ERCP Accomplished

If I'd taken two seconds to check the calendar, I might not have chosen to schedule this full-anaesthesia test on the first day of Hanukkah!  But now it's all done, and I was very happy to learn that the pancreatitis the doctors had feared seems not to be my problem.  We still don't know why I continue to suffer intermittent attacks of pain in my gut, but at least some of the bigger and scarier possible causes have been ruled out.  And they're still saying I may not need to have my gallbladder removed.  So, despite the mystery and not knowing when another attack might happen in the future, I'm enjoying the Hanukkah present.

Thank you to Larry U. for the ride to Beth Israel this morning, and to David G. for the ride home this afternoon.  I get by with a lot of help from my friends.

Giving Thanks for Surviving Thanksgiving + RIDE REQUEST for Thursday Dec. 2

I was exceedingly careful at Thanksgiving dinner.  I barely ate any of my own contributions to the holiday meal -- Blue Hubbard squash stuffed with roasted Brussels sprouts and chestnuts, plus my Very Seedy Hallah -- but the hosts and 15 guests all loved them, so I felt satisfied.  I barely ate anything else that was served, either, just a few bites of sweet potato, pumpkin muffin, and, with great trepidation, a stalk of well steamed broccoli.  Basically I ate very little, went home hungry.  Who goes home hungry from Thanksgiving dinner?  Oh, well, it matters not.  The main thing is that my strategy proved successful: nothing untoward happened, not even serious gut pain, so I felt -- and continue to feel -- extremely grateful.  And I keep drinking gallons of water.

Next medical test -- ERCP -- scheduled for this Thursday, December 2. Thanks in advance to David G. for the post-anaesthesia ride home from Beth Israel. 

Anybody out there available to drive me to the hospital this Thursday morning?  I have to be there at 11.  We could sing together in the car...

Good news re pain + ER plan + rides needed on Dec. 2

1. Good news on the pain front: It seems that if I keep the water-to-food ratio extremely high, especially while eating, the gut pain stays at a faint distance and sometimes even disappears.  It's a challenge to keep filling my water glasses/bottles so many times during the day, but the potential avoidance of pain is quite motivating.  I try to start drinking water immediately upon waking up in the morning, all day long, and all evening, too.   Resultant frequent trips to the bathroom to pee are a bit inconvenient, but again, more than worth it to avoid pain.

2. My landlord-the-doctor, who specializes in emergency medicine, has offered to take me to the Beth Israel ER for my next gut attack, if she is at home when it happens.  In her professional opinion I should go there instead of the closer Emerson Hospital because at BIDMC they already have all my medical info and images in their computer system.  These would be particularly important to have in case of emergency surgery.  She said I should call on her even if it's 3:00 AM!  Meanwhile, her take on my situation is that it probably is gallbadder attacks that I'm suffering, and that my experiment in super-hydration is probably diluting dietary fat into distant particles separated by water molecules, which is less challenging to my gallbladder.  An interesting theory, which I will pass by Dr. Sheth next time we talk.

3. My next test ordered by Dr. Sheth is called ERCP, scheduled for Thursday December 2.  It's an ultrasound of my digestive system, requiring full anaesthetization.  IF YOU CAN DRIVE ME TO THE HOSPITAL AT 11:00am OR TAKE ME HOME AROUND 5:00pm, PLEASE LET ME KNOW.

And: Thank you!

Gotta go refill my water glasses now.

Very Painful Episode

One day after my previous post I suffered one of the worst gut attacks in recent memory.  It started around midday, after I'd swum a very invigorating mile in the pool.  I do my best to drink extra fluids after swimming, knowing that I'm at highest risk of dehydration and its discontents for several hours post-exercise.

