Tag Archives: research

Takeover Challenge 2016

img_12651When it comes to thinking they know it all and can do it all better than the adults in their life, my kids are world champions. The frequency with which Mike is told that “Daddy, you just don’t understand..” is high and he often finds himself trying to defend his position to an irate 10 year-old, even on matters where he quite obviously has far more expertise than anyone else in the room – think anything building-related given his career as a chartered surveyor. There is a certain level of deference awarded to me, after all I’ve proved over and over again that Mummy knows everything there is to know and, besides which, she really isn’t someone you want to get on the wrong side of ever; but the opinion of just about every other adult is scrutinised carefully and often rejected on the basis that they just don’t understand either. M has some very strong opinions and would, and sometimes has, happily argued the case that the sky is green for hours, often with a reluctant truce having to be declared before World War III breaks out across the dinner table. As for G, well she has perfected the teenage eye-roll ahead of hitting her 13th birthday and it’s often accompanied by a surly shrug of her shoulders and a mumbled “Whatever” as she heads upstairs to the seclusion of her bedroom.

redevelopment-wed-2So, you can imagine my thoughts when G and M were invited to be a part of this year’s Takeover Challenge at Great Ormond Street Hospital through G’s involvement with the GOSH YPF. This is a fantastic project run during November by the Children’s Commissioner and sees organisations and businesses across the UK opening their doors and inviting children and young people to take over adult roles. The Challenge seeks to “…put children and young people in decision-making positions and encourages organisations and businesses to hear their views. Children gain an insight into the adult world and organisations benefit from a fresh perspective about their work.” Excitement has been building in our household for weeks as G and M looked forward to finding out more about how the hospital is run and last Wednesday couldn’t come soon enough for my two excited children. I was delighted for them to have this experience, but my true sympathies lay with those adults who would be brave enough to let this opinionated duo step into their shoes, even for a day.

The children were invited to take-over the Developmimg_12641ent and Property Services department as Director and Deputy Director for the day. The information they received in advance told them that they would have a “behind the scenes” tour of the hospital with opportunities to learn about the systems that help the hospital to run efficiently, including visiting the plant room with engineers, learning about the food ordering system and how the meals get to the children on ward and understanding more about how the hospital plans and designs spaces to be fun and interesting for the patients, their families and the staff. Ahead of the day itself, both G and M were asked to complete a profile to be shared with the Development team, explaining a little about why they were interested in this role as well as what their involvement with GOSH is. G had 2 key areas of interest – finding out how the kitchens cater for patients with food allergies and how new spaces and redevelopment work is done – whilst M was eager to see the plant and machinery that makes the hospital run and find out more about the technology in place.

img_12601Determined to dress for the occasion, M’s clothes were chosen the weekend before to make sure that everything he needed was washed and ironed, unlike his sister, who typically left everything to the last-minute and was then put out when her first couple of outfits were deemed unsuitable by me. Taking the challenge very seriously indeed, M solemnly told me that I needed to make sure he was in bed early on the Monday and Tuesday so that he could be well-rested and ready for a busy day. Our decision to head to London on the Tuesday night after a Year 6 meeting at his school slightly scuppered those plans and his night’s rest was then further disrupted by a 5am fire alarm in the hotel, something none of us appreciated. The further stress of the drive across London to make sure that we reached GOSH in time whilst being questioned constantly as to when we would arrive, tested my nerves thoroughly, though we did make it – by the skin of our teeth. The hurried unloading of G, M and me just around the corner so that we could dash to the main entrance by 10am as Mike went off to the park the car, was an unexpected drama I could really have done without.

