jbird1972

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 I saw Dr. Kroh today (Bariatric surgeon). I haven't seen him in about a year and a half, so a lot has happened. He reviewed my stuff, and this is the plan: (my medical peeps can tune some of the explanation out) Dr. Kroh has no doubt that I have Gastroparesis (basically paralyzed stomach) due to all the nerves that have been severed from the gastric bypass surgeries. He said I'm not really a candidate for the gastric pacemaker, I need to ask him a few clarifying questions about that, but I think he meant because my nerves are severed, where people who have diabetes have damaged, but intact nerves. I was starting to get emotional because I saw my holy grail option disappearing before me. He is going to put in a G-Tube (gastric/stomach) tube tomorrow in hopes that when I have these attacks of severe pain/nausea/bloating, I can use the valve to decompress the stomach. He's going to try that first, but he is consulting with my GI doc at clinic (Dr. Rizk) to discuss doing a complete gastrectomy (stomach removal), I have a partial one now. It's a drastic move, and ironically it would actually bring my anatomy close to what it was during gastric bypass days (no intestine re-routing), and in order to be pro-active (he is aware how close to dying I was from malnutrition when I had the first reversal at university of Chicago), if they had to remove the rest of my stomach, I would get an automatic J-tube(jejunostomy tube/small intestine) that I could receive nutrition through.  I told Dr. Kroh that I am really slipping through the cracks at home, especially when they hear Cleveland clinic. I told him I felt like I was at the end of my medical rope and had no options left. Dr. Kroh said that I have a dedicated team of doctors here at clinic, including him, and that we still have options. I felt a little better about that.  So, I'm leaving my stuff here at the hotel, just packing some things in my duffle to take to the hospital tonight. I'm going to take the last shuttle over, as long as I check in before midnight I'm fine. They will put the G-tube in tomorrow under twilight sedation, it's placement is similar to the EGD that I had (they know about the problem I just had, so he will be extra careful), they go down with scope through mouth to the stomach and create an opening that goes to the outside of the body. Once it is in, it has a little snap/cover on it, and in theory, if I eat and start turning into the Michelin Man, I can undo the valve and let the air out...sounds sexy, right? Ugh The stay in the hospital is two-fold, well maybe 3 or 4...part of it is the "you're here alone" thing, but I would have to stay anyway to have a consult with nutrition so they can show me how to "feed" myself through it if I need to (I do happen to know a 3 year old who could give me a very good tutorial, right Lainey?), and last good reason to be in the hospital? I'm a nightmare patient, and they have figured that out.  So, to wrap up, the kids just think I'm staying longer for a test, which is kind of true. The G-tube is a combo trial that may just fix me (although Dr. Kroh was looking at this as more of a first step/formality to the gastrectomy, but it may just work!). The gastrectomy is my other option and I'm sure would be another trip because I'm not doing that alone.  I'm very emotional, and the irony is getting me, but I'm ok. I can eat until midnight, so I'm going to get a quesadilla from my fav Mexican place. I'll have my phone & charger, so keep those games of words and hanging coming. I'll update you more when I know what time, etc...

I just got back from Cleveland on Sunday.  I was supposed to come back on Saturday, but I had a complication after my EGD.  I know you aren't supposed to remember anything from the sedation procedures, but I think at some point the medication may have started wearing off a bit because I do recall waking up while they were in the middle of the procedure and gagging/wretching like crazy, and they tried to talk me through it, and then the next thing I remembered was waking up in recovery.  My throat was dry, which is normal, but all those meds were still on board, so I didn't really have any soreness or trouble swallowing until about 4 hours later in my hotel room.  I had napped when I got back from the procedure, and when I woke up I was really thirsty, so I tried to sip some water and even though I have never personally swallowed glass, I think I know what it feels like.  I have had so many of these EGD's/upper endoscopies that if it weren't for the sedation part, I feel like I could do one to myself; so I know what to expect.  I usually get a mild to moderate sore throat for a few hours, no big deal, sometimes no sore throat at all.  I remembered the gagging/wretching, so I wasn't really starting to panic yet.  I had my procedure around 12pm, and they said I couldn't take my regular pain meds for 8 hours, so I waited, took my pain meds, and it had zero effect, and the weird thing was that it wasn't the back of my throat that was sore, it was way at the base of my neck, and shooting into my left chest.  It was worse when I tried to breathe in deeply and swallowing. 