Monday was not a successful eating day from the start (mistake #1), so I was quite hungry after swimming.  Against my own better judgment, I bought a Snickers bar at the vending machine and ate it (mistake #2) in the car on the way home.  Almost immediately it seemed to explode in my stomach.  Yet I was still hungry, so I ate the only thing I had in the car (mistake #3), which was a (rather stale) "Sweet & Salty Almond" Odwalla bar.  Last one in the box I keep in the car.  I've eaten tons of these in the past with not-too-terrible results.  But this time it just fuelled the explosion.  I drank a little more water.  This was mistake #4 -- I think I should have drunk a gallon more water!

Got home, pain kept getting worse, but I had to prepare to teach a Biblical Hebrew class in the evening.  And I was still hungry!  Figuring I had to eat something, and get it done a few hours before class so I wouldn't explode while teaching, I decided to whip up some matzah-ball soup.  Thinking it would be pretty safe, i.e., not too high in fat or fiber, I unthinkingly threw a large handful of wild rice into the pot, to make the soup more interesting and crunchy.  (My love of crunchy food is a big challenge to my jpouch.)

With my gut pain growing ever more acute, I ate a modest portion of soup -- enough to power me through my class without adding too much more to the fire in my belly.  Yes, the rice could have been cooked longer, but honestly I don't think I made things worse with this tiny meal.

I somehow managed to teach the class, 'though I could barely stand up straight due to the pain.  As I left the synagogue the pain was huge, which is very unusual.  Normally teaching Hebrew distracts me so delightfully that all pain goes away.  But not this time.

Back at home, it felt like I'd swallowed a giant chef's knife which was now slicing me up from the inside.  Eventually I couldn't move, couldn't walk, couldn't get to my phone in the bag where I'd dumped it near my front door.  My screaming and crying couldn't be heard by my landlords because all the windows were closed.  I lay there on my bed trying to decide whether this was a true emergency or not, and if yes, would it be too dangerous to try to drive myself to the hospital (located just across the way from where I'd been teaching, I realize now).

I couldn't bear the thought of choosing between driving dangerously vs. crawling to phone and calling landlord; then spending hours in the ER, for what would most likely be inconclusive results; and then being a basket case all day on Tuesday.  If my smart surgeon and GI docs can't figure it out, even after all the tests so far, why should I expect better from the ER?

Plus, I had a tutoring session scheduled for the next morning, and then a furniture-moving event in the evening that had taken me weeks to arrange, coordinating the schedules of four busy people.  I couldn't stand the idea of calling everyone expecting to see me and cancelling everything.  I've had to do that so many times these last few years!  It's almost the worst part of the whole ordeal.

The second-to-worst part is not knowing what the problem is or when it might strike, feeling so unclear about what I should or shouldn't do to avoid it.  Mistakes #1-4 above are things I often do on separate occasions, with no ill effects; basically I'm just guessing that the combination added up to this episode.  Since my pain profile is not obviously derived from the gallstones or from bowel obstruction, the treatment is non-obvious, too.  Makes me feel a bit jittery -- who knows when the knife in my gut will attack next?  How can I plan anything??

I made a guess based on experience that I would probably feel better after enough hours passed, by the time my student was due to arrive in the morning, and cried myself to sleep. 

Thank goodness I was right.  I woke up feeling almost normal, had a good tutoring session, moved lots of furniture around, drank lots of water, didn't cancel any plans, ate some more matzah balls with wild rice, and lived to tell the tale.

Today I was nearly pain-free, but didn't eat right again, so I was too scared of repeating the experience to go swimming again.  I think maybe I will go to the ER next time.

Eating bravely and carefully

Happy to report that later on Thursday (when I saw the nutritionist and became very grouchy) I was directed by an online jpouch acquaintance to an online discussion about diet and jpouches that completely improved my thinking about the whole challenge.  

Am bravely trying to conduct slightly more scientifically controlled eating experiments, such as drinking more water/electrolytes when I eat (in addition to the 70+ ounces I drink in between eating), eating bread along with higher-fat-content food, adding tiny amounts of well cooked veggies to my mainly carb/dairy meals, eating certain foods isolated from others and paying attention to any cause/effect I can detect.

