Doing the write thing

Here’s my top ten list of lessons learnt in the last few months since the publication of my book about surviving the chronic illness cystic fibrosis (CF)*…

1. Proof is in the pudding.
The feedback so far has been extremely promising and affirming for me as the author. Word of mouth and some marketing have helped it become viral and popular. It has been ticking the boxes in readers that I hoped it would – it’s been providing people with more knowledge about the illness (know), it’s been emotive through tears and laughter (feel) and is offering them perspective on their own lives and where appropriate some tactics to manage CF or other health conditions (do). Below are some sample reviews I’ve received…

“This brilliantly written book is a compulsive read. I struggled to put it down from the very first page. Tim’s honesty and openness drew me deep into his personal journey. At the same time his passion and gratitude for life in the face of painful, unrelenting challenges inspired a great deal of self-reflection. The text is profoundly moving yet filled with humour and light.” Work colleague

“Loved this book very true to life for me as I also have cfrd. An invisible illness that very few understand unless you have a loved one with it or have it yourself. Very well written, a great read!!!” CF adult

2. Cherry picking. It always intrigues me which story, joke, poignant moment, insight or chapter of the book appeals to each reader and why it resonated with them. Some have expressed their surprise at exactly how candid my writing has been, but in my defence and to borrow a line from the Mastermind TV programme – ‘I’ve started, so I’ll finish!’

3. Who knew? Book reviews received on Amazon are not syndicated onto both the UK site (co.uk) and world-wide (.com). websites so if someone has reviewed me for one site, it won’t appear on the other! Also, Amazon reviews are extremely important to where an author is placed in the chart of top writers for both the co.uk and .com. After a spate of kind reviews, I recently was placed 433 out of 6 million world-wide authors. Thanks to those who have already written reviews and given me 5 stars. Feel free to add more please!

4. Great pretender. Signing my book in public situations (my mum’s house and at Wimbledon Waterstones) and ‘pretending’ to be an author feels humbling and invigorating. It’s a special moment of celebration for the community of people who’ve followed by life-story all these years. It’s been great to have the company of close family (including Katie, Felix, Jez and Julie) and friends at these events which have doubled up as vital fundraisers for CF.

5. Marathon man. The promotion and marketing of one’s book is a marathon not a sprint – day by day, week by week, month by month you reach new audiences. There’s rarely a ‘big bang’ moment in the early days.

6. Counter-intuitive.
There’s no real science behind who does or doesn’t buy or onwards promote the book. Some people whom I expected to have bought or marketed the book have not done so yet; while there have been complete strangers around the world who have purchased it straight away.

7. The write way. People are really appreciating my written style, the insight and the engaging prose contained in the short, thought-provoking chapters of the memoir. I am often hearing that they read it very easily and ‘can’t put it down’. It’s certainly an encouraging sign that there’s an appetite for my reflections.

8. By popular demand. I am receiving a lot of requests from readers to write a follow-up which is a good sign that there’s a growing appetite for my story and how it comes across. The good news is that my second memoir is already being written… I’ll keep you posted of progress.

9. Tongue-tied. It was surreal being recently interviewed for a UK national newspaper (Express Online) by a long-term friend from my Southampton school.

10. CF waits for no one.
During the first few months of the book’s release I suffered with the backdrop of quite a serious lung infection and a marked increase in my habitual coughing both during the day and frustratingly during the night. CF is not at all sentimental and can be the worst party-pooper. It certainly appears not to be climbing on my band wagon of celebration for the book. There is also the not unsubtle irony of the title of my book ‘How have I cheated death?’ when I’m feeling so unwell and coughing so heinously.

So, it appears that I’m on the ‘write path’ with this memoir. Its popularity and positive feedback received justified the vision I had a few years ago, plus all the effort to write it in my spare time and secure a publisher.
My book arrived at a good time for me as an author and for those who’ve read it so far. Perhaps it was ‘write on time’…

Tim Wotton – the best-selling author (in his own house)

Winner of a copy of my book – In my last blog post, I asked for suggestions for another CF-related book or film title… The winning title was ‘Harry Potter and the Half Lung Function’ by Jess. Well done! She will receive a copy of the book in the post.

How to order a copy
Go to the relevant sites below or in the UK go to a WH SMITH, Waterstones or Foyles bookstore and give them my name, book title and this ISBN number (9781849637190). It’s also available via GARDNER’S, BERTRAM’S, AUSTINMACAULEY.COM, BLACKWELL’S, PLAY.COM, AMAZON.CO.UK AND AMAZON.COM

Other media – see my recently launched website, the Guardian blog on my survival and hear my radio interview on Kerry Radio.

I will keep you posted on my life affirming moments, trials and tribulations as and when they happen. Please keep reading and sharing my blog and sign-up (on the right hand side tab) if you have not already done so.

Yours cup half full.

