PART FOUR – WHEN THE GROUND MOVES

Chapter 19: Building Something New

Feeling well for the first time in years gave me confidence — not just physically, but mentally.

I decided to retrain as an accountant.

It wasn’t a small decision. I was working nights at Waitrose, studying during the day, and trying to build a future that didn’t revolve around illness. For the first time, my plans extended further than my next hospital appointment.

Vedolizumab continued quietly in the background, every eight weeks, almost forgotten — which, ironically, was the biggest gift it gave me.

I progressed. I learned. I passed exams.

Life felt like it was finally moving forward.

Chapter 20: Cracks in the Shield

The return of symptoms was subtle at first.

A bit more urgency.

Occasional blood.

A familiar heaviness in my gut.

I didn’t panic straight away. Four years of remission had taught me not to overreact to every bad day.

But bad days turned into bad weeks.

Blood tests showed rising inflammation. Stool samples confirmed what I already suspected.

Vedolizumab was starting to fail.

The dose was increased. The infusions were brought closer together. We tried to squeeze more life out of the drug that had already given me so much.

For a while, it held.

Then Covid hit.

Chapter 21: Covid and Collapse

Catching Covid while immunosuppressed was terrifying.

The guidance was unclear. The fear was constant. Every cough felt like a warning sign.

At the same time, my colitis flared hard.

Working in retail during a pandemic while dealing with bowel urgency felt impossible. I was exhausted, anxious, and barely holding things together.

Eventually, I lost my job.

It wasn’t dramatic. No shouting. No arguments.

Just a quiet, devastating end to something that had been my safety net for years.

Losing work stripped away more than income — it took routine, purpose, and confidence with it.

Chapter 22: Losing Control

The flare escalated rapidly.

I was going to the toilet constantly. Accidents became a real possibility — then a reality.

The first time I wore protective underwear, I cried.

Not because of the product itself — but because of what it represented. A loss of dignity. A loss of control. A line crossed that I never imagined I’d reach.

I stopped going out unless absolutely necessary. I mapped toilets. I planned routes. I declined invitations.

My world shrank again.

Mentally, I was struggling more than I wanted to admit.

Chapter 23: Back Where It Started

Eventually, there was no avoiding hospital.

Blood tests were bad. Weight dropped again. Energy disappeared.

I found myself sitting in familiar waiting rooms, hearing familiar phrases, answering the same questions.

“How many times a day?”

“Any blood?”

“Any pain?”

Yes.

Yes.

Yes.

Vedolizumab was officially stopped.

The drug that had given me four years of life was no longer an option.

Chapter 24: The Big Guns

With options running out, the conversation turned serious again.

Biologics. Stronger ones. Higher risk.

Infliximab was next.

I was admitted to hospital for loading doses. Cannulas. Drips. Monitoring. Hope balanced precariously with fear.

At first, it seemed promising.

Symptoms eased slightly. Numbers improved just enough to keep optimism alive.

But my body had other plans.

Chapter 25: When Hope Runs Out

The response didn’t last.

Blood returned. Urgency followed. Fatigue became crushing.

More tests. More discussions. More quiet looks exchanged between doctors.

I knew what was coming before anyone said it.

One afternoon, my consultant sat down and didn’t open his laptop.

That’s how I knew this was different.

“We’re running out of medical options,” he said gently.

“I think it’s time we talk seriously about surgery.”

This time, the word didn’t scare me.

It felt… inevitable.

PART THREE – THE LONG MIDDLE

Chapter 11: Learning to Live With It

After the colonoscopy, life didn’t stop — it just changed quietly in the background.

On paper, I had mild ulcerative colitis. In reality, I had a condition that needed managing every single day. I was sent home with Pentasa suppositories and told to use them nightly.

That alone was a learning curve.

There’s nothing quite like ending every evening inserting medication into your own backside to remind you that life has shifted slightly off course. It was awkward at first, uncomfortable, and undeniably unglamorous — but it worked.

The bleeding reduced.

The mucus eased.

Things felt… stable.

Not perfect — but livable.

I returned to work at Waitrose, trying to pretend that nothing significant had changed. I had a family to support, a routine to keep, and a life that needed normality.

And for a while, normality returned.

Chapter 12: The First Cracks

Over time, small things began to creep back in.

Urgency.

Fatigue.

The quiet anxiety of not trusting your own body.

