Monday, February 25, 2013

update

     I know it has been a billion years since I've posted, but things have been really crazy lately. Last Tuesday I was rushed back to Barnes in horrible pain in my abdomen. It took them less than an hour to admit me and decide I had an infection in my intestinal tract. I was lucky to have josh with me, holding my hand while I cried and talking to the docs when they had me basically sedated. Once I got up to my room they made sure I was started on Vanc and Zosyn and my pain meds were scheduled the best possible way to keep me comfortable. 
     To those of you who have the annoyance of knowing me personally you know that I am not the best patient. I'm great to the nurses and even respectful to the docs provided I get it back, but I am quick to bolt...extremely quick to bolt. A string of bad roommates and not seeing my baby I was hysterical by Thursday when they finally agreed to send me home on my IV meds. Did Thursday strike anyone else as not good since we had a friggin snow/ice storm? I ended up staying with my grandma until my uncle brought me to my baby Friday afternoon. 
     Josh thought it would be great to have a nice night together and rent movies, which was a great night since I felt like such crap anything else seemed like too much. Spent most of the night laying next to Josh sick as all get out. Woke up at four to run meds and take more pain meds well, they wouldn't go down my tube like they are suppose to. With the past permission of my surgeon I pulled the tube and tried to clear the blockage and then put it back in and it still didn't flush. I eventually got too tired and went to sleep set to deal with it in the morning.
     Morning came to me hearing my beautiful little miracle calling for me from his room with a huge poopy diaper (welcome home momma). I made him breakfast and played with him for a little while. As time came closer for home health to come and do labs and change my needle I went up and woke Josh up who took over being the daddy monster while I tried to flush my tube again. This time the ten ml of water pushed and then came streaming out of my stoma as bloody bile. It became apparent that we couldn't infuse meds or anything into it, which  isn't' much of a difference than usual. The nurse came and drew labs, took two needle sticks to get my port accessed and actually didn't have it in the right place. As soon as she left I went to run my antibiotics and the saline flush burned and began swelling,which to those of us in central line land know that means to leave it alone.
     Spent most of the day laying in bed crying like a two year old because I didn't feel well. I even resorted to cuddling with Damien in his elmo bed for a little while because he always makes me feel better no matter how bad it all hurts. I ended up getting a phone call late afternoon telling me my vanc troph was really high and they needed to call the doc. The doctor who was on call got the fun job of calling me, the truly compliant patient and telling me that my kidneys had stopped filtering the way they were suppose to which is why the antibiotics couldn't clear my system the way they were suppose to. Guess who had to go back to Barnes and wait in the ER for a very long time by themselves to be told they were in acute renal failure and would have to stay. 
     So, here I sit getting slowly better and facing another consequence after another. I guess during the tube ordeal it ended up in the wrong place and today when IR tried they couldn't get the tube back in, so I'm tubeless. That is a bit problematic since the docs are anti-TPN and my meds haven't all been switched to sublingual and patches. The choices available are start IV nutrition or another surgery to place a new J tube...blah! Just trying to stay positive and to those of you who read this and wonder if I'm on drugs...I am...2 of Diluadid every two hrs explains for the typos and spasticness of my usually better writing. Love all of you and hope to be free from here soon!

