Brandon Pomish researched his options and beat his illness in Spain.
Editor’s Note: When health issues surface, your life can change dramatically. This is one of those stories. Brandon Pomish, 35, of Bloomfield Hills was active and involved in his work and in the Detroit Jewish community. When he was struck with a complex medical problem, he began researching his options, including clinical trials around the world. This story, in Brandon’s words, documents his three-year journey back to health and his message to be proactive and never give up hope.
In October 2014, life was good. My wife, Emily, and I just had our first child, Nora, who was 7 months old. I was involved in our family business, PCI One Source Contracting, and was volunteering in the Jewish community.
My community involvement included serving on the NEXTGen Detroit executive board and Temple Israel board of trustees and on Federation’s Capital Needs, Security and Partnership2Gether committees. I was a mentor through Jewish Family Service’s Mentor Connection program and an active AIPAC participant.
Starting in November 2014, I was suddenly hit with a half-dollar-sized enormously painful perianal abscess. Not knowing what an abscess was or where the perianal region was, I went to my internist who directed me to a colorectal surgeon who insisted that he immediately cut and drain the abscess.
After two surgical attempts, he surrendered to the uncontrollable buildup of fluid and recommended me to another surgeon. This new surgeon was more tactful in his approach; however, he could not control the abscesses (yes, now more than one).
After four more surgical cut-and-drain attempts, he could not cut any longer because the skin was too raw. By July, I had two wounds underneath my scrotum about 1½ inches in length and about three-eighths of an inch deep.
The nuclear option of an ileostomy was recommended and performed. The first ileostomy failed and caused massive blockages inside of my small bowel requiring a nasogastric tube to be administered and many emergency visits to the hospital. After more complications, an ileostomy revision was performed, and I was admitted to the hospital for 23 nights.
After my release in September, I was introduced to the head gastrointestinal (GI) doctor at the University of Michigan, and he put me on Remicade and Imuran, which were supposed to heal my fistulas. At this point, I also had been introduced to a highly regarded GI at the Mayo Clinic in Rochester, Minn. She has written many influential papers on clinical practice for inflammatory bowel disease (IBD) and has written a highly praised book on patient management in IBD. I was also introduced to a new surgeon who would manage my surgical treatment.
SEARCHING FOR ANSWERS
For the next eight months, I visited Mayo dozens of times in hopes that my fistulas were healing. Each visit included pelvic MRIs. The MRIs continued to show each of the fistulas corresponding to the previous MRI with no improvement. At this point, after more surgeries for anal fissures and continued pain at the fistula/seton drain sites, I asked: “When is this going to end?”
The answer I was given changed my life forever. I was told that complex perianal fistula (cpf) healing isn’t measured in days, weeks or months, but rather in years. Not taking this answer lightly, I went home that evening and went onto clinicaltrials.gov in search of something that could accelerate my healing. I found numerous trials for cpfs around the world on almost every continent and started reading up on the studies.
I took into consideration the country and its medical establishments, time of healing, number of treatments, costs and many other factors.
The trial I was most fascinated with was the efficacy of a stem cell procedure being performed at Hospital Universitario Fundación Jiménez Díaz in Madrid, Spain. The two leading doctors behind the study had excellent credentials (one of the surgeons completed her fellowship at Mayo Clinic in Minnesota). I spoke to several contacts who validated the high-standing reputation of the institution and I set out to make contact.
I emailed the doctors explaining my condition, my research on their trial and my eagerness to fly to Spain to get their treatment (also pointing out that I was a patient at Mayo, which I thought couldn’t hurt). Almost instantly, I received a response back.
I went through some formalities in sending them some of my medical information and MRIs so they could validate my condition. After a few weeks of back and forth, the group accepted me as a patient, and I was off to seek approval from my quarterbacks at Mayo.
Since I was not a European Union citizen, I did not qualify for the actual trial, so the understanding was that I would have to pay cash to get this done. The efficacy of the treatment also took two visits to the hospital spread out about six months apart. I took all the trial information to Mayo and presented my case to my GI and surgeon. If they had any reservation about me going, I was ready to do whatever they instructed. If they advised against the treatment, I would not go.
They could not have been more open, excited and encouraging for me to try this. In fact, my GI had just in the last year sent a patient to this group. Because of our rules and regulations regarding health care, she could not inform me of this trial, which is a whole other matter. Nevertheless, I was booked to go to Spain in late September of 2016.
SPAIN FOR TREATMENT
My experience in the European medical system was mesmerizing. I was considered a “private” patient instead of a “public” patient (because of the cash) and was given an itinerary of preliminary exams and meetings before the procedure.
The hospital was a beautiful and very clean facility. I immediately felt a sense of comfort at how sterile the environment was and how “normal” the hospital looked in comparison to ours here in the U.S. The dress code is a different story. Many of the female doctors walked around in blouses, jeans and open-toe shoes, while the men were very sharply dressed in nice suits and ties. I would call it business casual.
I went straight to the front of every line and experienced some very different (positive and negative) approaches to testing and meetings than here in the U.S. The hospital cafeteria had better food and coffee than 99 percent of the restaurants here! After some shopping and sightseeing, I was ready for my procedure.
First, I was to have liposuction performed to extract the adipose tissue to extract the cells for replication. This happened first thing in the morning, and I was put under general anesthesia while the plastic surgeon performed the procedure. The surgical room was very sterile and had all the modern equipment inside of hospitals here.
I woke up to my stem cell surgeon running over in excitement! He had a small vial of about five million stem cells, and he was as animated as if this was the first time he was going to perform the procedure.
A few hours after the liposuction, the surgeons injected four million stem cells into the branch fistula and one million into the main trunk. Eight weeks later, and back home in the USA, I visited Mayo to see the results. My GI and surgeon were anxious to examine me and did so together. With confirmation from my MRI earlier in the day, they concluded that the results revealed a closed fistula at the branch!
STEM CELLS WORKED
I went back to Spain in April of 2017 for my second treatment, which consisted of injecting about 45 million cells into the remaining fistula. I did not have liposuction performed as they were able to culture enough cells the first time to keep reproducing.
After a few visits back to Mayo, which included a questionable period not knowing if the stem cells worked, the conclusion in July was that my fistulas were officially healed! This finally gave me the opportunity to get my ileostomy takedown on Nov. 8 — and I haven’t looked back since.
I am recovering terrifically and owe my success to my wife, Emily, and her loving dedication, companionship and support during the darkest times. My mother, Nancy, and father, Mike, and my brother, Evan, who have unwavering commitment to my health and success; my team of doctors who never gave up on me no matter how many times I asked them to throw in the towel and make my ostomy permanent; and, of course, I must give credit to myself, the patient.
I don’t say that in a narcissistic way — well, maybe a little — but I fought and battled, did my research, asked the right questions, educated myself to question how I was being medically and surgically managed, and never gave up hope.
If you want to get healthy, you must believe that there is light at the end of the tunnel no matter how dark, cold and damp that tunnel gets.
I am uncertain if my disease will ever resurface; however, if it does. I am ready!
Brandon Pomish Special to the Jewish News
Note From Brandon
I am open to helping anyone I can who shares a similar story of medical conquest. So far, I have helped two people get treatment in Spain. Feel free to reach out to me via Twitter: @bpomish, facebook.com\bpomish and email at firstname.lastname@example.org. Also go to the Crohn’s & Colitis Foundation of Michigan or call (248) 737-0900.