“a case study of my experiences with pilonidal sinus disease, the harsh realities and what I did to fight and overcome my 18-month+ battle”
Before I get into the breakdown of the actual reality and issues we currently face with pilonidal sinus disease, it’s important I provide a timeline of my surgeries:
Surgery 1: Jan 5th 2022 – NHS
Surgery 2: Feb 28th 2022 – NHS
Surgery 3: July 22nd 2022 – NHS
Surgery 4: August 25th 2022 – NHS
Surgery 5: April 11th 2023 – Private (Dr Carapeti)
October, 2021. I had just been told I would need surgery for my pilonidal sinus’ (yes, plural). Anyone who knows me well knows just how much I hate hospitals, and in three months time, I would be in one, this time as a patient. To say I was petrified would be an understatement.
But what I didn’t know was that my life was about to completely change. I was about to enter an 18-month period of darkness. Pure, vacant, inescapable darkness. Never in my life did I ever believe I would feel and think the way I did when battling this disease.
I started with hope. I was told the recovery would be three to four weeks and I would return to my normal life again. When you hear those words from a surgeon, you believe them – in fact, you don’t ever doubt them. And I believe, in my heart, they believed it too.
This is the biggest problem with pilonidal sinus disease. There is so much misinformation out there that even the most qualified, bar a small minority, don’t really know what to do with these surgery options – and it’s the patients who end up suffering.
Before we start my journey, it’s important I say this for those who are struggling – it will get better. It does get better. You are not alone. It’s hard to believe me if you are going through something similar, but I am telling you from experience that this is a short, temporary moment in your life that will change. And I hope this case study gives you hope for what can be done to turn things around.
January 5th, 2022. My first surgery I had ever experienced. It was the first time I would be under general anaesthetic and I was full of anxiety. I arrived at the hospital in the morning and the surgeon came to speak to me. The first thing he did was reassure me, followed by examining what type of surgery he would be doing.
Straight away, he decided that he would be operating the closed procedure; this is where they take away the pilonidal sinus by cutting away the skin around the sinus and then stitching the wound straight back together again as part of the surgery. At this point, I was not made aware of any alternatives and I certainly was not aware that this type of surgery almost never works.
As I made my way to the operating theatre, I was absolutely petrified, but I knew in my head that if I could just get through this moment, in 3-4 weeks’ time, my life would go back to normal. Well, that’s what I thought.
I was discharged from the hospital around five hours post-op. I didn’t feel amazing but I was desperate to get home. Get away from what had just happened and start my short road to recovery.
As part of the surgery, they put a drain in the wound that I had to leave in for 48 hours. The idea is to collect all of the discharge and fluids that are generated from that type of procedure. It was a long 48 hours. Sleeping was near impossible and I was petrified that going to the toilet would rip open the stitches.
It’s a massive problem I want to highlight – the aftercare for pilonidal sinus. When I left the hospital, I had almost zero guidance for what to expect and the best approach for the recovery.
Somehow I got through that initial 48-hour period and found myself back in hospital to get the drain removed. I was waiting for a couple of hours before someone saw me. That was really tough – I couldn’t sit down yet, I was extremely weak from the past two days and was basically told to wait.
However, when I was finally seen, what followed next surprised me. There were a few nurses in the room, but none had ever seen the type of drain that I had attached to the wound. It did not fill me with any confidence at all. Surely this is a common, routine part of the recovery process for pilonidal sinus? That was my first clue that things were not going to be smooth sailing.
Eventually, they called a senior doctor to assess the situation and he removed the drain. That feeling was amazing. I thought that was it. All I had to do was wait for another few weeks and I would be back to full health. Ready to go play football with my friends, go back to work, or even just sit down again.
Well, that’s what I thought. Long story short, I had multiple issues. Due to the closed procedure I had, the wound was not able to heal correctly. I knew something was not right as the pain was getting worse inside and I did not feel like any progress was being made. After multiple visits to the GP – who said I was fine and the wound looked great – I eventually found myself outside A&E in an extremely bad state.
February 27th, 2022. After several courses of antibiotics and multiple unscheduled hospital visits, I arrived at A&E in the worst physical (and mental) state I had ever experienced. Something was not right inside of me. My wound had opened at the bottom, was leaking blood and pus every day and I could barely eat. I was told this was normal and part of the ‘remodelling’ phase. I have now come to realise that this couldn’t have been further from the truth.