However, the day itself was a huge success redevelopment-wed-14and we are still hearing snippets about it a week on. Whilst both children took over the same department, their mornings were filled with different activities to meet the interests they had already expressed in their completed profiles. M spent the morning with Development Director, Matthew Tulley, the highlights being exploring the roof of the hospital and learning more about CAD. That second activity earned the accolade that “CAD is rad!”, something I suspect will stick with the Development team for a long time. G headed in a different direction to learn more about different aspects of what this department does. She went with Deputy Director Stephanie Williamson and spent the morning planning and designing a new orthopaedic therapy space, which she really enjoyed, though it proved to be a challenge to fit all the requirements into the space available. She then headed to the kitchen to find out a little more about how patient meals are prepared, before meeting up with M and Matthew for their lunch. A big thank you has to be given at this point to Stephanie and the rest of the catering team who did a sterling job at providing safe meals for both children to enjoy. Both had been able to choose their menus before the day itself and the team had taken on board M’s request for either rice pudding or a rice krispy cake for pudding, which he was delighted to see.

After lunch, they both went to the Special Diets kitchen, where I’ve been told they met the 4 Simons who work there and M wondered if that was a prerequisite of working in the kitchens. I understand that the team was delighted to finally put a face to a name and actually meet a patient that they have had to cater for in the past. 15069048_10153959799661921_8246658330976253376_oThere was then enough time to head off to Coram Fields and chair a meeting about the new research centre being built and discuss the hoarding that will be used to surround the site. They even managed to find their way on to the building site, where M’s enthusiasm in particular has earned him the offer of a return visit to see the completed building in a couple of years’ time.

After our own day spent walking round London together, Mike and I met them back at the main reception where they were both clasping bits and pieces they had accumulated during their day in the job. It had been a fun day spent learning more about the hospital we have spent so much time in over the last few years and they thoroughly enjoyed every moment of their experience. We had a peaceful homeward journey after M’s gastro appointment, with M taking a nap as we headed out to Westfield for dinner and then both falling asleep as we travelled back home.

I can’t thank Steph, Matt and the rest of the Development and Property Services department enough for the time they took to spend with G and M and show them what goes into making a busy children’s hospital run. They both had an amazing day and are already talking about what department they might be able to take-over next year if they have the opportunity again.
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My One Constant Companion

HS_Birthdays_30thToday I’m celebrating a very special day, a milestone birthday of a very different kind. Google has revealed that Steve Jobs, Ben Miller and Kristin Davis were all born on this day, but as interesting as that is, I’m not really celebrating their birthdays. Today is my Godmother’s birthday, but it’s much more than that too. Today also happens to be my birthday, but, according to my birth certificate and my Mum, both of whom I trust implicitly, I’ve got another 366 days to wait until I reach my next noteworthy milestone, so my birthday celebrations this year are relatively low-key. Despite all these great reasons to celebrate, today I’m marking 30 years of one of the most significant events in my life:

30 years of living with T1D*

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This is me, the Christmas before I was diagnosed

With a less than auspicious twist of fate, my life changed completely on the day I celebrated my 9th birthday and, believe it or not, 30 years on I can say that it arguably changed for the better. Don’t get me wrong, I would give anything to not be living side-by-side with a chronic illness, but the events of that day enabled me to return to much improved health and, most importantly, haven’t stopped me doing pretty much anything I’ve wanted to since then. After months, and maybe even years, of displaying what are now the well-recognised symptoms of undiagnosed diabetes – think excessive, unquenchable thirst; massive weight loss; increasing and unexplained lethargy and a constant need to wee – an unexpected collapse at school led to an emergency hospital admission, a fear-filled night as my parents had to face the unimaginable possibility of losing me and finally a diagnosis that would shape the way my future unfolded. Without even knowing it, and certainly with little regard for my opinion, this uninvited visitor came and took up permanent residence in my body, where it has lived in varying degrees of co-operation since the mid-1980s.

