[00:00:00] Narrator: This podcast is intended to support UK healthcare professionals with education. The information provided in this podcast is not a substitute for professional medical advice or treatment, and patients are encouraged to consult healthcare providers, including nurses, for any medical questions they may have.

or concerns.

[00:00:23] Hannah: Welcome to stoma and continence conversations from coloplast professional where health care professionals and experts by experience discuss the latest hot topics in the worlds of stoma, continence care and specialist practice. I'm Hannah Patterson, I've worked in specialist care and I'm currently the ostomy care associate education manager at coloplast.

On today's podcast, I'm joined by Peter Lannan, early estimate and expert by experience.

[00:00:51] Peter: I was going to the toilet 40 times a day. I was backwards and forwards to hospital, 29 hospital admissions in two and a half years. All this time, it's been that conscious thing in your head, that white noise, that white noise is going, do I need to loo?

Am I going to make it? Am I going to have time? And then it takes your mind completely off the subject. I used to change your bag as a regular routine. So I used to change it either once a day or once every other day, but now since having the Halo device, I've been able to get extended wear out of the bag.

[00:01:23] Hannah: Hello and welcome to the podcast and I've joined by a very special guest today. I've got Peter with me. Hi Peter.

[00:01:29] Peter: Hello, how are you?

[00:01:31] Hannah: I'm great. Thank you. How are you?

[00:01:33] Peter: Yeah, not too bad.

[00:01:34] Hannah: Thank you so much for joining me. Now, this is your first time on one of my podcasts. So welcome to our podcast as well.

[00:01:43] Peter: Thank you very much.

[00:01:44] Hannah: Now I first met Peter, I think it was coming up to around 12 months ago. Now, wasn't it? When I very first met you down in head office, I think you'd not long become one of Colourplus ambassadors. And I think that was back when I first met you. If you can, as. Still, I still, anyone that's still within that first sort of period, I still class you as a brand shiny new ambassador.

And as a new ambassador and someone that's not been on one of the recordings before, could you just give the listeners a little bit of an introduction to yourself, because you can do it far better than me.

[00:02:13] Peter: I, uh, suffered with proctitis in 2005. Um, which then later developed into ulcerative colitis in 2008.

Um, I had a ileostomy surgery in 2017 and due to having the ileostomy surgery, things were getting better for me. Uh, but because of my original disease, if you like. thing, uh, started with proctitis. I ended up having the rectal stump re inflamed again. So I opted in the 2018 for, um, the completion proctectomy.

So the rectal stump removed. Um, and so things got a lot better for me.

[00:02:57] Hannah: Yeah, it's quite a common thing that people that have surgery tend to either go one way. So you either end up, Going, do you know what, this is a far better life for me with an ileostomy. I might get some complications. Let's just get that rectal stump out.

Or you do get people, like myself, hands up, that I've gone down the J pouch route. But for, certainly for yourself with the, I'd say your main route of cause being the proctitis, I can absolutely imagine for you that was the best thing for you at that point.

[00:03:26] Peter: Yes, unfortunately, my very first experience of proctitis was on a farmer's field, on a scout camp, in the middle of nowhere.

Ugh. Using a chemical toilet and up most of the night.

[00:03:38] Hannah: Oh, gosh. I mean, chemical toilets are not the greatest at the best of times. I, I have a love hate relationship with port a loos. I love them when they're there, but on, like, yeah, chemical toilets and port a loos can, I think most people with ileostomies or internal patches, it does give them the shivers when you think of those sort of toilets.

I have a

[00:03:58] Peter: slight advantage now, I don't have to sit down.

[00:04:01] Hannah: I don't, I'm very very jealous at times because it's not a nice position to be in. Now, you've obviously been through quite a few surgeries, almost over quite a prolonged period of time. So, would you now say that You are almost becoming a better version of you.

You're becoming more and more confident within yourself now because you know, it's 2005 It's almost 20 years now that you've been through the process.

[00:04:25] Peter: Yeah, unfortunately my first diagnosis of broctitis, the follow up wasn't great. I basically went for a colonoscopy and given some suppositories and basically told to go with life, um, which then, which then led to ulcerative colitis and I was referred to a different hospital.