Anyway, when I arrived at A&E, I could barely walk. I had no energy, I felt extremely light-headed and, because I could not sit down, I had to stand up and wait. I am so thankful that I had my Mum to help me in this situation. She had to hold me up to prevent me from falling to the ground and those few hours of waiting was a scary experience.
Eventually, I was seen, given a bed and told I would be having surgery first thing in the morning. I will never forget that night for as long as I live – it was absolutely horrifying.
I was alone, I was weak and I was begging to just go home. I couldn’t stop crying. I was a complete mess. Going through the first surgery was tough enough, but now I found myself having to go through it again – only this time my body was weak and trying to fight off what was happening inside of me.
The morning finally came (after absolutely no sleep) and I was taken to the operating theatre. The nurse who saw me in the morning was trying her best to help me, but it was too late. The surgery took place and the next thing I knew, I was awake in a room full of other recovering patients.
This time for the surgery, they opened up the top and bottom of the stitched-together wound. I was told that this would allow all of the fluid and infection to drain out and it would heal nicely together again.
I remained in hospital for two days following the surgery. I had to be given antibiotics and fluids on a drip every few hours throughout the night, so I was still exhausted. Eventually, the two days came to an end and I was finally back home – once again full of optimism that this would be the final road to recovery.
The first couple of weeks were extremely tough. I had to go to the walk-in centre every day to get my dressing changed. As I now had two open wounds, they both had to be packed. Originally, I was told it should be packed with aquacel ribbon, and that’s what I did the first day, but I cannot describe the pain exerted on me. I was told it could be painful the first couple of weeks, but I did not anticipate it would be that painful – I would later realise that this pain was something else.
A couple of days later I went to a different walk-in centre as the waiting times were shorter. I saw a different nurse who told me about using a gel called ‘Flaminal’ instead of packing with aquacel. The point of using Flaminal is that it still absorbs the exudate from the wound, but it also protects it from infection. There were two different types – Forte and Hydro. You can read all about the Flaminal gel and take a closer look at what they do.
One thing you have to be careful of is the overgranulation of the tissue in the open wound. I will speak more about this at the end of the case study, but effectively you need the wound to heal slowly from the bottom to the top and not allow it to overgranulate.
However, I was not aware of any of this and kept putting the gel on every day as instructed – well, my Mum was, I can’t take the credit for that! Eventually, the smaller wound at the top overgranulated, but then the nurse, effectively, rubbed away the overgranulated tissue and it healed within the next few days.
The same cannot be said for the bottom wound, though. This one continued to bleed, leak a lot of fluids and really struggled to heal. It was starting to affect me again mentally. Staying optimistic and positive when this is happening is close to impossible – actually, it is impossible. I was not living a normal life. I did not feel like a person. I felt disgusting, I felt so abnormal. I still couldn’t sit down or carry out my usual daily routine that most are not even conscious of.
Problems continued for months. More trips to A&E. More trips to walk-in centres. There was clearly still an issue that was not addressed inside and I started to lose hope. And that takes me into July of 2022…
July 22nd, 2022. Surgery number three. Here we go again. The never-ending cycle was set to continue – but surely this has to be the last time, right?
I went to the hospital for a check-up the day before. I knew something was wrong. I was seen by a consultant around midday and she told me that I would require surgery again. It shattered me. I broke down. At this point, my mental state was the worst it had ever been. I’ve never said this to anyone before, but I want to get the seriousness of pilonidal sinus disease across to everyone reading this – I did not want my life to continue anymore.
And that petrified me. The fact I could acknowledge those thoughts at the time and still consider certain options was an extremely frightening moment. But then my Mum, who had been by my side the entire time since January, reassured me that I would beat this and we could get through this. We were going to beat this. Together.
The next day arrived and I was told to make my way to the hospital in the morning for surgery. I ended up waiting on some random hospital bed for the entire day as I was put last on the list. I had already stopped eating and drinking the night before (as you have to when going under general anaesthetic), so by the time the evening came, I was extremely weak and dehydrated.
But I got through it. The procedure was called an ‘incision and drainage’. This basically made the bottom wound go back to square one and I was told by the surgeon that it would heal now it had been cleaned out effectively. It was a fresh start and time to beat this once and for all.
Well, fast forward just one month and I found myself back with the same problems again. The wound was exudating lots of fluid and progressively getting worse each day. I didn’t have the energy to fight anymore. I was defeated.
