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