And I must say that the team there were fantastic. Um, they, as soon as you had a problem, you've contacted them. wrote an, wrote an email and they could send a prescription directly to your chemist locally for you to pick up medication. So they were really good and really proactive. Um, they then eventually exhausted the oral and rectal medications, um, and ended up with, um, Amira.

I started the Amira but was tested for it quite early, but unfortunately it wasn't put on Amira until nearly two years down the line. So, um, possibly, um, had it been started a bit earlier I might have, um, not ended up with a stoma.

[00:05:35] Hannah: Yeah, I think they probably, I mean, With IBD, there is so many medication routes you can end on that.

And, but I, what I really love you saying then about that relationship that you had with your team, that you felt you were able to contact them, able to get the support where you needed. I think this is something that we often say to our nurses is don't ever underestimate the importance of your relationship with your patient, having been on the other side of things as well, that.

I know that for me, my stoma nurses, my IBD nurses were like my little guiding lights. I couldn't have got through what I got through without them. So never underestimate what you do. And the thing that drives me mad, and I used to say it as well, is, I'm just doing my job. It's not It's not, you're not just doing a job, but what you're doing for people like yourself is massive, absolutely massive.

Now, again, I'm just looking to, we'd spoke about the extended period of time things have gone on for, how did that affect you within your working sort of career life? Did you end up doing any changes to work? What, what were you doing sort of in 2005, for example? So where, where were you at in 2005 work life wise?

[00:06:45] Peter: Ironically, um, I was working for the NHS. I was patient transport. Um, I was, uh, delivering patients backwards and forwards to home. Um, I then progressed as my symptoms gradually got better through medication. Um, I started doing emergency ambulance. And, but then things took a turn for the worse as such, and it was getting to the patient and potentially needing the loo as you arrive at the patient, rather than dealing with the patient.

Being on the blue light run on the way to the hospital and going, yep, are we gonna make it or not? You

[00:07:26] Hannah: think you're putting your foot down more for your own benefit almost at that point.

[00:07:30] Peter: So, um, all this time it's been that conscious thing in your head, that white noise, that white noise is going, um, do I need to loo?

Am I going to make it? Am I going to have time? And then it takes your mind completely off the subject of what you're meant to be doing, of dealing with the patient in the first place. So, um, I left the ambulance service, um, and joined an out of hours GP service in the local area. Um, I became a driver for them and a receptionist because the hours were reduced.

And then gradually over time, as my health deteriorated, so did my job role. Um, and I eventually ended up doing, uh, central booking for patients from home. Um, because I was basically confined to the toilet. I was going to the toilet 40 times a day. I was backwards and forwards to hospital, 29 hospital admissions in basically two and a half years, averaging between 14 to 20 nights a

[00:08:24] Hannah: stay.

So it really did impact you at that point? You almost didn't Completely changed your career because of your IBD at that point.

[00:08:35] Peter: Yeah. Now due to, um, the, obviously having a stoma and being more precautious with the stoma, um, I decided to change my own career for my own health benefits and decided to become a driving instructor instead.

[00:08:50] Hannah: Fantastic. So you've almost gone back to, to your driving routes though still. So there's been a lot of, with where you've been, there's definitely, there's been a, A driving theme, excuse the pun, a driving theme of driving, really, there. So, the fact that you've gone back to that, does that give you that sense of empowerment now that you've gone back to something that was more you, really, ultimately, the driving side of things?

[00:09:13] Peter: Yeah, driving side of things was always me. When I passed my car test, I did my pass plus. And then when I passed my pass plus, I wanted to do a bit more, so I did my advanced driving, then I did my advanced driving diploma. And that was before I even joined the ambulance service, so, um, yeah. driving is definitely me and I'm now putting my experience to help others, but just in a different way.

[00:09:33] Hannah: Fantastic. Now, I'm thinking I'm almost playing a bit of devil's advocate here. Now, when it comes to driving tuition, you are quite in close proximity with somebody. It's the nature of how it is. When you sat in a passenger seat next to somebody, you are in close proximity with them. How does How does life with a stoma affect that side of things, being potentially that close to somebody?