Tim
Tim Wotton

* Cystic Fibrosis is one of the UK’s most common life threatening inherited diseases, affecting over 10,000 people. The condition affects the internal organs, especially the lungs and digestive system, by clogging them with thick sticky mucus. This makes it hard to breathe and digest food. Each week, five babies are born with the condition, however, each week, three young lives are also lost to it. There is currently no cure for CF. However, existing gene therapy trials in the UK are bringing people with the illness closer to a form of cure but CF is not that well known and would benefit from more public donations. For more information and to find out more view the CF Trust Website.

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Live to tell

This last month has seen me notch up another milestone – that of book author – as I published a memoir of my 40 year battle defying the chronic illness cystic fibrosis (CF)*. Read on for more exciting news…

The month of May really has been crazy. It started with a house full of 15 marauding children celebrating our wonderful boy’s 7th birthday. I then got a cold which wasn’t helped by playing a Phantoms hockey game in the West of England (the night out was good though). Since then I’ve been to Holland with work and I was severely chastened by the 18 months anniversary since my poor dad passed away from Motor Neurone Disease.

And now my book is published by Austin Macauley and is available for anyone in the world to read. That feels pretty awesome, humbling and bewildering in equal measures. Indeed, last week involved one of the most surreal moments in my life – lying in bed at night time, I turned over to witness Katie reading my actual book!

So, how did this book reach its ‘tell by date’?

Telling my story
After reading Jean-Dominique Bauby’s exquisite chronicle ‘The Diving Bell and the Butterfly’ in the mid 90’s, I always knew that someday I had it in me to write my own candid, funny and profound book. Well, that day has arrived.

Back in 2011, I felt that reaching the age of 40 with CF merited the sharing of my battle with this relentless condition. I wrote a diary during the year leading up to my illusive 40th and this book is the output.
To seek re-assurance on my story and written style, I have used some extracts from the book in my blog posts over the years to assess their impact. I like to think that the finished product is a thought-provoking and amusing memoir which systematically unpicks what it has taken me (physically and mentally) to defy the medical odds both with the CF and recently diagnosed type 1 diabetes.

The book elaborates on my extensive medical regime, going to University, getting a job, the importance of sport, alternative therapy, faith and a positive mental attitude to counteract the multitude of dark moments. It also highlights the significance of family support, my marriage to Katie and the rollercoaster journey we undertook to start a family which finally delivered us the awesome Felix.

I am hoping to reach a global audience with this book, the first book written by a CF sufferer at 40 (that I’m aware of). The CF community should derive some hope and survival strategies from my story while wider audiences will hopefully understand CF better and appreciate what it takes to combat it on a daily basis.

I hope that my candid story will provide insight and solace to anyone suffering with a chronic condition, but equally offer perspective to perfectly healthy people.

Tim Wotton and his book

Tim Wotton and his book

What’s in a name?
The title of the book, ‘How Have I Cheated Death?’ is not an obvious choice but it was the title of my Guardian news feature three years ago which is still popular. Trust me, I did take my time deciding on this and I looked at many other book titles…
I could have gone for some obvious titles like ‘Breathless’, ‘Survivor’ and ‘Every breath I take’. Being mischievous, I could have gone for some comedic or playful title such as:
‘Confessions of a serial pill taker’
‘Everything you wanted to know about CF but were afraid to ask…’
‘How I cured my 40 (pills) a day habit?’
‘This is 40… with CF’
‘Gone with the cough’
‘Coughin’ in the rain’
‘Cough Hard’
‘The Coughing Games’
‘Shadowlungs’

But in the end, I was keen to be provocative and de-mystify CF for a wider audience, so I kept the Cheating Death one instead. I hope it gets your and other people’s attention…

How to order a copy
Go to the relevant sites below or in the UK go to a WH SMITH, Waterstones or Foyles bookstore and give them my name, book title and this ISBN number (9781849637190). It’s also available via GARDNER’S, BERTRAM’S, AUSTINMACAULEY.COM, BLACKWELL’S, PLAY.COM, AMAZON.CO.UK AND AMAZON.COM

I sincerely hope this book strikes a chord with anyone who is kind enough to purchase a copy. Also feel free to share this book news with your family, friends and work colleagues if you feel they would be interested.
I am looking to fundraise for CF at the same time as launch this book and will keep you posted on forthcoming activities.

Our CF lives are a narrative of triumph over adversity. By overcoming this rotten illness day-in-day-out, we all demonstrate what cannot be cured needs to be endured and thus offer hope and inspiration. I’ve fortunately lived long enough to tell you my narrative. I hope it reads well…

Win a copy of my book – if you can suggest another CF-related book or film title, I’ll choose my favourite one and post a free copy of the book to the winner… best of luck!

I will keep you posted on my life affirming moments, trials and tribulations as and when they happen. Please keep reading and sharing my blog and sign-up (on the right hand side tab) if you have not already done so.

Yours cup half full.

Tim
Tim Wotton

Congratulations to my cousin Sarah and CF friend Emma for successfully completing the recent London Marathon and good luck to my wife Katie as she runs both the London 10K and Parks Half-Marathon in the next few months. Should you wish you can sponsor Katie here.