But one thing that did change between my third and fourth surgery was my GP nurse. A new team arrived at my GP and instantly I was seen with amazing care. There were two new nurses who saw me and went above and beyond to keep on top of things. I look back now and those two arriving to help me was the best thing that could have happened – but more on that later.
Two days prior to my fourth surgery was my A&E visit. I waited for hours before being seen and was eventually taken through for my blood tests. I then returned back to the waiting room for another lengthy period of time before I was examined.
This time was different. The consultant who saw me was a general surgeon, but he also inherited a sub-speciality interest in colorectal surgery. This was it. This was the break I needed. A surgeon who knew what they were doing! At last! (Spoiler alert, it didn’t work).
August 25th, 2022. As I arrived at the hospital in the early hours of the morning, I saw the surgeon who explained what procedure I was about to have. He mentioned that my current cavity was “filled with pus” and the best thing to do was to clear out the infected area and suture it together while creating a new, separate wound to the side.
The idea was to make a pathway for the infection to clear out naturally. The inside area that was
not being addressed had ‘finally’ been sorted. The surgeon was full of confidence that he had identified the root of the problem and that this was the solution.
It ended up being the biggest surgery of the five. Once again, though, I had renewed hope. Hope that this really would be the final hurdle to overcome. I went into the surgery with a positive mindset and actual confidence in my surgeon.
The day after the surgery I went to my GP practice, just about managing to get there, lying on my side in the passenger seat of the car. I was told the new wound to the side was around 7cm long and very deep. It did scare me knowing that I now had two separate wounds to manage, especially one of this size and depth.
I wanted to read a part of my GP notes two days before the surgery to, once again, highlight the significant mental damage that pilonidal sinus has put onto my life: “ I called Frankie to see how he got on yesterday [at the hospital].
“He saw the surgeons and has to have repeat surgery again. Patient is feeling rather low – will keep an eye on his mood and report further deterioration.”
At the time of feeling so low, it’s now very clear to me how apparent it was to others. I would go to the GP and tears would fall from my eyes while my wound was examined. Silent, but uncontrollable tears. When you have 24 hours a day, seven times a week, to lay in your bed and think – it is one of the most dangerous mental positions a person can find themselves in.
However, this surgery, as I mentioned before, felt different. The original wound was stitched together and I now had a large but clean wound to the side to act as a natural drain. I am not a religious person, but I found myself praying every day that the stitches had remained intact and the wound was looking healthy.
I also had my new GP nurses by my side. And they both went above and beyond. One of the nurses was granted permission to come to my house to do my wound dressing as I was really struggling to get to the GP practice. Someone was taking time out of their weekend to make sure I was seen too. That’s something amazing that I can take away from this horrible part of my life – I will always be so grateful for those two and what they did for me.
One week after my surgery, I was back at the hospital with an appointment with the surgeon. I was told everything was looking great and I would return in one week’s time to have the sutures removed.
That was a painful 30 minutes. The sutures had nested into the skin, which made it incredibly hard to remove them. After the four surgeries and countless general anaesthetics, I asked the surgeon to just remove them without any anaesthetic inside of me – all I had in my mind was to get those sutures out and continue on my positive healing journey.
And then I was free. I walked out of the hospital in pain, but this time it was a different pain. For a brief moment, a smile appeared on my face. A smile that meant so much. It was now, once again, a waiting game. Once the new wound to the side healed and the original one remained together, it was time to get my life back again.
But then came the deterioration. Day by day, I started to feel no difference in how things were going. The bleeding returned just a couple of weeks after the sutures were removed. The wound was slowly coming apart. Pus and fluids started to come from the original wound and I was put back on antibiotics at the start of October.
While the main wound was collapsing, the new wound to the side healed excellently. It’s so difficult to judge; one day I was bleeding heavily and fluids leaking, the next it was settled and I started to get hopeful again. But that’s all it was – hope. It was never going to heal, I just couldn’t see it at the time.
The most frustrating thing was that I was being seen by the surgeon once a month post-operation. Each visit I raised my concerns and they were, pretty swiftly, disregarded. I started to doubt myself and what I knew. Could this just be part of the healing? They can see the wound better than me, so surely it must be fine?
And this went on for the rest of 2022. I was slowly losing hope, day by day, and it was getting to a point where I felt like I had lost the battle. No longer was I having fluctuating days with bursts of optimism or happiness, just a straight line of continuous darkness and, above all, sadness. All I wanted was normality. All I wanted was to see Izzy (my girlfriend, who was absolutely incredible throughout the entire process) happy too. It was so hard pretending to be fine when I was with her. But she knew.