I have never taken an ambulance to the ER, I have gone from one hospital to another in one, but never to the ER as a patient in one...I'm used to being on the other end of the cot, either driving or in the back with a patient.  I felt silly as I rode in this ambulance going to the ER at Cleveland Clinic, but I just knew something was wrong, and I am glad that I followed that feeling.  It was kind of confusing because although the ER resident was very nice, he didn't hear any air escaping when he listened to my neck/chest, so he was still going to order some tests but was pretty confident that everything was ok.  The ER attending came in and he listened to my chest and neck for a lot longer, and he heard something that was not right.  I ended up starting with an x-ray, and there was an abnormality that they could see, so then they were going to do a CT Scan (ah, more radiation, that's what I was thinking).  After talking to the radiologist, they decided that it would be better for the Ear/Nose/Throat doctor to come to the ER and do an intra-nasal scope...cue the giant freak out here!!!! I can take a million needles, pain, whatever...but I really have a thing about anything that is going to mess with my gag reflex, just can't take it.  I spent the next hour freaking out waiting for the ENT to get there.  I convinced the ER folks that it would be in everyones best interest to give me something to relax/pain med right before the doc started, and they did...I have to admit that it was all OK in the end, but seeing that 12" long scope that she was going to jam up my nose and down my throat pushed me to the edge.  I also had some time to ponder if what they were seeing on the x-ray was possibly cancer because that was discussed...it was just really a scary time.  In the end, they gave me a mega dose of IV antibiotic, pain control, fluids, and determined that the symptoms plus the weird x-ray added up to a microscopic leak of the esophagus that was causing the pain and weird air leak sound the ER doc was hearing in my chest.  I spent about 12 hours in the ER, and then went back to the hotel, stayed an extra day to make sure I felt ok going home, and then headed home.  It's still pretty painful, but it will get better as it heals.
I'm going back to Cleveland November 14th to meet with the surgeon to see if he has anything in his bag of tricks that can improve my quality of life and/or surgically treat the cause of my very frequent pain/nausea episodes.  I am also going to discuss the possibility of placing a medication port.  I'm seriously running out of veins, and the PICC line is just too much of a risk of infection, and I can't work with a PICC.  The last few PICC's I had kept failing anyway.
So, this last trip was a lesson in Listen to Thyself, if something doesn't feel right, and you have the heebie jeebies, don't ignore the signs, there's probably something wrong.