Sunday, February 17, 2013

My Late Feeding Tube Awareness Post

     Think about all the people you see in one day carrying around a backpack and you think nothing of it whatsoever. It is only natural you would assume they were carrying books from school, the library, a change of clothes for the gym after work. It would never cross your mind that the person was wearing the back pack as a life saver. By looking from a distance you never know the person is receiving life saving  nutrition and medication through the pack .
   I suffer from a disease known as gastroparesis  which means my stomach is pretty messed up and paralyzed. When I am able to take a few bites orally I have to spent most of the day curled up in bed crying in pain and the food doesn't absorb anything, And now things have got so bad motility wise if I tolerate anything orally I ended  throwing up undigested food two days later...trust me I know it is super gross. 
     Gastroparesis and pseudo obstruction disorder don't mix well together either. There is absolutely nothing pretty about constantly vomiting or having dumping syndrome. No one likes to point out that your tube opened and you have bile pouring through your shirt...these are tough diseases and very little can be done besides managing symptoms. We spend a lot of time laying in hospital beds, crying in pain, praying for relief, and quite a bit of time in the back of ambulances unable to be home home with our family members. 
     Options are limited, if the problem is somewhat minor sometimes diet changes can make things better simply avoiding super fatty foods, avoid large quantity of ruffage like certain fruits and veggies, and things high in fiber can be harder on the person to digest. There are some that respond really well in liquid diets and drinking a lot of meal replacements like boost and ensure. Unfortunately, most cases are very severe and require much more medical intervention. 
     There are surgical options that require feeding tubes to be placed, they can be placed in the nose, which is called a douphauff, placed through an endoscopic procedure called a gastrostomy tube, and another surgical tube that is surgically placed in the small intestine called a jejuneostomy tube.  Given it is feeding tube awareness week I am going into a little bit of detail about which each tube is.
             1) The douphauff is a small yellow tube that is passed down the nostril into the duodenum. When it is placed the patient is generally fully awake and sits up as the tube is passed. It can be uncomfortable because they  must leave the guide wire in until x-ray can confirm that the tube is in the right place because they have a tendency to coil in stomach and constantly need readjustment. Once the tube is in the right place they pull the guide wire and it is much more comfortable. The first few days it can be a bit rough, but it gets a lot easier. They are generally used for more short term feeds.
             2) A gastrostomy tube, generally known as a G-Tube is placed under anesthesia usually done endoscopically. They go in and make a whole in the stomach and there is a much more long term tube  to run feeds into the person's belly. The procedure can be uncomfortable like any surgical procedure, but the meds help and you find yourself able to just take Tylenol. It is a more permanent option for someone who is going to be tube fed for an extended period of time. 
           3) A Jejuneostomy is a little bit more invasive surgery done under general anesthesia, generally laproscopically.   The tube is placed in the jejunum which is the beginning of the small bowel. Recovery time is quite a bit  harder since they generally spike the intestine to the abdominal wall so nothing can leak into abdomen cavity. These tubes are generally done when the stomach has to be completely bypassed for reasons like gastroparesis.
     All of these tubes have different ways they can be fed...an IV pole with gravity or a pump can be used and with a G tube it can even be bolused which means a syringe is filled with tube feed and pushed into the tube.  You will see most tubies of all ages carrying around backpacks that hold their bag of tube feed and have a special place for their pump so they can live a pretty normal life just have to be cautious about getting your line stuck on some thing. Most of the time people don't even notice the backpacks or that there is a tube coming out of them. 
   I'm telling you all of this because I was late to Feeding Tube Awareness Week and I believe that knowledge is power, the only way people aren't going to be freaked out by people with tubes and other things is for us to share our experiences. 
     In my case I've lost all stomach function and intestinal function also...we haven't given up on tube feeds, but it is unlikely we will be able to attempt that much longer. I have a central line in my chest which is another thing a lot of us tubies have in common no matter what their age. Sometimes our guts just can't let us get  enough in so we have to have extra IV fluids and sometimes even IV nutrition. It is nothing for people to gawk out...we don't have third eyes or anything like that. We just have a different way to eat, be we are still cool and can do everything you can. I have a two  year old little boy who has never known known his mommy not sick. 
     I am not ashamed of being a tubie and I think if we can just get more awareness out besides one week a year or even one month a year. There are so many things people make judgments about when they see someone with a feeding tube and it makes me angry. One of my big pet peeves is people staring at me when they see my central line or my tube hooked...if you have questions just ask me because I'm fairly open and most assuredly unashamed. Sadly, there are always going to be people who don't understand and people who feel they have the right to say ignorant things but that is their own person issues at work. I decorate my backpacks, IV poles even my walker now and I'm twenty seven. People scoff at me like I'm trying to show it off of attention when I promise I'm not it is for my own amusement and helps me accept being sick. I hope this was able to answer some questions it was a very brief overview and if you ever want to chat or ask more questions I'm always up for a good conversation.

