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Thursday, February 20, 2014

The Grieving Process for a Chronic Illness and How to Overcome It

I woke up today to find that the Gastroparesis community on Facebook has lost another GP warrior. It makes me incredibly heartbroken that modern science has no cure for this yet. How many more people have to die before awareness can be spread?

On that note, I decided to write about the grieving process and how to overcome it with a chronic illness. Being told you have a chronic illness can be devastating and shocking, especially when you're told that your stomach will not work as it used to. Everyone goes through the grieving process - grieving for their life they'll never have again because chronic illness changes you. So, let's go through the grieving process together. That way, we can understand how to get through the process.



According to Judy Axelrod from Psych Central (LINK: http://psychcentral.com/lib/the-5-stages-of-loss-and-grief/000617)

The stages of mourning and grief are universal and are experienced by people from all walks of life. Mourning occurs in response to an individual’s own terminal illness or to the death of a valued being, human or animal. There are five stages of normal grief that were first proposed by Elisabeth Kübler-Ross in her 1969 book “On Death and Dying.”

In our bereavement, we spend different lengths of time working through each step and express each stage more or less intensely. The five stages do not necessarily occur in order. We often move between stages before achieving a more peaceful acceptance of death. Many of us are not afforded the luxury of time required to achieve this final stage of grief.

The death of your loved one might inspire you to evaluate your own feelings of mortality. Throughout each stage, a common thread of hope emerges: As long as there is life, there is hope. As long as there is hope, there is life.

Many people do not experience the stages in the order listed below, which is okay. The key to understanding the stages is not to feel like you must go through every one of them, in precise order. Instead, it’s more helpful to look at them as guides in the grieving process — it helps you understand and put into context where you are.



1. Denial and Isolation

The first reaction to learning of terminal illness or death of a cherished loved one is to deny the reality of the situation. It is a normal reaction to rationalize overwhelming emotions. It is a defense mechanism that buffers the immediate shock. We block out the words and hide from the facts. This is a temporary response that carries us through the first wave of pain.



2. Anger

As the masking effects of denial and isolation begin to wear, reality and its pain re-emerge. We are not ready. The intense emotion is deflected from our vulnerable core, redirected and expressed instead as anger. The anger may be aimed at inanimate objects, complete strangers, friends or family. Anger may be directed at our dying or deceased loved one. Rationally, we know the person is not to be blamed. Emotionally, however, we may resent the person for causing us pain or for leaving us. We feel guilty for being angry, and this makes us more angry.

Remember, grieving is a personal process that has no time limit, nor one “right” way to do it.

The doctor who diagnosed the illness and was unable to cure the disease might become a convenient target. Health professionals deal with death and dying every day. That does not make them immune to the suffering of their patients or to those who grieve for them.

Do not hesitate to ask your doctor to give you extra time or to explain just once more the details of your loved one’s illness. Arrange a special appointment or ask that he telephone you at the end of his day. Ask for clear answers to your questions regarding medical diagnosis and treatment. Understand the options available to you. Take your time.


3. Bargaining

The normal reaction to feelings of helplessness and vulnerability is often a need to regain control–

If only we had sought medical attention sooner…
If only we got a second opinion from another doctor…
If only we had tried to be a better person toward them…

Secretly, we may make a deal with God or our higher power in an attempt to postpone the inevitable. This is a weaker line of defense to protect us from the painful reality.



4. Depression

Two types of depression are associated with mourning. The first one is a reaction to practical implications relating to the loss. Sadness and regret predominate this type of depression. We worry about the costs and burial. We worry that, in our grief, we have spent less time with others that depend on us. This phase may be eased by simple clarification and reassurance. We may need a bit of helpful cooperation and a few kind words. The second type of depression is more subtle and, in a sense, perhaps more private. It is our quiet preparation to separate and to bid our loved one farewell. Sometimes all we really need is a hug.



5. Acceptance

Reaching this stage of mourning is a gift not afforded to everyone. Death may be sudden and unexpected or we may never see beyond our anger or denial. It is not necessarily a mark of bravery to resist the inevitable and to deny ourselves the opportunity to make our peace. This phase is marked by withdrawal and calm. This is not a period of happiness and must be distinguished from depression.

Loved ones that are terminally ill or aging appear to go through a final period of withdrawal. This is by no means a suggestion that they are aware of their own impending death or such, only that physical decline may be sufficient to produce a similar response. Their behavior implies that it is natural to reach a stage at which social interaction is limited. The dignity and grace shown by our dying loved ones may well be their last gift to us.

Coping with loss is a ultimately a deeply personal and singular experience — nobody can help you go through it more easily or understand all the emotions that you’re going through. But others can be there for you and help comfort you through this process. The best thing you can do is to allow yourself to feel the grief as it comes over you. Resisting it only will prolong the natural process of healing.




The tricky part is, how do you overcome the grieving process with a chronic illness?

Therese J. Borchard, from Psych Central (LINK: http://psychcentral.com/blog/archives/2009/06/16/5-rules-for-living-with-chronic-illness-and-depression-an-interview-with-elivra-aletta/) has these tips for you to help you overcome the grieving process. There are five rules of living with a chronic illness:

1. Be confident you have the right doctor.

When you have CI your relationship with your doctor is second only to your spouse or your parents. Being honest (and you must be honest!) with that person means you need to be able to trust them to hear you. If you don’t have that kind of relationship get a second opinion. Shop around. In my CI career I fired three highly recommended specialists because they were jerks. Thankfully I’ve also had wonderful physicians who literally saved my life and my mind.


2. Define your circle of support carefully.

Isolation leads to depression and it is so easy to isolate when you feel lower then dirt. People may surprise you. Peripheral friends may step up and be terrific support while others you thought you could count on cave. If someone inside the circle asks, “How are you?” Tell them the truth. When someone outside the circle asks, lie, say, “I’m fine” and change the subject. Too often they can’t handle the truth and they suck any energy you have taking care of them. A patient of mine found her mother would get hysterical at any medical news so it was better to keep her at arms length.

If someone asks if they can help say yes. Accepting help is a gift to them. Trust that someday you will be on the giving end. My patient’s mother could do laundry for her and that made both of them happy. One big way someone can help is to go to doctor’s visits with you. The extra eyes and ears take the pressure off you when the news is emotionally laden and important, even if the news is good.


3. Protect your health as you would a small child.

You are more than your illness. That part of you that functions well needs you to advocate for it. Of course there are the basics of getting plenty of sleep, exercise and eating smart. In addition to all that I suggest learning a new set of signals that are your clues for when you’re wearing your health thin. For me it’s lowered ability to concentrate, tension in my neck and shoulders, irritability and loss of my usually dependable sense of humor. When those yellow lights are blinking, it’s time for me to stop, assess and make changes. When I ignored those signals I relapsed and looking back I can see where I ran the red lights. So be a fierce protector of your health. Set limits and find the courage to say ‘No’!


4. Create a new measuring stick.

Our self-esteem lies in the standards with which we measure ourselves as we go through life. To thrive with chronic illness, throw out the old and rethink your standards. If you are used to defining yourself by your 50-hour workweek, for instance, you may feel lousy about yourself because now you can’t manage it.

Finding a new standard can be tough. One technique I use with patients is to have them ask themselves what is reasonable? Is it reasonable to do it all yourself or is it more reasonable to delegate? Is it reasonable to register the kids in travel hockey or is it more reasonable to stay local? This is where a lot of courage is needed. Courage to address old pressures to be a certain way and to imagine value in doing things differently. In my own life and in my work I find that those who thrive despite chronic illness creatively find opportunity in their new reality.


5. Have dreams and strive for them!

You had ambitions to get a degree or promotion, to see the world or save it, to get married and have kids. Now you’re thinking, do I have to give that up? No, you don’t. It’s imperative for your spirit that you have goals for living, big and small.

What might change with the reality of chronic illness is the path and timing. I wanted to have kids and was told for years, ‘No.’ I had to adjust to the idea of life without kids or adopting. Then in my late thirties, my doctor said, go for it. After a scary, thrilling journey, today I have two thriving teenagers.

As we reach for the stars let’s appreciate the ground we stand on. Mindfulness has a real place in keeping depression at bay for everyone. Sometimes our dreams are right before our eyes.


To overcome grieving for a chronic illness, you must adjust to life with a chronic illness. Mary J. Yerkes, from Focus on the Family (LINK: http://www.focusonthefamily.com/lifechallenges/emotional_health/living_with_chronic_pain_and_illness/adjusting_to_life_with_chronic_illness.aspx) tells us how to adjust with life with a chronic illness so that we may be able to move on.

She writes,

Adjust to life with chronic illness?

It might seem counterintuitive, but according to experts, you can live a full and meaningful life despite having compromised health. Millions of people living with serious chronic conditions have used their struggles as a springboard for spiritual, relational and emotional growth. Many have gone on to launch new ministries, careers, and friendships.