I hope this finds you all getting better, and at the very least, getting the right care and answers :)

I think the last time I left off, I had my spinal cord stimulator re-implanted at Cleveland Clinic.  I started having some really bad mid/lower back pain, not like I hurt my back or pulled something, but sharp, pinching pain.  I can't see anything myself back by my incision, so I was running my hand along my incision and I could feel a raised area that felt like a wire popping up!  I ended up taking that midnight train to Cleveland, and heading right to the ER there.  I spoke with the neurosurgeon's PA, let him know what was going on and that I was going to the ER.  The ER doc was fabulous, they were very busy, but I swear he was in my room 10 times to check on me.  They did some tests, imaging, and the neurosurgeon came down to the ER to check it out.  I was in terrible pain, but my veins are so terrible at this point that they couldn't get an IV started...you know your veins are bad when they can't start an IV at Cleveland Clinic ER!! Let me just say that an IM injection of pain med was almost more painful than the pain itself...eeeek! So, after evaluation, they realized that one of the wires from the lead to my spinal cord stimulator is popping up and being pinched between the lead and the skin, it's like being pinched from the inside according to the doctor, and I can say it is true, that's what it feels like.  The wires have lost their anchor, stimulator still works, but I am still having zinging moments with movement, and I wonder if it has to do with this wire popping loose.  Here is the ironic part, there's always irony, right?...the only way to solve the problem is to go back in surgically and re-bury the wire under the muscle because I don't have enough FAT to anchor it too.  I have to say, when the surgeon said this, I was at a loss for words...there aren't any times in my life, pre-WLS, that I was ever told I didn't have enough fat.  As you can imagine, the surgery is invasive, and extra painful because they would be cutting muscle, and has all the fun parts of surgery for me (anesthesia anxiety, etc...) So, for now I am holding off to see how long I can withstand the pain before pushing the surgery button.  I am also having a hard time using the device because of the variances in where it is "buzzing" me and the sudden changes in intensity that are happening with movements.
I also went back to Cleveland and had another EGD, I was still having trouble swallowing and feeling like food was stuck.  My GI in Cleveland did the EGD, a normal esophagus should be around 20mm, mine was narrowed down to 9mm. He dilated the esophagus to 14mm, and I am going back in October for him to open it up the rest of the way. When it is that narrow, it would be dangerous and risk perforation/bleeding to try and go from 9mm to 20mm in one EGD; so that's why I am going back for the second time.
I have had several more ER/hospital stays...always a fun-fest.  My primary is at St. Alexius in Hoffman Estates, a bit of a drive to go to the ER (25 mins), but knowing that my doctor is there is comforting to me.  I did have one really nasty ER visit, the nurse was awesome (she has taken care of me before, so she understood what was going on), the doctor on the other hand was ridiculously bad.  I'll make a long story short...she didn't listen at all, assumed that since it was my second ER visit in 3 months that I was nuts AND a drug-seeker, fabulous!  I just want to put this out there for any healthcare providers that may read these blogs/posts (keep in mind I am a healthcare provider myself): As a provider/care-taker, you must treat each patient as a person, not a disease, not a symptom.  Consider what a patient is saying, really listen; don't put a label on a patient because you are jaded.  I think for every 100 patients you see, maybe 1-2 have bad intentions, so please don't punish the rest, better yet, don't punish any of your patients, they don't deserve it and you are there to care for and treat your patients, not judge them.  As a final word of advice for ER docs, especially new grads; if you come out of medical school with blinders on and tunnel vision, the ER is probably the LAST place you should spend your career.  I'm getting off my soapbox now; but those of you that are suffering, you've probably been there and felt this, so I just feel like it's worth saying and putting it out there as an awareness.  I know there are a lot of healthcare providers on here as patients, and I think it's time to speak up for our patients and stop being scared, and most importantly, speak for ourselves and advocate for ourselves.

Hi friends,
I'm sorry that I have been away for so long, my health issues have taken me away from home a lot, either in the form of hospital stays or visits to the Cleveland Clinic for doctor visits, surgeries, etc...
Since I last posted, my spinal cord stimulator became infected. I developed a Staph (MSSA, not MRSA thank God) infection in my spinal cord around the device.  I boarded an Amtrak train as soon as I realized I had an infection, and travelled all night and went right from the train to the ER at Cleveland Clinic.  They weighed the risks of trying to save the implant VS the risks of continued infection, and decided that it would be best to remove the device, they started a PICC line for IV antibiotics that I would need to do for 6 weeks.  This all happened at the beginning of September, I had the surgery and spent 10 days in the hospital in Cleveland, and returned home with the PICC and antibiotics.  I started with one antibiotic, but they had to stop it because it was dropping my white blood count, so they switched me to Vancomycin IV, but I developed an allergic reaction, red man syndrome (hives, itching), but there was really no other choice, Vancomycin was the only choice for the type of infection I had.  The Vancomycin waged war on my system, and I developed non-infectious meningitis from the Vancomycin, and suffered horrible headaches for weeks until it got out of my system.
