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Vomiting query

  • Jeanine Helliwell
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9 years 3 months ago #129458 by Jeanine Helliwell
Vomiting query was created by Jeanine Helliwell
Hi, I have have been unwell for some time and off work much of the time since november so finally listened to the medical team looking after me to not work for some time. I have applied for ESA and sent the form off today.

I have been advised to apply for PIP and looking at the criteria I wonder if someone can help me clarify a couple of points.

I suffer from Crohn's and severe gastroparesis (stomach doesn't work basically and so if I eat it just sits there until I vomit). This has caused severe anaemia and i have recurrent infection of my oesophagus. I also have immune deficiency. I have been in and out of hospital for the last 3 years for Crohns, gastroparesis and severe sepsis including ITU stays.

Currently the main issue is eating/vomiting and resulting dehydration and fatigue. I have a BMI of 14. I have a nasojejunal feeding tube which is used to enterally feed me overnight, during the day I am encouraged to eat to prevent the gastroparesis spreading to my small bowel and me ending up on parenteral nutrition. But this means that I vomit a lot. Every day. I am mostly ok in the morning but by mid afternoon so nauseated I can't face food or prepare it for me or my family. I struggle to go out in the afternoons as I end up vomiting and if there is no toilet available I am just sick where I am, so embarrassing. Often this is all over myself as I try and get somewhere more discrete.

My questions are-
Does vomiting count as evacuating your bowel as the small intestine and stomach are part of the bowel? This would mean I would fit 'spontaneous evacuation of the bowel'. Not sure.

I could not travel by public transport as i need a toilet. I have been sick on a train in the past that had no toilet…never again. I am sure everyone thought I was drunk. The thought of going on a bus or train fills me with horror.Can I count this as a reason I cannot undertake a journey.
The way I get out is starve myself-don't eat or drink so that it reduces my risk of vomiting

Often I am sick at night, sometimes the bedclothes need changing for that and sometimes the feeding line leaks all over the bed sheets- my husband has to help strip the bed on a regular basis. Does this count for any points as it is vomiting?

Sorry for the long post. I don't want to go through the hassle of applying and the nightmare of attending an assessment if I have no chance of getting anything. Any advice, clarification would help as I have been trawling the internet and this site and cannot find anything like my case as it is really uncommon.

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9 years 3 months ago - 9 years 3 months ago #129461 by Gordon
Replied by Gordon on topic Vomiting query
JH

Welcome to the forum, you might want to have a look at the following FAQ which explain where everything is

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I've answered your specific questions first but I think you may be approaching this from the wrong direction.

I think you may struggle to argue that the stomach is part of the bowel and that vomiting is therefore akin to the evacuation of the bowel, however, that does not stop you arguing that this is the case, I just would not rely on this being your sole approach to the benefit.

Also, PIP Mobility is covered by two questions; Going Out which is primarily concerned with mental health or cognitive issues which prevent a person leaving their house or planning or following a route and Moving Around, which is concerned with a persons ability to walk. The latter will certainly not fit to your problems and I think you will struggle to show that the former does.

All of that said, this does not mean that you cannot qualify for PIP, you seem to be trying to qualify for PIP on a single Descriptor where in fact (and this applies to ESA also), an award will be made based on your scores across all of them.

Also, you are concentrating on the actual conditions themselves rather than the assistance you need as a result of them, you don't mention this in your post so it is unclear whether this is not a problem or something that you have overlooked.

So based on your post, you should also have a look at the following Descriptors; Eating and Drinking, Managing Treatments

On a broader view, if you have not done so already, have a look at our PIP Claim guide that explains in detail how each of the Descriptors for PIP operates. See

www.benefitsandwork.co.uk/help-for-claimants/pip

Also, you should have a look at our ESA Claim guides in regard to your ESA claim.

www.benefitsandwork.co.uk/help-for-claimants/esa1

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 9 years 3 months ago by Gordon.
The following user(s) said Thank You: Jeanine Helliwell

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  • Jeanine Helliwell
  • Topic Author
9 years 3 months ago #129471 by Jeanine Helliwell
Replied by Jeanine Helliwell on topic Vomiting query
Thank you Gordon. I had read the guidance but clearly I am a bit dense.