"Eventually, you adjust to a new normal," explains Lisa Copen, founder of Rest Ministries, Inc™*, an organization that serves the chronically ill.

According to Copen, once you find the right doctor, medication and support, you can learn to cope successfully with your limitations—as long as you remember that you're not just dealing with your physical well-being; instead, you're learning to cast your relationships, emotional and spiritual health and physical health in a different light.
Adjusting Relationally

Couples should devote as much time to managing their relationship as they do to managing the illness, advises Deborah B. Dunn, Licensed Marriage and Family Therapist.

"Find a third-party, outside of the family, who is supportive, encouraging and able to help you process the changes," she says. "Don't let your illness define you or your marriage."

She also advises against telling children that "everything will turn out fine."

It may not.

"Don't make promises you can't keep," she says. "I've talked to so many children during the years who have gotten so angry with God because they think He fell down on the job. Be honest without being graphic."

Family relationships are not the only ones to suffer. Friends, co-workers, neighbors—even people from church, may not know how to respond to the "new" you. Some may reject you because they're uncomfortable with your physical or emotional pain.

Copen also advises relying on a confidant who understands what you're going through.

"If you're having trouble finding support at the local level, use the Internet to find the help and support you need. In addition to Rest Ministries*, organizations like Joni and Friends* and Dave Dravecky's Endurance* offer tools and practical resources to guide you."
Adjusting Emotionally

For many, healthy grieving, which includes periods of shock and numbness, denial, anger, disorientation, and intense emotional pain, is the greatest challenge. Experts say it is essential that you engage your grief reaction. If you do not, they warn, it will surface in other, more destructive ways.

Here's another important point experts want sufferers to remember: While, the "grieving timetable" is different for everyone, changes in your condition may provoke additional losses and seasons of mourning. That's why it is important to practice patience with yourself, eat well, get sufficient rest, express your feelings—journal, cry, sing, and talk to others about your pain.

Scott Twentyman, M.D., a practicing psychoanalyst in the Washington, D.C. area, urges the chronically ill to watch for signs of depression and to seek professional help when needed.

"Trouble sleeping, loss of appetite, weight gain or loss, loss of interest in activities that were previously enjoyable, lack of energy and certainly suicidal thoughts… all are indications of clinical depression."

And if you are depressed, don't rely on medication alone.

"Treatment for depression is more effective when medication is used in conjunction with therapy," says Dr. Twentyman.

Here are some additional tips that will help you adjust to life with chronic illness:

Educate yourself about your condition.
Recognize your limits and learn to say no.
Accept help from others.
Build fun into your life.
Focus your physical and emotional resources on those things that matter most.
Share your gifts and talents with others.

Facing the Future

One of the biggest fears those living with chronic illness face is about the future. While no one can predict it, the experiences others have faced can help it if we have to deal with chronic pain or illness.

Trish Robichaud lives with relapsing remitting multiple sclerosis and depression.

"My health challenges…have taken my life in a direction that I would never have gone with the illness."

After her diagnosis, Trish built a home-based business that gives her flexibility and allows her to manage her condition.

"It's been a blessing," says Trish, "and I thank God daily for where I'm at in life today."

Then there's Linda Aufrance. She suffers from Lupus, but she believes her health issues has taught them compassion and sensitivity for those who are hurting; it has had positive affects on her marriage.

"As hard as it has been, my illness has brought me and my husband closer," she says.

Trish and Linda still struggle with physical pain. Still, they live rich and meaningful lives. And so can you.

It can be difficult to see God's hand in our pain. But we can be confident that, in Christ, there is always hope for your future.



When you accept your chronic illness and realize your limitations, it's almost like a weight lifts off of your shoulders. You can then find ways to cope. With myself, I've joined support groups, started this blog, started groups and pages on FB to get my illness out there, and I've done fundraising for it. All of this has helped me cope with having a chronic illness. I've come to terms with the fact that I may never go out to eat with my friends any time soon, but I'm happy to know that my friends and family love me and care for me no matter what. Unconditional love is almost as good as a cure!



Image Source: Taken from Imgur




Image Source: Taken from a friend who made it


There is an article on The Mighty that was shared by a friend of mine, which is related to this article and mourning the person you were because of a chronic illness diagnosis. According to the article https://themighty.com/2018/11/grieving-mourning-old-you-chronic-illness/?utm_source=engagement_bar&fbclid=IwAR0OvijxyNBo66ZBMJxXU6FJgVlTCD78hoQozNlpJlTBGA5_qcXhwMFet7w,


"When You Can't Stop Mourning the Person You Were Before Chronic Illness
Written by, Jamie Jasinski

Four years ago, I went to my doctor complaining of excessive tiredness and having so much pain in my hands that I couldn’t squeeze my shampoo bottle while showering. Four years ago, I received a call telling me I needed to see a rheumatologist right away because my blood work came back extremely abnormal in the autoimmune area. I can remember the exact emotions I felt in that moment on the phone and how scared I was, and I can remember the fear I felt the day upon receiving my diagnoses. While I knew that rheumatoid arthritis and Sjögren’s were bad, I didn’t know that they would be life-altering.

Each day, I find my mind going back to the same thing. I keep wondering why, after all of this time, I still am in mourning of my pre-sick self. Maybe I’m sad because I never got to say goodbye to who I used to be; I was so happy and had goals I wanted to achieve. Just a year or so before, I had challenged myself to run, and I came to find that running made me feel at my best and was a form of therapy for myself. As if in an instant, any happiness drained itself from my body and my running came to a halt. I also quit my job because I couldn’t handle the stress and pain my body was being put through and I had severe depression weighing me down and telling me I needed to choose myself or possibly not be here anymore.

Once I couldn’t work anymore, I felt so disappointed in myself and to this day, I want so badly to contribute to society. I want to not wake up each day thinking that my life lacks purpose. To say I had hopes and dreams is an understatement. I saw a future filled with traveling and finding my life’s purpose. Instead, I lost my happiness from depression and any ounce of pride I ever felt inside had left me. When your thoughts switch from thinking about one day buying a house with your significant other to just wanting to wake up one day and feel a little less pain, it makes you realize that you just really needed a warning that this was to come so you could have been more prepared.


With the help of a therapist, I have been through the cycle of grieving and accepting my chronic illnesses multiple times, but I don’t know that I’ll ever be completely OK with my situation. I’ve actually come to a point where I don’t even tell people anymore how I’m actually feeling when they ask because I feel like a broken record and a broken soul that can never be fixed. I have accepted that no matter how many times you try to tell others what you are feeling and experiencing, they may never truly understand. You may lose important people in your life as you have to say 'no' to many outings, but those who honestly are sympathetic to your situation will stick around.

While I was told I’d have this forever, I did think that with medicine, I’d be back to my normal self eventually. Maybe I was naive to think that. I, instead, seemed to have more symptoms as time went on. Just yesterday, I found myself saying out loud that I felt like I needed to be in the hospital hooked up to an IV because I couldn’t handle the pain anymore. This statement was coming from someone who is absolutely petrified of hospitals. The pain ranges from my fingers to my elbows, to my neck, hips, knees and ankles, and I turn into a child not knowing how to help myself.

I try so often to think of how I can explain the type of fatigue I experience because it’s probably one of the hardest components of this. I try to explain to my husband that I’ll be going through my day and all of sudden, fatigue hits me. It feels as though if I don’t lie down at the moment that I’m going to collapse. It feels like the time in your life where you have felt most drained and energy deprived, but it happens multiple times a day and lasts two to three hours each time. No matter how much I rest, I still feel like I haven’t slept in days.

Since I never was able to say farewell to the me before I got sick, I am taking this moment to do so now, and hoping that anyone else who has experienced similar feelings and situations will be brave enough to do this one day too. If I have discovered anything positive about myself throughout this journey, it’s that writing has been the best outlet for me in coping.

I’ve just been told that my body will never be the same again, so I wanted to say goodbye to you as I await the arrival of this new body. You gave me the privilege of being left-handed and being artsy since I was so young; you gave me the rhythm and moves that helped me find a love of dance that lasted me 10 years. You gave me the courage to go on stage and dance while my family and friends sat there to watch and support me. You sent those smiles to my face that others would often tell me made their day; you made me a genuinely happy person that would never allow the bad things in life to take over. You gave me the ability to take up running at the age of 26, and you showed me that if you really put your mind to it, you can achieve things you didn’t think you could do. You stayed with me while I began a weight loss journey and achieved what I set out to do. You gave me countless miles of walking around and exploring life like one should while growing up. I don’t think I gave you enough credit at the time, but you managed to keep going on the days where you barely had the energy to do so. You got through going to college full-time, while also working 30 hours a week and trying to make time for my family life and also a social life. You won’t be taken for granted and will be remembered and appreciated for the rest of my life. I will miss your energy. I will long for the days of being pain-free and being able to walk around with no issues. I will miss our shopping trips, as they will be few and far between soon. I will miss vacations where I didn’t have to worry about planning around taking breaks and rests throughout the day. I will miss a body free of medication in order to function. Most of all, I will miss the feeling of being me the most. My new body will be different and not the one I have known since I was born. I will still be me inside, but I’ll never really feel the same again. Thank you for the time I was able to have you."



