to be sufficient draw, but my boy’s love for all things theatrical combined with my own enthusiasm for going to see anything at the Royal Opera House eventually overcame his worst fears and won the day.  He agreed to let one of the doctors pass the tube and with 4 of us holding his head, arms and legs, another distracting him whilst it happened and the doctor doing the deed itself, we finally got the tube in place.  With that hurdle tackled, M and I rushed to get ourselves ready and a bag packed for our trip to the theatre.  We went by taxi with another little girl from the ward and a nurse and arrived just in time to take our complimentary seats in a box before the ballet began.  The performance was an amazing visual feast and proved to be a more than adequate distraction from all the tears and trauma of the morning.  M loved the outlandish costumes of the Mad Hatter and we had a lot of fun trying to work out which of Alice’s family and friends were depicted by each of the fantastic characters we met throughout the rest of the ballet.

Courtesy of The Royal Ballet/ROH

Courtesy of The Royal Ballet/ROH

Naturally, as I’ve come to expect when dealing with anything to do with M, nothing was as straight-forward as we might have hoped as we headed into that all important first full day of admission.  The stress of the tube placement led to him being violently sick within 10 minutes and he spent the rest of the day retching and bringing up bile, meaning the Klean prep couldn’t be started until much later in the day.  He reacted to the Duoderm, a dressing usually used to protect the fragile skin of the face by forming a barrier between the cheek and the tube and tape, which meant there was no alternative but to tape the NG-tube directly to his face.  The final straw came in the middle of the night, when after I’d finally got my tired chap to sleep, the quantity of the Klean prep being pumped in at the speed it was upset his system and he woke to be sick for the second time in less than 24 hours.

By the time Friday morning came around, we were both feeling emotionally fragile and physically exhausted and M refused point-blank to move from his bed.  We sat quietly on ward, with M plugged into the television via his headphones and I immersed myself in the escapism of a good book.  It had been a bumpy start, but finally we were on our way.

 

Merry Christmas!

May your Christmas be filled with love and laughter; times of happiness and of reflection; family and friends…

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…and may 2015 be a year that brings new hope, understanding and peace.

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Christmas decorations with a M twist

Whilst we are processing all that has happened in the last 3 weeks – think hospital admission (M), 11th birthday (G), 15th wedding anniversary (Mike and me), Carol services x 4 and metres of wrapping paper – I thought I’d share some quick snaps from a Christmas project that M undertook before he headed into GOSH.

20141126_204723[1]The challenge came from school – to create a unique Christmas tree decoration for a competition – and M knew exactly what he wanted to make.  A couple of weeks earlier, we had been watching a Christmas film (don’t ask me which one as I honestly have absolutely no idea, other than it starred Tori Spelling and was loosely based on the Dickens classic “A Christmas Carol”) and he had been fascinated to see the children threading popcorn into a garland to hang onto the tree.  He was adamant that this was what he wanted to make for the school competition, so Mike popped a saucepan of corn kernels and M and G sat down at the coffee table to start their threading.

20141126_204743[1]Bedtime arrived quickly and M asked if he could continue the job upstairs once he was ready for bed.  As M is rarely asleep much before 11pm on any given night, I swiftly agreed, knowing that this would be a great activity to keep him occupied and stop him bothering G too much, as well as a sneaky way to get 20141127_084222[1]another finger exercise to improve his fine motor skills into his day.   Whilst M was upstairs threading his garland, I was downstairs looking for simple instructions on how to make loom band candy canes to add an extra festive twist.

 

Six feet and six candy canes later, the garland looked amazing and M was proud to enter it into the competition.

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(Oh, and that Christmas film we’d watched? – A Carol Christmas.  Well, I couldn’t leave you wondering!)

The Mystery of the Missing Bed

It sounds like one of the Enid Blyton stories that my children have been listening to at bedtime recently.  M and G have been loving the adventures of Fatty, Buster and the rest of the Five Find-outers gang, but this was a mystery set to challenge even the hardiest of intrepid adventurers.

Having received our summons to GOSH less than 24 hours earlier, and laden down with suitcase, backpacks, Lego advent calendar and the ever-present Cat, M and I found our way across London, through those infamous front doors and up to the long-term gastro ward.  We approached the nurses station and were greeted by a bemused looking senior staff nurse, who seemed uncertain as to who we were and why we were there.  I gave her M’s name and that’s when a look of complete panic swept across her face.  His name wasn’t on her master list, she hadn’t been expecting him and at that precise moment of time, there was no empty bed ready and waiting for him.