Negative experience with nutritionist

After months -- nay, years -- of procrastinating, I finally met with a nutritionist today.  Although I haven't discussed it much (yet) on this blog, the whole business of food has become rather a torture for me.  I haven't been comfortable eating in the presence of other people for at least a year, mainly because most food has become so scary for me, and I make disastrous eating errors when distracted by social situations.  I only feel safe eating when I'm alone.  This is the short version.

Anyway, today I was extremely disappointed and quite surprised by the nutritionist's zealous discussion of "supplements" with minimal focus on actual food.  Zero mention of hydration, exercise, or sleep as important parts of anyone's diet.  Repetitious advice on how to handle a jpouch symptom that I don't currently have -- from someone who, it turned out, didn't even know what a jpouch is -- was a huge turn-off.  I wasn't impressed by being asked the same yes/no questions repeatedly.  And definitely not inspired by the focus on computer printouts as opposed to my actual human situation.  I can Google general diet suggestions myself! 

This person came highly recommended to me, in a practice that prides itself on progressive and holistic approaches to health, and charges a very high fee (not covered by my insurance), which I was prepared to pay for solid-gold consulting. The biggest deal-breaker for me was when this "professional" informed me -- in stark contrast to every extant bit of jpouch advice, not to mention received wisdom regarding mind/body health in general -- "You can't go by how you feel." 

I beg to differ!

Endoscopy Accomplished! More Tests to Come, Next Time with Anaesthesia

Endoscopy accomplished!   The procedure wasn't so awful, not least because it was mercifully short: less than ten minutes.  The worst part, which I avoided thinking about until right before it happened, was the "swallowing" of the instrument with the camera.  Unfortunately there was quite a bit of choking and gagging on my part, which is mainly what I was afraid of.  Now I have a slightly sore throat, which shouldn't last long.

Endoscopies are performed with the same sedative "cocktail" as colonoscopies.   Based on plenty of past experience with said latter procedure, I warned today's doctor in advance that I have a ridiculously high tolerance to sedatives, narcotics, and painkillers of all kinds.  "Feel free to give me a horse-sized dose," I suggested.  Thus they shouldn't have been surprised that I remained mostly aware and alert during the entire procedure.  When it was over, the nice doctor administering the sedatives remarked that she ended up giving me the very biggest dose they could manage short of complete anaesthetization.  I have heard that one before.

Diagnosis is still elusive.  There is inflammation of the pancreas, just as was shown in last week's MRCP.  This "pancreatitis" may or may not require treatment.  Biopsy results from today will be available in one to three weeks.  During that time I'll continue taking omeprazole, since I haven't been on it long enough to determine whether it's helping. 

Dr. Sheth doesn't think I need immediate surgery, which is a big relief.  On the other hand he does want me to undergo a few more tests, which *will* involve full anaesthesia.  These will probably get scheduled sometime in the next month or so.

I feel very grateful to Bill S., who picked me up at home, drove me to hospital, stayed with me the whole time and then drove me home.  His calm and steady presence made the experience much easier.

Since I didn't experience heavy sedation, it wore off very fast.  By the end of the drive home I felt 99% back to normal (such as it is).

I must also add that the young medical assistant in Dr. Sheth's office who drew my blood before today's exam did it in the most expert fashion.  I'm pretty squeamish about needles so I don't say this lightly: it was the most pain-free blood drawing experience I can remember in years.  And I've had a lot of them.  I must get his name next time to let his superiors know what a great job he did.

Endoscopy on Tuesday Afternoon

I stopped eating solid food at midnight, per instructions.  Liquids can continue until four hours before the procedure; after that, nothing at all, not even for taking meds.  I'll be okay, I did this last week before the MRCP.