NOTE: If you are interested, I have a Facebook Page. I'm trying to reach 500 Likes. If you want motivation, inspiration, and just straight up positivity, here's the link: https://www.facebook.com/emilysstomach

Monday, February 17, 2014

How to Pass Time in a Hospital

So, I have been thinking about this a lot lately, how do people spend their time during long hospital stays? I was hospitalized last year for eight days straight and I thought I was going to go crazy. I probably would have without my laptop!

Therefore, I am going to help you come up with ideas to pass time in a hospital. If you have more suggestions than I was able to think of, please comment and post them so that I can update this list. I want to make sure our members have suggestions. Also, if you can think of things to do in a pediatric hospital, let me know. But, for now, this is the list for the adults who are hospitalized.




According to Carepages, LINK HERE: http://cms.carepages.com/CarePages/en/ArticlesTips/HelpfulTips/BetterYou/pass_the_time.html

"Staying busy can be strong medicine for someone facing a long or extended hospital stay. Here are some ideas to keep boredom at bay. Use them for yourself or suggest them to someone in need. These tips also work well for someone recovering at home.

Take an online class. Have you ever wanted to learn how to scrapbook or speak fluent Italian? Now’s your chance. The Internet has plenty of online resources. Here are a couple to get you started:

Learn to play an instrument. The therapeutic effects of music have long been established. Depending on your mobility and situation, strumming a guitar or even simply picking up a harmonica can both soothe and distract [side note: this may not be the best thing to do at a hospital around a lot of sick people trying to rest]

Play board games or cards. A heated game of good old-fashioned Monopoly or Scrabble can take everyone’s mind off things for a few hours. And a deck of cards can be enjoyed together or solo (hellooooo, Solitaire).

Start a website journal. CarePages.com (that’s us) makes it easy to create a free website to share your journey, post photos and stay in touch with everyone. Create a website in minutes. [I use www.blogger.com]

Write letters. There’s nothing quite like getting a hand-written letter in the mail. While email and texting are instant, the flavor and fragrance of a real letter can be priceless (not to mention the anticipation of letter opening). Now that you’ve got some time, why not put pen to paper? Don’t forget to say “write back.”

Load up on brain food. Sudoku and crossword puzzles can be found everywhere these days. And studies show brain exercisers can sharpen mental acuity and even ward off age-related illnesses such as Alzheimer’s.

Watch movies. If hospital cable doesn’t tantalize you, create your own entertainment by downloading and watching movies on a laptop or iPod. Portable DVD players do the trick, as well.

Decorate your hospital room. Many hospitals have “Art-Cart” programs that provide a rotating art collection from which patients can choose for their rooms. Inquire at your facility or help get a new program started. [I have done this during Easter and my nurses loved it]"



Here are the thoughts that I've gotten from members or thought of myself, without reading this list. I apologize for duplicates:

1. Make friends with other patients
2. Make phone calls and talk to friends
3. Play around on the Internet
4. Read the news
5. Read books
6. Do a crossword puzzle
7. Play board games
8. Play card games (like solitaire)
9. Play video games on your laptop
10. Have friends and family visit for a distraction
11. Bring your own clothes from home to change into because gowns are awful
12. Play games on an IPAD
13. Read your Kindle/Nook/etc
14. Walk around the hospital and get some exercise
15. Watch TV (but it always seems like nothing is ever on)
16. Connect with friends through Facebook/Social Media
17. Text your friends
18. Sleep through your hospital visit
19. Watch Netflix
20. Watch movies on Laptop
21. Decorate your hospital room
22. Listen to Music (with headphones, of course)
23. Make your own Youtube videos about your illness
24. Make and write your own blog about your experience in the hospital for others
25. Write reviews for the hospital nurses, doctors, and staff online
26. Talk to the x-ray tech and ask what’s the weirdest thing they’ve ever seen
27. Write stories, long or short
28. Write poetry
29. Play video games on your Nintendo 3DS
30. Skype with loved ones who can’t see you at the hospital
31. Complete a puzzle
32. Learn to knit



If you can think of anything I might have missed, please comment with a suggestion. I hope this will give you enough ideas to stay busy the next time you are hospitalized. I know that I will be loading up a to go bag!

Friday, January 10, 2014

The Gastroparesis Diet & Recipe Help/Ideas

Gastroparesis Diet for Delayed Stomach Emptying Link found: http://gicare.com/diets/gastroparesis-diet/

Author: Frank W. Jackson, M.D.


Below is a published paper by Dr. Jackson explaining the Gastroparesis diet. I know it's a *huge* change to make, especially since you could eat almost anything before GP. But, following the GP diet will help avoid those severe spasms and pain if you can stick to the diet.




Source: This image was made by a friend for GP Awareness Month, in August.






Purpose

Gastroparesis is the medical term for delayed stomach emptying. During the process of digestion, the stomach must contract to empty itself of food and liquid. Normally, it contracts about three times a minute. This empties the stomach within 90-120 minutes after eating. If contractions are sluggish or less frequent, stomach emptying is delayed. This results in bothersome and sometimes serious symptoms, as well as malnutrition, because food is not being digested properly.

Gastroparesis may be caused by various conditions such as diabetes mellitus, certain disorders of the nervous system, or certain drugs. Often however, no cause can be found although a viral infection is suspected in some. Usually, the physician prescribes medication to stimulate the stomach to contract. The purpose of the gastroparesis diet is to reduce symptoms and maintain adequate fluids and nutrition. There are three steps to the diet.

STEP 1 DIET consists of liquids, which usually leave the stomach quickly by gravity alone. Liquids prevent dehydration and keep the body supplied with vital salts and minerals.

STEP 2 DIET provides additional calories by adding a small amount of dietary fat — less than 40 gm each day. For patients with gastroparesis, fatty foods and oils should be restricted, because they delay stomach emptying. However, patients at the Step 2 level are usually able to tolerate this amount.

STEP 3 DIET is designed for long-term maintenance. Fat is limited to 50 gm per day, and fibrous foods are restricted, because many plant fibers cannot be digested.



Nutrition Facts

The STEP 1 Gastroparesis Diet is inadequate in all nutrients except sodium and potassium. It should not be continued for more than three days without additional nutritional support. STEP 2 and STEP 3 Gastroparesis Diets may be inadequate in Vitamins A and C, and the mineral iron. A multivitamin supplement is usually prescribed.


Special Considerations

Diets must be tailored to the individual patient. This is because the degree of gastroparesis may range from severe and long-standing to mild and easily corrected. Patients may also have various medical conditions to be considered. For example, diabetes patients with gastroparesis are allowed sugar-containing liquids on the Step 1 diet, because that is their only source of carbohydrate. On the Step 2 and Step 3 diets, these patients should avoid concentrated sweets. These are noted with an asterisk (*) on the food lists.





On all of the diets, liquids and food should be eaten in small, frequent meals. This helps to maintain nutrition.






Sample Menu Step 1

Breakfast
Gatorade 1/2 cup
ginger ale 1/2 cup
bouillon 3/4 cup
saltine crackers 6


Lunch
Gatorade 1/2 cup
Coke 1/2 cup
bouillon 3/4 cup
saltine crackers 6


Dinner
Gatorade 1/2 cup
Sprite 1/2 cup
bouillon 3/4 cup
saltine crackers 6

This Sample Diet Provides the Following:

Calories 790 Fat 9 gm
Protein 11 gm Sodium 3531 mg
Carbohydrates 156 gm Potassium 244 mg




Sample Menu Step 2

Breakfast
skim milk 1/2 cup
poached egg 1
white toast slice
apple juice 1/2 cup


Lunch
mozzarella cheese
2 oz
saltine crackers 6
chicken noodle soup 3/4 cup
Gatorade 1/2 cup


Dinner
peanut butter 1 Tbsp
saltine crackers 6
vanilla pudding
1/2 cup
grape juice 1/2 cup


Morning Snack
ginger ale 1/2 cup
canned pears 1/2 cup


Afternoon Snack
skim milk 1/2 cup
cornflakes 1/2 cup
sugar 2 tsp

Evening Snack
frozen yogurt 1/2 cup
saltine crackers 6

This Sample Diet Provides the Following
Calories 1343 Fat 35 gm
Protein 52 gm Sodium 2639 mg
Carbohydrates 206 gm Potassium 1411 mg




Sample Menu Step 3


Breakfast
skim milk 1/2 cup
cream of wheat 1/2 cup
sugar 2 tsp
orange juice 1/2 cup
white toast 1 slice
margarine 1 tsp
jelly 1 Tbsp


Lunch
tuna fish 2 oz
low-fat mayonnaise 2 Tbsp
white bread 2 slices
canned peaches 1/2 cup
Gatorade 1/2 cup


Dinner
baked chicken 2 oz
white rice 1/2 cup
cooked beets 1/2 cup
dinner roll 1
skim milk 1/2 cup
margarine 2 tsp


Morning Snack
low-fat yogurt
1/2 cup
Sprite 1/2 cup



Afternoon Snack
chocolate pudding
1/2 cup
gingerale 1/2 cup


Evening Snack
ice milk 1/2 cup
pretzels 2

This Sample Diet Provides the Following:
Calories 1822 Fat 42 gm
Protein 75 gm Sodium 2234 mg
Carbohydrates 286 gm Potassium




Source: This was made by a friend of mine for GP Awareness Month.