I followed up with Infectious disease at the clinic in October, and as long as I was continuing to recover well, they cleared me for re-implanting the spinal cord stimulator.  The neurosurgery dept had a concern about trying to get through the scar tissue from the infection, but after some more healing time, they were willing to give it another try. I felt like I had no choice but to try again, I cannot continue to suffer daily with the abdominal pain, and I am determined to get rid of the medications, at least some of them, I know the damage that they do long term, and in the end, I'd rather be in pain than suffer more damage to my body than what has already been done.
I had more ER/hospital stays while awaiting the date to have the stimulator put back in.
I went back to Cleveland April 5th, and had the spinal cord stimulator put back in, and they were able to do the more minimally invasive surgery, open spinal surgery was an option if this didn't work.  I came home pretty sore and with two large incisions on either side of my spine, and one over my hip for the battery of the device.  I just had my stitches out yesterday, and so far things look good.  This is the time I hold my breath, it was after the stitches came out last time when I developed the infection, so we are checking the sites each day, even taking pictures to keep an eye on them for infection. The team at the Cleveland Clinic is amazing, and they are as dedicated as I am to getting my life as normal as possible, they realize all the damage that has been done in the past, and that most of it will be permanent.  The Vagus nerve controls many things in the body, the obvious symptoms are digestive for me, but I still need to be evaulated for other areas that may be affected by the damage.  I go back for a post-op check in Cleveland May 6th, I will feel a little safer and like the infection hurdle will be over by then.  I will also meet with the rep from Boston Scientific at that time to see if any adjustments need to be made to the stimulator settings/location of nerve stimulation.  Until the device scars itself in, it is hard to figure out the best location, as it can change direction just from me turning my head or twisting my back in different directions.  It seems to be a bit too high right now, more into the ribcage, but I think they will be able to adjust it and get it in the right spot.
I still feel that going to Cleveland Clinic was the best decision, it has been very difficult for my husband and the kids, all the time I have to spend away from home to travel to Cleveland, but they know that each trip makes a dent in making me better, it's just really hard for us.  We can't all pick up and go, there's work and school for the kids, and I have huge respect and love for my husband, when I am away he is the one holding everything together, heck, even when I am home, he's the one holding it together :)
I tried to make that the reader's digest version, there were some twists and turns in between, but I think this covers most of it.  I'm sorry that I have been out of the loop for so long, and I hope this finds those who are suffering finding a way to health again.
Hugs,
Jules

I just had the Spinal Cord Stimulator implanted at Cleveland Clinic (CCF) on Monday, August 2nd by Dr. Kapural and his team.  I am very sore, way more than I was for the trial version, but I have taken into consideration that this time around the incision in my back is a little bigger, and there is an added incision right above my left hip for the hardware with a tunnel in between the two, under the skin, to connect.  It feels like the worst back muscle cramp ever, but as my aunt says, you can stand anything as long as it is temporary, words to live by, seriously.
Next step, I am in the works to see a doctor in Mississippi to see if I am a candidate for a gastric pacemaker.  I do not have full-on gastroparesis, but I do have a severe case of delayed gastric emptying, so we will see what happens.  According to my GI at CCF, the doc in Mississippi is THE guy for gastric pacemakers, and one of the few that actually has a test to see if it works for you.
My PICC failed, and I am secretly pleased for all the wrong reasons, I just hated living that way, made me feel like a freak, of course I don't feel that way about anyone else who has one, just me...why are we so hard on ourselves?  I am looking at a 1-2 day trial of an NG feeding tube that runs to my small intestine to make sure I can tolerate the J-tube feedings before the surgeon will schedule the surgery to put in a Roux En Y Jejunostomy feeding tube, it will take the place of the PICC, and it is more liveable than a PICC, less risk of systemic infection, I can swim, etc...  I really just wish I could live without all of this stuff, but after going to CCF I have come to the harsh reality that this is all permanent.  They have told me that at this point, we just need to try and control the symptoms, the damage to my vagus nerve is permanent, it cannot be repaired.