In about twelve hours I'll be at Beth Israel for blood work, then prep at 1:00, endoscopy at 2:00, ride home at 4:00.  I've never had this procedure before, not sure what to expect, especially afterwards. 

Yesterday's MRCP wasn't too bad.  It was the same friendly young fellow as when I went for the MRI enterography a few weeks ago; I really appreciate his casual, direct manner.  I had to sip some awful stuff through a straw again -- different awful stuff from last time.  This one is apparently worse to most people, but I found it less offensive, simply like a really gross creamsicle.  And there was no painful shot to the shoulder muscle this time.

This MRI -- of my gallbladder and pancreas -- took a long time.  Part of it involved time-lapse photography: the radiologist slowly injected something into me via the IV in my left arm, and the MRI guy snapped a picture exactly every 30 seconds.  This way they can follow the progress of the injected stuff as it moves through the bile ducts.  The technology never ceases to amaze me. 

It was very uncomfortable holding my arms above my head, even horizontally as I lay on the "stretcher," for such a long time, especially in that cold room.  My left shoulder and also my neck and back are still sore.  But I'm a very good breath-holder, so they got good, well focused "slices" of everything they wanted to see.

I ended up fasting much longer than necessary or intended.  When I finally got out of the radiology department, I went to visit a good friend recovering from her own colon surgery.  She wasn't interested in all the brighly colored low-residue things they were trying to get her to eat, so I ate them for her -- I was starving!  Though the calories were the "empty" kind, I must report that my empty system found them very comfortable and gentle.  I even slept for almost eight hours straight without being awoken by my jpouch!  This happens maybe twice a year if I'm lucky.  If only it were possible to live on nothing but jello and popsicles...

The MRCP results should get to my GI doctor by tomorrow; I don't know when I will find out what they reveal.  In some ways I hope they show nothing at all -- which would leave me without a medical explanation for all the pain in my gut, but at least would rule out various scary possibilities.  On the other hand I might be sort of relieved to find out, for example, that it's definitely my gallstones causing the pain -- the solution to that is clear and simple: surgical removal of the gallbladder.

Meanwhile, the pain has changed dramatically over the past week or three.  I can't figure out what causes it, or how to avoid it other than by fasting.  I can feel the food as it travels through my system, because it seems to hurt at each point along the way.  It's hard to imagine this is all caused just by "stomach acid."  The pain does seem to settle in on the right side for the longest, which might implicate the gallstones.  Hurts there right now.  But if it's anything like the past week, the pain will slowly move south, wake me up a few times during the night, then finally be gone by morning -- when I'll have to start eating all over again.

I'm scheduled for an endoscopy -- or "gastroscopy," according to the instructions that arrived in the mail -- this coming Tuesday, November 2.  I'm actually looking forward to the required pre-test fasting and low-residue eating.  I even stocked up on popsicles.   Also settled the question of rides that day -- thank you in advance to Bill S. for the ride to the hospital and to David G. for the ride home. 

Soon I'll start making preparations for post-test recovery at home.

MRCP tomorrow

Tomorrow afternoon I go to the hospital for an MRCP -- a specialized MRI that looks specifically at my gallbladder and pancreas.   The goal, as I understand it, is to rule out possible scary causes of the frequent gut pain I've been experiencing.

I have to fast for four hours beforehand, including no liquids; would be easier if it weren't in the middle of the day, but I'm no stranger to  spontaneous fasting, so I'm not too worried about that part.  Besides, it only hurts when I eat.

Next Tuesday I go back in for the endoscopy, for looking at other body parts.  Since heavy sedation is involved, I'll need rides to and from the hospital.  Still looking.

Jpouch People on Facebook

A few months ago I finally discovered other people who have lived with a jpouch for many years -- on Facebook, of course.  I don't know why I didn't think of looking there sooner, given that I'd been searching in vain for a couple of years.  Actually there are a few different Facebook discussion lists for people with jpouches; I joined the largest one.  Finally, people who have the same problems that I have; and some of them even have solutions!

