Zapped!

We are now coming up on a year since Tube Flippalooza, in which I ended up on TPN (IV nutrition) for 9 months, suffering an undiagnosed case of C-Diff for months and then a SIBO infection that lasted months after that. I am not quite back to where I was this time last year, I am still venting continuously and am reliant on IV hydration. That being said, I am also doing better than I was in some very important ways.

Last year at this time, I was still fighting to get myself to full nutrition. I wasn’t yet able to read more than social media and short form articles. I certainly wasn’t spinning.

Going on TPN brought me up to full nutrition very quickly and gave me reading back almost immediately. That was a huge gift. And the extra nutritional support allowed to me to transition to essentially full enteral nutrition through Etisarap (my feeding tube). Something I have now been able to maintain for several months and I am still going strong.

Keeping myself adequately hydrated has been a problem since I developed gastroparesis, because I find drinking to be more painful than eating. Even small amounts of fluid in my stomach are painful. And they just sit there, going nowhere for hours. Since I already had the PICC line, adding in home hydration was easy, and has gone a long way to keeping me comfortable.

By far, the most exciting development is that I now have enough spoons to spin. And not just some days. I have been able to spin every day and it is doing wonders for my mental health. It unlocked all of my blocked creativity. I am now dreaming well beyond my capacity, but that is ok. Because I also have the brain space to come up with creative work-arounds.

After I warmed up by spinning some super easy fiber, I started spinning the other half of some fiber from a grab bag I bought at Oregon Flock and Fiber oh-so-many years ago. I had spun the first half of the bundle when I was first learning to spin on my e-spinner*. I still had the single from the first half on a bobbin. Yesterday I started plying the two halves.

It was such a great reminder of how far I have come, regardless of the 3 years when I couldn’t spin. The single on the first bobbin is filled with rookie mistakes. The single I just spun is also filled with mistakes, but mostly the kind of mistakes that require time and practice to resolve. They are mistakes that tell me that my hand positioning needs some adjustments. Or that my fiber prep was inadequate. All mistakes that mean that I will just have to keep spinning to work them out. And I am just fine with that. I am calling the resulting yarn “First Spins.” It may not be useable for anything more than knitting up a swatch, but I am damn proud of it.

In other news, it took almost exactly a month, but my Clog Zapper finally arrived. I am now kind of regretting that I only purchased two doses, given how long it took to arrive, but oh well.

My J tube has continued to get uglier and uglier, with little globs of old formula stuck to it everywhere. But today that ends. After I disconnect from my feed this afternoon, my J tube is getting a thorough cleaning. I am very much looking forward to it.

This week I also learned that we had lost our complaint with the California Insurance Board. They too, completely missed the point and insisted that I should be able to see an in-network psychiatrist for a non-psychiatric use of a tricyclic antidepressant.

Ironically, we also got a letter this week that our insurance company is at an impasse at negotiating terms with UCSF and MarinHealth. The implication being that if the two parties can not come to agreement by July 1st would put the psychiatrist they are insisting I can see out of network. So the saga continues.

This is particularly frustrating now because the greatest source of pain for me continues to be my brain misinterpreting gut motility as pain. And the switch to nortriptyline, which I have been waiting to initiate for over a year now, is the next step in working on resolving that.  I see my pain doctor on July 7th and I am hoping we can work out a Plan B to get me on nortriptyline as soon as possible.

David foot and ankle continue to heal, albeit a little more slowly than he necessarily always has patience for. He is out of the boot and in a regular shoe. We both prefer to walk around barefoot/in socks, but right now he has to wear shoes in the house to give his foot a little extra support and stay comfortable. I remember this stage from when I broke 3 metatarsals several years ago and it was more frustrating than the boot for me. Being that close to back to normal, but having to still be patient can really suck. Unsurprisingly, he is prone to overdoing it. But he will get there.


*Best adaptive tool ever. I don’t have to expend any energy on the foot pedals or trying to coordinate my hands and feet.

Other Hands and Onions

I finished my Xifaxan this week. But before I tell you how things are going, let me refresh your memories.

Back in February, I started needing to continuously vent my stomach to stay even somewhat comfortable. Since then everything I drink, and almost everything I eat, gets vented out. That is why I need IV fluids to stay hydrated.

In addition to the stomach discomfort, the pain in my intestines ramped up. The pain was so bad that I couldn’t make it through the day without tears.

Without going through the whole saga again, my GI team and I ended up with a plan where I would take a course of Xifaxan for Small Intestinal Bacteria Overgrowth (SIBO) and after I completed that, start Motegrity. I have used Motegrity before, and it didn’t help with my nausea. This time my GI prescribed it to help with the gas in my gut.

That brings us to today.

On the one hand, the Xifaxan has significantly reduced the pain in my intestines back to their usual 5 (on a pain scale of 10), which is my normal. I can get through the day without crying (mostly–I still need to close off my vent for an hour after I take my meds and that can get dodgy).

This is good news. I have felt better than I have in months and I am really enjoying the respite. I would be enjoying it more if the nausea were better controlled. I have tried all of the best meds for nausea, and only Zofran does the trick. But even that has limits. Today was a good day. Yesterday was not. That is how it goes.

On the other hand, I am still needing to continuously vent my stomach. I have only been on the Motegrity for a few days, so I am still adjusting to it and it is too early to make any kind of determination. I get to see my GI again on July 7th. By then, I should have a real handle on whether the Motegrity is helping at all.

This is a good reminder that my symptoms are complex and layered. Based on how effective the Xifaxan was, I am comfortable concluding that I did, indeed, have SIBO. And that when I get SIBO again — and given my slow motility and leaky pyloric valve, I am comfortable saying that it is a when, not an if — we will know what to do. In fact, we are hoping to get an Rx for Xifaxan to keep in the house so I don’t have to wait months for treatment again in the future.

It also means that I will be hanging on to my PICC line for a while longer.

Back in February, when I was getting off the TPN and before I started needing to continuously vent again, it looked like I was going to be able to get my PICC line pulled. In anticipation of getting my PICC lines pulled, we bought a couple of thank you gifts for my nurse Jennifer, who has been coming every week to change my dressing since last August when I was released from the hospital.

But, things didn’t work out quite as we planned, and here we are in June and it looks like I will be hanging on to my PICC line for the foreseeable future. Given that, we decided to give Jennifer her the gifts this week. Over the course of time, she had revealed herself to David as a fellow Swiftie, so the gifts were Swiftcentric. She was very touched and appreciative.

Most importantly, it gave David and I an opportunity to express our gratitude to her. She has taught us both so much and continues to be there for us, in person and by text, since those terrifying days back in August, with a brand new PICC line and all of our uncertainties about keeping me safe. She is the reason that when I recently had an issue with my PICC line that once might have sent us spiraling in panic, we were able to calmly resolve it just as any skilled infusion nurse would.

Just to be clear, this is the level of care that absolutely everyone should be receiving. But I know from way too many stories in my gastroparesis and tubie groups, that I am incredibly lucky. Lucky to have had a consistent nurse throughout. Lucky that the agency she works for has retained their nurses for years (although there has been some recent turnover and the agency is instituting cost cutting measures that may impact my access to their 24 hour nurses line) and lucky that the pharmacy that supplies me gives us everything we need to prevent infection. Not every pharmacy that she works with does that.