So I think I understand what you mean. Rather than say the effect on me that my illnesses cause, I need to explain what help I require because of them and their effects
So for eating and drinking an preparing food, I would explain that my husband has to do the cooking, if he didn't spend his time nagging me I wouldn't eat and at times I can't eat at all anyway.

He also has to drive me on many occasions, and get me to appointments, change the bedding at night, give my injections (because I am a wimp!). I can't go somewhere new without him and sometimes I won't go out anyway because I am too unwell or I am too anxious to do so, so he goes out instead. I pretty much don't socialise with others anymore.

Are these the sort of things that will get me some points then, or is it just that PIP doesn't take into account my type of illness. Bit of a bugger if it doesn't because it has pretty much limited anything I do and wrecked my life.

Thank you again.

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9 years 3 months ago #129484 by Gordon
Replied by Gordon on topic Vomiting query
JSH

PIP looks at the care needs that a claimant has, you do not need to be receiving the care to score points, just have a reasonable need for it, so yes, if you need your husband to prepare food and to prompt you to eat it, to help you with your treatments, then these are areas that you could score points for. There may well be other, they just stood out from what you had posted.

However, you need to show that you cannot do these things yourself, PIP looks at what you cannot do, rather than what you choose not to do, so you must be clear on the form as to what your restrictions are and why.

Have a look at some of the sample answers in the guide, whilst these won't match with your specific problems, doing so will help to explain what I mean and also help you to phrase answers that are relevant to you.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems

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  • Jeanine Helliwell
  • Topic Author
9 years 3 months ago #129876 by Jeanine Helliwell
Replied by Jeanine Helliwell on topic Vomiting query
Thankyou for your comments.

I found out today that I have been put into the support group for ESA with no medical but I realise after reading your guides this has no influence on PIP with it being a different type of benefit. But I now have the PIP application to contend with.

I don't want to put down anything wrong in the PIP form which I now have to complete and can't find the answer in the guides, so if you could answer a couple more queries I would be grateful.

Regarding 'Managing therapy or monitoring a health condition'. To work out the time my husband spends assisting me for 'Needs supervision, prompting or assistance to be able to manage therapy', can travelling to pick up my supplement drinks from the chemist count?- I cannot pick up and carry the cate load of feeds that I get fortnightly. (about 40-50mins for the trip)
He does also help flush my portacath and give me daily injections but I am not sure how long I should put down in hours.

Also I assume that the help he gives me to sort out my enteral feeding can't be in this section as well as the managing nutrition section? Is that correct, or can it be both as the enteral feeding is part of my treatment. (though this feed is delivered by the company that provides it).

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9 years 3 months ago #129877 by Gordon
Replied by Gordon on topic Vomiting query
JSH

Answering your questions in reverse order :)

Please do not assume that just because you mention a limitation in one section that you cannot do so in another, there is no such restriction in the legislation.

As a general comment the Decision Maker will have no medical training and it is quote possible that the assessor will have no first hand experience of your conditions, so it is down to you to argue what is relevant in regard to your problems. Don't try and second guess them as to what they will accept or not, all you will end up doing is putting forward a less than 100% case that you should be awarded PIP.

In the same vein in answer to your first question you should include those things that you believe to be relevant, so if you are unable to pick up your food supplements and it is not reasonable for it to be delivered then you should consider including the time and effort involved as part of your answer for managing therapies, just remember to explain why cannot do something yourself.

In regard the injections and other assistance, think not just about the time it takes to perform an action but also what preparation is required and whether monitoring of your condition is also involved. In your first post you talk about having the feeding tubes in overnight, do you need your husband to be with you during this time in case there is a problem, does he have to be there when the tubes are taken out? You can argue that this is also time that needs to be included in this category. Again remember to explain the problems you would have if he was not there.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems

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