I'm especially encouraged to "meet" people who have had their jpouches as long as I've had mine (almost seven years), and even longer in some cases.  For lack of a better term, we're calling ourselves "long-timers."  A few people in the long-timer group have replied to my inquiry about their experiences with gallstones and gallbladder surgery.  Unanimously they report positively regarding the surgery, i.e., that removing their gallbladder solved a lot of pain.

This week I'm hoping to compare symptoms with them, to establish whether my pain profile is similar to theirs.

Surgery cancelled for now, more tests instead

Dr. Mowschenson backed off on the gallbladder-surgery plan and decided I should consult with a gastrointestinal specialist first.  No surgery scheduled as of this writing!  And although Mowschenson says he doesn't believe in diet as being a big factor in any of these gut things, he nevertheless advised me to cut way back on fiber, especially in vegetables.  I am currently a vegetarian who doesn't eat vegetables.  I especially miss the beets and Brussels sprouts, but they were among the biggest offenders.  Mostly I have been feeling better, but read on...

As of Tuesday this week I now I have a new GI doctor, Sunil Sheth.  The appointment was for 5 PM at Beth Israel in Boston.  5:00 PM!  Never mind rush hour, that's a horrible time of day for a GI appointment, especially for someone with a jpouch.  I was very surprised at the scheduling, tempted to reschedule, but it was his first available so I took it, despite feelings of trepidation.

Good news:
- I didn't have to wait as long as I feared at that time of day.
- Dr. Sheth and his fellow Dr. Sepe seemed very smart and knowledgeable and kind.
- Dr. Sheth specializes in pancreas stuff, which might be relevant to my case.
- Dr. Sheth works with Dr. Mowschenson regularly -- which is a huge plus, as I have total confidence in Mowschenson.
- My gallbladder is not in urgent need of surgical removal.
- Despite the horrible diet I am now eating (that's my opinion; it's still not as bad as the average American's), my vital signs were all perfect.  I credit swimming laps.

Information:
- It's possible to have gallstones (which I do, as the MRI enterography revealed last month) without their causing pain.
- I definitely have pain, but not according to typical gallstone pain.
- Not clear whether my pain is caused by bowel blockage, either, since the MRI showed none of this.

Plain News:
- On October 27 I'm scheduled for an MRCP, which is a specialized MRI of the gallbladder and pancreas. 
- On November 2 I'm scheduled for an endoscopy.  "Like a colonoscopy but without the prep" is what the doctor actually said.  Having had way more than my share of colonoscopies in the past, I found that funny.   But I still feel anxious about it. 

On November 2 I need to find a ride there at 12:30 and a ride home at 4:00.  Anybody available?

- Dr. Sheth prescribed a new (to me) medication to address the possibility of stomach acid being the cause of my pain; apparently lots of Americans take this one.

Bad news:
- On the way to the Tuesday appointment I felt something bad happening in my gut.  Seemed sort of like what I have been assuming were partial bowel blockages for the last couple of years, and what Mowschenson thought, since the last MRI, might be gallbladder attacks.  I mentioned, during the appointment, that I was having some of the pain typical of the last few months right at that moment, and that it seemed to be growing steadily worse.
- On the drive home the "attack" got worse and worse till I almost couldn't drive.  I somehow made it home to Lincoln, went straight to bed with electric heating pad and hot tea.  But the acute abdominal pain was horrific, like a devil trying to cut himself out of me with knives.  After a supportive phone conversation and a few hours had passed, I started to feel minimally better, and thus decided not to go to the ER.  But lost most of Tuesday night and therefore most of Wednesday as well.
  Was this coincidence?  Psychosomatic? Stress about the 5 PM appointment?  I don't know.  But I regret eating all that freshly baked hallah on the way!