With profuse apologies and a promise to get hold of the ward administrator, the nurse in charge and the bed manager, M and I were left, with our bags, in the somewhat small and cramped playroom, whilst the mystery of M’s missing bed was investigated.  After the early start to our day and an emotional goodbye to G, I barely held it together as I called Mike with a slight hysterical edge to my voice. The play co-ordinator found a circuit board kit to entertain M and I got chatting to another patient and her Mum, who had just been turfed out their room and were waiting to hear where they were being moved to.  We all sat there for nearly 2 hours, whilst those in charge negotiated, discussed and settled the bed situation for all involved.

Courtesy of en.wikipedia.org

Courtesy of en.wikipedia.org

I might never know why the mystery of the missing bed happened or how it was resolved to everybody’s satisfaction, but I’m delighted that, thanks to the hard work of the nurses and the obviously determined look on my face that meant I wasn’t going to take no for an answer, M’s bed miraculously appeared in the “bay” and we could finally get ourselves settled in for the duration.

In Mummy’s arms

Courtesy of susanstark.net

Courtesy of susanstark.net

I lay awake in the early hours of this morning, watching my beautiful babies peacefully slumbering alongside me in the bed.  I know that this morning, more than any other morning in recent days, both children needed the comfort of being in Mummy’s arms and resting with me. After weeks of (im)patient waiting, yesterday afternoon the phone-call finally came and at the remarkably short notice that I had been anticipating.  I had less than 24 hours to book train tickets, pack a case, prepare crib notes for Mike and contact everyone who has anything to do with M to let them know about his hospital stay over the next 3 weeks, as well as the everyday tasks of cooking dinner, making packed lunches and sorting school clothes for the next day.

Whilst I whirled around the house in a haze of slightly panicked chaos, the children spent their last evening together for a while in typical fashion – hurtling from cuddling up to each other to threatening to scratch the other’s eyes out in a matter of minutes.  M was particularly hyper and could barely sit still in his seat.  Instead, he bounced, jigged and ran around the house like a mad thing, the clearest sign that his stress levels were high and gradually rising even higher.

eggWe had a “last supper”, together as a family.  One chosen by M.  His consultant had suggested that he could relax his diet just a little before coming off food altogether and so Mike and I had expected him to choose something like fish and chips or Chinese.  Instead, he requested the item that had been at the top of his Christmas list this year – an egg.  So, the four of us enjoyed a poached egg on toast as well as a “dippy” egg with toast soldiers.  It was a simple meal, but one that he heartily enjoyed and devoured with gusto.

Finally bathed and in their pyjamas, Mike read them a bedtime story, whilst I ran through my mental checklist and gathered up the last few bits to accompany us to London.  G settled to sleep as quickly as ever, whilst M was awake until 11pm.  He finally slept, snuggled into my side, with my hand tightly gripped in his much smaller one.  Mike carried him back to his own bed and then we tried to sleep ourselves, knowing that, for me in particular, sleep would be a precious commodity over the next 3 weeks on a hospital ward.

I’m not to sure what time G crept in to our room, but I was suddenly aware of her presence on my side of the bed and she was quick to climb in for a cuddle as soon as I invited her in.  My big girl doesn’t need my comfort so much these days, especially at night, but tonight she needed to feel Mummy near and I loved having that opportunity for an extended cuddle.  Less than an hour later, just as I was drifting back to sleep, I heard the sound of footsteps running across the landing and in climbed M, snuggling down in his preferred position between Mike and me.

Courtesy of paediatricsconsultant360.com

Courtesy of paediatricsconsultant360.com

Our bed isn’t really big enough to fit 4 these days, but tonight, of all nights, I relished the quiet opportunity to have our whole family together, in peaceful harmony; something that won’t happen again until M and I return from our adventures at GOSH,

Waiting

Patience is a virtue, or so the saying goes.   I’d always thought of myself as a relatively patient person, but maybe not.  And definitely not when it comes to waiting for a hospital bed to become available and for testing and treatment to start.  Another week of waiting is over and a new one is about to begin.

 

#awatchedphoneneverrings

#awatchedphoneneverrings

Children in Need

Courtesy of www.bbc.com

Courtesy of http://www.bbc.com

If you live in the UK, I doubt you could have missed the fact that it was recently BBC’s Children in Need.  For those of you who reside elsewhere in the world and are wondering what on earth I’m talking about, Children in Need raises money for numerous charities, large and small, who work to bring much needed help to children across the UK.  The evening is celebrated with a TV extravaganza, which sees celebrities singing, dancing and otherwise performing as you’ve never seen them do before, all in the name of fundraising. Children in Need has been running for over 30 years and since 1980 has raised well over £600 million for the children it supports.