According to LiveStrong, the link is HERE: http://www.livestrong.com/article/408015-foods-you-can-eat-when-you-have-gastroparesis/#ixzz2PjiAmh3D

"Gastroparesis is a condition in which food is delayed in emptying from your stomach into your small intestine. According to a 2008 article in "The Medscape Journal of Medicine," 4 percent of the United States population experiences symptoms of gastroparesis, which include nausea, vomiting, abdominal pain and bloating, weight loss, acid reflux and early satiety. Uncontrolled blood sugar with diabetes is often the cause of gastroparesis but intestinal surgery, Parkinson's disease, multiple sclerosis and other unknown causes contribute to the development of this condition. Treatment involves medication to stimulate stomach emptying and a diet that helps manage gastroparesis symptoms.


Meal Patterns

With slow stomach emptying, the amount of food you eat during a meal can trigger gastroparesis symptoms if you are not careful. Eat a balanced diet, broken down into six small meals throughout the day. Sitting up at meals and walking between meals will also help with digestion and increase your appetite for the next meal. If weight loss or maintenance is a concern, be sure you are eating enough or consider adding additional small meals during the day.


Low-Fat Foods

The amount of fat in your meals can further delay stomach emptying. Low-fat meals are recommended for better tolerance. Meat is a good source of protein, but can be high in fat. Choose lean cuts and remove any visible fat during meal preparation. Poultry, lean ground beef, fish and eggs are good diet choices. Milk, yogurt and cheese are rich in protein, calcium and vitamin D, but can also be high in fat. Pick low-fat versions for easier digestion. Added butter, margarine, sour cream, oils and salad dressings can contribute a lot of fat to your diet. Use this group sparingly and instead flavor foods with natural herbs and seasonings.


Dietary Fiber

While fiber is important for bowel health, a high fiber diet may exacerbate gastroparesis symptoms. Low fiber foods are better tolerated. Stick with white bread, rice and pasta. Read cereal labels and choose low fiber versions. Fruits and vegetables can be included in your diet, but stick with low fiber choices such as applesauce, canned peaches, tangerines, skinned potatoes, zucchini, lettuce and celery. Once your gastroparesis symptoms improve, you may incorporate more fiber foods in your diet with caution. Start with very small amounts to determine if you are able to tolerate any of these foods.


Carbohydrates and Concentrated Sweets

Managing your blood sugar level and being aware of the carbohydrates in your diet is important if diabetes is the cause of your gastroparesis. Carbohydrate sources include breads and grains, fruit and fruit juices, dairy, vegetables, sweets and desserts and some beverages. Be consistent with the amount of carbohydrates you are eating and the timing of your meals. Reading labels is helpful to identify the serving size and carbohydrate amount in your foods. Avoid a lot of sweets and desserts with added sugar and fat like cake, cookies and brownies. Instead choose low-fat cake or pudding which can help control your intake of sugar and fat."


For any more guidance or help with the diet, please visit: http://attachment.fbsbx.com/file_download.php?id=166937710179851&eid=ASvAlblP21aLoXUqJ0hQVstmFw63qF94GOkRyL2X9KHhmNmV4mee_We3Q421G85FG14&inline=1&ext=1389409563&hash=ASvp6Agd3yDl4V3r


If you are traveling with Gastroparesis, please refer to below:


Also, please visit: INFORMATION ABOUT GASTROPARESIS AND TRAVELING WITH GP.

If you have a feeding tube and need to travel, please visit: TREATMENT OPTIONS FOR GASTROPARESIS & TRAVELING WITH A FEEDING TUBE.



Low Residue Diet
Credit: Tracey J.





The Gastroparesis Diet from Mayo can be found here: http://www.emilysstomach.com/2013/01/gastroparesis-diet-from-mayo.html.





Recipe Ideas and Help on Pinterest

I have a board on Pinterest that my GP friends and I post GP friendly recipes to. Please check it out. As always, be careful because some people can tolerate things better than others. You know your body better than anyone else and what you can tolerate and what you cannot. Please keep that in mind when browsing recipes. However, there are lots of "GP friendly" recipes on our board that will give you some ideas about what to make for yourself. Changing your diet can be tough, especially when most of us don't feel like eating most of the time. However, my GI recently told me to try and eat small meals as often as I can, because it gives your gut a work out, so that your gut will move things through. If you are interested in helping pin Gastroparesis Friendly Recipes to the collaborative board, leave me a comment and I'll contact you. Having help really does help me and it helps others.

For recipe ideas and help, please visit my Pinterest Board at: http://www.pinterest.com/chikensrule/gastroparesis-friendly-recipes/

If you are interested in juicing, I have recipes on my Pinterest Board, but also this article I wrote a while back: http://www.emilysstomach.com/2013/06/juicing-recipes-and-tips-for.html



This is from the blog at http://blog.katescarlata.com/wp-content/uploads/2013/05/GP-FODMAPs_2013_Final.pdf, which was made by my friend, Stephanie Torres. This is the Food Map Diet I explained above laid out in a better format.



Saturday, December 21, 2013

Ovarian Cyst on Top of Gastroparesis

I went to the emergency room tonight because not only do I have an allergic reaction from adhesive tape and/or latex, but now I have a right ovarian cyst.

The allergic reaction happened after the doctor removed my Impanon. He put a strip of tape on my arm to stop the bleeding that I wasn't supposed to take off for another two days. However, I removed it when I saw this reaction:

My allergic reaction.

It was bothering me and really burning, so I called the doctor and sent him a picture on my cell phone. He wanted me to come to his other office today (more than an 1 & 1/2 away) but I wouldn't make it before he closed. I was in so much pain and I thought it was from the procedure yesterday. After I sent him the picture and waited a bit, he called me back to tell me to go to the Emergency Room.

We got there at 6pm and left at 1:30am. I thought I was going to die of boredom after my Kindle died. I didn't think to bring my charger and my husband tried his best to distract me. The nurse came in and gave me morphine and steroids in my IV. At least they got my IV on the first try but I would have loved to see my labs.

They came and got me for an ultrasound - regular and vaginal. I made them call my doctor because I didn't know if I could have the latter yet but he OK'ed it. It HURT like hell. They stopped and made me empty my bladder, so I went until I couldn't go anymore and went back in for the pelvic. That made me want to cry and jump off the table. This was around 12am, so my morphine had worn off. It was like torture and usually ultrasounds aren't bad. When they finished, they told me that the doctor would take 30 minutes to get the results.

When we got to my room, I waited more. The nurse came in and gave me Toradol, which helped with the cramping day before yesterday. Then, the doctor finally came in. He told me that I had an ovarian cyst on my right ovary and that my GYN will see me on Monday. I've seen my GYN twice this week, I should just put a cot in his office. So, I'm going Monday to see the doctor. I have an ovarian cyst on top of Gastroparesis now. I just want to scream!

The ER Doctor gave me prescriptions for codeine and for steroids. I put cortisone on the allergic reaction to speed up healing a bit.

Information about ovarian cysts can be found here: http://www.mayoclinic.com/health/ovarian-cysts/DS00129

You can read it here:

Ovarian cysts are fluid-filled sacs or pockets within or on the surface of an ovary. Women have two ovaries — each about the size and shape of an almond — located on each side of the uterus. Eggs (ova) develop and mature in the ovaries and are released in monthly cycles during your childbearing years.

Many women have ovarian cysts at some time during their lives. Most ovarian cysts present little or no discomfort and are harmless. The majority of ovarian cysts disappear without treatment within a few months.

However, ovarian cysts — especially those that have ruptured — sometimes produce serious symptoms. The best ways to protect your health are to know the symptoms that may signal a more significant problem, and to schedule regular pelvic examinations.


Symptoms:

Most cysts don't cause any symptoms and go away on their own. A large ovarian cyst can cause abdominal discomfort. If a large cyst presses on your bladder, you may feel the need to urinate more frequently because bladder capacity is reduced.