In November, we started to get desperate. My main GP nurse referred me to be seen by a Tissue Viability Nurse (TVN), which is incredibly difficult to get. We had to send them pictures and explain my situation. We had tried this before but they rejected our request.
At the time of this second referral, my GP notes said: “I am awaiting contact from TVN so we can decide how best to proceed as we don’t seem to be getting any further forward.
“Frankie is understandably concerned but I have reassured him that there is no sign of infection at present.”
Unfortunately, TVN once again refused to see me in person, but this time they sent me a wound care plan. They wanted me to switch to ‘Octenilin’ wound gel instead of Flaminal. They also stated to use a ‘Cavilon’ Spray, which acts as a ‘barrier’ for the wound. So, just before Christmas, I was on a new plan and, once again, a short, abrupt wave of hope and optimism surged through my body. The fire wasn’t completely out yet, and I had to keep going. I had to find the spark from somewhere.
And the first two weeks of the new wound care regime were the first time I felt momentum shifting. The bleeding slowed down, the exudate slowed down and we were seeing visual improvements. Marginal improvements at that, but it was something. The wound started to create fibres going across, which is what it does when it is trying to close together. It was trying so hard to close and heal, but there was just something stopping it.
At the time, I was just being patient. I told myself that it would come together and heal. I demanded it. I spoke it out loud when I was in the shower. I was going to beat this and we were so close to the end now.
But that, unfortunately, wasn’t the case. As I entered 2023 with renewed optimism, it wouldn’t be long until the slow mental deterioration would creep back upon me.
I want to also get across the point that it wasn’t for a lack of trying. I was so careful with my diet. I had not touched alcohol since the very first surgery. I don’t smoke. I was providing my body with healthy food every day to give myself the best chance of healing.
After some encouraging signs from switching to the new aftercare routine from the TVN, the healing stagnated. The wound was stable, but it remained in a state of being close to healing. Fibres continued to build across and then break. No matter how attentive we were, it just was not progressing to the next, crucial phase of healing.
I then started to encounter bleeding problems again, and that’s when my mental state reached the lowest point of this entire recovery process. I was heartbroken. For so long had I forgotten what hope or progress looked like, that when it greeted me again, the effects of it being taken away from me were heightened.
I was a mess going into the GP practice. Once again tears had returned with no real emotion behind them. My face was a blank canvas and inside me, everything had collapsed. I had no motivation for anything or anyone. For the first time, I had accepted my fate. This was my life now. There was no escaping the surrounding darkness.
But then a flicker of light emerged, and I have one of my GP nurses to thank. I was more than a patient to her and she was more than a nurse to me. After the recent shift in my mood, she demanded that I be seen in person by someone from TVN. It wasn’t a request this time – and she told me that they may just have something that could shift the momentum back into the right direction.
February 16th, 2023. This was the day I was seen in person by the TVN. During the visit, I was recommended something called ‘metronidazole 10%’ as a healing cream. It’s something the TVN had heard of success with wound healings for pilonidal sinus. However, it was something that could not be bought on prescription, so I went away to research it and see what I could find.
And what I tell you next, you could not write.
When searching ‘metronidazole 10%’ on Google, I found an article on a clinical trial of the drug for a case study of non-healing pilonidal sinus open wounds following surgery. There were 80 participants, all adults and in the same situation as myself. But there were no results online for the trial, so in a desperate attempt, I emailed the contact address saying:
“Hi there,
I am currently someone who is faced with a non-hearing pilonidal sinus wound.
I have had 4 surgeries and now I am trying to heal the open wound in the cleft area.
I am now tempted to try metronidazole 10% after seeing this study, but I cannot see the results.
Please could you tell me what the results were for this trial and whether you would recommend I do this? I have been trying to recover for over a year and I’m desperate.
Thank you so much,
Frankie.”
I got a response from Justin Slagel first thing the next morning. They were testing a topical ointment called ‘Ortem™’ that they developed with a surgeon specifically to treat non-healing pilonidal sinus wounds.
The most surprising part of this? Justin lives in the same town as me. This was a massive breakthrough. I was referred to see Dr Carapeti, who now operated privately, in London for a consultation and if he saw fit, he would provide me with Ortem™. This was a different feeling from before. Being seen by a specialist who developed a cream specifically for the situation I found myself in.
