Cathy: Eddie does get anxious over very small things, because very small things can make
a big difference to him. There have been times when he has been
close to death because of the Crohn’s.
If he did not have the parenteral nutrition, he would end up starving to death, or dying of dehydration, and that is the short end
of it. Edward: Yes.
Dr Fergus Hamilton (UH Bristol Foundation NHS Trust): People on parenteral nutrition
get nearly all, or all, their fluids through their veins – they do not take anything
through their mouth – and they often get a prescription for that, which is a set amount
per day, so if you imagine it is a very hot day and they have an illness of some kind,
they can very quickly become dehydrated. They simply cannot increase the amount of fluid
they intake, like most of us can do, by drinking more, and they sometimes lose the ability
to have thirst, because they are so chronically thirsty for them to even notice they are getting dehydrated.
It is one of the most serious conditions associated with people on intravenous nutrition and can
result in people dying.
The whole process can take one or two days, and people are quite aware this is quite a long time to wait.
Edward: It is a case of, ‘That much urine out. What colour is it? Okay. I think I’m
okay.’ There is a slight guessing game that I am playing at the moment.
Dr Fergus Hamilton: One of us came up with the idea, a Eureka moment, really, of thinking
about swimming pools. When people use swimming pools, they want to monitor how much chlorine
they have in them, and actually, the chlorine you have in swimming pools is the same chemical
as you have in urine. Salt. How much salt people have in their urine is a really good
marker of dehydration. Actually, when we did the research, we found out that people had
done this 20 or 30 years ago, and had no idea about using this in a slightly different context,
which was really helpful. What we are doing with this QuanTab stick is we are repurposing
an old technology and giving it a new lease of life.
Dr Fergus Hamilton: So, there’s not much salt on that stick. They may be a bit dehydrated.
The stick is performing really, really accurately. It is a lot cheaper
than doing it in the conventional way and we can get the result within 20 minutes, not
waiting two or three days.
If you can say to someone, ‘Actually, you do need to come in, your dehydration…’, you could save them becoming very unwell.
You can really improve their outcomes.
What we aim to do is to diagnose this quicker, and that is what we think will save money and time.
Edward: I am getting out. It is like my weekly sort of adventure. At home, in which I am
totally independent with my care, the more devices that I have, it just gives me peace
of mind. Speaker: Enjoy that.
Edward: I certainly will. Cathy: Gives him the control over his situation,
which he really likes and needs. Dr Fergus Hamilton: What we are really happy
about is having a great set of involved patients, who are really keen to try out this new technology,
and try and get some data out to show that this is effective and if it is, there is no
reason we cannot extend it to a much bigger population.