The symptoms of ovarian cysts, if present, may include:

Menstrual irregularities

Pelvic pain — a constant or intermittent dull ache that may radiate to your lower back and thighs

Pelvic pain shortly before your period begins or just before it ends

Pelvic pain during intercourse (dyspareunia)

Pain during bowel movements or pressure on your bowels

Nausea, vomiting or breast tenderness similar to that experienced during pregnancy

Fullness or heaviness in your abdomen

Pressure on your rectum or bladder that causes a need to urinate more frequently or difficulty emptying your bladder completely



When to see a doctor:

Seek immediate medical attention if you have:

Sudden, severe abdominal or pelvic pain

Pain accompanied by fever or vomiting

These signs and symptoms — or those of shock, such as cold, clammy skin, rapid breathing, and lightheadedness or weakness — indicate an emergency and mean that you need to see a doctor right away.


Treatment:

Treatment depends on your age, the type and size of your cyst, and your symptoms. Your doctor may suggest:

Watchful waiting. In many cases you can wait and be re-examined to see if the cyst goes away on its own within a few months. This is typically an option — regardless of your age — if you have no symptoms and an ultrasound shows you have a small, fluid-filled cyst. Your doctor will likely recommend that you get follow-up pelvic ultrasounds at periodic intervals to see if your cyst has changed in size.

Birth control pills. Your doctor may recommend birth control pills to reduce the chance of new cysts developing in future menstrual cycles. Oral contraceptives offer the added benefit of significantly reducing your risk of ovarian cancer — the risk decreases the longer you take birth control pills.

Surgery. Your doctor may suggest removal of a cyst if it is large, doesn't look like a functional cyst, is growing, or persists through two or three menstrual cycles. Cysts that cause pain or other symptoms may be removed.

Some cysts can be removed without removing the ovary in a procedure known as a cystectomy. In some circumstances, your doctor may suggest removing the affected ovary and leaving the other intact in a procedure known as oophorectomy.

If a cystic mass is cancerous, however, your doctor will likely advise a hysterectomy to remove both ovaries and your uterus. Your doctor is also likely to recommend surgery when a cystic mass develops on the ovaries after menopause.




Brief drawing of the cyst that I have. Image found: http://www.mayoclinic.com/images/image_popup/r7_follicularovary.jpg




According to http://www.medicinenet.com/ovarian_cysts/article.htm#what_is_the_ovary_and_what_are_ovarian_cysts

Ovarian cysts facts:

Ovarian cysts are closed, sac-like structures within the ovary that are filled with a liquid or semisolid substance.

Ovarian cysts form for numerous reasons.

Pain in the abdomen or pelvis is the most common symptom of an ovarian cyst, but most are asymptomatic.

Most cysts are diagnosed by ultrasound or physical exam.

The treatment of an ovarian cyst depends upon its likely diagnosis and varies from observation and monitoring to surgical treatment.


What is the ovary and what are ovarian cysts?

The ovary is one of a pair of reproductive glands in women that are located in the pelvis, one on each side of the uterus. Each ovary is about the size and shape of a walnut. The ovaries produce eggs (ova) and female hormones estrogen and progesterone. The ovaries are the main source of female hormones, which control the development of female body characteristics such as the breasts, body shape, and body hair. They also regulate the menstrual cycle and pregnancy. Ovarian cysts are closed, sac-like structures within an ovary that contain a liquid, gaseous, or semisolid substance. "Cyst" is merely a general term for a fluid-filled structure, which may or may not represent a tumor or neoplasm (new growth). If it is a tumor, it may be benign or malignant. The ovary is also referred to as the female gonad.



What causes ovarian cysts?

Ovarian cysts form for numerous reasons. The most common type is a follicular cyst, which results from the growth of a follicle. A follicle is the normal fluid-filled sac that contains an egg. Follicular cysts form when the follicle grows larger than normal during the menstrual cycle and does not open to release the egg. Usually, follicular cysts resolve spontaneously over the course of days to months. Cysts can contain blood (hemorrhagic cysts) from leakage of blood into the egg sac.

Another type of ovarian cyst that is related to the menstrual cycle is a corpus luteum cyst. The corpus luteum is an area of tissue within the ovary that occurs after an egg has been released from a follicle. If a pregnancy doesn't occur, the corpus luteum usually breaks down and disappears. It may, however, fill with fluid or blood and persist as a cyst on the ovary. Usually, this cyst is found on only one side, produces no symptomsand resolves spontaneously.

Endometriosis is a condition in which cells that normally grow inside as a lining of the uterus (womb), instead grow outside of the uterus in other locations. The ovary is a common site for endometriosis. When endometriosis involves the ovary, the area of endometrial tissue may grow and bleed over time, forming a blood-filled cyst with red- or brown-colored contents called an endometrioma, sometimes referred to as a chocolate cyst or endometrioma. The condition known as polycystic ovarian syndrome (PCOS) is characterized by the presence of multiple small cysts within both ovaries. PCOS is associated with a number of hormonal problems and is the most common cause of infertility in women.

Both benign and malignant tumors of the ovary may also be cystic. Occasionally, the tissues of the ovary develop abnormally to form other body tissues such as hair or teeth. Cysts with these abnormal tissues are really tumors called denign cystic teratomas or dermoid cysts.

Infections of the pelvic organs can involve the ovaries and Fallopian tubes. In severe cases, pus-filled cystic spaces may be present on or around the ovary or tubes. These are known as tubo-ovarian abscesses.



How are Ovarian Cysts Treated:

Most ovarian cysts in women of childbearing age are follicular or corpus luteum cysts (functional cysts) that disappear naturally in one to three months, although they can rupture and cause pain. They are benign and have no long-term medical consequence. They may be diagnosed coincidentally during a pelvic examination in women who do not have any related symptoms. All women have follicular cysts at some point that generally go unnoticed.

Ultrasound is useful to determine if the cyst is simple (just fluid with no solid tissue, suggesting a benign condition) or compound (with solid components that often required surgical resection).

In summary, the ideal treatment of ovarian cysts depends on what the cyst is likely to be. The woman's age, the size (and any change in size) of the cyst, and the cyst's appearance on ultrasound to help determine the treatment. Cysts that are functional are usually observed unless they rupture and cause significant bleeding, in which case, surgical treatment is required. Benign and malignant tumors require operation.

Treatment can consist of simple observation, or it can involve evaluating blood tests such as a CA-125 to help determine the potential for cancer (keeping in mind the many limitations of CA-125 testing described above).

The tumor can be surgically removed either with laparoscopy,, or if needed, an open abdominal incision (laparotomy) if it is causing severe pain, not resolving, or if it is suspicious in any way. Once the cyst is removed, the growth is sent to a pathologist who examines the tissue under a microscope to make the final diagnosis as to the type of cyst present.




What are the risks of ovarian cysts during pregnancy?

Ovarian cysts are sometimes discovered during pregnancy. In most cases, they are an incidental finding at the time of routine prenatal ultrasound screening. The majority of ovarian cysts found during pregnancy are benign conditions that do not require surgical intervention. However, surgery may be indicated if there is a suspicion of malignancy, if an acute complication such as rupture or torsion (twisting of the cyst, disrupting the blood supply) develops, or if the size of the cyst is likely to present problems with the pregnancy.

Medically reviewed by Edmund Petrilli, MD; American Board of Obstetrics and Gynecology with subspecialty in Gynecologic Oncology
REFERENCE: eMedicine.com. Ovarian Cysts.
http://emedicine.medscape.com/article/255865-overview

Previous contributing author: Carolyn Crandall, MD, FACP




Friday, December 20, 2013

Essure Permanent Birth Control and ThermaChoice

Yesterday, I had my procedure for essure permanent birth control control done. I have decided to have my tubes tied, and this is a big decision for me. After years of begging for the doctor's permission to tie my tubes, because of my endometrosis and ovarian cysts. But, the doctors decided, albeit probably correctly, that I was too young.

However, on the 17th, my doctor finally recommended it. The best thing of all was that I had no copay! It was covered completely! I also want to mention that I've lost 30 pounds since July of 2013 when I went into the doctor's office.

He suggested Essure. To read more about it please click here: http://www.mwobg.com/services-procedures/library/how-essure-works

He suggested ThermaChoice in addition. To read more about it please click here: http://www.pelvichealthsolutions.com/thermachoice-expectation

I never planned on having children, so if I decide to have a baby later, I will adopt. I've come to peace with that. I just want some of this pain to end. I deal with enough pain in my stomach and digestive system, if I can get rid of the pain in my reproductive system, I might have sort of a chance to leave a better life with this procedure.

Gastroparesis seems to make the endometrosis worse, so if I can eliminate some of that pain, that would be amazing. Additionally, to get me ready for the procedure so I wouldn't feel any pain, he gave me two dilaudid, a valium, toradol, and a nerve block. I felt pressure but not a whole lot of pain.




According to Planned Parenthood's website, they describe the Essure procedure and benefits:

Permanent contraception (sterilization) is the most common form of birth control for women over the age of 30 and the second most common birth control method for all women of child-bearing age.