* Cystic Fibrosis is one of the UK’s most common life threatening inherited diseases, affecting over 10,000 people. The condition affects the internal organs, especially the lungs and digestive system, by clogging them with thick sticky mucus. This makes it hard to breathe and digest food. Each week, five babies are born with the condition, however, each week, three young lives are also lost to it. There is currently no cure for CF. However, existing gene therapy trials in the UK are bringing people with the illness closer to a form of cure but CF is not that well known and would benefit from more public donations. For more information and to find out more view the CF Trust Website.

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Days like this

Knowing when you feel content is a tough trick in life. Is this harder or easier for someone, like me, battling with a long-term illness like cystic fibrosis (CF)*?

Being ‘in the moment’ (as is the modern parlance) and realising when life feels right or even perfect is a wonderful sensation for any of us. When it happens to me I have a sense of tranquillity; where I feel balanced and almost invincible. Simply put, I just feel utterly happy to be alive and grateful for all my blessings. I’m delighted ‘as is’ instead of wanting ‘to be’.
Recently I had the fortune to enjoy a whole day of such joy…

7:00AM It all started on a Saturday morning. I had got up early with Felix. As he’d done so well at school I had bought him a new Tintin book (In America) which he’d been wanting for a while. I left it downstairs for him to find as a surprise. On seeing it on the lounge table, he did a double-take and with unbridled joy performed his ‘happy dance’!

8:00AM We both enjoyed that Saturday morning luxury of not having to rush about as we would normally do on a work day/school run. While eating porridge we watched the ‘Despicable Me 2’ film which always makes us guffaw and features our favourite song ‘Happy’ by Pharrell Williams. Katie joined us for breakfast before driving off to near-by Kingston to go shopping.

9:30AM While Felix was getting changed, I took the chance to quickly view my emails and read a note from my recent CF acquaintance, Lucy Watson, who lives in Australia but originally comes from England – not only have we been mentoring each other on CF survival tips and health supplements but it turns out that both our mums knew each other from CF fundraising decades ago. Proof if ever needed that this is a small world.

10:30AM We met up with my twin brother Jez and his partner Julie and in the lush Spring weather we first visited the lovely grounds of a Buddhist Temple in Wimbledon before spending the rest of the morning and lunch in Wimbledon Park; a stone’s throw from the Wimbledon Tennis Championship courts.
It was the beginning of a glorious day with blue skies, bright sunshine, daffodils blossoming – a welcome break from the months of heavy rain that England has endured. It quite literally put a spring in our step as we trekked around this beautiful park.

12:15PM Before lunch Felix was feeling peckish so Jez offered him a tube of refresher sweets. Turns out that Jez carries sweets on his person whenever he meets me to mitigate against any diabetic hypo I might suffer – such a caring and thoughtful gesture and typical of him. Felix appreciated the gift as well!
This was followed by a game of crazy golf with Felix – I was delighted that he’d improved his technique and was now prepared to wait for me to finish putting on each hole before speeding off to the next tee.

13:30PM After dropping Jez and Julie at the top of Wimbledon Hill, we had a brief rendezvous back at home with Katie before I got changed into my field hockey kit and drove to the Bank of England sports ground in Roehampton for my London Edwardians league game against a strong Kenley team.

14:30PM I was asked to start the match. During the warm up, I reflected on the recent tough IV treatment I’d endured where I’d undergone grave doubts whether I’d be fit enough to play hockey again, let alone actually start a game. When in the midst of a depressing IV session, which can drag me down like quick sand, there are absolutely no guarantees of playing sport again or being properly active. When walking up a flight of stairs can cause me untold breathlessness, the thought of playing competitive sport is furthest from my mind.

Whenever I play hockey these days, just being on the astroturf pitch brings back salient memories of my dad, rest his soul. I always look to the sky as I start every game and have a quiet chat with him, which helps me to feel his presence once again. He hardly missed any of my games when he was alive and it invigorates me to think he catches every game from the lofty heights above.

16:30PM We had a hard-fought and much deserved 3-1 win over Kenley which at times tested my fitness and lung capacity to the extreme. This was followed by the usual post-game team refreshments in the bar along with all the sporting rituals of naming ‘man of the match’ and ‘idiot of the day’. (I was not named for the latter award in case you were wondering). It was in the bar that I began to feel that happy glow of post-exertion tiredness that envelopes me like a snug duvet and emphasises exactly what I’ve physically put myself through.

18:00PM Back home for family time, Felix bath and his bed time reading of the new Tintin book. It brought back sweet memories when I was a child as I used to enjoy reading and being read these books by my parents.

19:00PM Once my boy is asleep, I’ve got a short window to sit at my laptop and edit another chapter of my forthcoming CF-related book which is due for publication in early May. I recently discovered through email correspondence that the publisher’s proofer of my book has a young brother with CF and she was shocked and pleasantly surprised to review a book about the illness – another small world moment!