The last 30 years have seen amazing developments in the care of T1D, but the most momentous event actually happened 65 years before my own diagnosis. Before 1921, my parents’ worst fears of that night would have been realised as, until the discovery of insulin at the University of Toronto by Banting and Best, SAM_0827those diagnosed with diabetes mellitus had no chance of survival and could only delay death from the illness itself by starving the body instead. Their discovery followed on from the hard work of  other scientists and medics from around the world such as Oskar Minkowski, Joseph von Mehring and Paul Langerhans, for whom the cells in the pancreas were named, and I doubt that any can deny the life-changing impact that the discovery of insulin has had on those of us living with T1D.

My first decade with T1D was heavily influenced by the incredible mind of my consultant, Professor B, who was compassionate, understanding and impressively forward-thinking in his approach to my care. One great example of his progressiveness is reflected by the DAFNE (Dose Adjustment For Normal Eating) approach to T1D management, which teaches PWD** to “…match their insulin dose to their chosen food intake on a meal by meal basis…“, and which was introduced to mainstream diabetes care in 1998 as a somewhat revolutionary new step. I somewhat nonchalantly shrugged my shoulders at the announcement as I’d been following that regime for around 10 years before it was accepted as being effective by the rest of the diabetes world, all thanks to Professor B and his focus on helping to improve my teen struggles with T1D.

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My collection of Novopens!

Likewise, within 2 or 3 years of diagnosis, my “futuristic” disposable syringes and bottles of insulin, which had replaced the glass syringes and metal hypodermic needles of the 1950s that needed constant sterilising and re-sharpening, had themselves been replaced with one of the first models of the Novopen. This was the first insulin pen injector of its type and combined syringe, needle and insulin bottle in one unit. I worked my way through several upgrades of the Novopen and these days use a combination of a pre-filled disposable pen injector and the last pen injector that I had, a green Novopen 3, which still works in impeccable fashion nearly 20 years on from when I was first given it. Two decades on and I’m so excited to have embarked on another adventure, this time with the relatively new innovation in diabetes care, the Freestyle Libre system for blood glucose monitoring. Whilst I’m not at the forefront of PWDs trialling its use, I have offered to collect data concerning my usage for a research student looking to compare blood glucose monitoring behaviour following the use of the Freestyle Libre, a study that I would hope would encourage some NHS funding for these short-lived sensors which really could revolutionise T1D for many.

To put the last 30 years into context, I worked out some quick statistics of what 3 decades living with T1D has meant for me:

  • An average of 3-4 BGLs measured a day, sometimes a lot more and sometimes considerably less, adds up to around 43,838 blood sugar tests…
  • …and assuming equal use, though the truth is anything but, each of my fingers has been pricked nearly 4,500 times.
  • There’s been in the region of 41,636 injections to keep me healthy…
  • …most of which have in my thighs, bum and upper arms…
  • …although, after 25 years of steadfast refusal to consider anywhere else, I now inject almost exclusively in my stomach and have the bruises to prove it!
  • I’ve been involved in several research projects since almost day 1, including one which resulted in the longer-acting insulin I now use on a daily basis…
  • …and more medical students, visiting foreign doctors and interested consultants than I care to remember…
  • …and the involvement of both G and M in current research to investigate a possible genetic marker for T1D.
  • One amazingly fantastic juvenile T1D consultant, considered to be one of the top men in the diabetes world, around the world
  • …and another who I remember joining my team as a junior doctor at our local hospital and who is now a Professor in this field in that same hospital…
  • ..as well as the care of another unrivalled T1D consultant during both my pregnancies to ensure the safe arrival of my babies and my continued health too.
  • And there have been the inevitable times in hospital, particularly during my emotion-ridden years and fortunately only 1 major complication resulting from my teenage rebellion stage.

A cure may not yet be in sight, but with the amazing developments of the last 100 years, who knows what the next 30 years will bring?jdrf-ndam

 

*T1D – Type 1 Diabetes                                                                                                                      **PWD – People With Diabetes

The importance of doing research

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Not long after our January appointment in London, I received a phone-call from one of the research nurses at GOSH.  My details had been passed on to her by the Dietetics team, who felt that M was a good fit for the research project they were currently undertaking.