I'm trying to keep my spirits up, I have re-enrolled in paramedic class, I will only know if I try.
As always, I am here for anyone who is struggling like me, although I wish there weren't anyone else.  If it takes me a while to get back to your emails, I apologize, I am not on here as much as I used to because of all my trips back and forth to Cleveland.  I think I will be home for a while this time, I have to have my stitches removed in 10 days, but they said my local pain management doc can take them out, which is good, I am not up for an 8 hour one way car ride at this point.
Good health to all!
Jules

Here is my latest scoop:
I am extremely happy with our decision to go to CCF (Cleveland Clinic Foundation).  I feel like we made more progress in 5 days than we did in two years here.  I finished the trial of the spinal cord stimulator, and I am going to have the permanent one implanted.  It improved my chronic abdominal pain by about 80%, it did not help with digestion or the pain and nausea that comes with eating, so I still have my PICC line, but I am working with a local surgeon to either get a peg tube in my stomach, or a gastric pacemaker.  If there is anyone out there that has either one of these and could offer some feedback, I would really appreciate it.  The PICC is just a systemic infection waiting to happen, and I have developed a severe hatred for it and the nightly TPN.  I am scheduled to head back to CCF the end of July.  I will post another update after that.

I saw Dr. Kapural (Pain Management at Cleveland Clinic)  They are going to do a differential nerve block (sedation epidural under flouroscopy), it will reveal whether the pain is visceral (organ related), or somatic pain, and then they can make a treatment plan from there from a pain management standpoint.  One of the ways to treat the pain is an implanted device called a Precision Plus Spinal Cord Stimulation, I'm hoping this is a last resort, but I have to keep it in mind and watching the DVD will keep me busy.  I will be out of commission for the next few hours (remember, Ohio is Eastern time) to have the differential block, then I will stumble my way back to the guesthouse.  The nurse hooked me up with an alternative, safer method of getting back home...some thing called the MegaBus...it is half the price of Amtrak, in a less Ghetto (no offense to anyone, I just love that word) area of the city, and unlike AMtrak, their busses leave at times other than 3:45am.  That's all for now
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Well, drumroll please...it's visceral (organ) pain, which is not really a surprise.  Now that they have identified it, they know how to handle it from a pain perspective (it is not the overall solution to the entire problem, but if THE solution is never found this may be as good as it gets, so we need to embrace it for now) I am a cadidate for this spinal cord stimulator, so I have to see a pain psychologist first (insurance requirement), and then they can schedule to have the trial/temporary stimulator put in, that stays in for two weeks, then if it is helping/working, they schedule to put the permanent one in.  It is placed completely under the skin near the hip area, and the battery is rechargeable by waving some sort of device in front of it once a month.  The doc said that he has a LOT of gastric bypass patients on this device, that Cleveland Clinic designed and trialed the device and they are one of the few places in the country that does this.  He also said that in their trials, they found that many patients who had the device and also had digestive issues, found that the device also sped up their peristalsis/digestion as a happy side effect.  It does not have a numbing effect like the test today, but it massages the nerves and that is why it helps the digestion to be kicked along.  I hope that was a much easier explaination than what I received today :)
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Dr. Kroh (Bariatric surgeon, keep your scorecard straight) called me back a little while ago.  He read my 350+ page novel, and he knows I had a gastric emptying study already back home (remember the radioactive eggs I ate?), but he thinks it is worth doing again, plus theirs is more extensive (4 hour test). Based on those results, I may be a candidate for a temporary vagus nerve stimulator, placed by doing a scope/endoscopy. If that helps to restore more normal GI function, then they would recommend a permanent Gastric Pacemaker, which is placed under the skin of the abdomen. With all this hardware I don't think I will ever be able to fly again, and I'm pretty sure I will have to get in the "terrorist" line at security.  Let's not even talk about magnets.  So, I have to call Dr. Crowe's office tomorrow and set up the emptying study, I hope they have a lot of ketchup, since I don't like eggs on a good day. 