Essure offers women whose families are complete a proven and easy birth control choice that doesn’t require incisions, hormones or slowing down to recover. Women who choose Essure never have to worry about birth control again – no daily pill, no side effects, no quick trips to the pharmacy.

We are pleased to offer Essure, a permanent birth control procedure that works with your body to create a natural barrier to prevent pregnancy. The Essure procedure offers women benefits that no other permanent birth control can.



The Benefits of Essure:

Surgery-free

During the procedure, the Essure inserts are placed in the fallopian tubes through the natural pathways of the vagina and cervix, with no incisions and no surgery.

Hormone-free

Unlike many temporary methods of birth control, the Essure inserts do not contain hormones. Therefore, they will not interfere with your monthly cycle nor cause the side effects that many women experience with hormone-related birth control.

Virtually recovery-free

Following the Essure procedure, most women return to their normal activities in less than a day.
Most effective

Essure is proven to be the most effective permanent birth control available, based on five years of clinical data.
Trusted

More than half a million women have chosen Essure as their permanent birth control since 2002. Additionally, the Essure inserts are made from the same proven materials that have been used in heart stents for many years.


What to Expect:

During the procedure, your doctor will slide small, soft inserts through the natural pathways of your vagina and cervix into your fallopian tubes. No incisions are necessary, and this process typically takes less than 10 minutes. The inserts are designed to allow your doctor to see immediately that they have been properly placed. Anesthesia is not required for the procedure, although some doctors may offer it. Some women report mild discomfort or cramping during or after the procedure that is similar to a normal monthly cycle. Most women go home within 45 minutes of having the Essure procedure, and return to normal activities in less than a day.

Over the next three months, your body works with the Essure inserts to form a natural barrier within your fallopian tubes. These barriers prevent sperm from reaching the eggs so that pregnancy cannot occur. During this time, you and your partner will need to continue to use another form of birth control.

You will continue to have a regular menstrual period, but some women who have had the Essure procedure find that their period changes afterward, becoming slightly lighter or heavier. These changes may be due to discontinuing hormone-based birth control, such as the Pill, and returning to your normal cycle. Your ovaries will continue to release eggs, but they will be absorbed through your body’s normal process.

That’s it! Now you can focus on yourself, your family and the life you have created, with the confidence that you are protected from unplanned pregnancy.

Like all permanent birth control procedures, the Essure procedure is not reversible. You should make sure you do not want to get pregnant in the future.

The Wikipedia article for Essure can be found here: http://en.wikipedia.org/wiki/Essure

He also gave me a shot of Depo Provera, so I would be covered until things heal over.



ThermaChoice

This is a procedure the doctor is going to do for me in three months. He wants to make sure that the Essure procedure has completely blocked off before he does this.

You can read about it more at this link (http://www.pelvichealthsolutions.com/thermachoice-expectation but this is what the website says,

GYNECARE THERMACHOICE® Uterine Balloon Therapy with Fluid Circulation offers an effective, nonhormonal treatment for heavy periods, also known as menorrhagia. GYNECARE THERMACHOICE® is a minimally invasive, 8-minute procedure that can be performed in your doctor's office or in a hospital. What happens during the procedure? GYNECARE THERMACHOICE® uses a method called global endometrial ablation (GEA) to remove the endometrium, the lining of the uterus (womb).

Under local anesthesia, the doctor inserts a small silicone balloon into your uterus, which is filled with fluid and then gently heated to treat the lining of your uterus. No incision is required. You may feel a slight warmth or pressure during the treatment time, which is 8 minutes; the entire appointment usually lasts approximately 30 minutes. See step by step how GYNECARE THERMACHOICE® works.

In most cases, patients can resume their normal activities the next day.



What happens after the procedure?

The first postoperative check-up usually occurs within 7 to 10 days after the procedure, and your doctor may determine that sexual activity can resume after that check-up. Your first few periods after the procedure may continue to be heavy, with improvement thereafter. Some women experience a pinkish watery discharge for about 2 weeks that can last as long as 1 month.

All medical procedures carry risks. Talk to a doctor to determine whether GYNECARE THERMACHOICE® might be the right choice for you. Find a doctor familiar with GYNECARE® products who can provide treatment.
What are the risks with GYNECARE THERMACHOICE®?

All medical procedures present risks, so talk to a doctor about whether GYNECARE THERMACHOICE® is right for you. Find a doctor familiar with GYNECARE® products who can provide treatment.

As with all procedures of its type, GYNECARE THERMACHOICE® poses a risk of injury to the uterus and surrounding tissues. Most common side effects include discharge, cramping, nausea and vomiting.

Global endometrial ablation procedures, including GYNECARE THERMACHOICE® III Uterine Balloon Therapy System, are intended for pre-menopausal women with heavy bleeding due to benign causes who do not wish to become pregnant in the future. It is not appropriate for a patient who is pregnant or wants to become pregnant in the future. Becoming pregnant after this procedure can be dangerous for both the mother and the fetus.

Pregnancy after ablation is unlikely, but if it does occur, you and your baby could be at risk because the endometrial lining of the uterus has been removed. After treatment, you will need to continue to use a birth control method that is appropriate for you. There are several options available for birth control. You should discuss these options with your doctor.

For a complete description of risks related to this treatment, please see the Potential Adverse Effects section of the Risk Information.

The information represents no statement, promise or guarantee by Ethicon, Inc., concerning insurance coverage, levels of reimbursement, payment, or charge. Please consult your payor organization with regard to local or actual coverage determination processes.


This will get rid of my painful periods permanently. That would be amazing because they hurt and are erratic. So, I will be sterile with no periods, but I get to keep my ovaries so I don't need hormone replacements. This was a tough decision for me but I knew I could never carry kids to term. So, I figured that this would help the pain. And I need all of the help I can get with pain because Gastroparesis causes enough pain in itself.

So, I am very happy and a little sad, but I'll be OK. I think I've done the best possible thing that I could do for me and wanted to write about it because I had never heard of these procedures before.



Disclamier

My friend Stephanie wrote this for her group and I figured it was applicable to this site as well.

DISCLAIMER: THIS BLOG DOES NOT PROVIDE MEDICAL ADVICE

The information, including but not limited to, text, graphics, images and other material contained on this blog are for informational purposes only. The purpose of this blog is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Reliance on any information appearing on this blog is solely at your own risk. That said, I try to do research to support my claims but always check with a physician first.

Thank you!

Saturday, October 12, 2013

GP Surivial Commandments

Recently, I polled people from around different support groups and pages to ask their advice on what they did when they first realized that they had GP/DTP. I asked, "if you could give anyone advice who was newly diagnosed, what would it be?" I got some overwhelming responses. I'm going to type first names because I don't want to give away the privacy of the people giving the advice.


Speaking from person experience (I was diagnosed with GP in March 2012), the first two things really saved me:

1. I started a blog to keep track of my medical information but also to help others. When I was first diagnosed, I didn't know what gastroparesis was and there was barely anything online to explain it to me. I compiled my research to put into this blog and helped people that way. My blog today is used as a resource for United Healthcare, for when they get new GP patients.

2. I purchased a journal. While this may sound silly, I carry this thing around with me everywhere, and I do mean everywhere. I do daily entries to log what I eat, what time, when my gastric spasms start, when I get sick, how much I get sick, and how I feel. I also take pictures of my swollen belly after I eat and post those pictures in my journal. I print out and post motivational things in there too. There is also an app on your phone called "My Symptoms." It's $2.99 in the Google Play market but it will keep track of food, drinks, medications, and bowel movements. I use both because you can't be too safe. Also, the "My Symptom" application can be download into a spreadsheet to show your doctor. You can also give your written journal to your doctor. Maybe make a copy of it beforehand? It gives your doctor an idea of what you're going through. It will also help distinguish patterns.

3. Be your own advocate. Keeping the journal is well on your way to becoming an advocate for yourself. Do your own research and prepare questions in advance to ask your doctor. That way, you won't forget what you want to ask him and you can maximize the use of your time together.

4. Believe in yourself. This is hard sometimes. It's hard to keep going but just remember that you're a strong person, you've gotten this far. Things will be all right. Keep on believing in yourself and others believe in you, too.

5. This rule goes hand in hand with 3. Ask questions! If you can think of anything, write it down and bring it with you to the next doctor's visit. If it's an emergency, call your doctor after hours.

6. Research your condition and your doctors. Not all GI doctors are created equal. The newest one I just saw told me that gastroparesis does not cause pain. So, keep searching until someone believes you.

7. The GI Doctors at Mayo recommended cannabis, where ever it is legal. If you use cannabis, use it responsibly.

8. It's NOT *ALL* IN YOUR HEAD! I cannot stress that enough. I've been told that half of my life. The Spoon Theory helps with teaching those without a chronic illness what it's like to live with a chronic illness every day. It's rough but this is the most effective theory I can think of.