[00:09:58] Peter: Well, being a driving instructor, my, um, my risks and responsibilities are on the road. So, I have to do a dynamic risk assessment all the time. Um, being in close proximity with a pupil or client, obviously, if the stoma makes noises, It makes noises. There's nothing I can do about that. So I do let my pupils know that I do live with a stoma, and sometimes I may have to adapt the lesson in order to be able to, um, deal with my stoma, um, in various ways.

But to say I need my concentration to be fully on the road all the time, because they're inexperienced and I've got to be their eyes, ears, hands and feet.

[00:10:39] Hannah: Absolutely. And, uh, I'm thinking back to when, I mean, it's many years ago now, but when I learned to drive, it, that, that coordination factor when you're first learning, like you said, you, you feel like you're all fingers and thumbs everywhere.

So I think I'd be in the world's most useless driving insurance because I think I'd just be braking for no apparent reason all the time. So I'd be just. foot on the foot, like, foot on the brake. So, yeah, I absolutely take my hat off to you because I brake in the foot well when my other half's driving, so I don't know how you manage on a regular basis.

But what you haven't mentioned, Peter, more importantly, you are more than just standard driving instructor. Peter, again, I'm not going to take away your thunder here. You explain a little bit more about what you do and why. It's so amazing how you're able to adapt what you do.

[00:11:26] Peter: Um, I'm, uh, also teach, um, younger children to drive, um, at weekends, um, every 10 to 17.

So, uh, I sort of have a full day, six and a half hours, back to back lessons. And, I say, I enjoy teaching them from a very early age.

[00:11:46] Hannah: And you don't just do that in your local area, it takes you here, there and everywhere, doesn't it?

[00:11:52] Peter: Oh it does, I travel the length and breadth of the country more or less. Um, I spend a lot of time behind the wheel over the weekend, and I travel from Exeter to Norwich, Norwich to Cardiff, all sorts of areas, that I say, in order to help give children the experience of learning to drive early, and hopefully keeping our roads safer in the long term.

[00:12:15] Hannah: And because I think when you're teaching children to drive at that point you're also teaching them more about general road safety I imagine as well so not just being a driver but actually that general road safety and things that they may not have considered. When they were walking along, crossing the road themselves and actually I think it is a really, really good thing to give them that experience in that protected environment.

[00:12:37] Peter: Touching on that subject, it is quite common as well, even with the on road lessons that people now see a different way of being a pedestrian once they get behind the wheel. Yeah. I wouldn't have thought of that because the van's blocking the zebra crossing, for example. And I need to look round it beforehand, before crossing the road, rather than just step out into the road and hope

[00:13:02] Hannah: for your best.

Collar Plus Professional offers a lot of educational material for specialists, nurses and healthcare professionals. Visit collarplusprofessional. co. uk to find out more. Now, another thing that I want to talk about, because we are now allowed to talk about it so much more freely, is Halo. Out. Peter, you've been using Halo for quite some time now, haven't you?

[00:13:28] Peter: I certainly have, yes.

[00:13:29] Hannah: So, when did you first get introduced to Halo, so to speak, and what were your first thoughts when it got mentioned to you?

[00:13:38] Peter: Um, I went to one of the Ambassadors Days, I believe it was in April, and, uh, I was, uh, looked at one of the newsletters that I think, uh, Natasha sent out originally.

Yeah. Um, about the Halo. And, um, I was involved with a similar project a while ago, uh, with a different company, but unfortunately all the technology, all the resources, and all the research went downhill, basically. Um, so I was quite keen to, uh, understand the Halo aspect, and I'm quite a technical person, minded person really.

Um, if I'm not behind the wheel, I'm normally sat at the computer learning something or other. Um, and um, yeah, I've, I've, um, developed sort of digital forms and things like that. So Halo was definitely up my street and I wanted to know more about it. So, um, the Halo device is really good. And as I mentioned with the ulcerative colitis that I had and that white noise from even that early age.

And the early time of my IBD pathway, I, um, feel that the HALO device is now reducing that white noise.