This year it set the theme of “Be a Hero” and G and M, as well as thousands of other school children across the UK, were invited to come to school dressed as a hero.  The options were endless and as we walked to school that morning, we passed Superman, Spiderman, Tinkerbell, Violet Incredible, Harry Potter and Florence Nightingale to name but a few.  I’m always interested to see who my two will choose to dress up as, not least because M’s costume almost always inevitably involves some late night sewing and creating by me.

20141114_082807G, after a short discussion with Mike about what her options were, settled on dressing as Princess Leia from the Star Wars trilogy, a choice that fortunately didn’t need much more than a few minor adjustments to the base layers we had.  A long-sleeved white long tunic, a pair of white leggings, her brown boots and a chain-style belt accompanied by the iconic hair-style of 2 coiled bun over her ears and she was dressed and ready for anything the galaxy threw at her.  She was delighted with her costume and I was impressed that it came home almost as white as when she went to school in the morning!

 

20141114_082832With G’s decision made, I waited nervously for M’s choice of hero, fully expecting him to have chosen someone far more complex, which would leave me scrabbling around for clothes to meet his exacting requirements.  So you can imagine my surprised delight when he went for what is possibly the simplest, but most meaningful choice he’s made in years.  M wanted to honour his very own hero, his gastro consultant at GOSH, Dr H, who has made such a big difference to his life over the last 3 years.  We put him into a pair of home-made scrubs and Mike generously donated a white shirt, which I adapted to be his doctor’s white coat.  A printed name badge declaring him as a “Consultant Paediatric Gastroenterologist” from GOSH finished the look.

Once school was done for the day, we raced home and changed into their onesies, ready for an evening at Stagecoach, before spending the evening at my Mum’s for dinner and the best of BBC light entertainment.  The night raised over an amazing £32 million with more money still to come in and be added to the total.  This will make a big difference to the children it can help support and it’s never too late to donate – just click on this link.

Pudsey

 

 

 

 

 

 

 

 

Busy days

Now that Halloween and Bonfire night are behind us and Christmas is fast approaching, there’s finally a little time to look back and reflect on the start of the new academic year.  September seems like a lifetime ago and yet was a busy month with appointments right, left and centre that have had a lasting impact on decisions about M’s long-term care.  We had appointments with GOSH, a new community paediatrician, M’s OT and with CAMHS; and I needed to be the thread that linked them all to ensure that M remained at the centre of their focus and that all agencies were working together to provide the best support they could.

Courtesy of travaasa.com

Courtesy of travaasa.com

The OT’s review was everything we needed it to be and she has already started going into school once a week to work with M on his handwriting skills.  The clinical psychologist he meets with fortnightly through CAMHS is slowly building a relationship with him and gently pushing him to talk about how he feels about life with EGID and the frustrations he experiences.  As for the new community paediatrician, who was recommended by our local hospital, well, lets just say we won’t be rushing to meet with her again.  Her complete lack of understanding of his condition was glaringly evident as she suggested that regular toileting and a sticker chart were the answers to all our problems.  How I refrained from saying something very rude is nothing short of a miracle!

The most important of all these, for us, was our regular appointment at GOSH with the gastro team charged with M’s care.  The restricted diet and increased medications over the last 3 years have not brought about the results we’ve been aiming for and M continues to be symptomatic a lot of the time.  We have become increasingly concerned about his emotional well-being as he struggles with the impact of EGID and multiple food allergies on his daily routines and I was determined to come away from that appointment with a tangible plan in place.  Despite our best efforts with the challenging treatment suggested by the local consultant leading into the summer, our worst fears were realised when the registrar told us that M appeared to be impacted again and we would need another course of fairly heavy-duty laxatives to empty his bowel.

planningThat led into a lengthy discussion about where we’re headed and what the most sensible next steps for M’s care are.  Short-term plans are all well and good, but we now need a long-term care plan put in place.  He agreed that we can’t keep limping from one appointment to the next and promised to discuss M’s current situation with our consultant.  Medical terms such as “pellet study“, “elemental diet” and “manometry” were bandied around and I am glad that, thanks to the support from other FABED families, I have a reasonable layman’s understanding of what all these terms actually mean.

We left the hospital feeling that we were beginning to making some progress in dealing with the problems that continue to dog M’s every step and a short-term plan that would start to deal with the current impaction issue.  The longer term decisions would be discussed both internally and with us before anything was settled on for definite.  A follow-up appointment with the consultant herself was made and our step was just a teeny bit lighter as we felt our concerns were being heard and addressed.

Courtesy of abercrombierealestate.com

Courtesy of abercrombierealestate.com

However, since that day, over 7 weeks ago, I have spoken to GOSH at least once a week and almost daily over the past 10 days.  The improvements expected haven’t happened and so the decision has been made to admit M into the hospital for further testing.  We need to understand whether his bowel is working as it should or not as that will give us a clue as to the direction we need to head.  We have also agreed with his consultant that the diet and medicines just aren’t helping his hugely allergic colon and so have made the decision to remove all food from his diet and follow the elemental diet via NG-tube for a while.  This should give his bowel and body some much-needed time to rest and recuperate, something I believe it so desperately needs.