I listened with interest as she took her time to explain what they were doing and what involvement they needed from us.  The research was looking at the impact of multiple food allergies on the whole family and not just on M, thereby considering the emotional, social, psychological and financial impact as well as the physical symptoms that M suffers.  As soon as we had established that we fitted their criteria, I said yes.  There was no need to consult or discuss with family members, I knew that this was something we had to do.

After 27 years living as a T1D, I have taken part in very many aspects of research and teaching concerning not only my diabetes, but my pregnancy and my eye sight too.  I remember as a child, my parents agreeing for medical students to sit in on my diabetes clinic reviews to learn about treating a child with T1 diabetes.  As an adult, I’ve always agreed to having students in my appointments as I feel that this is a great way for them to get relevant and realistic hands-on experiences in the field.

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Back in 1998, I had laser eye surgery to correct a diabetes-related complication with my left eye, Diabetic retinopathy.  Unfortunately, the treatment went wrong and my eyesight was reduced to between 5 and 10% in that eye.  The damage caused by both the condition and the subsequent surgery is unusual and for a number of years, student doctors and newly qualified registrars were brought into my appointments to look at the eye for teaching purposes.

As a pregnant diabetic, I was asked to trial a new insulin that they believed would be effective in improving the health of diabetic mothers during their pregnancy.  Not only did I agree, but nearly 10 years on, I am now using that insulin on a daily basis.  That really is fantastic: seeing the medicine I trialled now being used actively in the daily management of diabetes and improving the control for many.  We’ve also encouraged both G and M to be involved in an important study into whether there is a genetic link relating to T1D.

I believe wholeheartedly that research and study is key in finding answers, treatments and cures for the many illnesses that strike people down.  It leads to an understanding of a condition and how best to support those suffering from it.  Without such research, I wouldn’t be around today to write this blog; I would have lost my life to T1D almost certainly within 4 years of diagnosis and those 4 years would have been spent on a “starvation diet”, which was the only known way to manage the condition.  The work of Banting and Best in Toronto, Canada in 1922 saved and changed the lives of millions of people as they discovered, refined and successfully introduced insulin to the medical world.

In comparison, EGID is a relatively young condition.  There is not a great deal known about it, what causes it and certainly no cure for it.  I felt that it would benefit not just the medical world, but also our family, to be involved in a research study that would seek to understand more about it.

questionnaire

We were sent a series of questionnaires to complete, which included:

  • a detailed food diary for 3 days, including any recipes used and how M felt about eating on those days
  • Mike and my opinions about the physical, social, emotional and psychological impact of M’s food allergies on M, on G and on us
  • details of any ways in which the food allergies hampered or changed the way we live our lives
  • M’s thoughts on how he felt about his food allergies and his life.

We filled these out and our return visit to GOSH in May saw us meeting not just with M’s consultant, but also with the Research team.  The meeting itself encompassed the final part of the research – taking M’s weight and height measurements, using a calliper to measure his body fat from a fold of skin on his arm and performing 20 skin-prick tests to common allergens.  The time passed swiftly, M enjoyed meeting the staff, discovered he was participant number 99 and we left having learned a little more about what they were finding out about multiple food allergies and EGID.

The most interesting thing I discovered on the day is that skin prick tests are notoriously ineffective in picking up allergies in children with EGID.  M did not react to a single one of the allergens tested, not even the 5 to which he currently suffers an allergic reaction.  This is apparently a common occurrence in EGID sufferers as their bodies react internally rather than externally in most cases.  I didn’t know this before and explains why previous skin prick tests always came back negative.

The results from this study won’t be available for a while as they seek to increase the number of children involved in it, but I’m glad we could be a part of it.  We feel involved in the process of learning more about this little recognised condition and M is proud that he has helped out.  We would happily do it all again in a heartbeat and if we are asked, the answer will inevitably be yes.  The truth is that no matter what insight this gives, however small, it will have a huge impact on the future lives of EGID children.