20:00PM I had some light dinner with Katie before popping out to Balham in London for my hockey friend Tina’s birthday drinks; which allowed me to catch up with some friends I hadn’t seen for a while and to celebrate the earlier hockey win. Beer always tastes better after a sporting win…

23:45PM Back home on the tube before midnight for a well-earned sleep. Lying in bed, Katie stirred which allowed me to hold her hand briefly without waking her up. As I drifted off to sleep, I reflected back on the day that had just occurred. It was an extraordinarily busy but wonderful day. It was a special day, despite the fact that I still fitted in all my CF and diabetes medication. (I purposely decided not to highlight the actual array of treatments during this day, but rather focus on the good moments).

A constant stream of love, joy and happiness pervaded through the whole day. Although it didn’t merit performing my own version of Felix’s happy dance, I was positively buzzing inside. I felt pure gratitude. Today was a memento for me to treasure always.

It served as a timely reminder that happy days can often be just around the corner which is particularly uplifting following some dispiriting times, like my recent IV treatment. It provided another deposit in the ‘Tim Wotton Bank of Hope & Well-being’ that gets severely pilfered during the rough times when my health crashes.

From my own experience and that of others I know, people with a life-threatening condition have a pronounced ability to not only identify but to fully appreciate magic moments and days as they contrast so strikingly with the usual daily hardship.

Indeed, I strive to defy the ravages of CF in order to keep as well as possible to be ready for and enjoy days like this.

‘Oh, such a perfect day
… just keep me hanging on’

Lou Reed – Perfect Day

I will keep you posted on my life affirming moments, trials and tribulations as and when they happen. Please keep reading and sharing my blog and sign-up (on the right hand side tab) if you have not already done so.

Yours cup half full.

Tim
Tim Wotton

* Cystic Fibrosis is one of the UK’s most common life threatening inherited diseases, affecting over 10,000 people. The condition affects the internal organs, especially the lungs and digestive system, by clogging them with thick sticky mucus. This makes it hard to breathe and digest food. Each week, five babies are born with the condition, however, each week, three young lives are also lost to it. There is currently no cure for CF. However, existing gene therapy trials in the UK are bringing people with the illness closer to a form of cure but CF is not that well known and would benefit from more public donations. For more information and to find out more view the CF Trust Website.

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Time Out

‘There’s always someone worse off than you.’ Taking time out to manage my debilitating illness cystic fibrosis (CF)* has allowed me to evaluate this saying…

Just like a greyhound chasing and finally catching the rabbit, my CF has caught up with me again. My lungs have deteriorated enough that I required some intravenous (IV) antibiotics. Though only a moral victory, this is the first time I’ve had to endure an IV for 16 months, which is the longest period I’ve gone without such an intensive treatment since my teens.

However, it means taking time out from the real world and my busy life in London as a business consultant, husband and father for a spell of recuperation time with my mum in Southampton. It’s proved to be a real shock to the system. Being away gets harder with every year that passes. This was reinforced by Katie relaying to me that Felix had recently said “I want daddy!”

It serves as a harsh reminder for this 42 year old that I can run but cannot hide from my unforgiving illness. One always feels hunted down by this condition.

In the last two weeks I’ve been through the mill. As well as feeling very washed out, the IV drugs have given me a few nights of delirium; one in particular was so fierce that it gave a new meaning to ‘Saturday Night Fever’.

As these IV treatments can take up to two hours three times a day and I’m still maintaining my usual CF and diabetes medications, a significant chunk of each day is medical related. It feels at times like a tag team event between each different drug.

I’ve also had to put up with a persistent pain and discomfort where the PICC IV line goes into my arm which recently had to be re-dressed at the local Southampton General Hospital.

Yes, it’s been rather a torrid time to be honest and it’s initiated in me the first really depressive thoughts for quite some time. At such times there is a natural tendency to really cover oneself in the bubble wrap of despair.

I have been able to utilise the little downtime to spend quality time with mum, see my brothers, my elder brother’s family, local friends and I did have a form of day-release to meet with Katie and Felix half way between Southampton and London. I’ve also been able to visit the rest home of Betty Lacey, the wife of Ken whom I featured in my last post ‘Always there’.

In this departure from reality I’ve had more time to view the outside word from within. See below a snapshot of CF news I’ve heard from local friends in Southampton or seen on social media, TV and in the press:

- A mystery CF diagnosis of an infant storyline on the UK TV programme ‘Call the Midwife’.
– A local Hampshire girl, Sarah, is responding well to the new lungs following her much needed transplant last November.
– A 31 year old mum in Ireland is belatedly diagnosed with CF following the diagnosis of her own child. She had been treated for chronic asthma all her life and CF had been missed.
The UK CF Trust have kick-started their 50 year anniversary activities with CEO, Ed Owen, on BBC Radio 2 talking about lung transplants but also launching their ‘No Party’ theme – highlighting that CF is no party as well as mandating that they won’t party until all CFers make it to at least 50!
– A 38 year old CF adult from London, Nick Talbot, is hoping to climb Mount Everest in June. Nick is an experienced mountaineer and is boosted by the wonder CF drug Kalydeco.
– A worried dad in Australia asking for help and advice for his recently diagnosed two month old daughter.
– A girl, claiming she was not a CF sufferer, on an online CF forum berating all CFers for making light of their illness with their ‘gallows-style’ humour.
– CF adult advisor for Scotland, Yvonne Hughes, taking part in a trial to see if singing can help lung function for CFers and separately signing up for the Great Scottish swim later this year.
– Danish scientists have discovered a natural garlic compound, ajoene, which could help fight CF infection. Tests are being carried out on rats. (Apparently, the male rats claim their lungs have never felt healthier but the females have stopped kissing them!)
– The British actress Jenny Agutter featured in a Daily Mail article that focused on her niece who has CF and the possibility that two of her siblings could have succumbed to the illness.
– My cousin from Oxford, Sarah McNaught, has sent out a donation website ahead of her wonderful commitment to run the London marathon in aid of CF.
– A wife asked for prayers as her husband was rushed to hospital in America to receive his donated lungs.
– A much loved 15 year old boy in America and a beautiful 23 year old girl from the Faroe Islands sadly passed away due to CF.

This full spectrum of news demonstrates that CF is a global condition and engulfs many people – from the sufferer, to their immediate family and associated friends. The last two sad stories are pretty commonplace on the web and provide the quickest antidote to any self-pity I might ever feel.

The news highlighted that there are very few winners with CF and helped me to re-set my mind set to the truth that even though I may be having a tough time in my microcosm of IV frustration, that there is always someone worse off than me. I can never be grateful for my suffering but I am deeply appreciative of every breath I take and any extra time I have in this world.

Taking time out is never going to be easy but it is vital to help galvanise my health so that I can return to my fulfilling life in London. However difficult it is to achieve, perhaps we can all benefit from occasionally taking time out to see the bigger picture around us?

I will keep you posted on my life affirming moments, trials and tribulations as and when they happen. Please keep reading and sharing my blog and sign-up (on the right hand side tab) if you have not already done so.

Yours cup half full.

Tim
Tim Wotton

* Cystic Fibrosis is one of the UK’s most common life threatening inherited diseases, affecting over 10,000 people. The condition affects the internal organs, especially the lungs and digestive system, by clogging them with thick sticky mucus. This makes it hard to breathe and digest food. Each week, five babies are born with the condition, however, each week, three young lives are also lost to it. There is currently no cure for CF. However, existing gene therapy trials in the UK are bringing people with the illness closer to a form of cure but CF is not that well known and would benefit from more public donations. For more information and to find out more view the CF Trust Website.

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Always there

It’s not just close family and friends that help people with chronic illnesses like cystic fibrosis (CF)*. The recent death of one of my unsung heroes reinforced this…

I received a text from my mum a few weeks ago breaking the sad news that Ken Lacey had died aged 92. Ken and his wife Betty, who survives him, were like pseudo grandparents to me.

We’ve known Ken and Betty Lacey all our lives and there’s a good reason for that. They tragically lost their CF son – their only child – Peter in 1974, aged only 24. Back then this was an unexpected age to reach considering the life expectancy of CF sufferers. As context, when I was born in 1971, I wasn’t expected to live much beyond 17…

Ken and Betty were realistic about Peter’s chances but realised that he shouldn’t be wrapped up in cotton wool. Instead he was encouraged to make the most of what life he was likely to have. When he was in his early twenties he bought a hearse car along with some college friends and they drove it on the Continent and had a wonderful time. The irony of driving around in a funeral car is certainly not lost on me.

Peter was very artistic and attended Art College and his paintings were shrined on the walls and cabinets of Betty and Ken’s homes. Those paintings were always there to remind them.

Peter was treated at Great Ormond Street Hospital (GOSH) in London, curiously at the same time that my mum was being trained there as a nurse, though we don’t think their paths crossed. He also was an inpatient at Tadworth Court, the country branch of GOSH. My mum trained there as well.

My parents met Ken and Betty at a local Hampshire CF meeting in May 1972 when Betty was the Secretary and Ken the Treasurer, positions they held for a while before my mum took up the post of Honorary Secretary in 1975.
In 1982 Ken and mum even went to Claridges, London, to meet HRH Princess Alexandra who was and still is, the CF Trust Patron.

They were a key part of the Hampshire CF fundraising committee and attendees at a plethora of events, often organised by my parents. From CF stalls at the Southampton Show, the balloon festival, tennis clubhouses, people’s homes and gardens, Ken and Betty were omnipresent. Ken took people’s entrance money at many of these events; a mantle that was passed to my dad overtime before his heart breaking demise due to Motor Neurone Disease just over a year ago. Betty would help out with the ‘bring and buy’ stall or serve refreshments.

