Daily Mail, Tuesday, March 3, 2020^ Page 37
T
om Speight should be
living the rock-star dream.
the critically acclaimed
singer- songwriter who
ha s w o r k e d w i t h e d
Sheeran, travis and Keane —
and gets more than one million
listens a month on the music
streaming service Spotify — is
fast becoming one of the UK’s
top artists.
So what about the drink, drugs and
late nights that might entice a young,
single man with this kind of success?
in fact, these temptations are very far
from tom’s mind.
For the 33-year-old Londoner doesn’t
touch alcohol or junk food, and avoids
late nights when he isn’t working. his
dressing room demands amount to little
more than a simple meal of poached
salmon, broccoli and rice.
As for drugs, well, he does take some
— though not for recreational purposes.
tom is one of 115,000 Britons who have
Crohn’s disease, a debilitating condition
in which the lining of the digestive
system becomes inflamed and often
ulcerated, causing abdominal pain,
diarrhoea, fatigue and potentially
dangerous weight loss.
Flare-ups can be prolonged, leading to
many patients having to take more than
five weeks sick leave a year.
in tom’s case, not only has it led to a
lifetime of health issues and having to
take medication to keep symptoms in
check, but the condition nearly floored
his career just as it was taking off.
it almost cost him his life, too.
in 2010, severe inflammation resulted
in a perforated bowel and an infection
so severe it felt like he was being
stabbed. Doctors told him he was just
20 minutes away from death and,
ironically, the steroids he was prescribed
to ease his symptoms when he was firstBy AngelA
epstein
Picture: reTna/avalon.reddiagnosed — and which he took
for two years — may have been
partly to blame.
indeed, experts are now warning
that long-term use of steroids
does nothing to prevent Crohn’s
flare-ups and can, in fact, make
them more likely.
the warning follows a British
study of almost 2,500 patients
with inflammatory bowel diseases
(iBD), including Crohn’s, which
found there had been excessive
steroid use among participants.
Seven per cent of excess steroid
use is avoidable, say experts, while
2 6 per cent of iBD patients are
deemed steroid-dependent.C
ertAinLy, flare -ups —
which can cause abdomi-
nal pain, persistent vomit-
ing and diarrhoea — have
peppered tom’s career. he was
diagnosed while studying at the
Liverpool institute for performing
Arts — the ‘Fame’ school founded
by paul mcCartney 24 years ago.
‘i was going to the gp all the
time, as i was experiencing symp-
toms that included loss of appe-
tite and weight loss,’ he says. ‘it
built up and then seemed to
gather momentum.
‘i had no idea what the matter
was. i would go to a class and then
had to leave quickly because i had
to vomit. people thought i had an
eating disorder.
‘i’m 6ft tall and my weight
dropped to just 9st. in fact, i
have a photograph of myself
with paul mcCartney and i look
painfully skinny.’
After the diagnosis, tom was
prescribed steroids to help reduce
inflammation in his gut.
Steroids are often the first-
choice treatment for Crohn’s and
play a valuable role in inhibiting
the initial flare-up by reducing
inflammation, putting the patient
into remission. they can also beused to control the disease while
longer-term treatments, such as
m e d i c a t i o n t o s u p p r e s s t h e
immune system, settle in to work.
Steroids should not, though, be
given for more than six to eight
weeks, says richard pollok, a
consultant gastroenterologist at
St george’s hospital in London.
‘When a patient has a new
diagnosis, they should be given a
short course of steroids to see if
they get better. then, if there is
another flare-up, it’s time to con-
sider other treatments.’
there are worries, though, that a
lack of communication between
gps and consultants means some
patients are being given back-to-
back courses of the drugs.
Crohn’s charities say some
people may even be stockpiling
the pills at home in order to have
them ready in case of a flare-up.
‘there is also a huge number of
side-effects, which can affect any
system in the body,’ says Dr p ollok.
Steroids can, for example, switch
off the adrenal glands. these are
found above the kidneys and make
cortisol and other vital hormones.
Disabling them can cause bruising
and weight gain.
‘there is a risk of infection,because steroids are immune -
suppressants and work in a broad
way, and they also affect so much
of the body,’ adds Dr pollok.
‘there’s also a risk of cumulative
damage — patients may be more
prone to conditions such as
osteoporosis, because repeated
use can cause bone-thinning.’
tom’s perforated bowel was
another side-effect of long-term
steroid use.
in December 2010, and on the
brink of signing a record deal, he
collapsed at home in excruciating
pain and began passing blood.