[00:14:52] Hannah: I love that analogy. I really love that analogy, because actually, that's something that I think we'll, we'll probably find a lot with HALO and IBD patients, because You go from having your horrific IBD before surgery where you've got that fear of bowel leakage and like you said, that constant white noise in your head almost.

And often when you get the stoma, yes, you're potentially out of that level of discomfort. But it's not necessarily taking away that white noise, as you put it, that you've still got that worry about leakage. It's just the other side.

[00:15:26] Peter: So when I started as a, um, heroinistomer, you used to get all these sensations of, Hmm, is that a leak?

That doesn't feel right. That's a bit of an itch. And, um, I say now having this halo sensor with these, uh, sensor rings that notify you, uh, when things, when there's a problem, then, uh, it makes things a lot easier for me. And I know and have peace of mind that a halo will notify me if there's a problem, which means I can concentrate on my people.

Concentrate on keeping our road safe, my pupils safe, and more importantly the public safe when they're on lessons.

[00:16:02] Hannah: And also just with the travelling aspect for yourself as well, like you say you travel length and breadth of the country, so it's not just when you've got that pupil with you, but also when you're going from one destination to the other, especially because I'm guessing a lot of that time is probably spent on motorways, and if you've got that white noise, which I'm really going to use that as an analogy now Peter, sorry I'm Pinching that one off you because I think that's brilliant.

It's White noise on a motorway is not good when you've got distractions Going down those motorways and don't you say just have that peace of mind and comfort there that actually someone else is almost looking out For you as well.

[00:16:40] Peter: Yeah, I say I've had no issues with it at all I've had no leaks outside of the bag in actual fact since using the halo device I used to change your bag as a regular routine So I used to change it either once a day or once every other day You But now, since having the Halo device, I've been able to get extended wear out of the bag.

Obviously, the Halo, uh, the stoma does erode the flange, and let's say there are various leaks that happen within the bag, and then it notifies you as soon as it gets to the, um, the sensor ring. But, um, It's definitely made a huge difference. And I've got to the stage that I let Halo let me know when to change the bow.

[00:17:22] Hannah: So you're actually using Halo. It's like your little, okay, right. Time to go now. Off we go. That's amazing that you've gone from, and it is true what you say you do, it does just become part of your routine. You're not particularly changing it because. You have to. It's just that ingrained thing, almost like changing your underwear a little bit, you change your bag and off you go.

I mean, I'm always quite vocal about the fact I used to change my bag because of that paranoia. I used to change my bag two or three times a day. I was that worried. And yet you say you get that sensation that it's the itch. I probably hadn't got an itch, but I was convinced I had got an itch. And then you go, have I got an itch?

I don't know. I maybe have an itch. I'm just going to change it. It's like, just in case, I'm going to change it, just in case.

[00:18:06] Peter: Yeah, so therefore, changing the bag unnecessarily. Absolutely. And say

[00:18:10] Hannah: half the time when you actually

[00:18:11] Peter: take the bag off, it hasn't eroded as far as you think it has. And it actually looks the same as it

[00:18:17] Hannah: did when you put it back on, put it on 24 hours before.

And that's really amazing. To hear that you're getting that extended wear. So not only are you getting the extended wear, you're getting that mental freedom as well that you're getting from, because your job is so different that you can't just, you're not sat behind a desk where you can then just go off and change your bag if you need to or if you get those sensations.

You're probably the amount of times that you're in a situation to change your bag. is far reduced to most people.

[00:18:52] Peter: Yes, very, very much so. Um, I say, it got to the stage that I would have to divert the lesson to meet my own needs and abilities um, to be able to change the bag or deal with any leaks or anything like that.

Um, rather than, I say, concentrating on the lesson, because part two, part three for the driving instructors thing is to be able to adapt the lesson to meet the pupil's learning objectives, goals, and abilities. But I'll say that was me, basically. I had to adapt it for me, um, some of the time.

[00:19:27] Hannah: So is there anything now with using Halo, are there any things that you've potentially, and I don't want this to be a leading question at all, that you've done that you maybe wouldn't have done without Halo?

