Friday

Whilst Michael's have a little rest, I'll blog.

Been another busy morning. When I arrived another transplantee was with Michael. He had his new bowel in early July and was coming back for a check up. One of the Team had asked him to pop in to talk to Michael about how he'd coped and where he was now. Nice guy who looked really well. Obviously he's had lots of ups and downs along the way but did say he felt things were now on an up. Really positive to see someone who's nearly 4 months post op.

Then the Pain Team came round. The Dr was extremely pleased at how michael's pain relief drugs had been decreased. Thought Michael looked remarkably well compared to last week which is always nice to hear. Michael is now just on his Fentanyl patches and the oramorph when needed. He'll have to reduce that very slowly as his body is so used to them having been 'using' for so long. Likelihood is he won't be off them til around April. But that's fine - no rush. To give u an idea of the strength of patches, we'd be lightly sedated if we had them on!!

Next was the Surgeon, ready for Michael's weekly scope. Last week when he had this scope camera put through the stoma they took a biopsy but because everything looked sooo good, it wasn't necessary today. Also the citrolene tests came back to say the bowel is absorbing well - was 25 and apparently that's good. The plan now is to restart the Enteral feed (into the stomach) today at 20ml per hour and increase by 10ml each day. Hopefully Michael's stomach will be able to cope better with this. If not, although the Nutritionist wanted to put a picc line in and restart TPN, because his bowel is now absorbing well, the surgeon does not want to restart tpn. He would want to change his stomach tube (which I think is a D tube) to a J tube. This would then go straight into the intestine, bypassing the stomach. Basically as the stomach hasn't worked for a long while and has often been drained it needs to be retrained. By bypassing the stomach, when the food hits the jejunum (the middle section of the small intestine) there's a bit of backflow into the stomach which should kick start it into working. From what he said, shouldn't take too long.

Michael's about to take me out for a cup of coffee. Nothing like the League of Friends coffee house. Forget Nero!! I'll be whizzing him off in the wheelchair shortly!!

Justine

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