9. Stay strong by finding a support group. If you need help, you can read my blog or join any of my groups of Facebook. We are all here to support one another. If you look in your local paper, you can probably find public meetings for those with chronic illness. Just talking to people who understand where you're coming from is like a burden lifting from your shoulders.

10. Don't give up! We all have rough patches that knock us down but we get right back up keep fighting. We're strong, especially all united together. Lean on others for support when it becomes too much. That's why we're there.

11. Stay positive! I preach this nonstop because it is important to your health. If you get too stressed out, then your immune system is compromised. Try and stay positive and calm.

12. Be patient. While there is no cure for GP, we have good days and we have bad days. If you are having a "GP Attack" because be patient until it passes. Work on deep breathing (it's in my blog in another article). Also, try and stick to the GP diet. Stay away from things that are hard to digest like fiber, gluten, some raw fruits and veggies.

13. Stay hydrated! If you let yourself get dehydrated, that brings along a whole new set of problems. Dehydration can cause dizziness, headaches, and fatigue. If it's severe enough, you'll need to go to the hospital for IV fluids. Even if you're vomiting, try and such on some ice chips and sip on Pedialyte.

14. Take liquid vitamins or vitamelts. I am currently dealing with a vitamin deficiency, which is common for people who suffer from GP. My body is malnourished and quite starved since I can't hold down food, even if I wanted to. Dehydration just digs you into a whole that you can't escape from. You can try Flinstone's vitamins, or the melt away vitamins. Stay away from the gummy vitamins! They are hard to digest.

15. Lean on family and friends. I know some people have families who aren't very supportive and I'm sorry. They probably don't understand what you're going through but keep your chin up and help them to understand. My favorite is called The Spoon Theory and I've found it's the most effective when explaining a chronic illness to those who don't understand. Keep in mind that family doesn't always mean blood relation.

16. If you are religious, prayer can help. You can also seek out emotional support from a church congregation or a priest to help you get through the initial shock of, "Oh no! I have gastroparesis and now what I am going to do?" You have a community who cares about you and they want to help you. They just may not always know how to help. You will have to tell them how they can help.

17. Keep Yourself Happy. I cannot stress this enough. Being upset does nothing to help your stomach and the stress will more than likely make your stomach worse. I can attest to this from personal experience. HERE is a list from a previous article that gives lots of ideas on what you can do to keep happy and distracted.

18. Keep looking until you find the right GI doctor. I've been told GP doesn't hurt - but if nerve damage hurts in the rest of the body, why not the stomach? I had a doctor at Mayo tell me it was all anxiety because did didn't want to treat me; I was too complicated of a case. Don't forget that these doctors work for YOU. Keep searching for a doctor that's right for you. Find someone you can trust and who will listen to you. I've gone through about 10 GI doctors here in Atlanta and I'm still looking for the one who will listen to me.

19. Don't be in Denial. We all go through it. It's almost like a grieving process when you hear you have GP. I've eaten fast food because I was starving. But, I shouldn't have done that. A few times I did think the GP was in my head and then the vomiting and the gastric spasms (they feel like you have a charlie horse in your stomach when they start). Don't torture yourself and follow the GP diet. Eat low fiber,no raw fruits or veggies, and try and stay away from gluten.

20. Take advantage of the good days. Good days can be few and far between. So, take every minute of every day and enjou it!


Thank you to:
Kirsten
Melissa
Diane
Melony
Jennifer
Tracy
Judy
Julie
Lyndsay
Monica
Nikki
Jessica

Who contributed to the ideas in this article.











Tuesday, October 8, 2013

Follow up with my Spinal Cord Stimulator Doctor

About a month and a half ago, I felt it shift when I bent over to vomit. Since then, it's caused me nothing but pain. I followed up with the PA on Friday, and she did trigger point injections all around the stimulator site to ease up some of the more tense muscles. I cried because it hurt so badly. She told me to follow up with the doctor on Monday, so I did. I went and saw the spinal cord stimulator doctor yesterday, the same doctor who put it in for me. He confirmed what I said, that it had shifted. Instead of lying flat, like it's supposed to, instead, it is more of a 90 degree angle. He scheduled me for back surgery on Monday at 3:30 EST. He said that they'll try and put it back where it was but more than likely, they would have to make a new incision and put it somewhere else. I guess it didn't heal enough and the gastroparesis made it worse. So, now, I have back surgery on Monday and I'm nervous, even though I've had it done before. The last time I was put under anesthesia, I died twice. So, definitely nervous this time. But, I'll get through it, I always do! I'll let you guys know how the surgery goes. Below is a picture of my stimulator. You can see how badly it's sticking out. I wish I could take a better picture but it's almost in such an awkward place in my back that it's hard for me to get a good shot of it.






What is the spinal cord stimulator for, you ask? In 2009, while at field camp, I lost my footing and slid down a mountain on my knees. They couldn't find anything wrong with my knees except for nerve damage. The stimulator is like having a TENS unit in your back, and it blocks out the pain signals of the nerves for relief. It reroutes the pain signals so that my knees and back shouldn't hurt anymore. It does help, tremendously and allowed me to hike again until I kept bending over to vomit and knocked it out of place.

You can read more about it here: http://www.webmd.com/back-pain/spinal-cord-stimulation-for-low-back-pain

Friday, September 20, 2013

Ultrasound Today - Update on my Personal Struggle

I went to Emory for an ultrasound today at the bequest of my Doctor, for my liver. My liver enzymes have been quite high over the past two years now, and no one has discovered why. When I was first diagnosed with Gastroparesis, the theory was that it was because of stones in my liver. They went in and relaxed my sphincter that doles out bile from my liver, removing a "gravely type sludge," as my doctor put it, from where my gallbladder used to be. The Doctor at Emory told me that with Gastroparesis, there should be no pain. Every time a doctor tells me that, I want to laugh in their face and correct them. Tell them that if they had Gastroparesis, they'd feel differently. Everyone I've talked to that has been diagnosed, even with mild Gastroparesis, has dealt with some sort of pain.

So, a good friend and fraternity brother of mine, picked me up and took me to Emory. I was led into the room with the ultrasound machine. I laid down on the table and lifted up my shirt for the procedure. I was happy to say that there were butterflies painted on the ceiling tiles so that I actually had something to focus on. The lab tech started and pressed the probe down on such tender parts that had been giving me such pain. I bit my lip and squeezed my friend's hand because it hurt so much. I had an emesis bag, just in case I needed it.

I looked away because it hurt too much. My friend said the lab tech was making awful faces and she had a feeling that they found something wrong. Of course, the lab techs won't tell you anything - it's a liability factor. She had me turn to my side and looked at my kidneys as well. Then, we were done. The procedure probably took half an hour of thorough investigating with a very painful probe. Ultrasounds normally aren't painful, but I've been experiencing pain in my upper right side. I didn't start retching until we were in the car. Anytime a doctor or someone presses on my upper right side and my stomach - I vomit. Thankfully, it waited until I was home. I fell over on the toilet and vomited up what I tried to eat for lunch today - considering I haven't eaten in a while. I was thankful I had something to vomit up besides bile. I realize how bad that sounds but I've been throwing up nothing but bile for days, my throat welcomed some relief.

I've been coughing a lot because my throat is irritated from vomiting. The doctor will receive my ultrasound report in a few days and call me with the results. I'm nervous because my liver enzymes are high and I don't know what that means. I've never been so nervous. Will I have to have more surgery? Will someone take me seriously? I need some help. What I'm doing right now is not living - it's awful.

The only solace in the past few days have been my husband, who is a wonderful and caring man, and reading outside in the sunshine.

I am anxiously awaiting the results and to wonder where to go from here.

In the meantime, I've made an appointment with a psychologist because I am determined to prove to these doctors that the anxiety didn't get worse until after I had Gastroparesis. The doctor I saw before, not at Emory, at Mayo, told me that this was all in my head an all anxiety related. I want a doctor to evaluate that and tell me that it's not true. I just need someone to listen to me. I can't make up vomiting or pain like this. It's immobilizing. My friends and family see me suffer and I barely recognize my own reflection in the mirror because of my hallowed out, pale face, and the dark circles under my eyes. I think it will be good to have someone to speak with anyway, but I want someone to validate me and say that my GP is legitimate and that it's not caused by anxiety. That made me angry more than anything when the Mayo doctor told me that. I think he only did so because he correctly assumed that I'd be a complicated case, and he didn't want to deal with me personally.

I'm keeping track of my symptoms in a written journal, along with how I feel. A GP friend of mine told me about an app available called MySymptom Tracker. It's $3 in the Google Play store but worth it. So, I track my vomiting, medications, mood, etc on my phone as well. You can download it and bring it in with you to your doctor, which I find useful. I document everything. It's a good habit to have.

I feel like I'm preparing for battle. I'm going to fight to be healthy again.