At first, it was easy to brush off. Everyone has bad days. Everyone gets tired. But I knew the signs now, and deep down I recognised them.

Blood started appearing again.

Mucus followed.

Back to the hospital.

This time, the conversations felt different — more cautious. The language changed slightly. Words like escalation and next steps entered the room.

The next drug was Azathioprine — an immunosuppressant designed to calm the immune system down.

I took it alongside the Pentasa, hopeful that this combination would finally keep things under control.

It didn’t.

Chapter 13: Enter the Steroids

When Azathioprine failed, Prednisolone entered my life.

Steroids work fast. Brutally fast.

Within days, the flare settled. The bleeding stopped. The urgency disappeared. Physically, I felt better almost overnight.

Mentally, I became someone else.

I didn’t sleep.

I was wired constantly.

I was angry — for no reason.

I’ve always been a calm, level-headed person, so this version of me felt foreign and unsettling. I snapped. I paced. My thoughts raced endlessly.

But the symptoms were gone.

And at that stage, that was all that mattered.

Chapter 14: When It Comes Back Harder

Steroids aren’t a solution — they’re a pause button.

Once the course ended, the disease returned.

This time, it didn’t creep in politely.

It arrived full force.

I was going to the toilet up to fifteen times a day. It wasn’t just stool — it was blood and mucus, every single time. The urgency was relentless. I barely trusted myself to leave the house.

Sleep was broken.

Energy vanished.

Life shrank.

I was introduced to Methotrexate next — self-administered injections into my stomach using EpiPens delivered to my house.

Oddly enough, the injections themselves weren’t the problem.

The side effects were.

Chapter 15: The Lowest Point

Methotrexate stripped me down completely.

Physically, I felt poisoned.

Mentally, I felt hollow.

I was still symptomatic, still exhausted, still bleeding — but now I also felt emotionally numb and fragile. Even the smell of the alcohol wipes used before injections made me gag.

One evening, I looked at my partner and said the words that had been quietly forming in my head for months:

“I can’t live like this.”

That was the first time surgery entered the conversation seriously.

Not as a future possibility — but as something I wanted.

We turned up at the hospital unannounced, desperate for answers. By chance, the consultant team were in a meeting, and my case was discussed there and then.

When the meeting finished, we were called in.

That’s when my consultant’s boss spoke.

She explained the surgery process — calmly, clearly — and for the first time, it didn’t sound terrifying.

Then she said something that stopped everything in its tracks.

“There is one more drug we’d like to try.”

Chapter 16: One More Chance

The drug was called Vedolizumab.

A long name. A new hope.

It was newer for colitis, more established in Crohn’s disease, and designed to be gut-specific — meaning it targeted the bowel without suppressing the entire immune system.

The plan was to start Vedolizumab while I was still tapering off steroids, keeping Methotrexate running temporarily to stop my immune system from rejecting it.

At that point, I didn’t care.

If this was the last hurdle before surgery, I was ready to jump it.

The first infusion took place in hospital. A cannula in my arm, a drip stand beside me, and an hour watching medication flow slowly into my veins.

I’d read the side effects beforehand — a mistake.

Every twinge felt suspicious. Every sensation felt exaggerated. By the end, I was lightheaded and cautious, sitting in the car before driving home, taking no risks.

That weekend, we went away to Woolacombe Bay with family and close friends — a short break to breathe and forget everything for a moment.

It was on the way home that everything changed.

Chapter 17: Starcross

Driving home, the familiar urgency hit.

I spotted Exeter services too late. Missed the turning. Panic rose.

Back roads. Dawlish. Starcross.

I remembered there were toilets at the train station.

I pulled into the car park across three spaces and ran.

What happened next still feels surreal.

For the first time in months, what came out was solid. Formed. Normal.

No blood.

No mucus.

No urgency afterwards.

I sat there in disbelief.

Vedolizumab had worked.

Chapter 18: Four Years of Breathing

Methotrexate was stopped.

Vedolizumab continued every eight weeks.

For four years, I lived symptom-free.

My consultant still talks about how quickly my body responded. How rare it was. How happy they were to see me get my life back.

And I did.

I worked nights at Waitrose.

I lived normally.

I planned a future.

My health was stable — for the first time since diagnosis.

And because I finally felt well, I made a decision that would shape the rest of my life.

It was time to build a career.