Surgery Scheduled for November 9, but could be sooner

My surgeon, Dr. Peter Mowschenson, was busy in the OR all day today, so he wasn't available to help me get onto the OR schedule in October -- yet.  So I took the first opening I could get through his office: 1:00 PM on Tuesday, November 9.  Seems nice and far in the future, way too early to start worrying.  But not too soon to start planning!  So I need to find help with

1. Moral support & hand-holding on November 8
2. Ride to hospital on November 9
3. Someone to hold my hand before and after surgery
4. Ride home on November 10 (we hope!)
5. Friendship and camaraderie Nov. 10-17
6. Meals, chores, errands, etc., Nov. 10-17

I don't even know what I'll be able to eat during that first week.  Maybe I can find out, and make things ahead of time to keep in the freezer.  I guess I should get started, especially since the date of surgery might get moved up much sooner.

Comforting thought

Today a friend told me that when doctors speak to their patients about upcoming surgery to remove gall bladder, it's typical for them to say they plan to do it laparoscopically but that things could change mid-procedure.  I found this extremely comforting, even though I know that in my case Dr. Mowschenson could very well run into a belly full of scar tissue.

New name for the surgery

Trying to look on the bright side and be optimistic, I've invented a new name for the surgery I have to have: it's a Chutzpectomy.  You can figure out the pun.

Good news: no blockage. Bad news: Gall stones

The MRI showed that I have no bowel blockages.  Hooray!

But it also showed that I have gall stones.  Dr. Mowschenson says this is most probably the cause of the pain, and he wants to remove my gall bladder.

Yikes!  More surgery.  Big questions of whether to go through with it, when to do so, and how to schedule Hebrew classes this fall, not knowing how I'll feel or what recovery will be like.

Hopefully the surgery can be done laparoscopically, but if I have many abdominal adhesions from my complete colectomy (2003), surgery would be bigger and require longer recovery.

It's a challenge to get myself back into proper mood for big Sukkot party tomorrow.

MRI Enterography

Tomorrow I have my first MRI -- enterography, which means they'll take pictures of my guts to see whether any partial bowel blockages have built up.  If so, it would explain all the agony I've experienced in the last few weeks, almost every time I eat.  Have been on a low-fiber diet for one week; it seems to be helping (less pain), but is a bummer in the middle of harvest season and the Jewish holidays.

I had previously understood that MRIs are dangerous to people whose bodies contain metal.  My leg is still full of hardware, which has always stopped the docs from wanting to use MRI on me.  When scheduling this enterography they asked whether I had any metal in my body; of course I said Yes.  Titianium? they asked.  No, stainless steel, I answered.  Oh, that's fine.  Titanium would be fine, too.  So which is the "bad" metal?  I don't know.

I'll receive the results of the MRI enterography in a few days.  For now, feeling a bit nervous about my guts!

Jpouch Feels Much Better; So Do I

My jpouch definitely feels better having had the exploratory surgery last Wednesday.  I measure this by pain (gone!), urgency (greatly diminished), and frequency (way, way down).  In fact these were all true starting one day after the procedure.  I attribute this to the antibiotics, which I'm still taking.  I've been using the steroid suppositories twice a day for several days now, which must also be helping a lot.

Less pain means, of course, less pain.  I finally stopped taking the serious pain killers, and have even reduced the amount of Advil I need.  Less urgency means greater peace of mind, less running pell-mell through the house risking stubbed toes, upturned furniture, and the like.  And lower frequency means more sleep!

I can actually begin a project, or an email, or a conversation, or dinner, and feel confident that it won't be interrupted every 20 minutes.

And when my jpouch feels better, I feel better!

Sore Throat is the Worst, then Leg

My neck and hips were hardest struck by the drug the anaesthesiologist pumped into me (unnecessarily?). Yesterday I couldn't lift my head or my left leg.  It was really hard to get out of bed!  All day yesterday I had to use my hands to lift my left leg up onto the couch, the squatting platform, the chair, etc.