Just when you thought it was going to be easy…

…something happens that shows you that it really doesn’t pay to be complacent, especially when it comes to children with complex medical needs.  The reason for my most recent angst? The whole ‘flu vaccination thing! Yes, you probably read my blog post over a month ago, where I discussed the decision process we were going through regarding M and the ‘flu jab, and almost definitely concluded by the end that everything was set firmly in place.  Having visited our new GP, I certainly felt that we had agreed what was best suited to M’s needs and was now just waiting for the confirmation phone-call and a date for my diary.

You’ll have guessed by now that it hasn’t been that easy and whilst that doesn’t come as any surprise to me when it concerns my youngest, the complexities of getting the situation sorted came at a time when, to be perfectly honest, I really didn’t need the added aggravation.  It all started when I phoned the surgery to book the appointment.  The receptionist needed to discuss which clinic to book M into because he was having the injection and not the nasal spray and so referred him on to the practice nurse, with a promise she’d call me back.  10 days and 3 phone-calls later, I was still waiting for the practice nurse to confirm which clinic M needed to attend.  Oh, and there was the added problem – or so I was told – that there wasn’t enough child vaccines in our health centre, so we would have to wait for those to arrive before I could make a definite appointment.

This is definitely a t-shirt us #EGID parents need!

This is definitely a t-shirt us #EGID parents need!

The string of events that followed are like the plot of a bad 1980s sitcom as we got bounced from one local medical establishment to the next.  The first problem was that the no egg vaccine is not licensed for use in under-18s and so the nurse wasn’t happy to give it to M, especially as he’s never had the vaccination before.  She was keen to discuss the situation further with one of our local hospitals and so I agreed to wait.  Next, I had a message telling me that the hospital would give M the injection, so that he could be monitored and could I confirm that I was happy for my contact details to be passed onto the appropriate administrator to arrange that appointment.  Needless to say, I confirmed as soon as I could and then sat waiting for the next installment in this latest saga.

Three days later, a copy letter arrived in the post from the community paediatrician, who has met M once, knows very little about him and just confirmed that he could have the ‘flu vaccination unless Mike and I knew of any reasons why he shouldn’t have it.  Er, no – after all, we’re the ones requesting he be given the damned thing.  A week after that, another phone-call from our local health centre, advising me that the local hospital won’t give M the injection because his 2009 blood tests didn’t show any sign of an egg allergy.  WHAT?!

Now, don’t get me wrong, M does not suffer an anaphylactic reaction to egg, rather a delayed non-IGE one, so I can understand that they don’t think it necessary to be monitoring him on the ward; but blood tests from 5 years ago are hardly a good basis for any medical decisions made in my opinion.  In the 5 years since those blood tests were carried out, he has been treated by GOSH, had a diagnosis of EGID and we have established that he struggles with several food allergies that, because of the very nature of his reactions, will never show up in the standard blood tests.

The next part of the conversation however, really took the biscuit for me, though I don’t blame the poor receptionist tasked with phoning me to make the relevant arrangements:

 

As his blood tests were negative, the hospital have said he can have the ‘flu vaccine here, so I can book him into this Saturday’s clinic for the nasal spray.”

“Um, no he can’t have the nasal spray because of his egg allergy and the nature of his underlying chronic illness.”

“Oh, well the hospital said he could have it as he doesn’t suffer an anaphylactic reaction, so they want him to have the nasal spray here.”

“Well,” – (a somewhat hysterical tone starts to creep into my voice) – “Great Ormond Street have said he needs to have the injection, so I think we’ll follow their advice as they understand his medical needs.”

“Right, so you want him to have the injection?” – (she’s now slightly perplexed) – “Well, I’ll have to check which clinic I need to book him into.  I’ll call you back.”

womenonthebusinessstage.co.uk

womenonthebusinessstage.co.uk

Have you ever felt like you’re going in circles?  Five weeks on from my original GP appointment and I was right back where I started and M still hadn’t had the ‘flu vaccine. I was even beginning to question just how important it is for him to have it, given he hasn’t had it before, but GOSH had recommended it as a good idea for him and I wasn’t prepared to give up at the first hurdle.  Fortunately, the receptionist was as good as her word, has booked him in for appointment after school one day next week and has left a note on the system for the nurse at that clinic to review his medical history before he has the injection.  Of course, I’m trying not to panic that she might take one look at his notes and refuse to give it to him, but at least we’re making steps in the right direction at long last.