I booked in to see Dr Carapeti on March 7th, 2023, a date that was about to finally change the course of my future – and for the right reasons. Justin also, extremely generously, offered to pay the initial consultation fee for this appointment. Justin was amazing from the very first email and he instantly understood the situation I was enduring when we spoke on the phone.
When the day finally came, I made my way to London Bridge full of nerves. My heart raced every stop closer on the train. Once again my Mum was with me, as she was every step of the way. This was the first time I felt like someone was going to know what was actually wrong with me.
And that’s exactly how it played out. Dr Carapeti looked at my wound and within two minutes realised the issue. There was a tunnel connecting both wounds and it was never going to heal inside. He told me I would require surgery, but he knew exactly what surgery I needed and he would provide me with Ortem™ and the correct aftercare instructions.
It was a bitter-sweet moment, but the most important conversation of my life so far. Dr Carapeti gave me Ortem™ and told me what to do from now until the surgery date. The most crucial thing he told me was to digitate the wound.
Wound digitation is something I really want to highlight to anyone in my situation. Previously, I was told not to touch the wound and leave it to heal by itself – this is simply the incorrect information. Wound digitation is when you get your finger and rub up and down on the wound. The wound may bleed to start with, but it prevents overgranulation and allows the wound to heal slowly from the bottom up.
Please, if you are in my situation, you have to digitate your wound. I will explain more about how I did it following my fifth and final surgery…
April 11th, 2023. Surgery number five. Once Justin found out I would require treatment, he offered to cover the cost of the surgery and aftercare. I will never forget such a moment of kindness and generosity. He allowed me to be seen and operated on by Dr Carapeti. And the whole experience was completely different to what I had experienced before.
When I arrived at the private hospital, Dr Carapeti explained what the surgery would entail and what he planned to do. He was going to sort the tunnel problem inside and provide the correct open wound base for healing. He offered me a level of reassurance I had not received before and explained exactly why he was doing the surgery he was. I finally had confidence that this was going to be my final surgery and we could see something happen in this recovery that we had not yet seen…actual recovery.
For the aftercare this time, I was told to apply Ortem™ once a day onto an Aquacel strip (not ribbon) for the early phases of healing. After one week, Dr Carapeti told me to start wound digitation again. I stuck to his requests rigidly. I followed the same process daily:
Go to the toilet. Digitate the wound in the shower with my finger. Apply Dermol 500 Lotion to clean the wound directly and wash it away with water from the shower head. Dry the area by patting it dry with non-sterile gauze swabs. Apply wound irrigation solution to the wound and pat dry again. Apply Ortem™ to the Aquacel strip and place it just inside the wound. Cover with a Mepore dressing.
That routine was my daily process. Nothing stopped me from doing this every day until I saw Dr Carapeti two weeks after surgery.
And when I did see him, Dr Carapeti was happy with the progress. He now wanted me to continue with the Ortem™ cream on the wound but I did not need the Aquacel strips anymore as the wound had now gone past the exudate phase and Ortem™ was enough with a dressing.
So I did the exact same routine minus the Aquacel strips. Dr Carapeti wanted to see me again in two weeks and that visit was even more positive.
The wound was healing. I noticed it. My Mum noticed it. My girlfriend noticed it. My GP nurses noticed it. But most importantly, Dr Carapeti confirmed it. On the second visit, which was four weeks post-surgery, he actually wanted to slow down the healing as it was going so well and he wanted the wound to heal at a pace that would allow it to come up slowly from the bottom. I was told to ease off using the Ortem™ and continue to digitate every day.
I could not believe what was happening. Every day, the wound looked clean and edged closer towards closing. I was told it would take 8-12 weeks to fully heal and I was ahead of schedule. Once again my diet remained consistent full of healthy food, high in fibre and plenty of protein. Nothing was going to stop me this time – this was the final stretch.
June 1st, 2023. My third visit to see Dr Carapeti post-surgery came seven weeks after the initial operation. I could not believe the words that were spoken to me. I still can’t quite believe it now.
“The wound has healed.” What? This did not make sense. I could not believe it. I went into a state of shock, followed by a smile that had not been seen for over 18 months. I thanked Dr Carapeti, repeatedly trying to emphasise the point that he had no idea what this meant to me.
But he did understand, which is the harsh and sad reality of pilonidal sinus disease. This cruel condition is something that spreads wide across the world and the UK does not have the correct information for surgery and aftercare.