In fact for over 30 years they were for many people synonymous with CF fundraising in Hampshire. They could have dipped out following the death of their son but they stayed loyal and dependable. I was always there and so were they.
So when that text came through and I read that one of my biggest supporters had perished, I did feel terribly upset, even though his failing health meant I hadn’t seen him in a few years. As a father myself I pondered on how rough it would have been for them to lose their one and only child at such an early age and that being that.

I believe that they viewed me as a pseudo grandson, making frequent visits to our house and always remembering my birthdays. They were extremely thrilled when I married Katie and when we had our son Felix. They must have felt pride and joy in all my life achievements and milestones. But that must have been twinned with gut-wrenching pangs of grief for their own boy who didn’t live nearly long enough to work full time, buy a house, marry or have children.

At 24 I was not long out of University, getting into work, playing my hockey and having more fun than is reasonably possible. I cannot conceive how awful it would have been for them to lose Peter at such a fledgling age.

Peter, who I never formally knew, is one of many sadly deceased CF sufferers who are hard-wired into my conscience, binding my soul with the fortitude and hope to carry on with my relentless fight for survival.

They lost their boy but found another one to make a difference for. I was always there to remind Ken and Betty of the cherished son they had and they were always there as extra grandparents for me and as willing helpers to raise money to treat my illness. I will always be grateful for their care and devotion. Love always…

I will keep you posted on my life affirming moments, trials and tribulations as and when they happen. Please keep reading and sharing my blog and sign-up (on the right hand side tab) if you have not already done so.

Yours cup half full.
Tim

Tim Wotton

* Cystic Fibrosis is one of the UK’s most common life threatening inherited diseases, affecting over 9,000 people. The condition affects the internal organs, especially the lungs and digestive system, by clogging them with thick sticky mucus. This makes it hard to breathe and digest food. Each week, five babies are born with the condition, however, each week, three young lives are also lost to it. There is currently no cure for CF. However, existing gene therapy trials in the UK are bringing people with the illness closer to a form of cure but CF is not that well known and would benefit from more public donations. For more information and to find out more view the CF Trust Website.

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Staying the course

Featuring in a recent TV programme on the ticking time-bomb of antibiotic resistance highlighted my own plight with the chronic illness cystic fibrosis (CF)*…

Let’s start with the basics… an antibiotic is a term for a drug or other substance used to kill or slow the growth of bacteria. Antibiotics are the bedrock of modern medicine. For 70 years they’ve been at the forefront of our fight against infection.

Since the manufacture of penicillin in 1943, antibiotics have saved millions of lives by combating infections. But there has been no new class of antibiotic developed for more than a quarter of a century. And bugs are battling back.
Through overuse antibiotics are losing their effectiveness. This is becoming a serious and growing phenomenon in contemporary medicine and has emerged as one of the pre-eminent public health concerns of the 21st century.
Resistance is a common yet problematic issue in treating pulmonary exacerbations or infections in people, like me, with CF.

However, despite a push for new antibiotic therapies there has been a continued decline in the number of newly approved drugs.

How does resistance develop?
Antibiotic or drug resistance results from bacteria changing in ways that reduce or eliminate the effectiveness of drugs or other agents used to treat infections. Not all bacteria are bad. However, there are some that can cause infections. As bacteria are exposed to antibiotics over time, resistance may develop, and the number of antibiotics we have to kill the bacteria decreases as well.

With antibiotic resistance, bacteria are now able to survive the use of these drugs meant to kill or weaken them. In effect, each time bacteria are “exposed” to antibiotics, they can change in a way that the antibiotics are no longer effective. So, the most common way resistance is acquired is by exposure to antibiotics. With antibiotic exposure, resistance generally develops overtime. The length of time depends on the bacteria and the antibiotic, which can range from one treatment course to several hundred.

Another way of acquiring resistant bacteria is through contact with other people or equipment when not using appropriate standard and contact precautions. Hand washing, hygiene, and washing of respiratory equipment are vital. The dynamic of cross infection among CF sufferers, getting too close to each other, is such a damaging one.
As well as feeling first-hand the diminishing effect over time of the drugs on my lungs; my doctors would analyse my sputum samples taken during hospital visits to determine the state of my bacteria. In simple terms, if my bacteria are ‘sensitive’ to certain antibiotics then I will be prescribed them and if I am resistant than I won’t.

Catch-22
On a daily basis, I take two different types of oral, two inhaled and one nebulised antibiotic. My CF catch-22 is that I need to be on a substantial amount of antibiotics permanently but this in turn reduces their every-day effectiveness and eventually builds up my resilience to them.

It’s different for CFers as we don’t tend to have a short burst or a week-long course of antibiotics. We tend to stay on certain tablets, inhalers and nebulised antibiotics continuously; sometimes alternating month on, month off with certain medication.

But as portrayed in the TV documentary which shows me with my family and out on a field hockey pitch, these antibiotics are life-savers. In my case, they act as enablers for me to work, play sport, be a husband and father. They are the breath of life for someone with CF.

