I had my surgery at 3pm on Tuesday 28th October 2003.

As I am a diabetic, at 11.30am that day I was hooked up to an insulin and glucose drip, the aim being to keep my blood glucose levels above 7mmols.

Following a pre-med the surgery was carried out at 3pm, and by 5pm, as a standard precaution I was back in the intensive care ward.

I had a catheter in place also. I was only allowed ice cubes for the next 24 hours and my blood sugars were monitored hourly. I also had a morphine, self administered drip attached.

The incision was approximately 2 inches long below the breast and above the navel. The disolvable stitches were visible, as there was no dressing in place.

I was moved back onto a surgical ward the following afternoon.

I did not experience pain as such, just soreness and a little discomfort.

A physiotherapist visited me throughout my stay, encouraging me from 24 hours post op to get out of bed and move around.

At 48 hours post op I was 'starving hungry' - the first time I had felt this in several months - my first meal was soup and a roll, it was heaven! My surgeon had explained that it is normal for the implant to not 'kick in' for at least 48 hours.

I was discharged 5 days post op. I would recommend having someone with you at this point as your mobility is still limited and you are not supposed to lift weights for a few weeks.

I did experience some pain post op - this was not as a result of the surgery, but as a result of my bowel stretching - it had shrunk where I had been unable to eat solid food for several months! At its peak this proved to be extremely uncomfortable, but lessened and then stopped over a period of about six weeks - this seems to be quite common and is dependant on how much, if any, solid food a person is managing to eat pre op!

I was out and about Christmas shopping six weeks post op and I took my children to Disneyland Paris, as a means of celebration, twelve weeks post op.

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Aftercare

The device can be affected by various 'electrical' equipment, such as electricity pylons, airport x-ray machines, certain x-rays/scans - you may even set off the odd 'anti theft' alarm at your local supermarket! However you are supplied with an identification card showing your implant serial number and a manual which is easy to follow and explains what to avoid! I have not had any major problems, and when going abroad, I take the ID card & manual (which is helpfully printed in several languages!)

I saw my surgeon 6 weeks post op, who checked that the incision was healing properly and checked that the implant was operating at the correct level.

It is common that the device will need to be adjusted/reprogrammed perhaps 2-3 times in the first year and maybe 1-2 each year after. This is a straightforward, non invasive procedure, but for legal reasons must be carried out at a registered hospital facility. Medtronic are currently (as of Apr 2008) endeavouring to set up a wide network of trained doctors to carry out the reprogramming as the number of 'implantees' increases, at present the workload is spread amongst two surgeons.

You will know when it requires adjustment as the gastroparesis symptoms return, nausea, vomiting etc - you then contact your surgeon/consultant, who contacts/refers you to the specialist at Medtronic (the manufacturers) - an appointment is then organised to take place. This process usually takes 2-3 weeks.

The Medtronic specialist puts a small sensor on your abdomen over the implant, and using a remote control, tests the strength
of the battery and the frequency, adjusting the strength of pulse and regularity of pulse where necessary. It takes just a few minutes, and the effects can be almost immediate, although for some the symptoms may take a couple of weeks to settle. He gives a printout to keep on your medical records, and keeps a copy himself.

The device is a sealed unit containing the battery power pack. When the battery 'runs out' the whole device will need replacing ie.another operation. Based on the available USA statistics it is envisaged that the battery has a life expectancy of 8-10 years.

I also participate in a statistical analysis programme, which at present each surgeon keeps his own database - at regular intervals (3 months/ 6 months/ 12 months/ 24 months etc post op)I complete an analysis booklet by monitoring my health/ vomiting episodes etc. This is helping to build a UK based picture of the effectiveness of Enterra Therapy - and could ultimately help win the NHS business case to incorporate this device as a standard NHS procedure in the treatment of gastroparesis.(see financing page). Hopefully in the future a UK wide and in turn Europe wide statistical database will be set up.