You can be referred at any stage of your baby’s admission to NICU.

If you would like to be referred, please ask any member of your hospital care team such as your baby’s nurse.

• You will be contacted to arrange a time to meet, either in hospital or via phone/video call if you prefer.
• The psychologist can see you on your own or with your partner or other family members. It is your choice.
• If you require an interpreter, please let us know.
• The first meeting is an opportunity to talk about what is most challenging for you. We can think together about what might support you while your baby is in NICU.
• There may be a small wait for appointments.
• Sometimes we have trainees working in the team, all of whom are supervised. We will check first to see if you are comfortable meeting with a trainee.
• Sometimes, it may be enough to meet with a psychologist once or twice, other times you may wish to meet more regularly.

Any information you share with the psychologist is confidential. This means it will not be shared without your permission unless there is concern about risk of harm to you, your child, or others.

Parents sometimes find it useful to share information with the clinical team to help them understand the best way to communicate with you, and care for your baby.

Notes from your conversations are documented in your hospital record, this is separate to your baby’s medical notes. A brief record of contact is made in your baby’s medical notes to the clinical team are aware the psychologist has met you.

The decision to use the psychology service is entirely up to you. If you decide not to, it will not affect your baby’s care.

This page on the North Bristol NHS Trust website has links to many organisations who provide support and information to parents of babies in the neonatal unit: NICU Useful Links | North Bristol NHS Trust

South West Neonatal Network 

The South West Neonatal Network have put together virtual tours of the neonatal units in the area as well as the ambulances that transfer neonatal babies in the region. You may find this useful to look at before your first visit: SW Neonatal Units — South West Neonatal Network

You can contact our team Monday to Friday (excluding bank holidays) 09:00 to 16:00 on 0117 414 6818. 

You can ask any of your baby’s care team to contact us on your behalf and they will be happy to help. 

We hope you are pleased with the psychological service you receive.  

Our service is continually developing and reviewing our practice so we can ensure families receive the best support possible. 

When your support from our service comes to an end, you may be asked if you are happy to be contacted for your feedback and views on how the services can be improved. 

If you have concerns about the service you receive from the psychologist, please discuss them with the psychologist or another member of the NICU team. 

If this does not address your concerns, please contact the Patient Experience Team on 0117 414 4569 or email pals@nbt.nhs.uk. 

The intragastric balloon is a minimally invasive procedure where a soft deflated balloon is temporarily placed in the stomach. This is done using a thin tube called an endoscope through the mouth and gullet (oesophagus) under a general anaesthetic (you will be asleep).

Once the balloon is in the top of the stomach it is inflated with blue stained liquid (sodium chloride). This fills part of the stomach and makes you feel full.

The aim is to help change your eating pattern, reduce the volume of food you eat, and make you feel full quicker and for longer. The balloon is normally left in for 6-12 months. After this it must be removed as it may start breaking down.

Most people will have some short-term complications. These include abdominal discomfort and gastrointestinal symptoms like nausea, vomiting, acid reflux, and dehydration. You will be given medication to take home to help relieve these symptoms.

If symptoms don’t go away and you are vomiting, or unable to have any food or drink please go to an Accident and Emergency Department.

Other risks of having an intragastric balloon are: 

• Intestinal obstruction by the balloon.
• Bleeding or gastric perforation.
• Balloon rupture and migration.
• Gastric ulcers and oesophagitis.
• Sepsis.
• Pancreatitis.

The chance of these risks happening are very small, but you should be aware of them before agreeing to the procedure.

Once you have a date for your procedure, you will be sent an appointment to attend the pre-assessment clinic. A nurse and anaesthetist will check you are well enough to have surgery. You will be advised at your pre-operative assessment:

• When to stop eating and drinking before your operation.
• What medicines to take/not take on the day of the procedure.

The procedure is a day case and most people will go home that evening. Someone over the age of 18 years old will need to stay with you overnight as you will be having a general anaesthetic and may feel very sick.

After the procedure you will feel a little groggy but this will soon wear off.

You might feel quite thirsty and like your mouth is dry, but it is important not to drink quickly and gulp. This will make you be sick and might cause pain. Start with drinking some water from a tea spoon. Sip the fluid one spoon at a time and stop if you feel any pain. Slowly increase the amount of fluid that you are able to take.

