Merry (Belated) Christmas

Merry Christmas from the Williamses!!

By the way - if you didn't get a card from us - it probably means I don't have your address. Let me know if you'd like to remedy that situation.



(A note on the new short hair cut: I haven't decided if I really like it, but it was seriously necessary. And didn't Michael do a good job? Most of my hair fell out last year back before I started forcing myself to eat. It all started growing back at the same time so I have lots of hair that is a couple of inches long. It had gotten to the point where it was making these weird little wings that were sticking out all over my head. They are still there, but with the old hair being short now, it is a lot poofier all around making the wings look less odd.)

For Christmas this year I resurrected a holiday tradition from my childhood: faux gingerbread houses. (I use graham crackers.)


My main house had its own dog house...


and a tree in the window.


I also made a gingerbread church...


with stained glass windows.


Michael made this:


I'm calling it "The house Willy Wonka threw up on."

Happy New Years!

Follow Me

As I have been rather infrequent in blogging, I know a lot of you stopped checking in regularly. So, I just wanted to point out that if you use an RSS reader (like iGoogle) you can get blog updates automatically by clicking here. Since not everyone uses RSS readers, if you would like to get an email letting you know when there is a new post, let me know and I'll get a list going. I'm hoping I can stay a little more on top of things now that I'm starting to feel better.

Along those lines, if I owe you an email, don't take it personally. You are one of many much beloved people whose emails I ignored for a while because I was quite literally doing nothing on the computer. (The iPhone is great for bathroom email reading, but the touch screen is a serious pain if you are trying to write anything.) I'm much better about email now - but the backlog is going to take a while to get through.

Ongoing Health Issues

This will be a Too-Much-Information post. Those of you who don't want to know the gorey details might want to skip on down to the next post.

It has been a while since I talked about all my bathroom issues so I thought I would fill everyone in since I'm sure this is a subject you are all just dying to hear more about.

Since I last wrote, there have been lots more tests done. Countless vials of blood and stool samples later - still no idea what's going on. So, the next step was to scope me. They did a colonoscopy and an upper GI endoscopy. The good news is that everything looks fine. The bad news - still no idea what's going on. Interesting side note (and anyone who's had a colonoscopy should appreciate this): Before a colonoscopy, you have to drink this stuff to clean you out. I had heard from people who had had this that the diarrhea is pretty bad. I was really dreading that because I have diarrhea on a good day so I thought this was going to be insane. But, my body didn't react to it like it does to food so there wasn't an additive effect. It was actually WAY better than what I was used to. My doctor said I was the first patient he'd ever had to be happy with the effects of colon prep.

Anyway, since we still don't know what's going on, I officially have irritable bowel syndrome. I really hate this diagnosis on many levels. First of all, a syndrome isn't much of a diagnosis. It is just a collection of observed unexplained symptoms. It means they don't know what is causing it. IBS in particular is even more meaningless as a diagnosis because almost any physical problem down to just being stressed can cause intestinal issues. So unlike say, restless leg syndrome where they don't know what's going on, but it is odd enough that it is most likely the same (albeit unknown) root cause for everyone who has it -- there are no doubt a myriad of root causes among those diagnosed with IBS. Basically, I went to a doctor saying that I had cramps and diarrhea and was told that I had cramps and diarrhea. Lastly, I feel like we sort of do know a cause (the surgery) even though we don't understand how that resulted the mad diarrhea.

That said, Mike found a paper on IBS that sounds a lot like me. They did this study where they measured the gastrointestinal reflect in IBS patients and controls. Normally, when food hits your stomach (and before it gets to your intestines), your intestines start their calm, controlled peristalsis motions which push everything along. In some IBS patients, this normal response was amplified such that their intestines just went crazy. The contractions were stronger and more erratic that normal. Again, still no idea why - but boy does that sound familiar. In fact (and I apologize for the mental image here) I have seen food come out of me less than an hour after eating. At speeds like that - no wonder the process hurts.

The good news is that I am doing better. First of all, as a rule of thumb, I get better as the day goes on. I usually only get really sick after breakfast. After lunch is much better and I'm often fine with dinner. Also, we are trying to manage the symptoms even though we don't know the cause. So, I'm trying different drugs aimed at dampening the muscle or nerve responses along my GI tract. Some have done nothing, some have helped, but we are still looking for that silver bullet that will make things totally better. Realistically, that may never come - but I am still happy to report significant improvement. There is still a lot of variability from day to day - but that variability now includes occasional days where I'm totally fine. I have even had a few solid bowel movements. (Hurray!) And, these days, a really bad day is like a normal day used to be.