One dilemma I faced ahead of the filming of my league hockey game was not how telegenic I was, but the fact that the rain clouds were looming and rain and my lungs are not a good match. Just my luck – I’m about to be filmed for a lot of people to view and I’d be wheezing all over the place! After much deliberation, I chose to play despite the rain and hope the cameraman would edit out the inglorious parts.

Holding my nerve
In the simplest cases, drug-resistant organisms may have acquired resistance to first-line antibiotics, thereby necessitating the use of second-line agents. And so it’s proved with me…

There’s a whole raft of ground-breaking antibiotics (oral and IV) that I was prescribed in the 1980’s that are now no longer part of my medical regime. They shone brightly, boosting my lung capacity, then after a while their effect petered out and I had to wait for the next mini-miracle drug to arrive.

I’ve become completely resistant to some drugs and the effect of other medication has reduced over the years as my body has been over-exposed to them.

Am I panicking about this potential antibiotic Armageddon? The answer to that is yes and no! If I dwelled on the likelihood of no more pipeline of medication I would get pretty depressed. But I tend to exist in the ‘here and now’ world where there are still drugs that I’m sensitive to which help me to fight CF.
To use the Forrest Gump vernacular, antibiotics are like a box of chocolates, you never know what you are going to get next!

For now, I’ll stay the course, hoping that my drugs keep knocking hell out of the bacteria, while I wait for the next miracle to come my way…

I will keep you posted on my life affirming moments, trials and tribulations as and when they happen. Please keep reading and sharing my blog and sign-up (on the right hand side tab) if you have not already done so.

Yours cup half full.

Tim
Tim Wotton

ITV Tonight 24 October: ‘When the drugs don’t work’ documentary (for those in the UK) – See me at 5:10 and at the end

http://www.itv.com/news/2013-10-24/tonight-when-the-drugs-dont-work/

http://stuartharley.com/tim.zip (just my section of the programme for those outside of the UK)

I read that Sir John Batten, UK specialist in chest diseases, has recently passed away. This man started the first clinic at the Brompton Hospital for adults with CF. He also trained my previous Doctor Ron Knight. I owe him a huge debt.

Good News - I have found a publisher for my CF-related book and I hope to launch it during Spring 2014… I’ll keep you posted!

* Cystic Fibrosis is one of the UK’s most common life threatening inherited diseases, affecting over 9,000 people. The condition affects the internal organs, especially the lungs and digestive system, by clogging them with thick sticky mucus. This makes it hard to breathe and digest food. Each week, five babies are born with the condition, however, each week, three young lives are also lost to it. There is currently no cure for CF. However, existing gene therapy trials in the UK are bringing people with the illness closer to a form of cure but CF is not that well known and would benefit from more public donations. For more information and to find out more view the CF Trust Website.

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Great Expectations

DrugComplianceImgIt’s staggering to learn that only half of people with a chronic illness are compliant with their medication. Even after 42 years of handling cystic fibrosis (CF)*, it’s hard to always get it right…

Wiki defines medical compliance (also adherence or capacitance) as the degree to which a patient correctly follows medical advice. Most commonly, it refers to medication or drug compliance, but it can also apply to other situations such as medical device use, self care, self-directed exercises, or therapy sessions. Compliance is commonly confused with concordance. Concordance is the process by which a patient and clinician make decisions together about treatment.
Worldwide, non-compliance is a major obstacle to the effective delivery of health care. In 2003 estimates from the World Health Organization indicated the startling fact that only about 50% of patients with chronic diseases living in developed countries follow treatment recommendations. Ten years on, a US Fox Business study highlighted that nothing had changed. Patients improperly taking their medication not only results in longer cure times, repeat doctor visits and more illnesses being spread, it’s also causing the US health-care system to hemorrhage money. According to The National Consumers League non-adherence costs the country more than $290 billion a year.

This lack of compliance is a global health problem that is of major relevance to the UK National Health Service (NHS). Non-compliance prevents patients from gaining access to the best treatment. This may be particularly problematic in chronic medical conditions, including current NHS priorities such as mental health, cancer, diabetes and respiratory illness.
It’s a huge predicament and there’s not one single good reason why people don’t take their medication. The Fox Business report stated that patients stray from their treatment regimes for a variety of reasons, with forgetfulness being the top reason – especially among patients taking multiple pills a day. The cost (in countries with no formal health service) and lack of education are also reasons people choose to be non-acquiescent. According to medical experts, if people don’t understand why they are taking the medication or can’t gauge the benefits, they are more apt to stop taking it, figuring they don’t need it or it’s not effective.

How do I compare?
I’m no paragon of virtue when it comes to meticulously taking every one of my prescribed meds. I would count myself as being 98 per cent compliant with my huge assortment of treatments for CF and diabetes.