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I can't get in for the gastric emptying test (radioactive eggs) until friday at 8am.  I am still trying to get in to see the psych doc for the spinal cord stimulator, waiting for a call back about that.  Other than the obvious boredom and loneliness, which I can handle, I am out of TPN, and home health can't set me up here, so I have to try and eat . Also, I am overdue for lab work drawn off the PICC, and my dressing needs to be changed, desperately.  Home health was going to call Dr. Haider and see if he can coordinate with Dr. Kroh (I had spelled it wrong in the other email, I think) to get the labs drawn and dressing changed here.  I don't have anyone to wrap my arm in saran wrap and tape, so the shower is going to take it's toll on that dressing.
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May 20, 2010:
I just want to say to anyone who is still struggling with complications from the surgery that no one can figure out, go to a place like Cleveland Clinic.  This is the place I should have come a long time ago.  I probably would have been able to eliminate at least 4 of the surgeries I had, and I probably would not be where I am physically.  It all happens for a reason, but save yourself the extra surgeries, and the "you are crazy" attitudes because they can't figure you out.  I hope that helps someone else out there.

I have been laying low lately, mostly because I have been horizontal in a hospital bed for the better part of the end of 2009.  I spent Christmas and the New Year in the hospital, and I was on the verge of just showing up at the Mayo clinic if I couldn't get in the conventional way, which seemed a long shot.  An associate of my original RNY surgeon had posed a plan to me about 6 months ago, a surgical plan that he was convinced was going to fix me.  I have obvious trust issues at this point of any doctors, and this surgeon does not do WLS, he is a general/vascular/trauma surgeon, so that also stopped me in my tracks, and I obviously didn't want anymore surgeries.  I kept drifting in and out of the ER, as a patient instead of working, encountered a very lovely doctor TWICE who was just convinced that I was a drug seeker, or some pathetic loser, which after some research I can't take it personally because I have heard he doesn't believe in pain...hmmm, has he ever been kicked in the groin? sorry, I have wandered off my track, it just felt good to get that out.
After spending the holidays in the hospital, I decided I had to do something and take control of this, because IT had control over me, still does at the moment.  The surgeon explained to me that he was going to have to do an "open" abdominal surgery, all my others had been laparoscopic.  He needed to see 360 degrees and needed to get his hands in there to really see and feel what is going on.  Just a refresh, I had already had my RNY reversed at U of C, but in order to prevent weight gain, that surgeon made my stomach kind of like an hourglass, I had a top pouch, then a passageway, then a bottom pouch, my intestines were stapled back together on top of each other, instead of end to end. The theory: where those small intestinal connections were stapled together end to end, it made it almost impossible for normal peristalsis (intestinal movement of food) to happen because the connections were so stiff, plus he felt that I needed to go back to having a normal stomach, as normal as I can have anyway, I have lost a certain percentage of my stomach to previous surgeries, so it will never be a normal size. He also put the small intestine connections together end to end and hand sewed them with dissolveable sutures, same with the stomach, all hand sewn, no more staples inside me.
I go back to my karma issues because while thankfully I made it through this complicated surgery, and with no leaks or infections, I did however have some problems, ones that could have been avoided if staff had done their job.  The surgeon told me that the surgery was going to be very painful, so he had the anesthesiologist put an epidural in before surgery to cut some of the post-op pain for the first couple days and I would also have a PCA pump for pain.  I woke up from surgery in the most horrific pain, and kept hitting the button, asking the nurses in recovery, why am I in so much pain? They didn't know, and didn't bother to look or check the epidural.  My family and friends came to visit me those first couple days and I couldn't even lift my hands to my face or move my legs because of the pain, my feet were twitching from the pain.  The surgeon had another anesthesiologist come in and check the epidural 2 days after surgery, and he walked in the room and looked at the pump sitting next to me on the bed, and knew from just looking at it, that it wasn't working properly OMG!