A few other random points - I ended up developing a sensitivity to Imodium. I tried really hard not to over use it, but I guess I did. Anyway - it got to where it would make the cramps way WAY worse. As it was hard to enjoy the lack of diarrhea whilst doubled over, lying on the floor in the fetal position - I stopped using it. After going without for about six months, I've started experimenting with using it again in very small doses. The sensitivity seems to have gone away. I'm hoping I can figure out a balance that will enable me to go camping next summer. I was so sad to not be able to go camping (or even hiking!) all last year. This would be a sad thing anywhere, but in the glorious pacific northwest - it is a tragedy.

We went back home for "Thanksmas" this year. (I highly recommend this as an alternative to getting caught in all the awful holiday traffic.) I had been really nervous that this trip - like so many other before it - would include an ER visit. It didn't! Yea! After a few more, I'm hoping I will feel safe traveling again. There are a lot of fun weekend trips we could do from here that I just haven't felt safe doing. (Who would have thought I would one day feel like I couldn't safely go to Canada?) And, I definitely need to feel safe spending the night in a hotel before I can think about camping in the woods.

Well, I think that should have everyone pretty well caught up. Hope all it well with you!

Cute Puppy Videos

When Dennis and Cheri came to visit they brought toys, including a chicken that Max HATED. The sound seemed to freak him out and he wouldn't touch it. Then we got the idea to wrap it up in his towel (part of his bedding and sometimes a toy in its own right.) The towel HAD to be rescued from the demon chicken.



For Max's birthday, Dennis and Cheri sent more toys.



Max's new magic trick is thanks to his girlfriend's mom, Brandi.

Whale Watching

Mike's family came out for a visit over the summer. (Yes, I am THAT far behind on blogging) For the most part I chilled at home while they did their thing, but I was not about to miss out on this. So, I relied on my good friend anorexia to keep me continent and joined them for an awesome day on the Salish Sea.

Of course, there are lots of pictures and you can also check out the tour blog.

One of the whales really put on a show for us. I was taking stills, but Cheri got a really great video of it.

Pictures!

Several albums have been updated including Maxwell Smart

The following picture is in the Mommy and Max album, but I thought you guys might like to see the subsequent pics.


There is also a new album for our Columbia River Trip. This is from the one overnight trip this year that didn't result in an ER visit!

Gallbladder surgery or Why I don't travel

I know it has been a while since I posted anything so I figured I start with the big "news." (Is it news if it happened 2 months ago?)

I had to have my gallbladder taken out. We tried to take a weekend trip to Wenatchee, WA which is on the other side of the cascades. Trips seem to be a bad thing for me. In the past 7 months, I've taken 3 overnight trips. Two have ended up involving an ER visit. Looked at another way, in the past 7 months I've had 3 ER visits, 2 of which involved an over night trip. I don't really see why sleeping somewhere else should be too much stress for my body to take, but apparently I am just that fragile.

Anyway, gallbladder issues are common with rapid weight loss. I was on some medication to lower my risk, but my risk was probably a bit higher than even the average weight loss surgery patient because of all the food issues I've had. So, while we were in Wenatchee I had a gallbladder attack and we decided to rush back to Seattle (~3 hr drive). We didn't know what was going on but figured it would be best to be seen in the hospital that knew the most about me. Michael dropped me off at the hospital before taking puppy home. I actually lucked out in that the surgeon on call does gastric bypasses so he was very familiar with my situation and now I no longer have a gallbladder. This isn't really a big deal. It means I won't digest fat as well which can lead to diarrhea, but with the issues I have already it is sort of a drop in the ocean.