Thursday, February 14, 2013

one of the hardest things I've written

     I've spent a long time keeping my secrets pushed down as far as they could go, almost four years of recovery trying to convince myself that all of it was gone and I had the control again. Once again I show the anorexic mindset, recovery or not it is still there. Control is an illusion, I couldn't control my pain by bleeding, by starving, purging, or swallowing my pain. It always found its way back and it has made its way back again. There is a lot about me that people don't know, mainly because it is personal and it tends to send people running the other way which feeds into my shame factor. The way I see it I'm twenty seven years old and I can never help people if I let my own shame run my life, it has done it enough. Between shame and fear nothing ever gets accomplished. I love it when people say they have no fear, everyone is afraid of something, everyone has something in their past that they don't want anyone else to know about. Fact of the matter is simple, I'm not going to live as long as I would like to so its time to push the fear aside because my story,my experiences might help someone else avoid some of the pain I've endured or at least let them know that they aren't alone and they have nothing to be ashamed of. 
     All of this was brought on by a medication that my doc put me on to help with my pain and also hopefully slow my gut down so some thing might absorb. Unfortunately, it didn't work it triggered the things that I had managed to bury deep inside me. After a few nights of taking it I found myself waking up screaming and my skin crawling for a razor blade. I was back living in the Women's Shelter, back in that court room begging the judge to grant to restraining order, praying they would arrest him. The man who took my innocence was back in the forefront of my mind...I was screaming begging him to stop while he hushed me and held me down. It had been a long time since I had dealt with a night terror that bad, so bad that I hid, couldn't even gather up the courage to wake up Josh. I found myself feeling ashamed again, those old voices were screaming that I deserved punishment, that it was my fault. I'm lucky enough now that I'm strong enough to send that screaming back away and realize that I did nothing wrong. I told him no, he made the choice to ignore me. I spent six days under the care of Dr. R on the med unit being tube fed because I wouldn't allow anything inside my body...I fought tooth and nail to get back from that and now I have to find it in me to trust another doctor with all of this and i can't lie and say that I'm not terrified because I am, but  I can't hide anymore. 
     I have to tell him how the anorexia began, how razors became my only way to escape. I have to tell the truth about my mom and the last thing I want to do is vilify her. She was sick, when she wasn't drinking she was a mom like any other mom. She wanted what was best for me, she encouraged perfection because she knew I was capable of doing wonderful things. She didn't start hitting me until I was a teenager, maybe I should have told, maybe I should have done a lot of things, but  she was my mom. I took care of my baby sister, I made sure that I tookere the brunt of everything when she was drinking. I will never stop blaming myself for her death, for not some how getting her help. My mom died from heptorenal on December 8, 2007 twelve days before my twenty second birthday and leaving my five year old sister without a mom. I resented her for a long time, I ate less and less, swallowed more and more laxatives, pills, and I cut deeper and deeper. I was lucky to have a doctor to help me through everything the best he could. Yet, fear still ruled me, controlled my sleep. I woke up on a nightly basis screaming my head off wanting to do anything to make it stop. I couldn't use my words, I couldn't tell anyone what was going on, I  had to seem fine....I wasn't fine, I just hid more and more secrets. They ate away at me until I saw no way out.
     By 2009 they had discovered the gastroparesis and removed most of my stomach. I was fed and medicated through my J-tube. They sent me to an outpatient psych doc who put me on high doses of "helpful" medicines...told me they would take away the anxiety, the night terrors, the depression, they would fix everything. They made me suicidal, not the attention seeking kind where I wasn't actually going to do it, but the kind where I had it all planned out. I went to the psych eval at the hospital and told them I was a danger to myself and they sent me home because I was too medically compromised. Later that day, by the grace of God and a miraculous friend I woke up in the ICU after pushing massive amounts of medications through my feeding tube. Again, this is not one of my proudest moments.
    It wasn't long after that incident that I was introduced to Josh and he immediately saw past the front I put up. He put my meds in a lock box and slowly but surely he helped me help myself climb out of the darkness I was living in. It took years full of ups and downs for me to find myself worthy of recovery, to let go of the shame and fear of what others would think of me if they knew the truth. I wrote this because I know there are so many others who live with the same secrets, the same burdens and you don't have to feel ashamed. tomorrow I am going to come clean to my new doctor and if he can't accept what I'm saying then he doesn't deserve to have me as a patient. The way I see it I have overcome some seriously jacked up events in my life and I don't feel sorry for myself at all because all of those evens have made me stronger. I know that I experienced all of this to help others. I was terrified to write this and if you comment I hope you are gentle. My demons still live in me, though they live in the distance they are still there and i fight them everyday, but I fight them. It is not impossible to come back from the edge...I did and so can you.