They took the epidural out to find it wasn't in all the way, I told the insurance company not to pay for it :)
I was in the hospital for about 9 days, I lost a unit of blood in surgery because they nicked my spleen trying to get rid of adhesions that were covering the small intestine. They gave me blood in the OR, but even a few days later I felt so weak and was sweating, feeling like I was going to pass out, and my hemoglobin was still only 8.8 (they transfuse at 8), so they watched it until I left the hospital, and I think that is one reason why my recovery has been extra long.
I'm not sure if it worked yet, I don't want to jinx myself.  I still have nausea that is crippling at times, but my guts have been re-arranged 7 times!  There is no reference point for me, no way for any doctor to say, oh yes when people have problems or surgery like you, they feel like this...I don't know anyone else like me yet.  I know there are a lot of people suffering with very similar problems, and I know I have heard of people having their surgery reversed, but to my knowledge this is a whole different animal...if there is someone out there, let me know how things went and how you are now.
I love some of the people from my support group, but I am done going.  I had not been in a while, and I went this week, and I don't talk openly about my problems, I don't want to scare people or be a bad example, someone brought up some symptoms similar to mine, and 4-5 eyes were drawn directly to me, their faces falling in sadness and disappointment, and a couple even said my name out loud...made me feel like a freak!  I don't think that every person who has pain in their left side and persistent nausea and eating problems has what I had, but I also don't think they want to talk about it and disrupt the happy flow of SG.  People talk about those first, rough 6-8 weeks, and symptoms that usually end up being stenosis, but that comment/question just struck a chord with the people who do know about my issues, it almost felt like, uh oh, our shiny happy party is over.  I know this is my interpretation, but it really felt that way.  So, I will rely on my close friends and family, and always be there, a positive force for anyone who is struggling, praying all the time that they aren't like me.  I have somehow managed to stay positive, difficult since I lost my job/career over this illness, and in trying to obtain new employment, all anyone wants to focus on is why have you been off work so long? I feel like this is going to curse me for finding a new job, I would have better luck if I had a criminal record!
I hope that updates everyone, thanks for all of you who have checked in on me, and sorry I have been out of the loop for so long.  I have a strong family, thanks to them, not sure where I would be without them.  I'm always here for anyone who needs help.
Jules

I will definitely write a real blog note tomorrow, but for now I will give you some of the info so you know I am still alive :)
I had another surgery, I already had the surgery reversed, so this was a re-reversal  I am only 3 weeks out, so I'm praying that this is it, but I still have some crippling nausea, but my guts were all re-arranged for the 7th time.  I need to go to sleep, but I will finish this tomorrow,
Thanks,
Jules

Well, things haven't changed.  I just fight everyday with my GI system.  My plan is to wait for spring break from my class, and then use that time to go to either the Mayo clinic or The Cleveland clinic.  My doctor is going to talk to the GI doc to see which one he thinks is better for my issues.  I am still on a writing campaign to Dr. Oz, I know it sounds crazy, but when you have been dealing with this as long as I have, you do find yourself trying desperate ways to get help, to get someone to listen that may be able to help.  I know I am not the only one out there with these "mystery" problems.  I think the issue becomes one that most doctors don't want to get involved in someone else's mess.  It's not right to live this way, and I think I am really stuck in that angry phase, especially when I think about losing my job in the ER, that irks me the most, more than the pain and suffering, as weird as it seems.  Thanks friends for checking in on me, I appreciate your emails, and I hope you are all doing well.