I followed my visit up with an email to Justin. It said:
“Hi Justin,
I hope you and your family are doing well?
I saw Dr Carapeti on Tuesday and got great news again! The wound has closed and healed. He said it may come apart when doing exercise and stuff but that is normal and it will just be part of the remodelling phase.
He is seeing me again in 2 months to check the progress and offer me advice for laser hair removal treatment around the area.
I really cannot thank you and Dr Carapeti enough. I’ve finally started to live my life again. I went on my first run, my first bike ride, and now I’m driving again!!
Even sitting down for dinner is a massive thing for me, so thank you.”
Everything about the timing of this seemed too good to be a coincidence. The football team I support, West Ham, had reached the final of the Europa Conference League – a match against Fiorentina on June 7th. In my calendar, I circled the date of eight weeks post-surgery like I was told. That date? June 6th. Everything fell into place in my life. I bought tickets to the final with my brother on the smallest of chances that I would be able to attend the match in Prague. As soon as I was told the news, we booked our flights and travelled out on June 6th, the day circled on my calendar.
What made me think that everything was meant to be was the fact that we won 2-1 with a 90th-minute winner. West Ham had won their first major trophy in 43 years and I was there with my brother to witness it. We became European champions in dramatic fashion and that day remains one of the best days of my life. I stood there in the stands crying, but this time it was tears of joy, jubilation, happiness. It was just so perfect and I never wanted the moment to end.
Two months later I saw Dr Carapeti and told him that the wound remained healed and I continued to live my life again. I could put my own socks on. I could sit down to eat my dinner. I could drive my car. I could smile again. He told me he was so happy for me, shook my hand and discharged me.
It was the end. We had done it. Months of suffering were resolved in two months by Dr Carapeti and Justin with the help of proper aftercare and Ortem™. I still think back to the moment I decided to search on Google for answers to the Metronidazole 10% treatment. It was a moment of desperation that changed my entire trajectory.
I am now about to start laser hair removal treatment around the wound to reduce the risk of recurrence. It’s something I hope to be able to discuss next year in more detail for those also looking at this option.
My final message to anyone is that this is not something that defines you. There are countless days of feeling like this will never end, but please never give up. You will beat this. If you are UK-based, go and see Dr Carapeti for a consultation. He will have the insight and knowledge that you just might need.
Ortem™ is currently available as an unlicensed medicine as it undergoes a Phase 3 clinical trial. If you think that Ortem™ would be suitable for your treatment, please contact your doctor who can prescribe it on a ‘Specials’ basis. This means that Ortem™ will be charged as a regular prescription.
More information regarding Ortem™ is available on the SLA website.
Every person and situation is different, but what remains a constant is the unspoken problem of pilonidal sinus disease. I am determined to make a change and if just one person reading this case study takes something positive away from it, I will be happy.
If you have any questions at all, or you just want someone to speak to, get in touch with me – frankie.levin@gmail.com. I know exactly how difficult it can be and if I can help in any way possible, I will.
Remember – it will get better. It does get better. You are not alone. Pilonidal sinus disease will not defeat you, it will simply be a small period in your life that becomes a distant memory.
End Notes of Recognition:
I want to say a massive, indebted thank you to both Justin Slagel and Dr Carapeti. Without their generosity in paying for my treatment and providing me with the correct aftercare and information, I would still be struggling today. Nothing I can do will ever repay that, but from the bottom of my heart, thank you.
Thank you to both of my GP nurses (you know who you are!) You both went above and beyond to ensure I was seen, even if I did not have an appointment or if it meant coming to my house to care for me post-surgery. You are both absolute stars and I will always hold a special place in my heart for you.
Also, my girlfriend Izzy. You stuck with me throughout the entire process and I know it was not easy for you. Once again, nothing I now do can show the gratitude and appreciation I have for you, but it’s made me love you even more as a person. I am so lucky to have you by my side and we can finally live our lives again!
I wanted to give a special mention to my Nan, too. She would take me to the GP surgery when my Mum physically couldn’t and it meant a lot to me having you by my side. Thank you, thank you, thank you.
And last but not least, my Mum. Not only did you give up your own life to care for me, I know exactly how hard this process was for you. I never wanted you to see me so upset and I would not have been able to get through this without you. You sacrificed so much for me and I know you would do it all over again if you had to, which is what makes you even more special. I will never be able to give back what you gave me and have given me my whole life, but I will always be there for you if you ever need me. Thank you so much.