I

[00:19:38] Peter: say I don't have the tummy tap anymore, I was like checking your bag constantly. Um, or go into the loo and what have you and just check it around the flange before you, you know, finish up in the loo. I wasn't fond of public transport anyway, especially with the ulcerative colitis and the lack of toilet facilities, and especially going into the city where the toilet, you know, Facilities are restrictive and you can't just pop into the restaurant and what have you and use the loop Um, so I say having a stoma has made a big difference to me But actually being able to be notified if there's a problem even things like Routine in the morning I can jump in the shower take the transmitter off jump in the shower And it takes me a few minutes in the shower Out dry dressed and what have you where if you're changing the bag all the time?

You've got extended time to be able to um deal with the stoma, clean the area, you know, shave around the area. So, uh, so even the routine of life has changed. And consequently, due to having the HALO device, you seem to get a lot more sleep now knowing that you've got peace of mind that HALO will notify you if there's a problem.

[00:20:50] Hannah: Fantastic. And that's one of my favorite things is, and I know a couple of the ambassadors that have used HALO have spoke about this, that It's actually that sleep and I don't think you realize how almost sleep deprived you become when you have a stoma until You're not almost because and the tummy tap the tummy tap is like the the stoma Universal thing I think that the tummy tap and it took me even after I had my reversal Months to get out of the habit of doing the tummy tap it becomes like it's like a way of life that little Tummy tap, the seal, as I used to call it, like the little seal, like patting your tummy, and it, it's amazing to hear these little things that, and I think we've spoken about it before in other ways, it's, it becomes like a habit.

You don't even realize you're doing, you don't even realize that you're tapping your tummy, you don't even realize that you're checking your bag all the time, you don't realize that you're doing this, you don't realize that you're not sleeping, and to hear that now you're almost adapting to a happier way almost, a more normal way.

[00:21:52] Peter: Yeah, so I don't think about it anymore, I just You know, I know where the bag's starting to fill and I know that each time I go to the loo I empty the bag or what have you, um, just to give myself more space and more capacity within the bag. So I don't even think about it now. What have I done this week?

Um, I've, uh, decorated my nephew's bedroom. Um, I've done all sorts of things, uh, including got a fireplace and built a fireplace the other day. So, um, yeah, I don't even think about the, uh, the stoma side of things anymore with the halo.

[00:22:26] Hannah: Brilliant. And I know that you've also told me as well, you're on off on a caravan holiday as well.

Soon aren't you off to? Yeah, looking to go

[00:22:34] Peter: in October, um, and take the, uh, the nephews and what have you across to a caravan holiday. What would be my first holiday since, um, about 2015. Oh,

[00:22:46] Hannah: fantastic. And again, that, that's obviously something you now feel like you've got the confidence to do.

[00:22:52] Peter: Yeah, I say because of all the surgery and the various things with ulcerative colitis and the hospital emissions and everything else.

So I had, my last holiday was 2015, uh, in Switzerland. Um, and then all the colitis and everything really flared up. Um, and then in 2023, I had a stoma due to a prolapse. But, uh, everything seems to be going well and, uh, halo seems to be working well with me as well.

[00:23:23] Hannah: Fantastic, and what a great note to finish on, and that's going to leave me to say thank you so much again for joining me and have a fantastic holiday.

I hope you get some good weather when you go, fingers crossed.

[00:23:35] Peter: Oh well, it's the same activity just with E. coli.

[00:23:40] Hannah: Yeah, and we're very versed to doing that here in the UK, aren't we? Always take half your wardrobe with you when you go on holiday, I think, isn't it, in this country? But thank you so much, Peter, and I really hope you join me again at some point.

I want to hear about the holiday next.

[00:23:55] Peter: Yes, that sounds good.

[00:23:57] Hannah: Thank you, and to everybody listening, will please join me next time. Thank you. Thank you for listening. To see more of the wide variety of education we offer, please visit color plus professional.co.uk. See you next time.

[00:24:14] Narrator: Stoma Incontinence Conversations is a vibrant sound media production for Coloplast Professional.