‘While it felt like someone was
stabbing me, i also had this
strange feeling of numbness, as if
my whole body was shutting
down,’ he recalls.
tom was rushed to hospital,
where tests revealed that he had a
hole in the wall of his bowel.
‘it was all very dramatic,’ he
says. ‘i mean, how do you react
when the doctors tell you that if
they don’t operate, you’ll be dead
within 20 minutes?
‘i felt so ill, i couldn’t really
process it. Looking back, i realise
now how scary it was.
‘mum and Dad rushed to my
bedside. All i kept thinking washow it couldn’t have come at a
worse time. i had a lot of industry
interest; i had gigs booked.’
it turned out that tom had
developed sepsis, a violent over-
reaction by the immune system to
an infection.
he had a six-hour operation to
remove infected and ulcerated
parts of his bowel and appendix,
and it would be another two years
before he felt well enough to play
live again.
A perforated bowel is a rare
complication of Crohn’s, affecting
about 3 per cent of patients, but
long-term steroid use may raise the
risk. it isn’t clear how, but one the-
ory is that steroids disturb a layer
of cells that line the intestine, in
some cases leading to perforation.
Christian Selinger, a consultant
gastroenterologist at St James
University hospital in Leeds and
the lead author of a study on
excessive steroid use, says reduc-
ing over-prescription is vital.
And iBD UK, a partnership of 17
inflammatory bowel disease chari-
ties, royal Colleges and other
professional bodies, is calling for
the use of steroids for Crohn’s to
be tightly monitored.
in 2012, tom was prescribedhumira, one of a family of drugs
called tnF inhibitors that block
tnF-alpha, an immune system
protein responsible for the inflam-
mation of Crohn’s.
the drug seemed to settle his
symptoms and, after he made his
recording debut in 2016 with the
self-released Falling ep, interest in
him started to snowball.H
oWever, in April 2018,
three weeks into record-
ing his first album, tom
had a severe flare-up and
spent two months in hospital.
‘Unfortunately, it’s quite com-
mon for drugs like humira to stop
working,’ says Dr pollok. ‘it hap-
pens when the body’s own anti-
bodies start reacting against the
drug and block its effect.’
‘it was such a stressful time,’
adds tom. ‘i thought: “my career’s
taking off, how can i do this? Why
i s t h i s h a p p e n i n g a g a i n? ” i
couldn’t do anything, other than
play my guitar when i felt well
enough. it was an awful time.’
however, within two months of
leaving hospital, tom released his
album Collide, and went on to
play 100 gigs in 22 countries.
he is now taking a new drug
called ustekinumab. injected
every eight weeks, it targets two
proteins involved in inflaming the
bowel. the threat of flare-ups,
however, remains.
‘i don’t live my life thinking:
“What if?” ’ says tom. ‘But i have
to be so careful all the time — my
life couldn’t be any less like that of
the classic rock musician. i’ve
learned not to get overexcited or
stressed, as that has been linked
to the flare-up of symptoms.
‘i love what i do and i won’t let
Crohn’s stop me ever making
music or pursing my dreams.’
n Tom SpeighT’S debut album
Collide is out now.ThiS week: Cosmetic surgery
ToDay, it’s a multimillion-pound global
industry, but cosmetic surgery was born out
of the need to rebuild the faces of soldiers
seriously wounded in the World War I.
Harold Gillies, a New Zealand-born doctor,
pioneered surgical techniques to treat men
left disfigured by head and facial injuries
caused by shells filled with shrapnel, as they
peered over trenches during fighting.
after the Battle of the Somme in 1916, Dr
Gillies treated some 2,000 cases, specialising inrebuilding broken jaws and restoring the
shape of the patient’s face.
after the war he began refining his
techniques on civilians as well as military
patients, and his work was developed
even further during World War II.
By the Eighties, cosmetic surgery
— from face-lifts to tummy tucks — had
become a choice, rather than a necessity,
for many people, and today more than
2 0 million surgical procedures are
performed around the world ever year.military medicine
Medical breakthroughs that
began on the battlefield
Pop star
who only
takes drugs on
doctor’s orders
He’s toured with Ed Sheeran and
played with Travis. But Crohn’s
nearly destroyed Tom’s career...
Living the
dream:
Tom