This morning I felt encouraged by waking up with much less pain in my neck and hips.  Decided to see if I could get through the day with just Advil.  Was okay for a few hours, but then the wicked sore throat came back with a vengeance. So I'm back on Dilaudid (twelve times stronger than morphine!) for now.  The irony of taking pain killers to treat side effects of anaesthesia has not escaped me.

Until today, the sore throat's been worst on the left side. I figured that was the side they jammed the hardest with the (unnecessary?) breathing tube. So I'm surprised to find the right side of my throat hurting most now. However, My Landlord the Doctor informs me that this is not uncommon. She also warned me that the sore throat could continue being this bad for another week!

This post doesn't really seem to be about my guts, does it.  Well, in other complainy news, my left leg is horribly swollen; haven't seen it this bad since the leg micro-surgery last summer. With the current hot, dry weather, my leg should be nice and unswollen today.  I fear side effects of the ciprofloxacin I'm taking for pouchitis.  Heading for my Normatec "leg pump" shortly.

Post Op Report: Jpouch pain overshadowed by anaesthesia screw-up

Well, I survived yesterday's procedure. The worst part was getting beaten up by the anaesthesiologist. At least that's what it feels like. He actually called me on the phone today to apologize! And tried to explain what happened, 'though not to my satisfaction. So, for the moment, any jpouch discomfort I might have is hugely overshadowed by pain in my throat, neck, shoulders, wrists, hips, and knees. It's rather scary, even though these symptoms will supposedly ease up within a few days.

As for my jpouch, it has pouchitis. So I'm taking antibiotics (Cipro). Dr. Mowschenson also found a lot of inflammation, which we're going to "hit hard with steroid suppositories." Starting when I receive them in the mail, within next few days. Then I report back to his office in two weeks to see if it worked. That's always the part I dread most -- the office visit and its rectal exam.

Jpouch Surgery Tomorrow

It's been many moons since I wrote here; since then I moved to Lincoln, MA, plus many other changes. Lots of stress in the last few months, taking its toll especially on my jpouch. Often too scared to eat, I've lost about ten pounds since last summer. Life in the bathroom is too long and too painful; I finally contacted Dr. Peter Mowschenson, and tomorrow he operates on me. It's "exploratory," but I'm pretty sure I know what's wrong: too much stress! Will be interesting to find out what his diagnosis is. Mowschenson is the surgeon who originally removed my entire colon back in November 2003 -- he saved my life! He's also the creator of my jpouch. I consider him the expert, will try to do whatever he recommends. But if he agrees with me and tells me the main thing is to make my life less stressful, I will need suggestions about how to do that!

Meanwhile, I have discovered that I can swim an Ironman-length swim very easily! It's 2.4 miles (that's 170 lengths of my 25-yard pool) -- first time I tried it was about two weeks ago. Coach Bill says my time (1:23:39) was "very respectable." I didn't even train for this, it was a sudden inspiration. Last week I suddenly felt inspired to do it again, and it was just as easy as the first time. And my time on the 2.4 miles was only 25 seconds longer, which barely counts.

If I could find the time to swim more often, even just the plain ol' mile I used to do, I'd probably be less stressed. But here in Lincoln I'm further away from my pool, find I'm going less often. There are pools in Concord I could join; I should probably look into it. But I like the social aspect of the Mount Auburn Club, where I've been swimming for ten years and know a lot of people. With all the other changes in my life I'm dealing with, I'm not ready to change pools.

I'm very scared about being in the hospital again, under full anaesthesia, with results yet unknown. Even though I've been through this before, and it's a lot less serious than losing my colon was, just being in that environment triggers many awful and painful memories.

I hope Dr. Mowschenson can find an easy solution so that I can resume eating enough to gain back some of the weight, feel healthy, sleep better (fewer trips to bathroom during the night), and get back to enjoying a leg that's much less painful than a year ago. (It's still not quite healed, but that's a story for another post.)