8.37pm I ended up back in bowel transplant hq on Monday night. After a brief text exchange with my surgeon he took the decision that I should come back in as I was at risk of dehydration. We get a few days sun and instead of catching the rays outside I spend it with my second family on a ward. As it transpired after pushing through fluids at a very quick rate my creatinine levels (kidney function levels)were actually pretty good.

The next day I had another scope and biopsy but this time they put the camera further down in order to take a biopsy from a different part of the new transplanted bowel. My previous biopsy had come back showing signs of inflammation in the new bowel. The most likely cause of it would probably be my bacterial issues but it can also be due to very mild rejection issues. This time with the new biopsy my surgeon was going to try and evaluate the results by looking at the bigger picture. I'm probably not articulating that very well but basically he doesn't by the rejection comments but does accept the bacterial problems as I still seem to have the classic symptoms. The view is that sometimes the labs look at these things in a totally one dimensional way. They have to and that is their job but occasionally it has to be done in conjunction with everything else. By that I mean, the transplant surgeon knows what the new bowel looked like after transplant; he also does my scopes so he can see the condition of the new bowel and those two markers do not always tally with the lab results. Unfortunately with this form of transplant it is not always clear cut. You can have a case of rejection without having any other symptoms. It is really why they have to watch you like a hawk and that is where I am so very lucky to have the team that I have.

I managed to escape the clutches of my ward by Tuesday afternoon on the proviso that depending on what this biopsy shows then I may need to be back on Friday.

We also decided that we will now go ahead with the balloon procedure in the stomach. Forgive me for being a little vague on it at the moment but I am not exactly sure what will happen. Apparently it is a pretty new thing to do and will be done by the upper GI consultant obviously under the careful watch of my transplant surgeon. I am feeling pretty optimistic that it will work. I have been warned that it may not work first time but they can do it again. What happens if it doesn't well there is the potential for having a gastric pacemaker inserted but let's not get ahead of ourselves. I am staying positive about the balloon dilatation.

That really wraps up what has been happening to me at the moment. Although I am back on my loperimide and other meds the stoma output has not yet settled. At its max I had about 2 litres of output and at the moment it has settled at around 1800ml but it needs to go down further still.

One final thing I did want to mention. I feel incredibly lucky that I am able to communicate with my surgeon and the transplant team via text and email. It makes like so much easier and saves them time and means that when I see them they already have all the information and have formulated a plan of action. If I am not sure of something then I can email a photo mobile to mobile or via email and I update my dietitian via email every few days. Obviously this cannot happen in some instances but I just wondered if anyone else does the same? In this age of technology, what a saving this could be for the NHS and health care in general. Political speech over.

Will be in touch again soon.

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