Tom Speight should be living the rock-star dream. The critically acclaimed singer-songwriter who has worked with Ed 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 Speight – the critically acclaimed singer-songwriter who has worked with Ed Sheeran, Travis and Keane – is fast becoming one of the UK’s top artists
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.
Tom (pictured) 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 first diagnosed — 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 26 per cent of IBD patients are deemed steroid-dependent.
Certainly, flare-ups — which can cause abdominal pain, persistent vomiting 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 symptoms that included loss of appetite 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.’
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
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 be used to control the disease while longer-term treatments, such as medication to suppress the 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 consider 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.
In December 2010, and on the brink of signing a record deal, Tom collapsed at home in excruciating pain and began passing blood
‘There is also a huge number of side-effects, which can affect any system in the body,’ says Dr Pollok. 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 was how 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 theory 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 reducing over-prescription is vital.
And IBD UK, a partnership of 17 inflammatory bowel disease charities, Royal Colleges and other professional bodies, is calling for the use of steroids for Crohn’s to be tightly monitored.
In 2012, Tom was prescribed Humira, one of a family of drugs called TNF inhibitors that block TNF-alpha, an immune system protein responsible for the inflammation 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.
However, in April 2018, three weeks into recording his first album, Tom had a severe flare-up and spent two months in hospital.
‘Unfortunately, it’s quite common for drugs like Humira to stop working,’ says Dr Pollok. ‘It happens when the body’s own antibodies 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 is this happening again?” 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.’
- Tom Speight’s debut album Collide is out now.
Military medicine: Medical breakthroughs that began on the battlefield
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 in rebuilding 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 20 million surgical procedures are performed around the world ever year.