If you get thirsty at home, make sure you keep sipping little and often and try sucking an ice lolly or ice cube.

After having the intragastric balloon inserted you may feel extreme nausea for up to 72 hours. It’s very important to take the following medication which will be given to you before leaving hospital:

• Proton Pump Inhibitor (protects your stomach):
  • Lansoprazole.
• Anti-sickness medication:
  • Cyclizine.
  • Ondansetron.
  • Prochlorperazine Buccal.

You will need to buy over the counter chewable A-Z multivitamins and take them twice a day. This will help you get enough vitamins while you are eating and drinking less. 

Once you have the balloon it is important to eat slowly and keep hydrated. Aim to drink 200mls an hour and avoid drinking 20 minutes either side of eating. Have a sip of water 30 minutes after eating to ‘rinse’ the balloon.

Remember, sip drinks slowly. You might find it helpful to carry a sports bottle around with you. Sips little and often are important to make sure that you stay well hydrated.

You need to follow a liquid and soft diet for the first 2 weeks after the balloon has been inserted. Then you can gradually move towards normal diet.

Days 1-7: runny fluids

• Water.
• Low calorie fruit squash.
• Weak tea or coffee.
• Clear soup or broth.
• Sugar-free jelly.
• Low fat/low sugar yoghurt drinks.
• Skimmed milk.
• Flavoured sugar-free water.

Day 8-10: thick fluids

Try introducing thicker fluids such as:

• Smooth soups such as tomato.
• Yoghurt drinks.
• Sloppy Ready Brek or Weetabix.
• Fruit and yoghurt smoothies.
• Milkshakes.

Day 11-14: soft food

Aim to gradually introduce soft textured food that can be mashed with the back of your fork. You will need to do this slowly. If you feel uncomfortable when you eat, take a break, wait, and then try another mouthful.

Here are some examples:

• Cottage cheese.
• Scrambled eggs.
• Porridge.
• Canned tuna with light mayonnaise.
• Lasagna.
• Bolognese sauce.
• Home made soups.

Day 15: solid food

Start introducing a diet of normal texture food, high in protein with the aim of a healthy balanced eating.

You will not feel like eating as much as before and if you eat fatty foods or sweets, you may feel nauseated.

Aim for 3 small meals a day with 2-3 high protein snacks if you can. Limit or avoid bread, pasta, and rice as these can stick to the balloon and cause bad breath and increase risk of nausea and heartburn.

A helpful technique to use is called ‘20, 20, 20 rule’. This involves:

1. Cutting your food to the size of a 20 pence piece.
2. Chewing 20 times before swallowing.
3. Leaving 20 minutes between bites.

An extra ‘20’ is to stop eating after 20 minutes to give you time to recognise how full you are feeling. You can always add a little more, but you want to avoid feeling overfull or being sick.

Regular overeating, to the point where you feel sick, can be dangerous with a balloon in place. If you are struggling to manage your eating, please reach out for support.

Drinking alcohol in moderation will not affect your balloon but the extra calories will not help your weight loss.

Possible problems

• Vomiting – if you vomit, stop eating for at least 2 hours then drink a small amount of water and proceed with soft foods again when you can. Aim to get back to solid foods. If the vomiting continues, or you are unable to drink fluids, contact your GP or go to A&E. Some people will need the balloon to be removed in the first few weeks because of severe nausea.
• Reflux – avoid eating late at night and wait at least 2 hours after eating before going to bed. The balloon tends to move up when you lie down and could cause reflux. If you have reflux in the evening avoid coffee, tea, and alcohol. Raise your bed at the head end and avoid certain foods which may make these symptoms worse.
• Smelly breath – this can be caused by food becoming trapped around the balloon. Try to drink water 30 minutes after eating to help clear the balloon.

The balloon can work as a tool to help you feel fuller for longer and reduce your overall food intake. If you are not noticing any difference in your hunger or fullness please contact the team for support.

The balloon will not necessarily take away the feeling of ‘head hunger’ or emotion-based urges to eat. These can be difficult to manage, please reach out to the team for support if you are struggling to manage these.

