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Trial drug saves patient just ‘two days from death’

12 March 2019

Health Care

Sixteen months ago, Alexander Farmer and his family felt like they were staring death in the face. The 65 year old from Rayleigh couldn’t walk, had difficulty breathing, had chronic heart failure and was told he was only 48 hours from death when he was admitted to Southend University Hospital…until he was offered a new research drug at the Essex hospital.

Mr Farmer was enrolled in the TRANSITION trial in October 2017, after he was admitted onto the Critical Care Unit (CCU) with end stage heart failure. He was grossly overloaded with fluid and was barely conscious. His kidney function had significantly deteriorated and he had a very low blood pressure.

That heart disease is still here, but so is Alexander. He explained what difference the dedication of staff and the drug have made to the lives of him and his family.

He said: "I've gone from not being expected to leave hospital alive to now having some quality of life, which I just didn't have for so long. Before, I couldn't breathe, couldn't walk more than a few steps and spent much of my time in a wheelchair. I just can't thank everyone enough for their care and for giving me and my family this opportunity, this time that we thought I would never have."

By all accounts Alexander has made a remarkable recovery and leads a better quality of life after starting a new heart failure medication, Entresto, as part of the TRANSITION trial, run by the Cardiology department at the Trust.

Mr Farmer's case highlights the benefit of patients being involved in research trials. They get the benefit of close and regular follow up and the collaboration between the research team and the clinical heart failure nurses has ensured that he has obtained optimal treatment and management for a very difficult and debilitating heart condition.

With the ongoing support from research and the heart failure team he now leads a better quality of life and is able to even go on short trips in the UK with his family with the help of his mobility scooter which he was unable to use before.

Leading the trail is Dr Thuraia Nageh, a consultant cardiologist at Southend Hospital. She said: "Mr Farmer's case is a great example of how we can benefit our patients through clinical research, in collaboration with the clinical services we provide in the Cardiology department. He was a patient with very advanced heart and kidney failure, barely conscious and was not expected to survive for more than a few days.

He hasn't needed admission to hospital for well over a year, a rarity in patients with such advanced heart failure. The key has been early intervention, optimal medical management, education of the patient and his family and the close collaboration between all the relevant teams involved in his care."

The involvement of both the research team and the clinical Heart Failure team has made a dramatic and significantly positive impact to Mr Farmer and his family, by ensuring close monitoring, patient education and support. A key part of that support has also been his family, especially that of his wife, Carol.

Carol Farmer said: "We've had lots of help and support regarding nutrition education from the doctors and nurses, I have always made our meals from scratch but with the nutritional advice provided I have made alterations to ensure a sea salt, low potassium diet so we know exactly what is in each meal.


"I'm also checking Alexander's weight, blood pressure and fluid daily and this is logged daily to show the medical staff. It's a real team effort between us and the amazing staff at the hospital and they are just so supportive. If there is an issue I know I can just give them a call.

"We are now able to go away, something we couldn't do before, the scales and blood pressure machine are just part of our luggage now. Every day is a blessing, I can't thank Dr Nageh and her team enough for turning our lives around and giving Alexander a second chance."


Images: Carol and Alexander Farmer

Group picture l-r: Dr Thuraia Nageh (Consultant Cardiologist and Clinical Research Lead for Cardiology); Mr Alexander Farmer (patient); Kirsty Dangerfield (Heart failure Nurse); Gemma Smith (Heart failure nurse); Helen Bailey (Heart failure nurse).