I did have a few surgery side effects. First of all - apparently they were worried I had hepatitis. I'm not sure who heard what, so I just wanted to go on record as saying that my liver is fine. It was just mad because it got banged around during the surgery. (The gallbladder sits right up against the liver.) There is no damage. The other issue is this weird pain that I had. There was this line going from my belly button (where they pulled the gallbladder out) diagonally down to the front of my left hip. There was this divot in my skin that looked like it had been pulled too tight and along the line the skin was numb. At either end of the line - there was pain. It was actually more painful than any of the incisions. Everyone was confused by this on two counts. (I used to enjoy thinking of myself as unusual and interesting, but it gets old when you are unusual and interesting medically.) First of all - the gallbladder is in the upper right quadrant of the abdomen and the pain was on the exact opposite side of where they were working. Secondly - what I just described (numbness combined with pain and a seizing up a tissue) sounds a lot like nerve issues. But, in that part of your body, nerves don't run diagonally. So, for about a month it hurt to do just about anything including just having something touch my belly there. I went around all the time in sweatpants that were 5 sizes too big. Then all of a sudden - the pain was gone. Not coincidentally (I think) a month out from surgery is about when you would expect the dissoluble sutures to let go. My theory is that something got pulled too tight when they sewed me up. None of the doctors (including Michael) put much stock in this theory, but I like it.

Well, that concludes the story of the ill-fated gallbladder. I have more posts planned and hopefully it won't take another three months for me to get around to them. But, now I'm on my way to meet my GI doc to see what he has to say about my other issues.

Health Update: The Good, the Bad, and the Ugly

Quite a few of you have expressed concern over my current state of health - so I thought an update was in order.


The Good:
As we get farther and farther away from my partial bowel obstruction with no similar problems, it is rather unlikely that I will need a follow up surgery to deal with an obstruction.
I don't have sleep apnea anymore, so that's great.
I had some hormonal issues that put me at risk for diabetes and they are correcting themselves.
My doctors are happy with my muscle tone. Also, b12 and iron levels are fine. (These are the two most common deficiencies with gastric bypass.) So, I can only be but so malnourished.
While I do have issues, they are getting better as well, so on the whole I feel really good about how things are going.


The Bad:
I just had my second ER visit. We are currently in NC visiting my god-parents. We flew into C'ville and were able to catch up with a few people over the weekend, but it would appear that I over did it. It was hot and I wasn't as careful as I should have been. I've been flirting with dehydration for a while (more on that later) and I crossed a line. I got a kidney stone and my potassium levels were really low. I recovered quickly, which is good. I had hoped, however, that my previous ER visit would be my last. And, it was rather disconcerting to strike out for an ER in the middle of the night in a town that isn't your own. Luckily, Michael did a rotation in this area while he was in med school, so he knew where to go. I'm still working on the kidney stone, but hopefully it will work its way out soon.


The Ugly:
This is the TMI section of this post - so if you don't want the gorey details - you may want to stop reading here.

The big problem that I have now is that I get sick whenever I eat. I get cramps, diarrhea and sometimes, I throw up. When this first started, I thought I had a stomach flu but it has been a couple of months now and I'm still dealing with it. I'm tried food experiments (like cutting out dairy) but I can't find particular foods that are and are not problematic. What I eat doesn't seem to mater - just the fact that I have eaten. As not fun as all this is, the real problem is that all the diarrhea is leaving me dehydrated. I'm drinking as much as I'm supposed to, but I can tell from how I feel that it isn't enough. I'm also not eating enough (so I'm losing some muscle mass due to protein deficiency) and I recently tried to add in an extra meal, but the extra diarrhea got me notably dehydrated so I had to drop that idea.

At first, I could eat breakfast and I would be sick all day (without eating anything else) and into the night. Now, I'm down to only a few hours of being sick. This is a very significant improvement. For one, now I eat breakfast and by the time I need to eat lunch - I'm no longer feeling sick. As you can imagine, this makes it much easier to make myself eat. Also, I have this little break between meals where I'm ok and can get things done. For a long time, I'm just been spending all day in the bathroom. Now, I can emerge from the bathroom and I have a little time to do some ironing - or write a blog post - before I eat lunch and make myself sick again. This little break has been a huge sanity boost and I look forward to it getting longer. I also have learned a couple of ways to control it. For one - I can just not eat. Now, obviously, I can't do this much (as tempting as it is) but used judiciously it can enable things like flying back to the east coast. I also respond to Imodium. More than getting rid of the issues, it more slows them down. The diarrhea isn't as crazy, the cramps aren't as bad, but food seems to stay in my stomach longer making it more likely that I'll throw up. And, if I take too much I become very nauseated. I also don't want my body to adjust to a constant presence of Imodium. In general, I use it just once a week - but I can make exceptions for special occasions like my cousin Emily's visit.


Well, that's about it. I hope you all are doing well.