If you feel a craving coming on, you may find it helpful to focus on why you decided to start this journey and to have the balloon.

Think back to what has helped manage urges in the past, common techniques include:

• Identify the feeling: Is this a physical hunger? In which case, have a high-protein snack or meal. Is this a head hunger? Try the below:
  • Urge surfing: notice the feeling, rate the craving from 1-10, wait 20 minutes (distract yourself) then rate the feeling once again – usually it will have significantly reduced if not disappeared.
  • Distraction: arts and crafts, music, game on your phone, go for a walk, call a friend, taking yourself away from the kitchen/shops can be helpful.
  • Create an emotional toolbox: when I feel x (emotion) I will do x/y/z (action).
  • Plan your next meal/snack: sometime cravings happen when you are unsure where your next food is coming through – planning can help manage this.

Bariatric Coordinator:

• 0117 414 0855
• 0117 414 0854

Bariatric Clinical Nurse Specialist:

• 0117 414 7557
• 07557 312784

• Drinks and snacks are provided throughout the day and a lunchtime sandwich, but you can bring your own refreshments if you prefer.
• Something to keep you occupied like a newspaper or book. Wi-fi is available and you can bring your own laptop. We have portable DVD players and a selection of DVDs to use in the department.
• Some patients like to have a family member or friend with them during their treatment; this is entirely up to you.

Depending on what treatment you have, drips may be given through a cannula in the back of your hand or you may be advised to have a PICC (peripherally inserted central catheter) placed in your arm. This is a thin tube which stays in place for the duration of your treatment. This can be used to give medication and take blood tests.

Some treatments are given by sub-cutaneous (under the skin) injections.

Before starting each cycle of treatment, you will be seen by a doctor or senior nurse. You will also be asked to give a blood sample and have your blood pressure and temperature checked. This is a good opportunity to discuss any problems or side-effects you are concerned about.

The pre-assessment will help to decide whether you are fit enough to start the next cycle and whether any adjustments are needed.

Your treatment should not be painful. If you are feeling pain let a member of staff know immediately.

Your disease and the treatment can make you more vulnerable to infection. Neutrophils are white blood cells that fight off infections and if you don’t have enough of them then you are much more vulnerable to catching infections and becoming unwell. Your neutrophil count is a good indicator of how vulnerable you are.

A normal neutrophil count is between 1.5 and 8.0 x 10⁹/L. A neutrophil count that is below 1.0 x 10⁹/L is particularly dangerous. If you have an infection (we call this neutropenia).

Usually, the neutrophil count drops about 7-10 days after having chemotherapy. It is safe to be at home with a low count as long as you do not have any symptoms of infection, but it is a good idea to be extra careful, avoiding people with coughs, colds and infections as well as large gatherings of people. For example, the theatre, supermarkets, and restaurants for the duration of your treatment.

Handwashing is an important infection prevention measure, before and after going to the bathroom, handling food or rubbish. Before eating is probably the most important thing you can do to avoid picking up infections.

We will take extra precautions if you are in hospital and if your count is less than 1.0 x 10⁹/L.

Neutropenic sepsis means that you have an infection when your white blood cells are too low. This is a life-threatening emergency. Call for help immediately if you have recently had treatment or if you have been told that your condition puts you at risk and you become unwell with any of the following symptoms:

• Temperature – Above 37.5°C or below 36°C.
• Uncontrollable shivering/shaking (rigor).
• Other signs of infection for example sore throat, cough, diarrhoea or vomiting that last for more than 24 hours, pain, burning or difficulty passing urine.
• Pain, swelling, or redness at the site of your PICC line, if you have one.
• Suddenly feeling unwell, even with a normal temperature.

Use the numbers on your Chemo Alert card (also on the back of this leaflet to speak to a nurse straight away.

Depending on the reason for you calling, you may be asked to contact your GP or come to a specific department in the hospital.

If you cannot get hold of us on the numbers on your chemo alert card and you think you have an infection, go to the nearest A&E. (You may need to phone 999 for an ambulance if you don’t have transport and feel too unwell to drive).