Monday, September 16, 2013

Gastroparesis Journals, Poetry, and Mentorship Program

I have a favorite poem that I wanted to share with all of you. It has been my favorite since high school. It really spoke to me because for the past few days, I've been very sad. Sometimes, it just seems like the Gastroparesis (GP) cycle is endless. Also, it feels like I'll never get better. I'm not usually so negative, but vomiting for the past three days and having the new doctor write me off just made me a bit depressed. Then, I thought about my favorite poem. It has always spoken to me and cheered me up when I've been at my lowest. It made me realize that I need to keep going. That things will get better and that I have the best Gastroparesis Warrior network that anyone could have.


"'If'
By: Rudyard Kipling


If you can keep your head when all about you
Are losing theirs and blaming it on you,
If you can trust yourself when all men doubt you,
But make allowance for their doubting too;
If you can wait and not be tired by waiting,
Or being lied about, don’t deal in lies,
Or being hated, don’t give way to hating,
And yet don’t look too good, nor talk too wise:

If you can dream—and not make dreams your master;
If you can think—and not make thoughts your aim;
If you can meet with Triumph and Disaster
And treat those two impostors just the same;
If you can bear to hear the truth you’ve spoken
Twisted by knaves to make a trap for fools,
Or watch the things you gave your life to, broken,
And stoop and build ’em up with worn-out tools:

If you can make one heap of all your winnings
And risk it on one turn of pitch-and-toss,
And lose, and start again at your beginnings
And never breathe a word about your loss;
If you can force your heart and nerve and sinew
To serve your turn long after they are gone,
And so hold on when there is nothing in you
Except the Will which says to them: ‘Hold on!’

If you can talk with crowds and keep your virtue,
Or walk with Kings—nor lose the common touch,
If neither foes nor loving friends can hurt you,
If all men count with you, but none too much;
If you can fill the unforgiving minute
With sixty seconds’ worth of distance run,
Yours is the Earth and everything that’s in it,
And—which is more—you’ll be a Man, my son!"
Poem can be found at: http://www.poetryfoundation.org/poems-and-poets/poems/detail/46473


The meaning behind the poem is this:

"‘If‘ by Rudyard Kipling: About the poem

The poem ‘If’ by the India-born British Nobel laureate poet Rudyard Kipling is a poem of ultimate inspiration that tells us how to deal with different situations in life. The poet conveys his ideas about how to win this life, and after all, how to be a good human being.

The poem, written in 1895 and first published in ‘Rewards and Fairies’, 1910 is 32 lines long with four stanzas of eight lines each. It is a tribute to Leander Starr Jameson. The poem is written in the form of paternal advice to the poet’s son, John. You may read more about the poem at Wikipedia.

For the theme, as already told, the poem basically tells us the conditions that we should meet to succeed in life and make this life happy and a beautiful one. The whole poem is written in a single complex sentence. So all the subordinate clauses begin with ‘if’ and the main clause concluding the entire theme comes at the end, and the poem ends with a full stop.

This structure of the poem was important to achieve the conditional goal. The poet speaks of the achievement at the end, after discussing all the requirements to reach there. This structure is actually symbolic in suggesting that you can get the rewards only after you have fulfilled the preconditions. Moreover, this makes the readers eager to know what would happen when we meet all these conditions, thus retaining the curiosity and interest till the end.

And, as the main theme of the poem is a combination of so many if’s, the title ‘If’ is an apt one for the poem."
The meaning of the poem can be found here: http://englicist.com/summary-analysis/poem-if-rudyard-kipling-summary-explanation




There are several pen pal groups in the Gastroparesis community, so I wanted to put out a warning to everyone:

**WARNING** Any Pen Pal groups that you join is to get to know people. If you feel comfortable, friend them, and then share your private information with them. The admins should NEVER ask you for your personal information, unless you get to know them and you want to share your information with them as pen pals, but that's if you are comfortable enough. Just be careful. Your personal information should not be posted on the wall for all to see, because you never really know who is looking at it. The admins try to screen our groups carefully, but occasionally, we miss someone who may be a scammer.

I just wanted to caution anyone who is joining a pen pal group because I've had that happen and it's a very scary feeling, especially if someone tries to steal your identity. I've had this happen to me, which is why I just want to caution people to be careful. Pen pal groups can be amazing because they make you feel less isolated and alone, and it's nice to get real mail instead of spam for a change. Just be diligent. And your information should NOT be in the files section of the group for all to see. Pen pals usually only need your address and maybe your birth month and day to send you things on your birthday. You don't have to give them the year unless you know that person and trust them completely. I'll reiterate, just be careful with who and where you give out your personal information.









We've added a mentorship program to the group so you can get or give support to another member of our community. I am excited to see all of us build stronger relationships with each other and hope you'll join. Facebook has implemented a mentor/mentorship app in the groups now. I have turned it on in our group. There are a lot of mentorees that could use mentors, so far!

If you would like to read about the program, it's below:

https://newsroom.fb.com/news/2018/08/people-can-now-find-mentors-and-mentees-in-groups/

If you would like to sign up to be a mentor (and please don't be nervous about it, because you could really make a difference in someone's life. If you are worried about mistakes, don't be. Mistakes are a learning tool anyway - it's not a mistake if you can learn from it. Plus, instead of having a pen pal group, this is easier and more personal) or a mentoree, please see the left sidebar of the group that says "Mentorship" and here is a link:

https://www.facebook.com/groups/strongerthanGP/mentorship_application/


Here's how the program works:

You sign up, match yourself with a partner, and get helpful conversation starters each week so you get to know each other better better. It's up to you how much time you want to spend together and what goals you want to work towards. It's a new feature FB just implemented and I thought it would be a great idea to add it to the group. I just wanted to point out that option, in case you would be interested in it. It is an option to the left of the group’s feed, under “mentorship.”


Please feel free to send the group link to any friends who might be interested in joining. If anyone is added to the group by another member, it's automatically declined, for the groups' safety. I have stories about this for why I made it a rule. If you have any questions, you can contact me, Emily Randolph Scherer. We just want to make sure that each group member wants to be here, and they also need to answer the questions. But, on a positive note, we LOVE having new members! <3









SMART PHONE APPLICATION - MYSYMPTOMS





If you have a smart phone, my friend Sarah recommended an app to me. It's called MySymptoms: Food Diary and it's a diary for your phone. You can add your medications, what you eat, how often you get sick, all of your symptoms, stress levels, sleep quality, energy level, bowel movements, and more. It's easy to keep up with it.

I downloaded it at the Google Play store.

The only drawback is that it's $2.99 for the application, but it's worth it since we all carry our phones with us everywhere - even when we go out to eat (as rare as that happens).

You can download your data and give it to your doctor as well. I downloaded it and would highly recommend it to anyone with Gastroparesis. It's easy to learn how to use and it is easier to add things to your phone than to write them down sometimes. But I know that we all carry phones with us. I'm still going to use my Gastroparesis journal and write in it but I'm also going to keep track of things on my phone now too. It never hurts to have a back up.












This is my Gastroparesis Journal. It's actually River Song's journal replica from Doctor Who.











Keep a written journal. Write down the date in each entry.

You do want to make it as detailed as possible and you might notice a pattern in yourself.


I started a Gastroparesis journal, which you know of from previous articles in this blog. My Gastroparesis diary is really useful when I'm not near my computer to blog. Write down what time you wake up, what time you take your medicine, what you took, what time you eat, how much you eat, and what you ate. Write down what time you get sick, with what you were sick with, how much, and make it as detailed as possible. Write down any questions you think of to ask your doctor, since the visits with them go by so quickly and you may forget your questions. My doctor actually copies my journal for my chart. This way, you can eventually recognize a pattern with yourself - what makes you sick and maybe what doesn’t. Since every GPer Is different, this is a way to find out what works for you. I know GP is trial and error when it comes to diet, but this written record (I have to admit, my brain fog and memory are terrible so it’s good to write things down) will help you so much. I even print out research or positive things and paste them or tape them in my journal too. I carry it with me everywhere, even when I actually get to leave the house and go to the pharmacy or the doctor. It can be a spiral notebook, binder, you can buy a blank journal from amazon or in a store, you can make anything a GP journal. Give it a try and see if it works for you.

It really helps to keep track of what's going on with my body for my doctor, including questions so that I don't forget to ask since I don't get a whole lot of time to talk to the doctor. I write in mine daily. I keep track of my medications, when I attempt to eat, when I vomit, if I have a bowel movement, and the times of all of it. I also vent in it because it's not healthy to keep your feelings bottled up, and writing helps me cope, but everyone has different coping mechanisms that help them. Your gastroparesis journal could be as simple as a spiral notebook. I would highly suggest that you start one, if you don't have one already, because it really does help keep track of things, especially if you have a hard time remembering things like I do. I call it, "GP brain."



















I'm also going to share a few images that have gotten me through the past few days. I usually cut out images I find like this and put them in my diary to remind me to be strong.