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New specialist brings community immense relief

Katie Gracie, with Masterton Mayor Lyn Patterson and Wairarapa MP Kieran McAnulty, at the opening of the Unmasking IBD exhibition at Parliament. PHOTOS/FILEL

Erin Kavanagh-Hall
[email protected]

For Wairarapa’s inflammatory bowel disease (IBD) community, the appointment of a new gastro-intestinal specialist at the region’s hospital is an “immense relief” – which comes after several years of tireless advocacy.

Wairarapa DHB recruited Dr John Wyeth, a gastroenterologist with close to four decades’ experience, at the start of this year.

Dr Wyeth has had an illustrious career in medicine, which has, as well as working in hospital settings throughout the Wellington region, included roles as medical director at PHARMAC, regional clinical lead for bowel cancer screening, and lecturer at the Wellington School of Medicine.

Dr Wyeth’s appointment has been touted as “a huge win” for Wairarapa residents living with IBD and other gastric conditions – who have previously had to travel to Wellington or the Hutt Valley to receive diagnoses and treatment.

IBD, an autoimmune condition which attacks the body’s digestive tract, affects over 20,000 New Zealanders – one of the highest rates in the world, per head of population.

Despite these figures, publicly-funded medications are limited and, due to a national shortage of gastroenterologists, IBD sufferers can face long waits for specialist care.

Lisa Clough, chairwoman of Crohn’s and Colitis Wairarapa.

Lisa Clough, chairwoman of Crohn’s and Colitis Wairarapa, estimated it had been at least five years since Wairarapa Hospital had a permanent gastroenterologist on its staff.

Both Clough and long-time gastroenterologist Dr Richard Stein, in his capacity as chairman of Crohn’s and Colitis New Zealand, had been in regular communication with Wairarapa DHB, advocating for the provision of locally based IBD services.

However, she said, their efforts were often “ignored” by the DHB – leading to Dr Stein treating several Wairarapa patients at his private clinic, free of charge.

Clough said Dr Wyeth’s appointment will have a significant impact for the region’s IBD community, estimated to make up at least 200-300 people.

“Beforehand, people were travelling for treatment at their own cost – having to pay for transport and take leave from work,” Clough said.

“Even (at other hospitals), it’s been hard for a lot of people to get a specialist to see them.

“Having a specialist in Wairarapa will also provide continuity of care: making sure follow-up appointments can occur and people are seen on a regular basis to [manage] their disease – not just when becomes urgent.

“Dr Stein has been outstanding: his constant battle to get care for those of us with IBD in Wairarapa has been incredible.”

Brent Gare, Masterton district councillor and More FM announcer, was similarly thrilled to hear of Dr Wyeth’s arrival.

Gare’s son Braeden was diagnosed with Crohn’s disease at age 10 – although it took “a good 18 months” of tests and scans, and many trips back and forth over the Remutaka Hill, before doctors reached their conclusion.

His father described this time in his family’s life as “pretty horrific”.

“We went for every possible test – it was an absolute nightmare,” Gare said.

“At one stage, he was vomiting blood. He had to be taken to Wellington Hospital for emergency surgery – where he had 20cm of his bowel removed.

“As a parent, seeing your child in constant pain, and knowing you can’t do anything to stop it, is heartbreaking. It takes its toll on the whole family.”

Thankfully, 18-year-old Braeden is now in remission, and had been receiving regular checkups at Hutt Hospital.

However, Gare said he had now “been dropped off the books”, as the hospital needed to prioritise patients from the Hutt Valley area.

He said he has had to be “a pretty aggressive advocate” for Braeden over the years – which has included several meetings with former Wairarapa MP Alastair Scott and his successor Kieran McAnulty, urging them to help secure a local specialist.

“There was a lot of lobbying behind the scenes. I remember telling Alastair, ‘mate, it’s just not good enough’.

“But we’re absolutely stoked to have Dr Wyeth on board now – it will change a lot of lives.

“It will be a massive relief, especially to cut down on that travel time for people who are already feeling uncomfortable in their own bodies.”

Masterton artist Katie Gracie, who was diagnosed with ulcerative colitis 10 years ago, knows that feeling of discomfort all too well.

Her treatment has involved travelling to Lower Hutt for colonoscopies – preparing for which can be taxing enough without factoring in the three-hour round trip.

Ahead of a colonoscopy, patients need to fast for 24 to 48 hours, and drink 2 litres of a powerful bowel-clearing substance – which Gracie describes as “saltwater mixed with a whole lot of grossness”.

“After doing the prep, sitting in [a moving vehicle] can make you feel so sick,” she said.

“A lot of colonoscopies are done using sedation, so you can’t drive back home straight afterwards – so people are having to pay for accommodation, or organise to stay with family. Which isn’t exactly quality time, when you’re stuck on the toilet afterwards.

“Physically, logistically and mentally, it’s a lot to cope with.”

Gracie, who provided artworks for an exhibition at Parliament for World IBD Day last year, said Dr Wyeth’s appointment was “absolutely wonderful”.

“It just adds so much more comfort and convenience. It’s a huge win.”

Crohn’s and Colitis New Zealand chairman Dr Richard Stein was pleased to hear about the new developments at Wairarapa Hospital – but said it was vital “excellent gastroenterologist” Dr Wyeth was “well supported” by the DHB in order to retain his services.

Stein is a familiar face in Wairarapa: he worked as a general physician at Wairarapa Hospital from 2007 to 2010, where he cared for patients with IBD.

While working at Hutt Hospital, he was able to continue treating patients in Wairarapa for three days each fortnight – but stopped in 2016, citing “a lack of support” from Wairarapa DHB.

While at Wairarapa Hospital, Stein trained one of theatre nurses in IBD care – and the DHB had committed to excuse her from her theatre duties for one-a-half days every two weeks to attend to IBD patients.

“She was absolutely wonderful – I couldn’t speak highly enough of her,” he said.

“IBD nurses are a lifeline for patients. They can do things like follow up on test results, and help people manage their symptoms when they’re having a flare up of their disease.

“If people are concerned about their symptoms, nurses can generally reply in about 48 hours.

“It can have a tremendous impact on quality of life – and, if patients aren’t needing to go to the emergency room or have surgeries, it’s a cost saving for the DHB.”

However, Stein said Wairarapa DHB had not permitted the nurse he trained to put her skills in IBD care to use.

“They said they can’t release her from her theatre work – which goes back on the agreement we made.”

In 2019, he and Lisa Clough met Shawn Sturland, then chief medical officer at the DHB, on behalf of the Wairarapa IBD community – many of whom were left “in limbo” by the lack of local services.

“I presented the DHB with letters from our community, talking about the effect of their conditions on their lives,” Clough said.

“After that meeting, we never heard anything back.

“A lot of the time, our attempts to make contact (via email) would be ignored.”

Dale Oliff, DHB chief executive, said senior managers have “no recall or knowledge” of the nurse to be released from her theatre duties to work with IBD patients, or any conversations “between the chair of Crohn’s and Colitis Wairarapa and the DHB” in 2019.

“There have been a number of changes of senior staff since 2019, and this has meant a loss of institutional knowledge,” Oliff said.

She said Dr Wyeth’s “experience and expertise will be of immense value to the local community, and especially to those suffering from inflammatory bowel disease”.

 

 

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