Tuesday, February 12, 2013

have to have a "tell all" with my doc thursday

   I find myself facing reality more and more lately, a reality that Josh and everyone else in my life is making the choice to ignore. I can feel myself weakening, the chest pains, dizzy spells, blood pouring out of places that it isn't suppose to be pouring. Even the doctor is trying to convince us that I have more time than I have. I know my body, I can feel it quitting, and I can feel it more and more difficult to keep fighting. I get out of bed everyday to fight for my son. I ignore the short breath and the chest pains because the medical docs insist they are going to get me on a holter monitor and figure out why my heart is weakening so fast. I know why things are getting weak so fast...lack of nutrition. It was been proven that I absorb nothing through my guts. It takes less than eight minutes for things to move from my small intestine to my colon which means I'm not absorbing any of my meds which is causing the pain to just stay more and more unbearable. They were all about starting the patch to help me get a grip on the pain and then some attending at my resident's clinic who has never bothered to meet me decided to try me on a medicine that triggered me into a  PTSD flash and left me crying with a razor blade in the bathroom until Josh came and helped me put it down without giving in. They tell me that my guts are bipolar and that for some reason my body rejects food and nutrition, it treats it as a foreign invader and causes unbearable pain. 
   I have no doubt in my mind that these people are going to kill me if they don't start my TPN soon. They expect me to just keep hanging on "sustaining". I'm tired of simply sustaining. I would rather live five years with my son and have a happy life than live ten years with him while I'm stuck in bed in pain. If it weren't for my son I don't know how I would keep up the fight. People want me to lie and say that I am just gunho ready to beat this beast, but the fact of the matter is most of the time I feel defeated and alone. I feel more alone than most people understand. If it weren't for my son I don't know if I could keep up the fight. At this point I'm pretty sure  I will be spending time at Barnes for a blood infection...Happy Valentine's Day for me. Sorry if I seem like a downer right now, but I truly am. 
   I am currently trying to find the courage to discuss everything with my doc...everyone says he needs to know about my mom beating the shit out of me, about being raped, about waking up in the ICU disappointed because they revived me. I was raped and no one cared besides my doc and the Women's shelter where I had to live since it wouldn't have happened if he wouldn't have been at my dad's house, so rather than support me or have my back he kicked me out and I was left with a razor and a few bottles of pills...it is nice getting to share how much of a loser I am with my doc on Thursday.
   People think I want sympathy for the a fore mentioned things, I don't. I am not the first person whose parents had problems, I still loved my mom despite the bruises and the venom she so often spewed when she got that whiskey down her throat. In her own way she loved me, she was trying to make me stronger, better, and in her own jacked up way she did. I was able to protect my baby sister by pissing her off and that means more to me than anything else. That son of a bitch took from me what I will never get back and he made me think that I couldn't survive, but I did. Forcing me to hide in a Women's shelter I was able to meet wonderful women who I am still friends with today. I did hit rock bottom, I starved and cut and swallowed whatever I could get my hands on and I woke up in the intensive care unit cursing the world for my breath, but here I am today with a two year old who loves me more than anything in this world and I love him just as much. I'm sick, I'm going to die before he is old enough to truly learn enough from me, but I'm not giving up and I'm not going to be ashamed anymore. I'm done being ashamed, I've been bloody and broken and that isn't happening again. I will go down on my own terms and I will fight for as many years as I can get before this fucking disease take me out and anyone who doesn't like me or believe in me can take a leap.