• Please do not attempt to come to the Haematology Department or Chemotherapy Suite without an appointment as this may lead to a delay in getting the attention you need.
• If you are admitted to hospital with a possible infection, you need to receive an intravenous dose of antibiotics within one hour of arriving. Please show your Chemo Alert card to staff and make sure they are aware of this.

Not all anti-cancer treatment causes nausea and vomiting. If your treatment is expected to cause nausea, we will give you anti-sickness medication. We will explain the best way to take them.

If you are unsure how to use them or if they are not controlling your symptoms, please contact us.

Not all treatment causes hair loss. Your CNS or chemotherapy nurse will be able to advise you about this. If you would like to be referred for a wig, they can organise this for you.

There will be a charge for your wig. This may be reduced if you are receiving certain benefits.

If you lose your hair, it grows back after treatment has finished but can be different in colour or texture than before.

Some cancer treatments can affect your ability to become pregnant or father a child. Options for fertility preservation will be discussed with you if this is a concern.

Many medicines can harm unborn babies and you may need to take precautions to reduce this risk. In some cases, this will be discussed with you specifically. Please ask if you have any concerns.

A cancer diagnosis can cause many different feelings and emotions. People react in different ways and there is no right or wrong way to feel.

If you are feeling overwhelmed and/or distressed, please feel free to speak to any of the Haematology team about your concerns.

Whether you continue to work or not throughout treatment will depend on you, your job, and the environment you work in. Please discuss this with your nurse or consultant.

We are happy to support you in letting your employer know what is going on and helping you access financial support and advice.

You do not have to inform the DVLA that you have cancer or are having treatment. We recommend that you do not drive to your first treatment session as it is difficult to know how you may be affected. For example, some medicines can make you feel drowsy. If you are feeling at all unsafe then do not drive. In some cases, we can offer hospital transport to and from hospital.

If you are receiving treatment at North Bristol NHS Trust, you are entitled to a free car parking pass. This is valid for up to 3 months and is renewable for as long as you need it. Please ask the CNS or chemotherapy staff for details.

Exercise means different things to different people. Research has shown that some gentle exercise has been beneficial to patients undergoing treatment. However, this does depend on how you feel. It is important to not push yourself too much.

If you feel tired or fatigued, it is important to rest. However sometimes getting out for some fresh air or to walk the dog can be just as beneficial. We can refer you to a physiotherapist if you need help dealing with fatigue or returning to normal activity levels.

We usually recommend that you do not travel abroad during treatment. Your doctor can advise you about having a holiday within the UK. If your blood counts are satisfactory and you feel well, you may benefit from a short break within the UK. It is important that your life is not completely put on hold during this difficult time.

If you become unwell when you are away from home do not attempt to return to Bristol before seeking help. Please go to the nearest hospital with an emergency department. Take your chemotherapy alert card with you and provide as much information as you can about your diagnosis and the treatment you are having.

Living with cancer can have a significant impact on your income and the cost of living. There is a team of benefits advisors provided by Macmillan and the Citizens Advice Bureau. Talk to your CNS or the team at the Macmillan Wellbeing Centre and ask to be referred.

You may also be able to apply for a grant from Macmillan to help with the cost of living with a cancer diagnosis.

If you have a cancer diagnosis you are entitled to free NHS prescriptions. If you do not already have exemption from prescription charges, please ask the CNS about this.

Everybody with a cancer diagnosis has access to a specialist nurse or Macmillan nurse.

The nurse is here to provide you and your family with the support and information you need before, during, and after your treatment. For most people with a haematological cancer the CNS will be your ‘Key Worker’ and your point of contact with the Multi-Disciplinary Team responsible for your care.,

You should see the CNS before you start your treatment. Whenever possible this will happen in the outpatient clinic or Medical Day Unit at the same time as another appointment.

Our CNSs work Monday to Friday from 09:00 to 17:00 and can be contacted by phone or email. Please be prepared to leave a message when you call.

Phone: 07545 421893

Email: haematologyCNS@nbt.nhs.uk

The Acute Oncology Nurses work Monday-Friday, 08:00-16:30, and you can phone them 07860 783116.

The Acute Oncology Service provides specialist advice and support for cancer patients with urgent problems related to their illness or treatment.