Over the course of this recent English summer (we actually got one this year!) I have had a number of occasions when my normal water-tight medical regime was breached. Top of the list were two beach trips during one week in July when I forgot to transfer my enzyme tablets (essential for me to digest my food) to my beach bag. The first time in Hampshire I decided to eat hardly any lunch to reduce the likely stomach ache; and five days later in Brighton with Katie on our tenth wedding anniversary. This time, on realising my mistake, I decided to get a taxi from the seafront back to the Park n’ Ride in order to raid my stash of enzymes in the car. That cab fare cost me £20 – a costly error!
Outside of these beach aberrations I have missed the odd nebuliser session through the busyness of life causing me to forget; while in a hurry to get out of the door I have been prone to only taking two of the four antibiotic inhaler blisters.

Sometimes I just can’t physically do my treatments due to life and work circumstances; like doing my physiotherapy when at an all-day work conference or when attending an after work social function. At work when in back to back meetings, fitting in the check of my blood sugar levels before lunch occasionally goes missing in action. A weekend event such as a wedding can also limit getting ‘everything done’.

I do try mitigating against any treatments I am likely to miss later in the day by doing my essential medication such as my nebuliser in the morning. At certain times, needs must. In the 1990’s, I did once conduct my heavy-duty intravenous treatment in the back room at a cousin’s wedding, ably supported by my mum.

Taking my own medicine
By way of contrast I made a rough calculation of a year’s worth of medicine intake versus what I actually missed. Annually I would be expected (prescribed) to take 15000 tablets, nebulise 364 times, undergo 750 physiotherapy sessions, inject diabetic insulin into myself over 1500 instances and prick my fingers on 1000 occasions to test my blood sugar levels.
In that same year, I reckon on average I would miss 40 tablets, 3 nebulisers, 15 physiotherapies, hardly any injections and the odd blood sugar test. So it’s not full compliance but close enough considering I have to fit all that in alongside a busy life working full-time as well as being a dad to Felix and husband to Katie.

Setting my own expectations
Through my lens, there’s a huge disparity between drug adherence if one has had a chronic health condition from an early age compared to developing an illness later in life, usually after a period of reasonably ‘normal’ health. I have had a life time to hone this utter devotion to medical duty. What is 40 tablets missed a year for me might be five pills for someone who is new to it all with a smaller drugs regime.

In order to make the treatments a way of life for me, I had to take personal responsibility for myself and I needed to own my care. After all these years, it been rather embedded into my sub-conscience. It’s like I have a radio voice, ‘Tim Wotton FM’, in my mind, constantly reminding me when the next medication is needed. “I’m about to do this, therefore I need to do that before, during and after.” “You’ve just done this, now you need to do this.” Sometimes if feels like I’ve got the computer HAL from the film ‘2001: A Space Odyssey’ in my head. “I wouldn’t forget that tablet if I were you Tim!”

Early on with a new drug I look to catch myself doing the right thing; taking it even when no one was watching or by my side. One has to find a way to remind themselves – post-it notes around the house if nothing else works – until it becomes second nature and as routine as brushing one’s teeth. If I’m not entirely sure why I’ve been prescribed a particular medication, I feel empowered to ask my doctor a few pertinent questions to sanitize whether it’s the right one for me.

I like to bring some competition into it – mentally ticking myself off when I miss or forget part of my regime. Physically I will suffer as any missed treatment will cause a detrimental effect to my health. I know that I can’t teach CF and diabetes a lesson by not complying. However, it will surely teach me a harsh lesson if I don’t knuckle down.
Even when I do everything 100 per cent right I’m not content with the state of my health, so why would I want to jeopardise the health I could have? My mantra is that I’m only as healthy as my last treatment.

I try to be understated about my meds – showing the illness the right amount of respect and care without making the minutiae of it all-encompassing and overly obvious for those around me.

No one else can take those meds for me. The buck stops here. I try to make the illness live with me rather than me living with it. From bitter experience I don’t defy the medicine. Instead I look to defy the illness itself by adhering to the medical regime. A tricky balance can be found between doing your medicine and having a life – I certainly don’t forgo one to have the other.

The deepest motivation I have to not miss a trick is one based on the CF version of the film ‘Two Weeks Notice’ – what would happen to me if I stopped my treatments for just two weeks? How ill would I become? Even when I miss the odd treatment the effect on my health is pretty noticeable. I’m pretty sure that after two weeks of living without due diligence, I’d be in hospital and really struggling.

This awful thought provides me with enough commitment to be as close to 100 per cent medically compliant as is humanely possible. After all, no human is perfect.

I will keep you posted on my life affirming moments, trials and tribulations as and when they happen. Please keep reading and sharing my blog and sign up (on the right hand side tab) if you have not already done so.

Yours cup half full.
Tim
Tim Wotton

* Cystic Fibrosis is one of the UK’s most common life threatening inherited diseases, affecting over 10,000 people. The condition affects the internal organs, especially the lungs and digestive system, by clogging them with thick sticky mucus. This makes it hard to breathe and digest food. Each week, five babies are born with the condition, however, each week, three young lives are also lost to it. There is currently no cure for CF. However, existing gene therapy trials in the UK are bringing people with the illness closer to a form of cure but CF is not that well known and would benefit from more public donations. For more information and to find out more view the CF Trust Website.

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