They can advise the best thing to do, whether this is to attend hospital or your GP for assessment.

Cancer Support Workers work with the Clinical Nurse Specialist team and cancer team. They provide support and advice to patients at the time of diagnosis, during, and after treatment.

They are trained to provide support and information about physical, emotional, and practical concerns to help you self-manage your recovery and return to a healthy lifestyle as soon as possible.

Support is provided face to face, over the phone, or by email.

The Wellbeing Centre is located opposite the main hospital entrance at the end of the car park, next to the Breast Care Centre. We offer help and information about different kinds of cancers and treatments. We also talk about, finances and benefits, diet, exercise, and emotional support. We are here to listen to you and the people who support you.

The centre offers ‘drop-ins’ for coffee and a chat or appointments for specific needs.

Opening times: Monday to Friday, 08:30 to 16:15

Phone: 0117 414 7051

Blood Cancer UK

Information and support for everyone affected by all blood cancers. Leukaemia, lymphoma, myeloma, MDS, MPN.
Blood Cancer UK | We're here to beat blood cancer
Phone: 0808 2080 888

Cancer Research UK

Information service about cancer and cancer care for people with cancer and their families.
Cancer Research UK
Phone: 0808 800 4040

Leukaemia Care

Information and support for people living with leukaemia, MDS and MPNs
Leukaemia Care - The UK's leading leukaemia charity
Phone: 0808 801 0444

Lymphoma Action

The UK's only charity dedicated to lymphoma.
Lymphoma Action
Helpline: 0808 808 5555

Macmillan Cancer Support

Offers a range of support for the emotional and practical impacts of living with cancer.
Macmillan Cancer Support | The UK's leading cancer care charity
Support Line: 0808 808 0000

MDS UK Patient Support Group

Supports anyone affected by MDS or CMML. Providing reliable information and support.
Home | MDS UK Patient Support Group
Phone: 020 7733 7558

MPN Voice

MPN Voice’s mission is to provide clear and accurate information and emotional support to everyone who has been diagnosed with a myeloproliferative neoplasm (MPN) and their families/friends.
MPN Voice – mpnvoice.org.uk
Phone: 07934 689 354

Myeloma UK

Provides information and support to anyone affected by myeloma. Offers support groups, discussion forums and Infoline. Includes related disorders including AL amyloidosis, Monoclonal Gammopathy of Undetermined Significance (MGUS) and Plasmacytoma.
Homepage - Myeloma UK
Info line: 0800 980 3332

Penny Brohn

Health and wellbeing support for people living with cancer.
Penny Brohn UK – Cancer wellbeing for everyone
Phone: 0303 3000 118

NHS website

Offers general health information
NHS website for England - NHS

Haemotology Clinical Nurse Specialists

Monday-Friday, 09:00-17:00
07545 421 893

Acute Oncology Nurse

Monday-Friday, 08:30-16:00
07860 783 116

Chemotherapy Suite

Monday-Friday, 09:00-17:00
0117 414 3580

Clinical Hub (out of hours)

0117 414 0700

• Write down your most important questions.
• List or bring all your medicines and pills – including vitamins and supplements.
• Write down details of your symptoms, including when they started and what makes them better or worse.
• Ask your CNS team for an interpreter or communication support if needed.
• Ask a friend or family member to come with you, if you like. 

• Don't be afraid to ask if you don't understand. For example, 'can you say that again? I still don't understand.'?
• If you don't understand any words, ask for them to be written down and explained.
• Write things down or ask a family member or friend to take notes.

Ideas of questions to ask at the time of your appointment

• 'what's happening if I'm not sent my appointment details,' and 'can I have the results of any tests?'
• If you don't get the results when you expect – ask for them.
• Ask what the results mean.

Before you leave your appointment

• Ask who to contact if you have any more problems or questions.
• About support groups and where to go for reliable information. 

• Write down what you discussed and what happens next.
• Keep your notes.

• What are the tests for?
• How and when will I get the results?
• Who do I contact if I don't get the results? 

• What happens next?
• Do I need to come and see you?
• Who do I contact if things get worse?
• Do you have and written information?
• Where can I go for more information?
• Are there any support groups or other sources of help?